Showing papers in "Scandinavian Journal of Public Health in 2012"
TL;DR: Systematic text condensation is a strategy for analysis developed from traditions shared by most of the methods for analysis of qualitative data that offers the novice researcher a process of intersubjectivity, reflexivity, and feasibility, while maintaining a responsible level of methodological rigour.
Abstract: Aims: To present background, principles, and procedures for a strategy for qualitative analysis called systematic text condensation and discuss this approach compared with related strategies. Metho...
1,542 citations
TL;DR: In this article, the authors present a systematic review of validation studies that compare data to external information, focusing on the validity of the Finnish Hospital Discharge Register (FHDR) in the case of vascular disease, mental disorders or injuries.
Abstract: Aims: The Finnish Hospital Discharge Register (FHDR) is one of the oldest individual level hospital discharge registers and has been intensively used for research purposes. The aim of this study was to gather information concerning the quality of FHDR into one place in terms of a systematic review of validation studies that compare data to external information. Methods: Several reference databases were searched for validity articles published until January 2012. For each included study, focus of validation, register years examined, number of compared observations, external source(s) of data, summary of validation results, and conclusions concerning the validity of FHDR were extracted. Results: In total, 32 different studies comparing FHDR data to external information were identified. Most of the studies examined validity in the case of vascular disease, mental disorders or injuries. More than 95% of discharges could be identified from the register. Positive predictive value (PPV) for common diagnoses was ...
924 citations
201 citations
TL;DR: The survey was a result of extensive national cooperation across sectors, which makes it unique in its field of application, e.g. health surveillance, planning and prioritizing public health initiatives and research, however, the low response rate in some subgroups of the study population can pose problems in generalizing data.
Abstract: Aims: In 2010 the five Danish regions and the National Institute of Public Health at the University of Southern Denmark conducted a national representative health survey among the adult population in Denmark. This paper describes the study design and the sample and study population as well as the content of the questionnaire. Methods: The survey was based on five regional stratified random samples and one national random sample. The samples were mutually exclusive. A total of 298,550 individuals (16 years or older) were invited to participate. Information was collected using a mixed mode approach (paper and web questionnaires). A questionnaire with a minimum of 52 core questions was used in all six subsamples. Calibrated weights were computed in order to take account of the complex survey design and reduce non-response bias. Results: In all, 177,639 individuals completed the questionnaire (59.5%). The response rate varied from 52.3% in the Capital Region of Denmark sample to 65.5% in the North Denmark Region sample. The response rate was particularly low among young men, unmarried people and among individuals with a different ethnic background than Danish. Conclusions: The survey was a result of extensive national cooperation across sectors, which makes it unique in its field of application, e.g. health surveillance, planning and prioritizing public health initiatives and research. However, the low response rate in some subgroups of the study population can pose problems in generalizing data, and efforts to increase the response rate will be important in the forthcoming surveys.
194 citations
TL;DR: In an increasingly globalized world more people have the possibility to settle in a country other than the one in which they were born, and to the new country migrants bring their lifestyle and other important risk factors and protective factors for health.
Abstract: Summary In an increasingly globalized world more people have the possibility to settle in a country other than the one in which they were born. To the new country migrants bring their lifestyle and other important risk factors and protective factors for health. If the immigrants are refugees, a period of uncertainty awaits them before their life in a new country can begin. As newcomers to Swedish society, they often end up in low-status neighborhoods, are reduced to heavy and low-wage jobs and often also continue to be socially vulnerable as a result of discrimination. Immigrants in Sweden of non-European background report three to four times as often as Swedishborn people that they suffer from poor or very poor health. Male immigrants smoke more than Swedishborn men, while alcohol-related diseases are less common among many immigrant groups. The incidence of a number of specific public health problems, such as allergic diseases and diabetes, varies widely across different immigrant groups. The particular background of refugees makes them especially susceptible to psychiatric morbidity, a susceptibility that is further increased by the stresses that occur during the asylum process. Adult undocumented migrants and asylum seekers have limited access to health and medical care in Sweden.
122 citations
TL;DR: The proportion of elderly people in the population has been growing for more than a century and is expected to continue to rise given the gains in average life expec tancy and the fact that large age cohorts are reaching retirement age.
Abstract: Summary Over 18 per cent of Sweden’s population – approximately 1.8 million people – are 65 years of age or older. The proportion of elderly people in the population has been growing for more than a century and is expected to continue to rise given the gains in average life expec tancy and the fact that large age cohorts are reaching retirement age. The average remaining life expectancy among those who had reached the age of 65 in 2011 was 21 years for women and 18 years for men. The most common causes of death among elderly people are cardiovascular diseases and cancer. The risk of suffering a stroke or heart attack has declined and morbidity has shifted to the upper age groups. On the other hand, the cancer incidence has increased, while cancer mortality has declined, owing to earlier detection and more effective treatment. The most common forms of cancer among elderly people are prostate cancer, breast cancer, colorectal cancer, and lung cancer. There has been a rise in the proportion of elderly people who perceive their general state of health as good. In the case of women, however, the increase is mainly noticeable among younger pensioners, while in men, it is spread across all age groups, according to the Statistics Sweden’s Survey of Living Conditions (ULF). The percentage of elderly people reporting long-term illness has risen, while the proportion with illnesses or complaints that interfere with daily life activities has declined. The percentage of people suffering from impaired mobility has fallen since the 1980s, while pain issues have remained at about the same level. Reports of nervousness, anxiety and sleeping
106 citations
TL;DR: The intake of whole grain (WG) in Norway, Sweden and Denmark was described and what proportion of the study population that met the new WG recommendation (75 g WG/day per 10 MJ) was investigated.
Abstract: Aims: The aim of the present study was to describe the intake of whole grain (WG) in Norway, Sweden and Denmark, and to investigate what proportion of the study population that met the new WG recommendation (75 g WG/day per 10 MJ). Methods: Descriptive study. Data is from one 24h dietary recall (24HDR) collected in 1995–2000 from a subset (n = 8,702) of the large Scandinavian cohort “HELGA” consisting of participants aged 30–65 years from three cohorts. Results: The mean WG intake was far below the recommended level. Between 16% (Danish men) and 35% (Norwegian women) consumed at least the recommended intake of WG. Among women, the median intake of WG products (g WG products/day) was 114 g/day in Norway and 108 g/day in Denmark, whereas the intake was much lower in Sweden (64 g/day). For women, the median intake of WG in absolute amounts (g WG/day) was again highest in Norway (44 g/day), but lower in both Sweden (35 g/day) and Denmark (31 g/day). For men (no data available for Norwegian men), the intake of...
102 citations
TL;DR: The SPSQ together with GHQ-28 and STAI-X1 allow a targeted screening aimed at contrasting parents who experience reduced emotional wellbeing with those who struggle with stress directly related to their parenting role, and all endpoints of the analysis are positively correlated.
Abstract: Aims: The aims of the study were to compare parenting stress and emotional wellbeing in mothers and fathers of preschool children, to look for predictors of different aspects of parenting stress in...
81 citations
TL;DR: An imbalance between demands placed on us and the authors' ability to manage them and the body’s stress system is adapted to confront sudden physical threats today.
Abstract: Stress can be defined as an imbalance between demands placed on us and our ability to manage them. The body’s stress system is adapted to confront sudden physical threats. Today, however, we are in ...
76 citations
TL;DR: Urban–rural differences in diet and weight status indicates that the nutrition transition was similar in both countries despite large sociodemographic differences; however, rural Kenyan women had a better MAR, DDS, and FVS than South African women, most probably due to 60% having access to land.
Abstract: Aims: To determine and compare the extent of the nutrition transition between Kenyan and South African women. Methods: A nationally representative sample of women aged ≥15 years (n=1008) was assessed in Kenya. Weight, height, and waist and hip circumferences were measured. A 24-hour dietary recall was conducted with each participant. This data was compared with data of the Demographic and Health Survey (DHS) of women in South Africa (n=4481). Dietary intake of South African women was based on secondary data analysis of dietary studies using the 24-hour recall method (n=1726). Results: In South Africa, 27.4% women had a BMI ≥30 kg/m2 compared with 14.2% of Kenyan women. In both countries there were large urban–rural differences in BMI, with the highest prevalence in women in urban areas. BMI increased with age, as did abdominal obesity which was equally prolific in both countries with more than 45% of women in the older groups having a waist/hip ratio ≥0.85. The nutrient mean adequacy ratio (MAR) of the So...
72 citations
TL;DR: This study was an attempt to include hard-to-reach groups in an assessment of population health, and homeless persons had considerably worse HRQoL than the general population and reported most problems in the dimension anxiety/depression.
Abstract: Aims: To describe and compare health-related quality of life (HRQoL) among homeless persons with a general population sample in Stockholm County, 2006, and to analyse the importance of certain social determinants of health among the homeless. Methods: Face-to-face interviews with 155 homeless persons and a postal survey to a general population sample, mainly based on the same questionnaire, including questions on social determinants of health and HRQoL measured with the EQ-5D. Results: Chronic illness was three times more common among the homeless. HRQoL was worse among homeless persons than in the general population sample: the homeless reported more problems, especially more severe problems, in all the EQ-5D dimensions and had considerably lower EQ-5Dindex and EQVAS score than the general population. Most problems were reported in the dimension anxiety/depression. Among the homeless, longer duration and more severe degree of homelessness lowered HRQoL, but few determinants were statistically significant...
TL;DR: This study will be the first to determine whether school meals based on the NND improve children’s diet, health, growth, cognitive performance, and early disease risk markers.
Abstract: Introduction: Danish children consume too much sugar and not enough whole grain, fish, fruit, and vegetables. The Nordic region is rich in such foods with a strong health-promoting potential. We lack randomised controlled trials that investigate the developmental and health impact of serving school meals based on Nordic foods. Aim: This paper describes the rationale, design, study population, and potential implications of the Optimal well-being, development and health for Danish children through a healthy New Nordic Diet (OPUS) School Meal Study. Methods: In a cluster-randomised cross-over design, 1021 children from 3rd and 4th grades (8–11 years old) at nine Danish municipal schools were invited to participate. Classes were assigned to two 3-month periods with free school meals based on the New Nordic Diet (NND) or their usual packed lunch (control). Dietary intake, nutrient status, physical activity, cardiorespiratory fitness, sleep, growth, body composition, early metabolic and cardiovascular risk mark...
TL;DR: The effects of socioeconomic position on disability retirement may not be fully captured if the pathways between the various subdomains are disregarded, and efforts to delay and prevent disability retirement should focus on lifestyle and cognitive factors associated with education, as well as on factors associated as working conditions and power resources.
Abstract: AIMS: The association between a low socioeconomic position and disability retirement is established in the literature, but the interrelationships between various subdomains of socioeconomic position are poorly understood. We examined the independent and interdependent effects of education, social class, and income on disability retirement. METHODS: Using nationally representative register data we followed up over 260,000 Finns aged 30-63 at the end of 1995 for disability retirement from 1996 to 2004. Cox regression analysis was used to calculate hazard ratios (HR) and relative indices of inequality (RII). RESULTS: Each socioeconomic indicator had a linear negative association with disability retirement. The socioeconomic gradients were stronger in the younger age groups. The effect of education was largely mediated through succeeding social class. Social class was largely explained by preceding education, but was only moderately mediated through income. Income was largely explained by education, and even further by social class. The independent effects of education, social class, and income on disability retirement as measured by the RII were 1.74 (95% CI 1.60-1.90), 1.95 (1.78-2.15), and 1.35 (1.25-1.47) for men and 1.76 (1.61-1.92), 2.14 (1.95-2.34), and 1.14 (1.05-1.24) for women. CONCLUSIONS: The effects of socioeconomic position on disability retirement may not be fully captured if the pathways between the various subdomains are disregarded. Our results suggest that efforts to delay and prevent disability retirement should focus on lifestyle and cognitive factors associated with education, as well as on factors associated with social class such as working conditions and power resources. Language: en
TL;DR: The organisation did not see patient handover as a critical safety point of hospitalisation, revealing that the safety culture in regard to handover was immature and the eight factors identified indicate that handovers are complex situations.
Abstract: Aims: Improvement of clinical handover is fundamental to meet the challenges of patient safety. The primary aim of this interview study is to explore healthcare professionals’ attitudes and experiences with critical episodes in patient handover in order to elucidate factors that impact on handover from ambulance to hospitals and within and between hospitals. The secondary aim is to identify possible solutions to optimise handovers, defined as “situations where the professional responsibility for some or all aspects of a patient’s diagnosis, treatment or care is transferred to another person on a temporary or permanent basis”. Methods: We conducted 47 semi-structured single-person interviews in a large university hospital in the Capital Region in Denmark in 2008 and 2009 to obtain a comprehensive picture of clinicians’ perceptions of self-experienced critical episodes in handovers. We included different types of handover processes that take place within several specialties. A total of 23 nurses, three nurs...
TL;DR: The Danish healthcare system seems responsive to health across different population groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes, and for dentists, who require co-payment, inequity is found.
Abstract: Background: legislation in Denmark explicitly states the right to equal access to healthcare. Nevertheless, inequities may exist; accordingly evidence is needed. Our objective was to investigate whether differences in healthcare utilisation in immigrants, their descendents, and ethnic Danes could be explained by health status, socioeconomic factors, and integration. Methods: We conducted a nationwide survey in 2007 with 4952 individuals aged 18−66 comprising ethnic Danes; immigrants from the former Yugoslavia, Iran, Iraq, lebanon, Pakistan, Somalia, Turkey; and Turkish and Pakistani descendents. Data were linked to registries on healthcare utilisation. Using Poisson regression models, contacts to hospital, emergency room (ER), general practitioner (GP), specialist in private practice, and dentist were estimated. Analyses were adjusted for health symptoms, sociodemographic factors, and proxies of integration. Results: In adjusted analyses, immigrants and their descendents had increased use of ER (multiplicative effect 1.19−5.02 dependent on immigrant and descendent group) and less frequent contact to dentist (multiplicative effect 0.04−0.80 dependent on the group). For hospitalisation, GP, and specialist doctor, physical health symptoms had positive but different explanatory effects within groups; however, most immigrant and descendent groups had increased use of services compared with that of ethnic Danes. Socioeconomic factors and integration had no systematic effect on the use in the different groups. Conclusions: The Danish healthcare system seems responsive to health across different population groups. We found no systematic pattern of inequity in use of free-of-charge healthcare services, but for dentists, who require co-payment, we found inequity among immigrants and descendents compared with ethnic Danes.
TL;DR: As the care system in Iceland is now under reconstruction, the important contribution of informal carers must be recognised and taken into account when planning the care of older people.
Abstract: Background:The Icelandic old-age care system is universal and the official goal is to support older people live independently for as long as possible. The aim of this study is to analyse living con ...
TL;DR: The elderly are using prescription drugs to an increasing extent, a pattern that entails risks as well as benefits, and use of multiple drugs, or polypharmacy, carries the risk of side effects and drug-drug interactions as different medications affect one another.
Abstract: One of the most common medical actions performed by a doctor is to prescribe medicine for a patient [1]. In 2007, two in every three Swedes purchased at least one prescription drug at a pharmacy. The volume of drugs dispensed by pharmacies increases by 3–4 per cent every year. Recent years have seen the addition of a number of new and more effective drugs. The cost of prescription drugs rose by about 10 per cent annually in the period 1986–2002. However, the rate of increase has since slowed due to changes in the rules on pharmaceutical benefits, primarily those governing generic substitution. The combined cost of all medicines, i.e. prescription drugs, prescription-free drugs and drugs administered during hospital care, accounted for 11.6 per cent of total health and medical care costs in 2006. Pharmaceutical drug use patterns among women and men differ, as does drug use within social groups. Although these disparities are partly accounted for by variation in the disease burden across population groups, there are also gender and social disparities that cannot readily be attributed to differences in the needs of those who use prescription drugs. Examples include drugs for treating dementia and post-heart attack patients, which long-term follow-ups show are used more extensively by the highly educated than by the less well educated. People born outside the EU are less likely to use recommended medicines for heart attacks, heart failure, stroke and chronic obstructive pulmonary disease (COPD). The elderly are using prescription drugs to an increasing extent, a pattern that entails risks as well as benefits. A major proportion of the most frequently used drugs have a proven effect in treating many of the diseases and conditions common among the elderly. At the same time, use of multiple drugs, or polypharmacy, carries the risk of side effects and drug-drug interactions as different medications affect one another. The elderly are particularly vulnerable. Sensitive to drugs owing to dementia or multiple morbidity, they are among those most often exposed to polypharmacy. As a result, drug treatment is not always entirely appropriate. The Swedish National Board of Health and Welfare has accordingly developed quality indicators [2] and assessed and discussed the quality of drug treatments for the elderly in a number of reports [3–5]. According to the World Health Organization (WHO), deficiencies in drug prescribing are a principal cause of inadequate clinical treatment [6].
TL;DR: The results suggest that the family context plays an important role in providing meaningful experiences for the development of a strong SOC in adolescence.
Abstract: Aims:The aim of this work was to study the influence of several family dimensions on sense of coherence (SOC) in adolescence, controlling the possible effects from the demographic variables, gender...
TL;DR: A higher sense of coherence score predicted more prudent food choices in women and higher physical activity in men and the possibility to use the sense ofcoherence questionnaire as a screening instrument to identify patients who could benefit from intensified counseling is investigated.
Abstract: Background: Successful management of type 1 diabetes depends on the self-care practices. Sense of coherence has been associated with various measures of lifestyle choices. We aimed to study the ass...
TL;DR: The study suggests that the construct of work history is a useful element in defining precariousness and illustrates the association of precariousness, perceived job insecurity, and mental distress.
Abstract: Aims:Precarious type of employment may have a negative impact on health, notably on low psychological wellbeing. The basis of the former relationship is constructed by definition and operationalisa...
TL;DR: A definition using harm or risk of harm as cut-off point as the most appropriate in Danish hospital settings was deemed, and a substantial lower occurrence of medication errors was found when applied to historic data.
Abstract: Aims: Definitions of medication errors vary widely in the literature, and prevalence from 2–75% in part because of this lack of consensus. Thus, clarification of the concept is urgently needed. The objective was to develop a clear-cut definition of medication errors and specify relevant error types in the medication process. Methods: Based on existing taxonomy and through a modified Delphi-process consensus of definition and error types were reached among Danish experts appointed by 13 healthcare organisations and the project group. The experts prioritised five definitions of medication errors and score the relevance of 76 error types. Based on explicit criteria, the project group settled non-consensus cases. Results: The panel consisted of 12 physicians, seven pharmacists, and six nurses. Consensus was reached for the definition “An error in the stages of the medication process – ordering, dispensing, administering and monitoring the effect – causing harm or implying a risk of harming the patient”. Moreo...
TL;DR: Sweden has one of the world’s lowest child mortality rates in the 1-15 age-group and the rate of infant hospitalisation due to unintentional or intentional injury has increased, as has hospitalisation of 14–16-year-olds due to severe injuries from moped and motorcycle accidents.
Abstract: Summary The health status of Swedish children is in many respects among the best in the world, as shown by the low infant mortality rate, the high percentage of breastfed infants, the low childhood accident rate, the high proportion of vaccinated children, and the relatively low percentage of children who experience corporal punishment. The low infant mortality rate notwithstanding, the first year of life is a vulnerable period; the number of children who die in this first year is higher than the total for the 1–15 age group. The most common causes of neonatal morbidity are preterm birth and low birth weight due to intrauterine growth retardation. 2.5 per cent of newborns exhibit low birth weight, and 6 per cent are born preterm. These levels have remained the same over the past decade. However, mortality in the first weeks of life continues to decline thanks to increasingly better care during delivery and in the neonatal period. Improvements have also meant that fewer preterm babies now develop cerebral palsy (CP). Stillborn rates, on the other hand, are as high today as they were ten years ago, and stillbirths are more frequent among low-income mothers. Approximately 1.5 per cent of all children are born with malformations or chromosomal anomalies severe enough to cause death or significant functional impairment. The most common chromosomal anomaly is Down’s syndrome, a condition more common among offspring to older women. At present, 20–25 children are born annually with spina bifida (meningomyelocele) and approximately 80 pregnancies are terminated after the disorder has been detected during prenatal ultrasound examination. In the 1–15 age group, accidents account for a quarter of all deaths among girls and a third among boys. Twenty per cent of deaths are caused by cancer. Mortality due to accidents is low during childhood up until the teen years and gender differences are small. Sweden has one of the world’s lowest child mortality rates in the 1-15 age-group. This is primarily due to the low child accident mortality rate. Since the turn of the century, however, the rate of infant hospitalisation due to unintentional or intentional injury has increased, as has hospitalisation of 14–16-year-olds due to severe injuries from moped and motorcycle accidents. Children in the 5 th grade of compulsory school
TL;DR: There is a trend of increasing use of hypnotic drugs among 0–17 year olds, mainly owing to increase use of melatonin, used in high amounts, still, melatonin is not recommended in Norway for use in this age group because of insufficient data on safety and efficacy.
Abstract: Aims: To (a) describe the prevalence, trend, and amount of hypnotic drug use, (b) determine the prevalence of chronic diseases among hypnotic drug users, and (c) determine levels of recurrent hypnotic drug use (2007–2011), among 0–17 year old Norwegians Methods: Data were obtained from the nationwide Norwegian Prescription Database (NorPD) in the period 2004–2011 Results: Hypnotic drug use in 0–17 year olds increased during the period, from 89 to 123 per 1000, mainly owing to doubling of melatonin use Hypnotic drug use peaked at 15 per 1000 among those aged 1–2 years Melatonin use increased steadily from 6 to 12 years of age, most pronounced in males Among females, hypnotic drug use increased threefold from 13 to17 years of age Melatonin was dispensed in the highest annual amount of all hypnotic drugs; accounting up to a median of 360 defined daily doses in 9–13 year old boys A total of 62% and 52% of all male and female hypnotic drug users were co-medicated with reimbursable drugs for chronic di
TL;DR: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social differentiation.
Abstract: Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals world...
TL;DR: This study presents a French version of the Copenhagen Psychosocial Questionnaire (COPSOQ) and analyses its psychometric properties for the purpose of validation and demonstrated the validity of the French COPSOQ.
Abstract: This study presents a French version of the Copenhagen Psychosocial Questionnaire (COPSOQ) and analyses its psychometric properties for the purpose of validation. The questionnaire assesses psychosocial risk factors at work. The French questionnaire (derived from the Danish short version) is composed of 32 items grouped into 17 scales measuring five domains and eight additional questions assessing aggressive behaviour at work. Method: The questionnaire was administered to 935 employees of a large firm in the Parisian area. Results: All psychometric analyses performed (internal consistency of the scales, exploratory factor analysis, concurrent validity analysis) gave satisfactory results and demonstrated the validity of the French COPSOQ. Conclusions: A new questionnaire is now available in French. A large body of data is currently being gathered in view of comparing occupations and types of firms using this new instrument.
TL;DR: In this article, the authors compared older male and female cat owners, dog owners, and non-owners with regard to demographic and health-related characteristics, and found that cat owners showed higher body mass index values and higher systolic blood pressure.
Abstract: Aim: The main objective was to compare older male and female cat, dog, and non-owners with regard to demographic and health-related characteristics. Method: Data in the present cross-sectional population study were drawn from HUNT-3 in Norway. A total of 12,297 persons (5631 men; 6666 women) between the ages of 65 and 101 years were included, of whom 2358 were pet owners. Results: The main finding was that owning a dog demonstrated several health-related characteristics to a higher positive degree than both non-pet and cat ownership among the participants. Cat owners showed higher body mass index values and higher systolic blood pressure, and reported worse general health status. They also exercised to a lower degree than the others. Conclusions: As the result implies that older cat owners are negatively outstanding in many aspects of health compared with the dog owners, in the future, more focus must be put on the worse health of those. Further, there were more married male than female cat and dog owners...
TL;DR: A COPD diagnoses from the Swedish Inpatient Registry is of acceptable validity for epidemiological research as the degree of certainty varies but less than 10% were considered as misclassified or having an uncertain COPD diagnosis.
Abstract: Aims: The Swedish National Inpatient Registry is an important source of data for numerous epidemiological studies, amongst them studies on chronic obstructive pulmonary disease (COPD). General validation studies indicate that in general 85-95% of diagnoses reported are correct, but this is not true for all groups of diseases, why specific validation studies are of great importance. Methods: Charts from 374 individuals discharged with a COPD diagnosis between 2000-07 from two central hospitals and two university hospitals in the county of Skane were validated against the original medical files. Criteria for the degree of certainty of the COPD diagnosis were predefined and the association between predictors of diagnostic probability and the level of certainty was assessed using an ordinal logistic regression model. Results: According to the Global Initiative for Chronic Obstructive Lung Disease criteria, 21.7% of the diagnosis were classified as proven COPD, 35.5% were classified as probable, another 34.0% as possible COPD, 2.1% were classified as having an uncertain diagnosis, and 7.0% as an unlikely COPD diagnosis. Age category (adjusted ORs: 60-79 years, 2.6, 95% CI 1.2-5.4; ≥80 years, 1.6, 95% CI 0.7-3.3) and discharge from a non-surgical department (adjusted OR: 1.7, 95% CI 1.1-2.8) were significantly associated with higher level of diagnostic certainty. Conclusions: A COPD diagnoses from the Swedish Inpatient Registry is of acceptable validity for epidemiological research. The degree of certainty of the diagnosis varies but less than 10% were considered as misclassified or having an uncertain COPD diagnosis. (Less)
TL;DR: P Paid sick leaves for caregivers that are employed, and hospital-at-home programmes that provide education and surveillance to the patient and his/her family through different phases of the illness, are policy means that both can help the informal caregivers to manage daily life and reduce the pressure on the formal healthcare and long-term care services in the future.
Abstract: Aims: The article aims to answer who the informal caregivers of patients with chronic obstructive pulmonary disease (COPD) are, what kind of help they provide, and how they experience providing help to the patient. Method: Data from a questionnaire survey to next of kin of COPD patients carried through in Norway in December 2009 and January 2010 is explored. Result: About 70% of the patients have one or more informal caregivers, and a majority of the caregivers is the patient’s spouse, most often a wife. The help provided is, to a large extent, practical help like housework, garden work, and shopping. Another important support is to accompany the patient to health care. About 45% of the caregivers are part of the work force. Rather few of the respondents experience the caregiving as so demanding that they have chosen to work part-time or quit working. The most demanding part of being an informal caregiver is an overall worrying for the patient. Conclusions: Paid sick leaves for caregivers that are employe...
TL;DR: The odds for familial dysmetabolisms was higher in cases than in controls, confirming their role in determining or maintaining acne, and this is the first study demonstrating a protective role of the Mediterranean diet in the pathogenesis of acne.
Abstract: Aim: To investigate the effects of adherence to the Mediterranean diet and familial dysmetabolisms on acne development. Methods: A community-based case–control study was carried out in Italy enroll...
TL;DR: The study finds that respondents employ a number of different behavioural and cognitive strategies aimed at controlling their own and close friends’ drinking behaviour, and that short-term negative social implications are of much greater concern than long-term health consequences.
Abstract: Background: Danish youth has for years had the highest alcohol consumption in Europe, however recent surveys show that consumption levels have diminished slightly and that the age of first intoxica...