Comparing Swedish Foundations: A Carefully Negotiated Space of Existence.

Foundations and philanthropy currently play a very limited role in the Swedish welfare. The same is true in fields like Culture and Recreation or International Activities. Only in the case of funding of research do Swedish foundations exhibit a role possible to define in terms of substitution rather than weak complementarity in relation to government. Despite marginal positions for philanthropy, Sweden displays a wealthy as well as growing foundation population, which seems like a paradox, at least in comparison to the situation in Germany and the United States where foundations traditionally play a more visible and pronounced role in society. A striking difference between the Swedish foundations and their U.S. or German counterparts is their weak bonds to religious communities or causes. Instead, we can identify in our new data set a growing segment of the Swedish foundation world that is affiliated with other parts of civil society. The same is true for the category of independent foundations, which points toward the U.S. model. We find in the article some limited support for a "philanthropic turn" in Sweden, but overall the foundation world is still deeply embedded in the social contract and strong Social-Democratic regime of the 20th century. In comparison to neighboring Scandinavian or Nordic countries, both similarities and differences are identified where, for example, the Norwegian case display a much larger segment of operating foundations, closely affiliated with government, while in Denmark, on the other hand, the corporate-owning foundation seems to be a much more important form than in Sweden.

Diabetic eye screening with variable screening intervals based on individual risk factors is safe and effective in ophthalmic practice.

PURPOSE: To test in a 'real world' diabetic eye-screening programme, a computer-based personal risk evaluation for progression to sight-threatening diabetic retinopathy. Screening intervals were individualized, and clinical outcomes, safety and cost-effectiveness documented. METHODS: The RETINARISK algorithm was used in an ophthalmology clinic in Norway. The diabetes cohort was divided on voluntary basis into two groups: one with variable screening intervals based on their personal risk profile and the other group with conventional fixed interval diabetic eye screening. Compliance, clinical outcomes, safety and health economics were evaluated. A total of 843 diabetic patients participated in the program 2014-2019. A total of 63 had type 1 and 780 type 2 diabetes. A total of 671 patients had no diabetic retinopathy at baseline and 171 had retinopathy. RESULTS: A total of 444 (53%) diabetic patients were included in the personal risk profile program and 399 in the fixed interval group. The RETINARISK algorithm calculated 563 screening intervals for the variable interval group, which was 23 ± 16 months (mean ± SD), compared to 14 ± 5 months for the group with fixed screening intervals. Due to selection bias, the two groups could not be directly compared. We did not experience any delay in detecting diabetic retinal changes when using the personal risk profile program. CONCLUSION: The RETINARISK algorithm was safe and effective in a diabetic screening program in an ophthalmology clinic over 5 years. The use of the program reduces the mean frequency of screening visits and liberates valuable time in ophthalmic practice to be used on high-risk diabetic patients or other patient groups.

Relationship between daily dose of oral medications and idiosyncratic drug-induced liver injury: search for signals.

UNLABELLED: Idiosyncratic drug-induced liver injury (DILI) is traditionally thought not to be dose-related. However, it has been pointed out that most medicines that were withdrawn from marketing or received a black-box warning because of hepatotoxicity were prescribed at daily doses greater than 50 mg/day. To examine the relationship between daily dose of medications and idiosyncratic DILI, we conducted a study with two aims. First, using two pharmaceutical databases, we examined the relationship between daily dose of commonly prescribed medicines in the United States and reported frequency of their selected hepatic adverse events. Second, we examined serious DILI cases reported to the Swedish Adverse Drug Reactions Advisory Committee (1970-2004) for any signals supporting the relationship between daily dose and idiosyncratic DILI. Medications were categorized into < or =10 mg/day, 11-49 mg/day, and > or =50 mg/day groups. Among US prescription medicines, a statistically significant relationship was observed between daily dose of oral medicines and reports of liver failure (P = 0.009), liver transplantation (P < 0.001), and death caused by DILI (P = 0.004) but not alanine aminotransferase (ALT) > 3 x upper limit of normal (P = 0.10) or jaundice (P = 0.16). Of 598 eligible Swedish DILI cases, 9% belonged to the < or =10 mg/day group, 14.2% to the 11-49 mg/day group, and 77% of cases were caused by medications given at dose > or =50 mg/day. A statistically significant relationship was noted between daily dose and poor outcome (death or liver transplantation) of Swedish DILI cases (2%, 9.4%, and 13.2% in < or =10, 11-49, and > or =50 mg/day groups, respectively, P = 0.03). CONCLUSION: These data suggest a relationship between daily doses of oral prescription medications and idiosyncratic DILI. More studies are needed to validate these observations and to explore their implications.