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Accurate diagnosis and effective treatment of leg ulcers reduce prevalence, care time and costs.

https://arctichealth.org/en/permalink/ahliterature81702
Source
J Wound Care. 2006 Jun;15(6):259-62
Publication Type
Article
Date
Jun-2006
Author
Oien R F
Ragnarson Tennvall G.
Author Affiliation
Blekinge Wound Healing Centre, Lyckeby, Sweden. rut.oien@ltblekinge.se
Source
J Wound Care. 2006 Jun;15(6):259-62
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Bandages
Community Health Nursing - economics - education
Cost Control
Cost of Illness
Education, Nursing, Continuing
Female
Humans
Leg Ulcer - diagnosis - economics - epidemiology - nursing
Male
Nursing Administration Research
Nursing Assessment
Nursing Staff - economics - education - psychology
Population Surveillance
Practice Guidelines
Prevalence
Questionnaires
Risk factors
Skin Care - economics - nursing
Sweden - epidemiology
Time and Motion Studies
Workload - economics
Wound Healing
Abstract
OBJECTIVE: This long-term follow-up recorded the prevalence, aetiology and treatment of hard-to-heal leg and foot ulcers, and an estimated nurses' time spent providing care, for the years 1994-2005. METHOD: A questionnaire was sent to all district and community nurses in the county of Blekinge, Sweden, during one week in 1994, 1998, 2004 and 2005. Calculating the costs of hard-to-heal leg and foot ulcer care was not a primary aim, but the reduction in prevalence and time spent on wound management suggested it was important to illustrate the economic consequences of these changes over time. RESULTS: Estimated prevalence of hard-to-heal leg and foot ulcers reduced from 0.22% in 1994 to 0.15% in 2005. Treatment time decreased from 1.7 hours per patient per week in 1994 to 1.3 hours in 2005. Annual costs of leg and foot ulcer care reduced by SEK 6.96 million in the study area from 1994 to 2005. CONCLUSION: Improved wound management was demonstrated; leg and foot ulcer prevalence and treatment time were reduced. The results could be attributed to an increased interest in leg and foot ulcer care among staff, which was maintained by repeated questionnaires, continuous education, establishment of a wound healing centre in primary care and wound management recommendations from a multidisciplinary group. The improved ulcer care reduced considerably the annual costs of wound management in the area.
PubMed ID
16802562 View in PubMed
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Ache, pain, and discomfort: the reward for working with many cows and sows?

https://arctichealth.org/en/permalink/ahliterature166311
Source
J Agromedicine. 2006;11(2):45-55
Publication Type
Article
Date
2006
Author
Christina Kolstrup
Marianne Stål
Stefan Pinzke
Peter Lundqvist
Author Affiliation
Swedish University of Agricultural Sciences, Department of Agricultural Biosystems and Technology, Alnarp, Sweden. christina.kolstrup@jbt.slu.se
Source
J Agromedicine. 2006;11(2):45-55
Date
2006
Language
English
Publication Type
Article
Keywords
Adult
Agricultural Workers' Diseases - epidemiology - etiology
Animal Husbandry - manpower - methods
Back Pain - epidemiology - etiology
Cumulative Trauma Disorders - epidemiology - etiology
Dairying - manpower - methods
Female
Humans
Male
Middle Aged
Musculoskeletal Diseases - epidemiology - etiology
Risk factors
Sweden - epidemiology
Workload
Abstract
The main purpose of the study was to investigate the prevalence of perceived symptoms of musculoskeletal disorders (MSD) among workers on large-scale dairy and pig farms in Sweden (herd size more than 300 cows and 450 sows) and to identify potential risk factors in the development of MSD. A study based on questionnaires was carried out among 42 workers on 10 large dairy farms and among 37 workers on 10 large pig farms in Southern Sweden during the autumn of 2002. Most importantly, the study showed that 86% of the dairy workers and 78% of the pig workers reported some kind of MSD during a period of 12 months prior to the study. The most frequently reported MSD among both the dairy and the pig workers were in the "upper extremities" (52% and 62%, respectively) especially in the shoulders and in "the back" (60% and 57%, respectively) especially in the lower back. Furthermore, being of short stature, doing repetitive work, working in awkward positions and being exposed to dust were significant risk factors in having MSD among the workers in this study. Thus, working with many cows and sows on large-scale farms in Sweden can be considered as a high risk job with regard to MSD.
PubMed ID
17135142 View in PubMed
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[Acute abdomen calls for considerable care resources. Analysis of 3727 in-patients in the county of Stockholm during the first quarter of 1995]

https://arctichealth.org/en/permalink/ahliterature72078
Source
Lakartidningen. 2000 Sep 13;97(37):4008-12
Publication Type
Article
Date
Sep-13-2000
Author
G. Fenyö
M. Boijsen
L. Enochsson
M. Goldinger
S. Gröndal
P. Lundquist
I. Meldahl
M. Nilsson
U. Wenger
Author Affiliation
Kirurgiska kliniken, Södersjukhuset g.fenyo@telia.com
Source
Lakartidningen. 2000 Sep 13;97(37):4008-12
Date
Sep-13-2000
Language
Swedish
Publication Type
Article
Keywords
Abdomen, Acute - diagnosis - epidemiology - surgery
Abdominal Pain - etiology
Adolescent
Adult
Aged
Emergency Service, Hospital - statistics & numerical data - trends
English Abstract
Female
Health Services Needs and Demand - statistics & numerical data - trends
Humans
Male
Medical Illustration
Middle Aged
Retrospective Studies
Surgery Department, Hospital - statistics & numerical data - trends
Sweden - epidemiology
Workload
Abstract
A total of 3,727 in-patients with acute abdominal symptoms were identified during the first quarter of 1995 at the surgical clinics of the nine hospitals with emergency departments in the county of Stockholm. The diagnoses were: non-specific abdominal pain 24%; cholecystitis 9%; appendicitis 8%; bowel obstruction 7%; intra-abdominal malignancy, diseases of the urinary tract and peptic ulcer 6% each; gastrointestinal hemorrhage, diverticulitis of the colon and pancreatitis 5% each; other diseases as a cause of abdominal symptoms, 19%. 1,601 operations were performed of which 47% were endoscopic procedures. The mean duration of hospital stay was 4.8 days. The length of stay increased significantly with age. The age-related relative frequency of hospitalization due to acute abdominal pain was also dramatically higher in the elderly cohorts. These facts and the prognosis of an 18% increase of inhabitants 50 years of age or older until 2010 in Greater Stockholm signal an increased need of hospital resources for this large group of patients in the coming years.
PubMed ID
11036359 View in PubMed
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Age-related accident risks: longitudinal study of Swedish iron ore miners.

https://arctichealth.org/en/permalink/ahliterature210969
Source
Am J Ind Med. 1996 Oct;30(4):479-87
Publication Type
Article
Date
Oct-1996
Author
L. Laflamme
V L Blank
Author Affiliation
Department of Public Health Sciences, Karolinska Institute, Sundbyberg, Sweden.
Source
Am J Ind Med. 1996 Oct;30(4):479-87
Date
Oct-1996
Language
English
Publication Type
Article
Keywords
Accidents, Occupational - statistics & numerical data
Adult
Age Factors
Back Injuries
Bone and Bones - injuries
Contusions - epidemiology
Craniocerebral Trauma - epidemiology
Efficiency
Facial Injuries - epidemiology
Hand Injuries - epidemiology
Humans
Iron
Longitudinal Studies
Male
Middle Aged
Mining - classification - organization & administration - statistics & numerical data
Multivariate Analysis
Odds Ratio
Poisson Distribution
Regression Analysis
Risk factors
Sprains and Strains - epidemiology
Sweden - epidemiology
Workload
Abstract
The study investigated whether occupational accident risks were equally distributed across age categories over time in the context of production reorganization and work rationalization in a Swedish iron ore mine between 1980 and 1993. Three phases of reorganization, defined by productivity levels, and four age categories were related to age-related accident risk ratios using the Poisson-regression method. Accident risk ratios (ARRs) were found systematically to be higher during the two first phases and also for younger workers, in the cases of both nonspecific and specific accident risks. The steady reduction in accident rates observed did not favor all age groups of workers to the same extent. For two accident patterns out of five, workers in their thirties and forties recorded higher ARRs than those in their fifties.
PubMed ID
8892554 View in PubMed
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Appraised psychological workload, musculoskeletal symptoms, and the mediating effect of fatigue: a structural equation modeling approach.

https://arctichealth.org/en/permalink/ahliterature179046
Source
Scand J Psychol. 2004 Sep;45(4):331-41
Publication Type
Article
Date
Sep-2004
Author
Pernilla Byström
Jan Johansson Hanse
Anders Kjellberg
Author Affiliation
Department of Psychology, Göteborg University, Sweden. pernilla.bystrom@niwl.se
Source
Scand J Psychol. 2004 Sep;45(4):331-41
Date
Sep-2004
Language
English
Publication Type
Article
Keywords
Adult
Cross-Sectional Studies
Fatigue - psychology
Female
Humans
Male
Models, Statistical
Musculoskeletal Diseases - epidemiology - psychology
Occupational Diseases - epidemiology - psychology
Stress, Psychological - complications
Sweden - epidemiology
Workload
Abstract
The aim of the present study was to test two structural models of the relationship between appraised psychological workload and musculoskeletal symptoms from the neck, shoulder, and upper and lower back with different aspects of perceived fatigue as mediating variables. In this cross-sectional study a questionnaire survey was conducted among employees at three Swedish assembly plants (n= 305). The proposed models were tested for one general fatigue dimension--lack of energy--and four specific fatigue dimensions--physical discomfort, physical exertion, lack of motivation, and sleepiness--using structural equation modeling. The results indicate that the role of perceived fatigue in the relationship between appraised workload and musculoskeletal symptoms is different for different aspects of fatigue. The general fatigue dimension, lack of energy, does not mediate the relationship. As regards the specific fatigue dimensions, the relationship is partially mediated by physical discomfort and lack of motivation but not by physical exertion or sleepiness. Appraised psychological workload has a unique effect on musculoskeletal symptoms not mediated by fatigue.
PubMed ID
15281923 View in PubMed
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Are manual workers at higher risk of death than non-manual employees when living in Swedish municipalities with higher income inequality?

https://arctichealth.org/en/permalink/ahliterature167962
Source
Eur J Public Health. 2007 Apr;17(2):139-44
Publication Type
Article
Date
Apr-2007
Author
Göran Henriksson
Peter Allebeck
Gunilla Ringbäck Weitoft
Dag Thelle
Author Affiliation
Department of Social Medicine, Göteborg University SE 405 30 Göteborg, Sweden. goran.henriksson@socmed.gu.se
Source
Eur J Public Health. 2007 Apr;17(2):139-44
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Adult
Censuses
Employment - classification - economics - statistics & numerical data
Female
Humans
Income - classification - statistics & numerical data
Male
Middle Aged
Occupational Diseases - mortality
Occupations - classification - economics - statistics & numerical data
Poisson Distribution
Poverty Areas
Residence Characteristics - classification
Risk factors
Social Class
Sweden - epidemiology
Urban Health - statistics & numerical data
Vulnerable Populations - statistics & numerical data
Workload - statistics & numerical data
Abstract
To test the hypothesis that manual workers are at higher risk of death than are non-manual employees when living in municipalities with higher income inequality.
Hierarchical regression was used for the analysis were individuals were nested within municipalities according to the 1990 Swedish census. The outcome was all-cause mortality 1992-1998. The income measure at the individual level was disposable family income weighted against composition of family; the income inequality measure used at the municipality level was the Gini coefficient.
The study population consisted of 1 578 186 people aged 40-64 years in the 1990 Swedish census, who were being reported as unskilled or skilled manual workers, lower-, intermediate-, or high-level non-manual employees.
There was no significant association between income inequality at the municipality level and risk of death, but an expected gradient with unskilled manual workers having the highest risk and high-level non-manual employees having the lowest. However, in the interaction models the relative risk (RR) of death for high-level non-manual employees was decreasing with increasing income inequality (RR = 0.77; 95% CI, 0.63-0.93), whereas the corresponding risk for unskilled manual workers increased with increasing income inequality (RR = 1.24; 95% CI, 1.06-1.46). The RRs for skilled manual, low- and medium- level non-manual employees were not significant. Controlling for income at the individual level did not substantially alter these findings, neither did potential confounders at the municipality level.
The findings suggest that there could be a differential impact from income inequality on risk of death, dependent on individuals' social position.
PubMed ID
16899476 View in PubMed
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Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs. Stockholm MUSIC I Study Group.

https://arctichealth.org/en/permalink/ahliterature52699
Source
Scand J Work Environ Health. 1997 Apr;23(2):130-9
Publication Type
Article
Date
Apr-1997
Author
A. Toomingas
T. Theorell
H. Michélsen
R. Nordemar
Author Affiliation
Karolinska Institute, Department of Medicine, Huddinge, Sweden.
Source
Scand J Work Environ Health. 1997 Apr;23(2):130-9
Date
Apr-1997
Language
English
Publication Type
Article
Keywords
Adult
Female
Humans
Internal-External Control
Linear Models
Male
Musculoskeletal Diseases - epidemiology - psychology
Occupational Diseases - epidemiology - psychology
Prevalence
Research Support, Non-U.S. Gov't
Risk factors
Social Environment
Social Support
Socioeconomic Factors
Sweden - epidemiology
Workload
Abstract
OBJECTIVES: The aim was to study the associations between self-rated psychosocial work conditions and the characteristics and location of musculoskeletal symptoms, signs, and syndromes. METHODS: Perceived psychosocial work conditions were recorded in a cross-sectional study with 358 men and women in various occupations. Symptoms were recorded from the musculoskeletal system with a questionnaire, and signs were detected in a medical examination of all body regions. The analyses of statistical associations between the psychosocial factors and musculoskeletal disorders were performed with control for age, gender, and physical load. RESULTS: The most consistent and pronounced associations were mainly seen between poor psychosocial work conditions and coexisting symptoms and signs of the neck and back regions. Poor psychosocial work conditions were more consistently and strongly associated with signs of muscular (soft tissue) tenderness than with signs of tenderness in the joints, tendons, or muscular insertions or signs in nerve compression tests. Mainly low social support at work, but also high psychological demands and high job strain, were associated with such symptoms and signs, whereas decision latitude at work showed few associations with musculoskeletal disorders. CONCLUSIONS: Perceived poor psychosocial work conditions are statistically associated mainly with symptoms and signs of muscular tenderness in the central body regions. Studies on associations between psychosocial work conditions and musculoskeletal disorders should separate effect measures of different clinical signs and different body regions in order to avoid attenuation of the risk estimates.
PubMed ID
9167236 View in PubMed
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Background factors in the decline of infant mortality in Sweden 1800-1930.

https://arctichealth.org/en/permalink/ahliterature37383
Source
Scand J Soc Med Suppl. 1991;46:53-61
Publication Type
Article
Date
1991
Author
U B Lithell
Author Affiliation
Department of Pediatrics, University Hospital, Uppsala, Sweden.
Source
Scand J Soc Med Suppl. 1991;46:53-61
Date
1991
Language
English
Publication Type
Article
Keywords
Age Factors
Cause of Death
Communicable Diseases - epidemiology - mortality
Educational Status
Energy intake
Female
Fertility
Food Supply - standards
Health Education - standards
Humans
Hygiene
Infant
Infant Mortality - trends
Infant, Newborn
Mothers - education
Nutritional Status
Seasons
Smallpox - mortality
Sweden - epidemiology
Women's health
Workload
Abstract
The aim of this paper is to present an overview of the changing Swedish society during the period 1800-1930 and to highlight factors which may have determined the decline in infant mortality during this period. A women's perspective will be used as a method to approach the problem. The following hypothesis has been formulated: a declining infant mortality was indirectly linked to and mediated through improvements in women's and mothers' living conditions in the past. Health information was successful when women and mothers possessed the necessary prerequisites for understanding and utilizing this information. Because of improved harvests food consumption per capita increased from the second decade of the 19th century. Deaths related to smallpox decreased from the beginning of the 19th century and fewer children under five and above died. A pronounced growth of the population due to declining mortality started from the second decade of the 19th century. The decline of infant mortality was, firstly, a combined effect of an increased intake of calories and a gradual decrease of work loads for women, which indirectly and directly influenced infants' health and survival. Fewer small-for-date infants were born, and mothers had more time for breast-feeding and child care. Secondary factors of importance were improved delivery care, health information on child care and hygiene, and declining fertility.
PubMed ID
1805369 View in PubMed
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Blood lipid levels in a rural male population.

https://arctichealth.org/en/permalink/ahliterature10185
Source
J Cardiovasc Risk. 2001 Jun;8(3):165-74
Publication Type
Article
Date
Jun-2001
Author
A. Thelin
E L Stiernström
S. Holmberg
Author Affiliation
Swedish Farmers Safety and Preventive Health Association, Gatugård, S-355 94 Wederslöf, Sweden. athelin@wgab.se
Source
J Cardiovasc Risk. 2001 Jun;8(3):165-74
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Age Factors
Blood Pressure - physiology
Body mass index
Cholesterol - blood
Comparative Study
Cross-Sectional Studies
Human Activities - psychology
Humans
Lipids - blood
Lipoproteins, HDL Cholesterol - blood
Lipoproteins, LDL Cholesterol - blood
Male
Middle Aged
Multivariate Analysis
Population
Research Support, Non-U.S. Gov't
Rural Health
Smoking - adverse effects
Sweden - epidemiology
Triglycerides - blood
Workload - psychology
Abstract
OBJECTIVES: Farmers have a low risk for cardiovascular disease, which may be related to a favourable blood lipid profile. In order to study the blood lipid levels and evaluate the effect of other cardiovascular risk factors on the blood lipid profile, this cross-sectional study was made. MATERIAL AND METHODS: A total of 1013 farmers and 769 non-farming rural men in nine different Swedish counties were examined, interviewed, and replied to questionnaires. The inter-relationships between different risk factors were analysed using a multivariate linear regression model. RESULTS: The farmers had a significantly more favourable blood lipid profile than the non-farmers although the total cholesterol levels were almost the same for the two groups. In the total study population there were significant positive relationships between total cholesterol level and body mass index (BMI), diastolic blood pressure and smoking. The high-density lipoprotein (HDL) level was positively related to physical workload and alcohol consumption, and negatively related to BMI, waist/hip ratio and smoking. Triglyceride levels showed a positive relationship to BMI, waist/hip ratio and blood pressure. Differences between farmers and other rural males were seen, especially with respect to the effect of physical activity and psychosocial factors. Among the farmers, a negative correlation between the Karasek-Theorell authority over work index and total cholesterol, the low-density lipoprotein (LDL)/HDL ratio and triglyceride levels was observed. CONCLUSIONS: This study indicated that diet is of minor significance for the blood lipid profile, whereas factors such as physical activity, body weight and the waist/hip ratio, smoking, alcohol consumption, and perhaps psychosocial working conditions are major independent factors affecting the blood lipid profile most prominently among farmers, but also among non-farming rural men.
PubMed ID
11455849 View in PubMed
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Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study.

https://arctichealth.org/en/permalink/ahliterature78084
Source
BMC Med Educ. 2007;7:6
Publication Type
Article
Date
2007
Author
Dahlin Marie E
Runeson Bo
Author Affiliation
Department of Clinical Neuroscience, Division of Psychiatry St. Göran, Karolinska Institutet, Stockholm, Sweden. marie.dahlin@ki.se
Source
BMC Med Educ. 2007;7:6
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Burnout, Professional - diagnosis - epidemiology
Clinical Clerkship - statistics & numerical data
Depression - epidemiology
Female
Humans
Interviews
Longitudinal Studies
Male
Mental Disorders - epidemiology
Personality Inventory
Prevalence
Prospective Studies
Questionnaires
Risk factors
Self Concept
Sex Distribution
Students, Medical - statistics & numerical data
Sweden - epidemiology
Workload - statistics & numerical data
Abstract
BACKGROUND: Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3rd year of medical school, considering personality and study conditions measured at 1st year. METHODS: Questionnaires were sent to 127 first year medical students who were then followed-up at 3rd year of medical school. Eighty-one of 3rd year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1st and 3rd years. Diagnostic interviews (MINI) were used at 3rd year to assess psychiatric morbidity. High and low burnout at 3rd year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. RESULTS: 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1st year and Financial concerns at 1st year. When controlling for 3rd year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1st year, only the later remained significant in the adjusted analysis. CONCLUSION: Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available.
PubMed ID
17430583 View in PubMed
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118 records – page 1 of 12.