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Sökning: AMNE:(MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin) > VTI - Statens väg- och transportforskningsinstitut

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1.
  • Kjeldgård, Linnea, 1985-, et al. (författare)
  • Sickness absence and disability pension among injured working-aged pedestrians - a population-based Swedish register study
  • 2021
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 21:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The knowledge is scarce about sickness absence (SA) and disability pension (DP) among pedestrians injured in a traffic-related accident, including falls. Thus, the aim was to explore the frequencies of types of accidents and injuries and their association with SA and DP among working-aged individuals. Methods: A nationwide register-based study, including all individuals aged 16-64 and living in Sweden, who in 2010 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Information on age, sex, sociodemographics, SA, DP, type of accident, injury type, and injured body region was used. Frequencies of pedestrians with no SA or DP, with ongoing SA or full-time DP already at the time of the accident, and with a new SA spell >14 days in connection to the accident were analyzed. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new SA were estimated by logistic regression. Results: In total, 5576 pedestrians received healthcare due to a traffic-related accident (of which 75% were falls, with half of the falls related to snow and ice). At the time of the accident, 7.5% were already on SA and 10.8% on full-time DP, while 20% started a new SA spell. The most common types of injuries were fractures (45%) and external injuries (30%). The body region most frequently injured was the lower leg, ankle, foot, and other (in total 26%). Older individuals had a higher OR for new SA compared with younger (OR 1.91; 95% CI 1.44-2.53, for ages: 45-54 vs. 25-34). The injury type with the highest OR for new SA, compared with the reference group external injuries, was fractures (9.58; 7.39-12.43). The injured body region with the highest OR for new SA, compared with the reference group head, face, and neck, was lower leg, ankle, foot, and other (4.52; 2.78-7.36). Conclusions: In this explorative nationwide study of the working-aged pedestrians injured in traffic-related accidents including falls, one fifth started a new SA spell >14 days. Fractures, internal injuries, collisions with motor vehicle, and falls related to snow and ice had the strongest associations with new SA.
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2.
  • Kjeldgård, Linnea, 1985-, et al. (författare)
  • Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals
  • 2020
  • Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Bicyclists are the road user group with the highest number of severe injuries in the EU, yet little is known about sickness absence (SA) and disability pension (DP) following such injuries.  Aims: To explore long-term patterns of SA and DP among injured bicyclists, and to identify characteristics associated with the specific patterns. Methods: A longitudinal register-based study was conducted, including all 6353 individuals aged 18–59 years and living in Sweden in 2009, who in 2010 had incident in-patient or specialized out-patient healthcare after a bicycle crash. Information about sociodemographic factors, the injury, SA (SA spells > 14 days), and DP was obtained from nationwide registers. Weekly SA/DP states over 1 year before through 3 years after the crash date were used in sequence and cluster analyses. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for factors associated with each identified sequence cluster. Results: Seven clusters were identified: “No SA or DP” (58.2% of the cohort), “Low SA or DP” (7.4%), “Immediate SA” (20.3%), “Episodic SA” (5.9%), “Long-term SA” (1.7%), “Ongoing part-time DP” (1.7%), and “Ongoing full-time DP” (4.8%). Compared to the cluster “No SA or DP”, all other clusters had higher ORs for women, and higher age. All clusters but “Low SA and DP” had higher ORs for inpatient healthcare. The cluster “Immediate SA” had a higher OR for: fractures (OR 4.3; CI 3.5–5.2), dislocation (2.8; 2.0–3.9), sprains and strains (2.0; 1.5–2.7), and internal injuries (3.0; 1.3–6.7) compared with external injuries. The cluster “Episodic SA” had higher ORs for: traumatic brain injury, not concussion (4.2; 1.1–16.1), spine and back (4.5; 2.2–9.5), torso (2.5; 1.4–4.3), upper extremities (2.9; 1.9–4.5), and lower extremities (3.5; 2.2–5.5) compared with injuries to the head, face, and neck (not traumatic brain injuries). The cluster “Long-term SA” had higher ORs for collisions with motor vehicles (1.9;1.1–3.2) and traumatic brain injury, not concussion (18.4;2.2–155.2). Conclusion: Sequence analysis enabled exploration of the large heterogeneity of SA and DP following a bicycle crash. More knowledge is needed on how to prevent bicycle crashes and especially those crashes/injuries leading to long-term consequences.
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3.
  • Almberg, Maria, et al. (författare)
  • Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors
  • 2017
  • Ingår i: Developmental Neurorehabilitation. - : Taylor & Francis. - 1751-8423 .- 1751-8431. ; 20:2, s. 59-67
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education.Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors.Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors.Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges.Conclusion: Obtaining a driving license was associated with stressful training experience.
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4.
  • Ohlin, Maria, 1987, et al. (författare)
  • Duration of sickness absence following a bicycle crash, by injury type and injured body region: A nationwide register-based study
  • 2018
  • Ingår i: Journal of Transport & Health. - : Elsevier BV. - 2214-1405 .- 2214-1413. ; 9, s. 275-281
  • Tidskriftsartikel (refereegranskat)abstract
    • In recent years, bicycle injuries have increased but little is known about the relation of such injures to sickness absence (SA). The aim of this study was to investigate duration of SA > 14 days after a bicycle crash, in general and by injury type and injured body region. A population-based study was conducted, including all individuals living in Sweden, aged 16-64 years, who in 2009-2011 had in-or specialized outpatient medical care due to a new injury from a bicycle crash (n = 22,045), excluding those already on SA or full-time disability pension at the time of the crash. Crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for a new SA were estimated by logistic regression. In total, 4387 (20%) had new SA in connection to the crash. SA was most common among individuals aged 55-64 years (32%), and more common among women (23%) than men (18%). Fractures was the injury type with the highest OR for SA across all durations, but highest for 30-89 days (8.09; CI 6.30-10.39). Spine and back was the body region with the highest OR for SA >= 90 days (11.98; CI 7.38-19.46), followed by Traumatic Brain Injuries (6.64; CI 4.01-10.98), and injuries to lower extremities (5.28; CI 3.58-7.78). For 235 individuals (5%) the SA spell lasted >= 180 days. Among those cases, the most commonly injured body regions were lower leg (21%) followed by shoulder and upper arm (17%), and Traumatic Brain Injuries (15%). In conclusion, the duration of SA varied with type of injury and injured body region. Among the very long SA spells, common injuries were injuries to the lower leg, to the shoulder and upper arm, and traumatic brain injuries.
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5.
  • Kjeldgård, Linnea, 1985-, et al. (författare)
  • Bicycle crashes and sickness absence - a population-based Swedish register study of all individuals of working ages
  • 2019
  • Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundIn recent years, bicycle injuries have increased, yet little is known about the impact of such injures on sickness absence (SA) and disability pension (DP). The aim was to explore SA and DP among individuals of working ages injured in a bicycle crash.MethodA nationwide register-based study, including all individuals aged 16-64years and living in Sweden, who in 2010 had in- or specialized out-patient healthcare (including emergency units) after a bicycle crash. Information on age, sex, sociodemographics, SA, DP, crash type, injury type, and injured body region was used. We analyzed individuals with no SA or DP, with ongoing SA or full-time DP already at the time of the crash, and with new SA >14days in connection to the crash. Crude and adjusted odds ratios (OR) with 95% confidence intervals for new SA were estimated by logistic regression.ResultsIn total, 7643 individuals had healthcare due to a new bicycle crash (of which 85% were single-bicycle crashes). Among all, 10% were already on SA or full-time DP at the time of the crash, while 18% had a new SA spell. The most common types of injuries were external injuries (38%) and fractures (37%). The body region most frequently injured was the upper extremities (43%). Women had higher OR (1.40; 1.23-1.58) for new SA than men, as did older individuals compared with younger (OR 2.50; 2.02-3.09, for ages: 55-64 vs. 25-34). The injury types with the highest ORs for new SA, compared with the reference group external injuries was fractures (8.04; 6.62-9.77) and internal injuries (7.34; 3.67-14.66). Individuals with traumatic brain injury and injuries to the vertebral column and spinal cord had higher ORs for SA compared with other head, face, and neck injuries (2.72; 1.19-6.22 and 3.53; 2.24-5.55, respectively).ConclusionsIn this explorative nationwide study of new bicycle crashes among individuals of working ages, 18% had a new SA spell in connection to the crash while 10% were already on SA or DP. The ORs for new SA were higher among women, older individuals, and among individuals with a fracture.
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6.
  • Filtness, Ashleigh J, et al. (författare)
  • Sleep-related eye symptoms and their potential for identifying driver sleepiness
  • 2014
  • Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 23:5, s. 568-75
  • Tidskriftsartikel (refereegranskat)abstract
    • The majority of individuals appear to have insight into their own sleepiness, but there is some evidence that this does not hold true for all, for example treated patients with obstructive sleep apnea. Identification of sleep-related symptoms may help drivers determine their sleepiness, eye symptoms in particular show promise. Sixteen participants completed four motorway drives on two separate occasions. Drives were completed during daytime and night-time in both a driving simulator and on the real road.Ten eye symptoms were rated at the end of each drive, and compared with driving performance and subjective and objective sleep metrics recorded during driving. 'Eye strain', 'difficulty focusing', 'heavy eyelids' and 'difficulty keeping the eyes open' were identified as the four key sleep-related eye symptoms. Drives resulting in these eye symptoms were more likely to have high subjective sleepiness and more line crossings than drives where similar eye discomfort was not reported. Furthermore, drivers having unintentional line crossings were likely to have 'heavy eyelids' and 'difficulty keeping the eyes open'. Results suggest that drivers struggling to identify sleepiness could be assisted with the advice 'stop driving if you feel sleepy and/or have heavy eyelids or difficulty keeping your eyes open'.
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7.
  • Forsman, Åsa, 1972-, et al. (författare)
  • Injury crashes and the relationship with disease causing excessive daytime sleepiness
  • 2021
  • Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 22:4, s. 272-277
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: The objective of this study was to understand the relationship between some of the most common diseases that are known to contribute to excessive daytime sleepiness (EDS) and traffic injury crashes. Specific focus was on the relationship between disease and crash type (single-vehicle or multiple-vehicle crash) and between disease and injury severity.Methods: This registry-based study considered all passenger car drivers involved in a crash in Sweden between 2011 and 2016 who were 40 years or older at the time of the crash (n = 54,090). For each crash-involved driver, selected medical diagnoses registered from 1997 until the day before the crash were extracted from the National Patient Register. The drivers were assigned to 1 of 4 groups, depending on prior diseases: sleep apnea (SA; group 1, n = 2,165), sleep disorders (group 2, n = 724), Parkinson's or epilepsy (group 3, n = 645) and a reference group (group 4, n = 50,556). Logistic regression analysis compared single-vehicle crashes with multiple-vehicle crashes and moderately/severely injured drivers with slightly/uninjured drivers.Results: Drivers with EDS-related diseases (groups 1-3) had higher probability of a single-vehicle crash than a multiple-vehicle crash compared to the reference group. The most sizeable effect was found for Parkinson's/epilepsy with an odds ratio (OR) of 2.5 (confidence interval [CI], 2.1-3.0). For multiple-vehicle crashes, the probability of a moderate/severe injury was higher for drivers with other sleep disorders (OR = 1.5; CI, 1.0-2.2) and Parkinson's/epilepsy (OR = 1.6; CI, 1.1-2.3) compared to the reference group.Conclusions: This study has made first steps toward understanding the relationship between some of the most common diseases that are known to contribute to EDS and crashes. Having Parkinson's/epilepsy, in particular, elevated the probability of a single-vehicle crash compared to a multiple-vehicle crash. A single-vehicle crash was seen as indicative of causing a crash; thus, having Parkinson's/epilepsy could be interpreted as a risk factor for crash involvement. Having Parkinson's/epilepsy, as well as other sleep disorders, was also related to more severe outcomes in multiple-vehicle crashes, given that a crash occurred. This was not identified in single-vehicle crashes.
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8.
  • Bränström, Richard, et al. (författare)
  • Sickness certification at oncology clinics : perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences
  • 2014
  • Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 23:1, s. 89-97
  • Tidskriftsartikel (refereegranskat)abstract
    • Physicians' work with sickness certifications is an understudied field. The aims of this study were to gain knowledge of experiences concerning the sickness certification process among physicians working at oncology clinics. In 2008, all physicians working in Sweden (n = 36 898) were sent a questionnaire concerning sick-listing practices. All respondents working at an oncology clinic (n = 428) were included in the current study. Most of the physicians had sickness certification consultations at least weekly (91.3%). More than one fifth (22.3%) reported that they worked at a clinic with a workplace policy regarding the handling of sickness certification and 61.1% reported receiving at least some support in such cases from their immediate manager. Issuing unnecessary long sickness certificates were related to experiencing delicate interactions with patients and to lack of time. To a moderate degree, further competence was requested regarding: different types of compensation in the social insurance system, responsibilities of the Social Insurance Agency and employers, and sickness insurance rules. The large majority of physicians working in oncology reported regularly having consultations involving sickness certification. Overall, they reported few problems, low level of need for more competence regarding sickness certification, and low frequency of issuing sickness absences for longer periods than necessary.
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9.
  • Leo, Christoph, et al. (författare)
  • Analysis of Swedish and Dutch accident data on cyclist injuries in cyclist-car collisions
  • 2019
  • Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-957X .- 1538-9588. ; 20:sup2, s. 160-162
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To reduce the number of severe injuries sustained by cyclists in crashes with vehicles, it is important to understand which kinds of injuries are occurring to identify what should be assessed by means of virtual testing. Method: A detailed analysis of injuries was made based on Swedish and Dutch accident data. The most frequently injured body regions and the most frequent single injuries of these body regions were analysed. Results: Cyclists most frequently injured their heads, upper and lower extremities, and bone fractures as well as brain injuries were identified as one of the most important injuries. Conclusions: For the virtual assessment of cyclist protection, injury predictors for long bone, skull and pelvic fractures as well as brain injuries are required in Human Body Models.
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10.
  • Virtanen, Marianna, et al. (författare)
  • Work disability before and after a major cardiovascular event : a ten-year study using nationwide medical and insurance registers
  • 2017
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • We examined the trajectories of work disability before and after IHD and stroke events. New IHD (n = 13521) and stroke (n = 7162) cases in 2006-2008 were retrieved from nationwide Swedish hospital records and their annual work disability days five years before and after the date of diagnosis were retrieved from a nationwide disability register. There was no pre-event differences in disability days between the IHD and stroke cases and five years prior to the event, they were close to those observed in the general population. In the first post-event year, the adjusted mean days increased to 83.9 (95% CI 80.6-86.5) in IHD; to 179.5 (95% CI 172.4-186.8) in stroke, a six-fold increase in IHD and 14-fold in stroke. Work disability leveled off among the IHD cases but not among those who had stroke. The highest disability levels for the fifth post-event year after a stroke event was associated with pre-existing diabetes (146.9), mental disorder (141.2), non-employment (137.0), and immigrant status (117.9). In a working-age population, the increase in work disability after a cardiovascular event decreases close to the pre-event level in IHD but remains particularly high after stroke; among patients with comorbid depression or diabetes, immigrants, and those not in employment.
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