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1.
Lakartidningen ; 1182021 07 23.
Artigo em Sueco | MEDLINE | ID: mdl-34296754

RESUMO

Infection fatality ratio (IFR) in covid-19 is highly debated in international and Swedish press. In Sweden, three different estimates have been used to estimate mortality, based on statistics either from the Swedish National Board of Health and Welfare, and the Public Health Agency of Sweden, whereas excess mortality calculated by EuroMOMO. Mortality is based on death certificates, which can be accurate or erroneous, but previous analyses have suggested that over- and underdiagnosis usually even out. EuroMOMO on the other hand reports all-cause mortality compared to an estimated baseline. In view of high correlation between the different measures, we suggest that mortality is relatively correctly reported in Sweden. We discuss IFR internationally  and in Sweden, and suggest that IFR in the Western world is approximately 0.5-1%. However, these numbers will change over time depending on immunity induced by vaccination efforts, but also the potential spread of new virus variants.


Assuntos
COVID-19 , Humanos , Mortalidade , Saúde Pública , SARS-CoV-2 , Suécia/epidemiologia
2.
Front Public Health ; 9: 642983, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277534

RESUMO

Infectious diseases exacerbated by Antimicrobial Resistance (AMR) are of increasing concern in Sweden, with multi-drug resistant strains associated with new resistance mechanisms that are emerging and spreading worldwide. Existing research has identified that sub-optimal living conditions and poor access to healthcare are significant factors in the spread and incubation of AMR strains. The article considers this linkage and the effort to control the spread of AMR in relation to migrants, highlighting deficiencies in public policy where such individuals are often increasingly exposed to those conditions that exacerbate AMR. In many of the richest countries, those conditions are not accidental, but often direct goals of policies designed with the goal of deterring migrants from staying within host countries. Without engaging with the politics around migration control, the article points to urgent need for more holistic assessment of all public policies that may, however unintentionally, undermine AMR control through worsening living conditions for vulnerable groups. The consequences of prioritizing policies meant to deliberately worsen the living conditions of migrants over avoiding those conditions that accelerate AMR spread, are today made ever apparent where new AMR strains have the potential to dwarf the societal effects of the current Covid-19 pandemic.


Assuntos
COVID-19 , Migrantes , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Humanos , Pandemias , Saúde Pública , Política Pública , Fatores de Risco , SARS-CoV-2 , Condições Sociais , Suécia/epidemiologia
3.
BMC Palliat Care ; 20(1): 102, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34210312

RESUMO

BACKGROUND: At the time of the first wave of the COVID-19 pandemic in Sweden, little was known about how effective our regular end-of-life care strategies would be for patients dying from COVID-19 in hospitals. The aim of the study was to describe and evaluate end-of-life care for patients dying from COVID-19 in hospitals in Sweden up until up until 12 November 2020. METHODS: Data were collected from the Swedish Register of Palliative Care. Hospital deaths during 2020 for patients with COVID-19 were included and compared to a reference cohort of hospital patients who died during 2019. Logistic regression was used to compare the groups and to control for impact of sex, age and a diagnosis of dementia. RESULTS: The COVID-19 group (1476 individuals) had a lower proportion of women and was older compared to the reference cohort (13,158 individuals), 81.8 versus 80.6 years (p < .001). Breathlessness was more commonly reported in the COVID-19 group compared to the reference cohort (72% vs 43%, p < .001). Furthermore, anxiety and delirium were more commonly and respiratory secretions, nausea and pain were less commonly reported during the last week in life in the COVID-19 group (p < .001 for all five symptoms). When present, complete relief of anxiety (p = .021), pain (p = .025) and respiratory secretions (p = .037) was more often achieved in the COVID-19 group. In the COVID-19 group, 57% had someone present at the time of death compared to 77% in the reference cohort (p < .001). CONCLUSIONS: The standard medical strategies for symptom relief and end-of-life care in hospitals seemed to be acceptable. Symptoms in COVID-19 deaths in hospitals were relieved as much as or even to a higher degree than in hospitals in 2019. Importantly, though, as a result of closing the hospitals to relatives and visitors, patients dying from COVID-19 more frequently died alone, and healthcare providers were not able to substitute for absent relatives.


Assuntos
COVID-19/complicações , COVID-19/epidemiologia , Cuidados Paliativos , Assistência Terminal , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/virologia , COVID-19/psicologia , Estudos de Coortes , Delírio/epidemiologia , Delírio/virologia , Dispneia/epidemiologia , Dispneia/virologia , Feminino , Mortalidade Hospitalar , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Náusea/epidemiologia , Náusea/virologia , Dor/epidemiologia , Dor/virologia , Sistema de Registros , Suécia/epidemiologia , Avaliação de Sintomas , Adulto Jovem
4.
Lakartidningen ; 1182021 07 05.
Artigo em Sueco | MEDLINE | ID: mdl-34228810

RESUMO

Osteoarthritis (OA) is a highly prevalent group of disorders and among the most common causes of chronic pain and disability globally. First-line evidence-based treatments for hip and knee OA, two of the most common variants, are available in Sweden with the potential for wide national reach through face-to-face and digital platforms. Research results suggest important reductions in symptoms in patients with knee or hip OA. Despite evidence, availability and low cost, first-line evidence-based treatments are not utilized to the full extent to reduce the burden of OA.


Assuntos
Osteoartrite do Quadril , Osteoartrite do Joelho , Terapia por Exercício , Humanos , Articulação do Joelho , Osteoartrite do Quadril/terapia , Osteoartrite do Joelho/terapia , Suécia/epidemiologia
5.
BMJ Open ; 11(7): e049302, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34233997

RESUMO

OBJECTIVES: There is concern that the COVID-19 pandemic will be associated with an increase in suicides, but evidence supporting a link between pandemics and suicide is limited. Using data from the three influenza pandemics of the 20th century, we aimed to investigate whether an association exists between influenza deaths and suicide deaths. DESIGN: Time series analysis. SETTING: Sweden. PARTICIPANTS: Deaths from influenza and suicides extracted from the Statistical Yearbook of Sweden for 1910-1978, covering three pandemics (the Spanish influenza, the Asian influenza and the Hong Kong influenza). MAIN OUTCOME MEASURES: Annual suicide rates in Sweden among the whole population, men and women. Non-linear autoregressive distributed lag models was implemented to explore if there is a short-term and/or long-term relationship of increases and decreases in influenza death rates with suicide rates during 1910-1978. RESULTS: Between 1910 and 1978, there was no evidence of either short-term or long-term significant associations between influenza death rates and changes in suicides (ß coefficients of 0.00002, p=0.931 and ß=0.00103, p=0.764 for short-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates, and ß=-0.0002, p=0.998 and ß=0.00211, p=0.962 for long-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates). The same pattern emerged in separate analyses for men and women. CONCLUSIONS: We found no evidence of short-term or long-term association between influenza death rates and suicide death rates across three 20th century pandemics.


Assuntos
COVID-19 , Influenza Humana , Suicídio , Feminino , Hong Kong , Humanos , Masculino , Pandemias , SARS-CoV-2 , Suécia/epidemiologia
6.
BMJ Open ; 11(7): e051316, 2021 07 05.
Artigo em Inglês | MEDLINE | ID: mdl-34226237

RESUMO

OBJECTIVE: To investigate the possible connection between cardiorespiratory fitness (CRF) and muscle strength in early adulthood and severity of COVID-19 later in life. DESIGN: Prospective registry-based cohort study. PARTICIPANTS: 1 559 187 Swedish men, undergoing military conscription between 1968 and 2005 at a mean age of 18.3 (SD 0.73) years. MAIN OUTCOME MEASURES: Hospitalisation, intensive care or death due to COVID-19 from March to September 2020, in relation to CRF and muscle strength. RESULTS: High CRF in late adolescence and early adulthood had a protective association with severe COVID-19 later in life with OR (95% CI) 0.76 (0.67 to 0.85) for hospitalisation (n=2 006), 0.61 (0.48 to 0.78) for intensive care (n=445) and 0.56 (0.37 to 0.85) for mortality (n=149), compared with the lowest category of CRF. The association remains unchanged when controlled for body mass index (BMI), blood pressure, chronic diseases and parental education level at baseline, and incident cardiovascular disease before 2020. Moreover, lower muscle strength in late adolescence showed a linear association with a higher risk of all three outcomes when controlled for BMI and height. CONCLUSIONS: Physical fitness at a young age is associated with severity of COVID-19 many years later. This underscores the necessity to increase the general physical fitness of the population to offer protection against future viral pandemics.


Assuntos
COVID-19 , Adolescente , Adulto , Índice de Massa Corporal , Estudos de Coortes , Humanos , Masculino , Força Muscular , Aptidão Física , Fatores de Risco , SARS-CoV-2 , Suécia/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34206396

RESUMO

The COVID-19 pandemic has had a vast influence on Swedish society. Related recommendations and political decisions have greatly affected schools. This study aimed to describe school nurses' experience working in Sweden during the pandemic in 2020. The study used a qualitative method with an inductive approach. Interviews with 17 school nurses in five focus groups and one individual interview were conducted. Qualitative content analysis was used. The impact of the pandemic on school nurses can be described through three categories: "Changes in working methods in relation to the students/guardians", "Impact on cooperation with school staff", and "The school nurse's prerequisites for major changes." Overall, school nurses experienced a transition to a digital way of working. Policies and decisions on global and local levels affected the work situations of school nurses as well as the school nurses' social, cultural, and professional experience. The highest priority for school nurses is students, and school nurses adapted their working methods to give support to students during the changing circumstances. School nurses are both pragmatic and highly creative. Cooperation with other school professions is critical, as is support and guidance during crisis situations.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Atitude do Pessoal de Saúde , Humanos , Papel do Profissional de Enfermagem , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Serviços de Saúde Escolar , Instituições Acadêmicas , Suécia/epidemiologia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34207621

RESUMO

Currently, there is limited knowledge on how the Swedish strategy with more lenient public health restrictions during the COVID-19 pandemic has influenced people's life satisfaction. Here, we investigated self-reported life satisfaction during the first wave of the pandemic in Sweden, and perceived changes in life satisfaction in relation to various sociodemographic factors. A total of 1082 people (mean age 48 (SD 12.2); 82% women) responded to an online survey during autumn 2020 including the "Life Satisfaction Questionnaire-11". A majority (69%) were satisfied with life as a whole, and with other important life domains, with the exception of contact with friends and sexual life. An equal share reported that life as a whole had either deteriorated (28%) or improved (29%). Of those that perceived a deterioration, 95% considered it to be due to the pandemic. Regarding deteriorated satisfaction with life as a whole, higher odds were found in the following groups: having no children living at home; being middle aged; having other sources of income than being employed; and having a chronic disease. The Swedish strategy might have contributed to the high proportion of satisfied people. Those who perceived a deterioration in life satisfaction may, however, need attention from Swedish Welfare Authorities.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , SARS-CoV-2 , Suécia/epidemiologia
9.
PLoS One ; 16(7): e0253371, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34197498

RESUMO

BACKGROUND: The Covid-19 pandemic has had unprecedented effects on individual lives and livelihoods as well as on social, health, economic and political systems and structures across the world. This article derives from a unique collaboration between researchers and museums using rapid response crowdsourcing to document contemporary life among the general public during the pandemic crisis in Sweden. METHODS AND FINDINGS: We use qualitative analysis to explore the narrative crowdsourced submissions of the same 88 individuals at two timepoints, during the 1st and 2nd pandemic waves, about what they most fear in relation to the Covid-19 pandemic, and how their descriptions changed over time. In this self-selected group, we found that aspects they most feared generally concerned responses to the pandemic on a societal level, rather than to the Covid-19 disease itself or other health-related issues. The most salient fears included a broad array of societal issues, including general societal collapse and fears about effects on social and political interactions among people with resulting impact on political order. Notably strong support for the Swedish pandemic response was expressed, despite both national and international criticism. CONCLUSIONS: This analysis fills a notable gap in research literature that lacks subjective and detailed investigation of experiences of the general public, despite recognition of the widespread effects of Covid-19 and its' management strategies. Findings address controversy about the role of experts in formulating and communicating strategy, as well as implications of human responses to existential threats. Based on this analysis, we call for broader focus on societal issues related to this existential threat and the responses to it.


Assuntos
COVID-19 , Crowdsourcing , Medo , COVID-19/epidemiologia , COVID-19/psicologia , Humanos , Estudos Longitudinais , Pandemias , Suécia/epidemiologia , Fatores de Tempo
10.
Scand J Trauma Resusc Emerg Med ; 29(1): 99, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289881

RESUMO

BACKGROUND: In chemical incidents, infrequent but potentially disastrous, the World Health Organization calls for inter-organizational coordination of actors involved. Multi-organizational studies of chemical response capacities are scarce. We aimed to describe chemical incident experiences and perceptions of Swedish fire and rescue services, emergency medical services, police services, and emergency dispatch services personnel. METHODS: Eight emergency service organizations in two distinct and dissimilar regions in Sweden participated in one organization-specific focus group interview each. The total number of respondents was 25 (7 females and 18 males). A qualitative inductive content analysis was performed. RESULTS: Three types of information processing were derived as emerging during acute-phase chemical incident mobilization: Unspecified (a caller communicating with an emergency medical dispatcher), specified (each emergency service obtaining organization-specific expert information), and aligned (continually updated information from the scene condensed and disseminated back to all parties at the scene). Improvable shortcomings were identified, e.g. randomness (unspecified information processing), inter-organizational reticence (specified information processing), and downprioritizing central information transmission while saving lives (aligned information processing). CONCLUSIONS: The flow of information may be improved by automation, public education, revised dispatcher education, and use of technical resources in the field. Future studies should independently assess these mechanism's degree of impact on mobilisation of emergency services in chemical incidents.


Assuntos
Vazamento de Resíduos Químicos , Operador de Emergência Médica/estatística & dados numéricos , Serviços Médicos de Emergência/organização & administração , Desastres , Feminino , Grupos Focais , Humanos , Masculino , Polícia , Suécia/epidemiologia
11.
BMC Geriatr ; 21(1): 342, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078277

RESUMO

BACKGROUND: Knowledge is scarce on how needs for home help and special housing evolve among older people who begin to receive support from municipal social care. The purpose of this study was to describe baseline distributions and transitions over time between levels of dependency among older persons after being granted social care in a Swedish municipality. METHODS: Based on a longitudinal cohort study in a Swedish municipality, data was collected retrospectively from municipal records. All persons 65 years or older who received their first decision on social care during 2010 (n = 415) were categorized as being in mild, moderate, severe, or total dependency, and were observed until the end of 2013. Baseline distributions and transitions over time were described descriptively and analysed with survival analysis, with the Kaplan-Meier estimator, over the entire follow-up period. To test potential differences in relation to gender, we used the Cox-Proportional hazards model. RESULTS: Baseline distributions between mild, moderate, severe, and total dependency were 53, 16, 24, and 7.7%. During the first year, between 40 and 63% remained at their initial level of dependency. Among those with mild and moderate levels of dependency at baseline, a large proportion declined towards increasing levels of dependency over time; around 40% had increased their dependency level 1 year from baseline and at the end of the follow-up, 75% had increased their dependency level or died. CONCLUSIONS: Older people in Sweden being allocated home help are at high risk for decline towards higher levels of dependency, especially those at mild or moderate dependency levels at baseline. Taken together, it is important that municipalities make use of existing knowledge so that they implement cost-effective preventative interventions for older people at an early stage before a decline toward increasing levels of dependency.


Assuntos
Apoio Social , Idoso , Idoso de 80 Anos ou mais , Cidades , Estudos de Coortes , Humanos , Estudos Longitudinais , Estudos Retrospectivos , Suécia/epidemiologia
12.
BMC Geriatr ; 21(1): 338, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078292

RESUMO

BACKGROUND: Being an informal carer of a person with dementia (PwD) can have a negative effect on the carer's health and quality of life, and spouse carers have been found to be especially vulnerable. Yet relatively little is known about the care provided and support received by spouse carers. This study compares spouse carers to other informal carers of PwDs regarding their care provision, the support received and the psychosocial impact of care. METHODS: The study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire explored how much care the respondent provided, the support received, and the psychosocial impact of providing care. Of 30,009 people sampled, 11,168 (37.7 %) responded, of whom 330 (2.95 %) were informal carers of a PwD. RESULTS: In comparison to non-spouse carers, spouse carers provided more care more frequently, did so with less support from family or the local authority, while more frequently experiencing negative impacts on their social life and psychological and physical health. Spouse carers also received more carer support and more frequently experienced a closeness in their relationship with the care-recipient. CONCLUSIONS: Spouse carers of PwD differed from non-spouse carers on virtually all aspects of their care situation. Policy and practice must be more sensitive to how the carer-care-recipient relationship shapes the experience of care, so that support is based on an understanding of the individual carer's actual needs and preferences rather than on preconceptions drawn from a generalised support model.


Assuntos
Cuidadores , Demência , Estudos Transversais , Demência/diagnóstico , Demência/epidemiologia , Demência/terapia , Humanos , Qualidade de Vida , Cônjuges , Suécia/epidemiologia
13.
Euro Surveill ; 26(22)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34085632

RESUMO

BackgroundIn mid-March 2020, a range of public health and social measures (PHSM) against the then new coronavirus disease (COVID-19) were implemented in Denmark, Norway and Sweden.AimWe analysed the development of influenza cases during the implementation of PHSM against SARS-CoV-2 in the Scandinavian countries.MethodBased on the established national laboratory surveillance of influenza, we compared the number of human influenza cases in the weeks immediately before and after the implementation of SARS-CoV-2 PHSM by country. The 2019/20 influenza season was compared with the five previous seasons.ResultsA dramatic reduction in influenza cases was seen in all three countries, with only a 3- to 6-week duration from the peak of weekly influenza cases until the percentage dropped below 1%. In contrast, in the previous nine influenza seasons, the decline from the seasonal peak to below 1% of influenza-positive samples took more than 10 weeks.ConclusionsThe PHSM against SARS-CoV-2 were followed by a dramatic reduction in influenza cases, indicating a wider public health effect of the implemented measures.


Assuntos
COVID-19 , Influenza Humana , Dinamarca/epidemiologia , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Noruega/epidemiologia , SARS-CoV-2 , Países Escandinavos e Nórdicos , Estações do Ano , Suécia/epidemiologia
14.
BMC Public Health ; 21(1): 1023, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059034

RESUMO

BACKGROUND: The impact of Covid-19 and its long-term consequences is not yet fully understood. Sick leave can be seen as an indicator of health in a working age population, and the present study aimed to investigate sick-leave patterns after Covid-19, and potential factors predicting longer sick leave in hospitalised and non-hospitalised people with Covid-19. METHODS: The present study is a comprehensive national registry-based study in Sweden with a 4-month follow-up. All people who started to receive sickness benefits for Covid-19 during March 1 to August 31, 2020, were included. Predictors of sick leave ≥1 month and long Covid (≥12 weeks) were analysed with logistic regression in the total population and in separate models depending on inpatient care due to Covid-19. RESULTS: A total of 11,955 people started sick leave for Covid-19 within the inclusion period. The median sick leave was 35 days, 13.3% were on sick leave for long Covid, and 9.0% remained on sick leave for the whole follow-up period. There were 2960 people who received inpatient care due to Covid-19, which was the strongest predictor of longer sick leave. Sick leave the year prior to Covid-19 and older age also predicted longer sick leave. No clear pattern of socioeconomic factors was noted. CONCLUSIONS: A substantial number of people are on sick leave due to Covid-19. Sick leave may be protracted, and sick leave for long Covid is quite common. The severity of Covid-19 (needing inpatient care), prior sick leave, and age all seem to predict the likelihood of longer sick leave. However, no socioeconomic factor could clearly predict longer sick leave, indicating the complexity of this condition. The group needing long sick leave after Covid-19 seems to be heterogeneous, indicating a knowledge gap.


Assuntos
COVID-19 , Licença Médica , Idoso , Estudos de Coortes , Humanos , SARS-CoV-2 , Suécia/epidemiologia
15.
J Oral Facial Pain Headache ; 35(2): 139-149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129659

RESUMO

AIMS: To compare the prevalence of facial pain and headache across various regions in Sweden. METHODS: This study involved a comparison of cross-sectional questionnaire studies over a period of 10 years including 128,193 individuals and assessed facial pain, pain on function, and headache. Participants included (1) all Public Dental Service patients aged 16 to 90 years in Västerbotten (n = 57,283) and Gävleborg (n = 60,900); and (2) random samples of residents in Kalmar (n = 3,560) and Skåne (n = 6,450). Facial pain and pain on function were assessed for all participants, and headache was also assessed for participants in Kalmar and Skåne. Descriptive statistics were used to estimate unadjusted prevalence estimates and demographic characteristics. Prevalence estimates were adjusted for age and sex using weighted distributions from the 2015 data in the Swedish population registry before comparisons across the regions. RESULTS: Overall, the prevalence of facial pain and headache were significantly higher in female than in male participants (P < .01). The standardized prevalence of facial pain was 4.9% in Västerbotten, 1.4% in Gävleborg, 4.6% in Kalmar, and 7.6% in Skåne. For headache, the standardized prevalence was 18.9% in Kalmar and 21.3% in Skåne. In Skåne, individuals with facial pain had a 15-fold higher odds of headache than those without. CONCLUSION: In the present Swedish epidemiologic study, the prevalence of facial pain ranged from 1.4% in Gävleborg to 7.6% in Skåne. Besides different sampling frames and other population characteristics, the presence of a high number of immigrants in Skåne may account for some differences in pain prevalence across the Swedish regions.


Assuntos
Dor Facial , Cefaleia , Estudos Transversais , Dor Facial/epidemiologia , Feminino , Cefaleia/epidemiologia , Humanos , Masculino , Prevalência , Suécia/epidemiologia
16.
BMJ Open ; 11(5): e046583, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059512

RESUMO

OBJECTIVE: To examine the association between breastfeeding practice and hospitalisations for infectious diseases in early and later childhood, in particular, to compare exclusive breast feeding 4-5 months with exclusive breastfeeding 6 months or more. Thereby, provide evidence to inform breastfeeding policy. DESIGN: A register-based cohort study. SETTING: A cohort was created by combining the Swedish Medical Birth Register, the National Inpatient Register, the Cause of Death Register, the Total Population Register, the Longitudinal integration database for health insurance and labour market studies, with the Uppsala Preventive Child Health Care database. PATIENTS: 37 825 term and post-term singletons born to women who resided in Uppsala County (Sweden) between 1998 and 2010. MAIN OUTCOME MEASURES: Number of hospitalisations for infectious diseases in early (<2 years) and later childhood (2-4 years). RESULTS: The risk of hospitalisations for infectious diseases decreased with duration of exclusive breastfeeding until 4 months of age. In early childhood, breast feeding was associated with a decreased risk of enteric and respiratory infections. In comparison with exclusive breast feeding 6 months or more, the strongest association was found between no breastfeeding and enteric infections (adjusted incidence rate ratios, aIRR 3.32 (95% CI 2.14 to 5.14)). In later childhood, breast feeding was associated with a lower risk of respiratory infections. In comparison with children exclusively breastfed 6 months or more, the highest risk was found in children who were not breastfed (aIRR 2.53 (95% CI 1.51 to 4.24)). The risk of hospitalisations for infectious diseases was comparable in children exclusively breastfed 4-5 months and children exclusively breastfed 6 months or more. CONCLUSIONS: Our results support breastfeeding guidelines that recommend exclusive breastfeeding for at least 4 months.


Assuntos
Aleitamento Materno , Doenças Transmissíveis , Criança , Pré-Escolar , Estudos de Coortes , Doenças Transmissíveis/epidemiologia , Feminino , Hospitalização , Humanos , Lactente , Políticas , Gravidez , Suécia/epidemiologia
17.
BMC Public Health ; 21(1): 1040, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078322

RESUMO

BACKGROUND: The risk of heart failure is disproportionately high among the socioeconomically disadvantaged. Furthermore, socioeconomically deprived patients are at risk of inequitable access to heart failure treatment and poor outcomes. Non-employment as a risk factor in this respect has not previously been studied at the level of the individual. The aim of this register-based cohort study was to analyse equity in access to renin-angiotensin system blockers and mortality, by employment status and educational level. METHODS: The study population consisted of Swedish patients aged 20-64 years hospitalised for heart failure in July 2006-December 2010, without a heart failure hospitalisation within one year or more before index hospitalisation and without renin-angiotensin system blocker dispensation in the 6 months preceding index hospitalisation. Non-access to renin-angiotensin system blockers, measured as drug dispensations, was investigated by employment status and educational level through logistic regression. Cox regression models were used to obtain hazard ratios for all-cause death by educational level and employment status. Interaction analysis was used to test whether associations between access to treatment and mortality differed by employment status. RESULTS: Among the 3874 patients, 1239 (32%) were women. The median age was 57 years. Fifty-three percent were employed. The non-employed patients had more comorbidity and lower access (68%) to renin-angiotensin system blockers compared with the employed (82%). The adjusted odds ratio for non-access to renin-angiotensin system blockers among the non-employed was 1.76. Non-employment was associated with an adjusted hazard ratio of 1.76 for death. Low educational level was associated with a higher death risk. Mortality was highest among the non-employed without access to renin-angiotensin system blockers and the association between access to renin-angiotensin system blockers and survival was slightly weaker in this group. CONCLUSIONS: Non-employment and low educational level were associated with elevated mortality in heart failure. Non-employment was a risk factor for lower access to evidence-based treatment, and among the non-employed access to treatment was associated with a slightly smaller risk reduction than among the employed. The results underscore that clinicians need to be aware of the importance of socioeconomic factors in heart failure care.


Assuntos
Inibidores da Enzima Conversora de Angiotensina , Insuficiência Cardíaca , Estudos de Coortes , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Suécia/epidemiologia
18.
BMJ Open ; 11(6): e045143, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34078636

RESUMO

INTRODUCTION: There is a lack of studies that focus exclusively on return to work (RTW) and sick leave patterns following a work injury among young adults. This study aims to close the gap by contributing with knowledge regarding young adults' sick leave pattern after a work injury and their experience of RTW after a work injury in Sweden. METHODS AND ANALYSIS: The present study is a multimodal study, which will use Swedish national register data and qualitative data collection by photovoice. Injuries classified as work injuries according to the Swedish injury classification were included. Registry data will be retrieved from the Swedish National-based registers of Swedish Information System on Occupational Accidents and Work-related diseases, the Swedish Social Insurance Agency's database MicroData for Analysis of Social Insurance and the Swedish Longitudinal Integration Database for Health Insurance and Labour Market Studies. Persons who have registered a work injury at the Swedish Work Environment Authority in 2012 will be included. Sick leave patterns will be analysed using group-based trajectory models and multivariate analyses to explore how sick leave patterns have developed over 5 years. Subsequently, a participatory approach using photovoice method will be conducted to explore young adults' perceptions of barriers and facilitators in RTW after a work injury. Results from the photovoice group sessions will be analysed using a grounded theoretical approach. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Ethical Review Board (case number 2019/028-6) in Sweden. Results of the study will be disseminated through peer-reviewed journals, print and media presentation, conferences and via reports to the funding agency.


Assuntos
Retorno ao Trabalho , Licença Médica , Humanos , Previdência Social , Suécia/epidemiologia , Local de Trabalho , Adulto Jovem
19.
BMC Oral Health ; 21(1): 304, 2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-34126983

RESUMO

BACKGROUND: With the aim to study dental pathological lesions in an early Swedish modern population, with special reference to sex variances of dental caries, the prevalence and distribution of dental caries and tooth wear were determined in complete and partial human dentitions from an early modern-time city graveyard (1500-1620) excavated in Gamlestaden, Gothenburg, Sweden. METHODS: Partial and complete dentitions were examined through visual inspection and using a dental probe. Pathologies were studied, evaluated and presented by teeth and alveoli. RESULTS: The study population consisted of 308 individuals. A total of 4,951 teeth in adults and 1,660 teeth in children were examined. Caries prevalence in the studied population was 55% and the highest prevalence of caries was found among the adults, where 68% of the individuals had at least one carious lesion. Caries experience (DMT > 0) in the entire population was 60%, and among adults caries experience was 76%. Women had significantly higher caries experience than men (p < 0.05). Caries was most prevalent in the molar teeth and least prevalent in the incisors and canines. Significant age-related increases in tooth wear were found, and a positive correlation between wear in molars and incisors (p < 0.001). Other clinical findings were signs of apical lesions, crowding of teeth, aplasia, non-erupted canines and calculus. CONCLUSIONS: Findings show that dental pathological lesions affected a majority of the studied population, and indicate that women were more predisposed to dental disease than their male counterparts. Results are discussed from a multi-factorial explanation model including dietary, physiological and cultural etiological factors.


Assuntos
Cárie Dentária , Desgaste dos Dentes , Adulto , Criança , Cárie Dentária/epidemiologia , Suscetibilidade à Cárie Dentária , Feminino , Humanos , Masculino , Prevalência , Caracteres Sexuais , Suécia/epidemiologia
20.
BMC Musculoskelet Disord ; 22(1): 564, 2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34147080

RESUMO

BACKGROUND: 40-50 % of all boys and 30-40 % of girls suffer from at least one fracture during childhood. A quarter of these fractures affects the wrist, making it the worst affected part of the body. Children often sustain the injury during play or sport activities. There has been a lifestyle change among European children during the last decades, and there is reason to believe that fracture incidence is changing. METHODS: For the purpose of this observational cohort study registry data was retrieved from the Swedish National Patient Register for all pediatric patients registered with a distal radius fracture during the period 2005-2013. Incidence rates were calculated for each year using data from Statistic Sweden on population size by age and gender. RESULTS: 90 970 distal radius fractures were identified. The mean age at the time of fracture was 10 years. In ages 10-17 the proportion of male patients was significantly larger. Seasonal variations were detected with peak incidences in May and September. A decreasing total fracture incidence was observed during the study period. CONCLUSIONS: The incidence of distal radius fractures in a population 0-17 years in Sweden was higher among male than in female patients. The incidence was lower in 2008-2013 as compared to 2005. Further studies are necessary to reveal if the incidence will continue to decrease.


Assuntos
Fraturas do Rádio , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/epidemiologia , Suécia/epidemiologia , Punho
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