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At least 613 records · Page 34Linked to original sources
PubMed2006

Competence development of registered nurses in municipal elderly care in Sweden: a questionnaire survey.

BACKGROUND: Skilled and specialist registered nurses (RNs) are central to evolving elderly care. The past decades' organisational and structural changes have altered RNs' roles and work situations in municipal elderly care in Sweden. This calls for appropriate educational preparation. However, a substantial proportion of RNs in municipal elderly care lack adequate specialist competence. AIM: The focus of this study was to describe RNs' perceptions of needs and possibilities for competence development in municipal elderly care and compare the perceptions of RNs' who work solely in dementia care (DC) with those who work in general elder care (GC) where older persons have diverse diagnoses. DESIGN: A non-experimental, descriptive and comparative design was used. SETTINGS: Sixty special housing with subunits in a large city in the middle of Sweden. PARTICIPANTS: Participating RNs were a total of 213, with a response rate of 62.3%. Of the 213 RNs, 95 (44.6%) worked in DC and 118 (55.4%) in GC. METHOD: A structured questionnaire that was specifically designed for this study and focused on needs and possibilities for competence development in nursing. RESULTS: The RNs were on average not lacking or were hardly lacking knowledge in examined domains. However, RNs in GC lacked knowledge of dementia, falls, and fall injures to a greater extent than RNs in DC. RNs in DC perceived greater possibilities for competence development at work. Most RNs requested a better organisation for competence development, especially in GC. The majority of RNs had no supervision. The use of RNs' competence was high, although they used their highest competence about half of the working hours. The employers' financial contribution to RNs' continuing education was poor. CONCLUSION: A better organisation and greater possibilities for RNs' competence development is needed. The employers need to make a greater contribution financially to RNs' continuing education. It is essential to provide RNs with supervision.

Adult↗
PubMed2005

Occurrence and fate of pharmaceutically active compounds in the environment, a case study: Höje River in Sweden.

Pharmaceutically active compounds (PhACs) in the environment lately have been acknowledged to constitute a health risk for humans and terrestrial and aquatic ecosystems. Human and veterinary applications are the main sources of PhACs in the environment and the major pathways are excretion and discharge to the environment through sewage treatment plants (STPs). In this study, the occurrence and fate of selected human PhACs belonging to different therapeutic classes (non-steroidal anti-inflammatory drugs, lipid regulators, anti-epileptics, antibiotics and beta-blockers) were investigated in a small river in the very south of Sweden. The objectives of the study were to evaluate the impact of a high and rather constant load in sewage influent on downstream concentrations and whether substances that are metabolized to a high degree in humans also show a low persistency in a natural aquatic environment. Water samples were collected from the influent and effluent of the STP, in a series of dammed reservoirs leading to discharge into the Höje River in Sweden, and at several locations in the river downstream of the outfall. After enrichment by solid-phase extraction, the compounds were analyzed using GC-MS (methylated derivatives) or LC-MS/MS. In addition to the targeted pharmaceuticals, GC-MS analysis of the samples revealed the presence of other sewage-related pollutants (triclosan, caffeine, flame-retardants, antioxidants) and these results where included for comparison. Removal efficiencies were calculated in the STP and found to display a wide range with numerous species surviving treatment at greater than half their influent concentrations, including diclofenac, the anti-epileptic carbamazepine, a beta-blocker (propanolol), and antibiotics trimetoprim and sulfamethoxazole. Low removals were also observed for Tris(2-chloroisopropyl)phosphate (flame retardant), BHT-aldehyde (oxidation product of BHT) and synthetic musk (HHCB). The concentrations of chloride (Cl(-)) and boron (B) were used as natural inert tracers to estimate the relative extent of dilution of PhACs measured in the effluent of the STP on concentrations measured further downstream. Based on spatial trends of concentrations (recalculated to reflect a hypothetical scenario with no dilution), ibuprofen, ketoprofen, naproxen and dicofenac were shown to be subject to significant abiotic or biotic transformations or physical sequestration in the river. The beta-blockers atenolol, metoprolol and propanolol, the antibiotics trimetoprim and sulfametoxazole, and carbamazepine demonstrated a high degree of persistence. Fluctuations in the concentration of carbamazepine and gemfibrozil were observed along the series of reservoirs and within the river and are hypothesized to be due to release of parent compound from glucuronides. Several of the investigated substances (metaprolol, propanolol and carbamazepin) that exhibit low excretion rates as parent compounds demonstrate a surprising persistence in the aquatic environment. It is concluded that pharmaceutical substances with a high metabolic rate in humans (low excretion rate) do not necessarily induce a short lifetime in aquatic environments. Results from this study emphasize the need for a broader view on the concept of persistence that accounts for loading rates, in addition to removal mechanisms (e.g., transformation, volatility and physical sequestration by solids), under a variety of spatial and temporal scales.

Adrenergic beta-Antagonists↗
PubMed2005

Experiences from BVDV control in Sweden.

A control scheme on BVDV was launched in Sweden in 1993 with the aim to prevent spread of the infection between herds, to eliminate virus from infected herds and, ultimately, to eradicate BVDV from Sweden. At the start it was voluntary and fully financed by the affiliated farmers. The estimated prevalence of infected herds was 40%. After 11 years there were only 205 (0.9%) herds still under clearance. Measures perceived to be of importance in concluding the scheme are subsidies on costs for analyses, gradually making regulations for contacts between herds and prevention of indirect infection stricter and also to eventually make the scheme compulsory.

Animals↗
PubMed2005

Characteristics and outcome among children suffering from out of hospital cardiac arrest in Sweden.

AIM: To evaluate the characteristics, outcome and prognostic factors among children suffering from out of hospital cardiac arrest in Sweden. METHODS: Patients aged below 18 years suffering from out of hospital cardiac arrest which were not crew witnessed and included in the Swedish cardiac arrest registry were included in the survey. This survey included the period 1990-2001 and 60 ambulance organisations covering 85% of the Swedish population (8 million inhabitants). RESULTS: In all 457 children participated in the survey of which 32% were bystander witnessed and 68% received bystander CPR. Ventricular fibrillation was found in 6% of the cases. The overall survival to 1 month was 4%. The aetiology was sudden infant death syndrome in 34% and cardiac in 11%. When in a multivariate analysis considering age, sex, witnessed status, bystander CPR, initial rhythm, aetiology and the interval between call for, and arrival of, the ambulance and place of arrest only one appeared as an independent predictor of an increased chance of surviving cardiac arrest occurring outside home (adjusted odds ratio 8.7; 95% CL 2.2-58.1). CONCLUSION: Among children suffering from out of hospital cardiac arrest in Sweden that were not crew witnessed, the overall survival is low (4%). The chance of survival appears to be markedly increased if the arrest occurs outside the patients home compared with at home. No other strong predictors for an increased chance of survival could be demonstrated.

Child↗
PubMed2004

Home mechanical ventilation in Sweden--inequalities within a homogenous health care system.

We examined local differences in prescription pattern of home mechanical ventilation (HMV) within the homogenous health care system in Sweden. We used 6 years prospective data from the national HMV Register covering the entire Swedish HMV patient population (more than 1000 patients). The treatment prevalence of HMV in Sweden, January 1, 1996 was 6.2/100,000 and January 1, 2002 10.5/100,000 with a steady increase each year in all counties. The differences between leading and non-leading counties showed a tendency to diminish due to an increasing prescription rate in the non-leading counties. During the 6 years, the proportion of Pickwickian patients increased significantly in the country as a whole, but remained considerably and significantly higher in the leading counties, in spite of similar and temporally stable prescription criteria. Even if the evident dissimilarities in treatment prevalence may be levelling out, it will most probably do so at a level as high as or higher than today's top level of more than 20/100,000 since we found that HMV therapy was well founded also in the counties with the highest prescription rates and that the prescription rate of the non-leading counties was approaching the level of the leading counties.

Adolescent↗
PubMed2005

Critical evaluation of measures to mitigate phosphorus losses from agricultural land to surface waters in Sweden.

The aim of this paper is to collate information on potential measures to reduce phosphorus (P) losses, with particular reference to Sweden. In Sweden, three dominant types of soils or soil profiles are at risk of suffering from high P losses through different pathways: clay soils with a naturally poor structure, usually situated on the large central plains, are prone to lose P through drain tiles; silty soils, usually situated on hilly terrain, are prone to erosion; and sandy soils with a low P sorption capacity in both topsoil and subsoil and that have had heavy applications of fertilisers, are prone to high leaching losses. Fields with such soils and landscape position with connectivity to surface waters may lose more than 0.5 kg P ha year-1 and often more than 1 kg P ha year-1. Losses of soluble reactive P (SRP) are commonly 30-50% of the total P losses. Improved soil tillage together with other measures aimed at improving soil structure are suggested to have the best potential to reduce losses, with short-term and long-term effects, for the clayey and silty soil profiles. For the silty soils, keeping the surface densely vegetated in winter and liming backfill of the drainage systems are suggested to be important ways to reduce the losses of particulate P (PartP). For sandy soils prone to P leaching, appropriate application of fertiliser and improved contact between fertiliser and the soil may be one of the few effective ways to reduce SRP losses.

Agriculture↗
PubMed2006

The close relation between birth, abortion and employment rates in Sweden from 1980 to 2004.

Birth and abortion rates in Sweden have fluctuated since 1980 while the proportion between the rates are the same at the beginning and end of the period. An increase in birth rates in the late 1980s resulted in a peak in 1991 and 1992, with 124,000 live births each year. Thereafter followed a steady decline in the rate until 2000, when the number of live births was about 90,000. At that point, the trend changed to an increase. The aim of this analysis was to investigate any relation between employment rates and the number of live births among women aged 20-34, and at the same time to explore the trend for abortion rates compared to the trend for live births. The relation between employment status and live birth rate is statistically more significant for women than men, and the rates have a higher correlation for the period after 1986. Young adults in this age group are vulnerable to economic cycles that can explain this covariation but the decline in birth rates in economically developed societies has multidimensional aspects and many other possible explanations. Much has been done in recent years in Sweden to decrease household inequality for families with children to avoid the risk of relative poverty, but the fact that there is no explicit health policy to reduce the abortion level that remain unchanged since the early 1980s may appear as a notable lack of strategy in a country with many other health-related goals.

Abortion, Induced↗
PubMed2006

High prevalence of influenza A virus in ducks caught during spring migration through Sweden.

As part of our ongoing screening of wild birds in Northern Europe, 358 mallards (Anas platyrhynchos) and 203 shelducks (Tadorna tadorna) were caught in southern Sweden during the spring 2003. Faecal samples were analyzed by real time RT-PCR for the presence of influenza A virus. In contrast to what has been found in North American studies; Eurasian spring migrating ducks passing through Sweden had a relatively high prevalence of influenza A virus.

Animals↗
PubMed2006

Targeted selective treatment of lungworm infection in an organic dairy herd in Sweden.

The effect of targeted selective anthelmintic treatment on the seroprevalence of the lungworm Dictyocaulus viviparus in cattle was investigated. The study was commenced on an organic dairy enterprise in Sweden in November 1998 after the observation of an outbreak dictyocaulosis in the herd, and then continued for almost 3 years. The first year sampling was conducted on a monthly basis and then biannually with the exception of between August and November 2000 when sampling was performed monthly following a second outbreak of dictyocaulosis. Throughout the study, blood samples were examined for specific IgG(1) levels from all animals in the herd that had been grazing for more than 3 months. At the first sampling occasion, 13% out of the 90 blood samples were seropositive. One month later, after targeted selective treatment with eprinomectin (Eprinex), Merial), the whole herd was seronegative. Seroprevalence then gradually increased and 1 year later it returned to levels similar to those observed at the start of the study. At turnout in April 2000, seroprevalence was 1.3% but it then rapidly increased to 28% and 30% in August and September, respectively. This increase was mainly due to an increase in FSG animals of which many were coughing. Consequently, all seropositive animals were injected with ivermectin (Ivomec), Merial) at 0.05 mg/kg body weight in late August 2000. Although all animals recovered, seroprevalence was only reduced to 12% 1 month later. The differences in seroprevalence after both of these anthelmintic treatments were probably attributed to the timing. The first deworming with eprinomectin was conducted in November when the infection already was transient, whereas ivermectin in connection with the second outbreak was injected in a more acute phase of the infection cycle. Infection levels in 2001 were low with seroprevalences of 2.3% and 5.6% in May and September, respectively. These results show that dictyocaulosis in Sweden can be effectively controlled by the use of macrocyclic lactones. However, the infection was not eradicated from the herd despite close monitoring of the seroprevalence and targeted selective treatment of every seropositive animal on two occasions.

Animals↗
PubMed2004

Tiered environmental risk assessment of methyltins from heat stabilizers in rigid PVC in Sweden.

The methyltins, methyltin 2-ethylhexyl mercaptoacetate and methyltin-2-mercaptoethyloleate sulfide, are used as heat stabilizers in rigid PVC. The degradation products monomethyltintrichloride (MMTTC) and dimethyltindichloride (DMTDC) may leach from the PVC, and enter the environment. A risk assessment was executed for the use of these products in Sweden, with the double aim to (a) assess the potential environmental risks, and (b) explore the possibilities of a tiered risk assessment. An initial assessment was executed with EUSES 1.0. The initial assessment showed no significant environmental risks on a regional scale. On a local scale however, emissions from a sewage treatment plant to the surface water pose a potential risk for the near proximity. In a second tier, this critical exposure route was studied in more detail; an improved exposure scenario was drawn up; and an additional sorption experiment was performed. This refinement resulted in much lower predicted environmental concentrations (<<PNEC). Measured methyltin concentrations in countries where methyltin heat stabilizers are registered, reveal concentrations ranging from < detection limit to intermediate values between concentrations predicted in the initial and refined assessment. The tiered assessment scheme proved valuable. Using this, the environmental risks due to the leaching of MMTTC and DMTDC from rigid PVC in Sweden are of no concern.

Animals↗
PubMed2003

Decreasing number of young licence holders and reduced number of accidents. A description of trends in Sweden.

The following study compares rates of licence holders and rates of car accidents in two age cohorts born in Sweden in 1972 and 1977, respectively. The research material consists of all accidents with injury which these young people have been involved in as car drivers at age 16-21. The periods concerned are 1988-1993 and 1993-1998, respectively. In the respective periods altogether 2082 and 1453 car accidents leading to injury were recorded. The results show a lower rate of licence holders and a lower rate of car accidents in the later age cohort. Particularly the rate of fatal accidents and accidents leading to serious injury was lower. Comparing the earlier with the later age cohort, the reduction of accidents was greatest in the most densely built-up counties of Sweden and in the groups with the highest risk, namely those age and socio-economic groups who had the highest rate of fatalities and accidents leading to serious injury. Factors behind the decrease in the rates of licence holders and the rates of car accidents are discussed. Recession in the economy and less interest in car driving among young people are factors which are suggested as explanations.

Accidents, Traffic↗
PubMed1997

Can a combination of local, regional and national information substantially increase bicycle-helmet wearing and reduce injuries? Experiences from Sweden.

Is it possible to substantially reduce the incidence of injuries related to cycling through the provision of information on helmet wearing? This issue has been investigated in Skaraborg County, Sweden, where 90 percent of all pre-school children now use bicycle helmets. For children under 15, there was an average annual decrease in all bicycle-related injuries of 3.1 percent, equivalent to a decrease of 48 percent over the study period, 1978-93 (for head injuries, 59%). Sweden as a whole showed a reduction of 32 percent in bicycle-related injuries (head injuries, 43%). In Skaraborg, children have been the target of helmet-wearing programs at local and regional levels since 1982, and at national level since 1987. The elderly have not been targeted in helmet-wearing programs; currently, they scarcely wear helmets at all, and showed a significant increase in their injury rate over the period (4.7% annually). The number of concussions sustained by helmet-wearers is estimated to be one-third fewer than that of non-wearers. Comparisons with Australia and some parts of the U.S.A. indicate that, despite the significant decrease in Skaraborg, greater effects might be achievable if information is supplemented by compulsory-helmet-wearing legislation.

Adolescent↗
PubMed1997

The importance of the time factor in fire and rescue service operations in Sweden.

The aim of the paper is to measure the benefits and costs for the society if the fire and rescue service is delayed by 5 and 10 min respectively. A 5 min longer turn-out time is often the difference between a full-time and a voluntary crew. A 10 min difference may represent what happens if a voluntary crew on the outskirts of the municipality is closed down and their services are taken over by the centrally located full-time staff. In Sweden a full-time staff costs USD 180,000 more per year and man on duty. When it comes to the costs of a longer turn-out time three items dominates: fires in buildings; road transport accidents; and drowning cases. These three account for 38% of the alarms but 97% of the damage increase if the rescue operation is delayed, whether it is for 5 or 10 min. For all these three items we have carried out calculations based on our own empirical material. To be allowed to fight fires using breathing apparatus Swedish legislation requires a minimum crew of five. For a municipality in Sweden with the average number and distribution of alarms a full time crew of five is not economically justifiable until it reaches a population of 30,000.

Accidents↗
PubMed2000

Sixteen years age limit for learner drivers in Sweden--an evaluation of safety effects.

Through a reform implemented in Sweden, September 1993, the age limit for practising car driving was lowered from 17 1/2 to 16 years while the licensing age remained 18. The purpose of lowering the age limit was to give the learner drivers an opportunity to acquire more experience as drivers before being allowed to drive on their own. The primary aim of this study was to evaluate the effect of the reform in terms of accident involvement and data were therefore obtained from the national register of police reported accidents. The results show that after the reform there was a general reduction in the accident risk (accidents per 10 million km) of novice drivers with approximately 15%. Additional analyses show that the reduction of accident risk in the group who utilised the new age limit was approximately 40%, whereas those who did not utilise the prolonged training period did not benefit at all. Between 45 and 50% of the age population were found to utilise the reform. The accident reduction does not seem to be just an initial first year effect since the results were similar over 3 years of novice drivers during their first 2 years with a licence. These results suggest that the reform has been beneficial for the safety of novice drivers in Sweden. The results also suggest a potential for additional safety improvements if more young learner drivers can be brought to utilise the low age limit.

Accidents, Traffic↗
PubMed2003

Comparison of treatment and outcomes for patients with acute myocardial infarction in Minneapolis/St. Paul, Minnesota, and Göteborg, Sweden.

BACKGROUND: Treatment of acute myocardial infarction (AMI) is changing, and differences in medical practice are observed within and between countries on the basis of local practice patterns and available technology. These differing approaches provide an opportunity to evaluate medical practice and outcomes at the population level. The primary aim of this study was to compare medical care in patients hospitalized with AMI in 2 large cities in Sweden and the United States. A secondary aim was to compare medical outcomes. METHODS: All resident patients (age range, 30-74 years) hospitalized with AMI in Göteborg, Sweden (1995-1996), and a representative population-based sample of all patients with AMI in Minneapolis/St. Paul, Minn (1995). RESULTS: Patients with AMI in Göteborg (GB) were older than patients in Minneapolis/St. Paul (MSP), but fewer patients in GB had a prior history of cardiovascular disease. During the AMI admission, coronary angiography, percutaneous coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) were performed twice as frequently in MSP than in GB. Echocardiogram and exercise testing were more frequently performed in GB. During hospitalization, beta-blockers were more frequently prescribed in GB, whereas calcium channel blockers, long- and short-acting nitrates, intravenous nitroglycerine, digitalis, aspirin, oral anticoagulants, heparin, and lidocaine were significantly more common in MSP. Thrombolysis, acute PTCA, ACE inhibitors, and diuretics were similar. Reinfarction was higher in men in GB (4% vs 1%, P <.009) and women in GB (3% vs 1%, P = not significant). On discharge, beta-blockers and diuretics were prescribed significantly more often in GB, whereas calcium channel blockers, nitrates, and digitalis were prescribed more often in MSP. Aspirin and ACE inhibitors had similar usage rates. Despite these diagnostic and treatment contrasts, there were no differences in mortality rate at 30 days or after 3 years of follow-up after risk-adjusting for patient baseline differences. CONCLUSION: Comparing patients hospitalized with AMI in MSP and GB, we found marked differences in medical care, with invasive strategies more likely to be used in MSP. This may be the result of historical practice patterns, the healthcare system, and healthcare financing differences. Despite these differences, short- or long-term mortality rates were identical.

Adult↗
PubMed1997

Comparison of medical care and one- and 12-month mortality of hospitalized patients with acute myocardial infarction in Minneapolis-St. Paul, Minnesota, United States of America and Göteborg, Sweden.

We compared medical care and mortality through 1-year of hospitalized acute myocardial infarction (AMI) patients in 2 large metropolitan areas in the United States and Sweden. All hospitalized AMI discharges (International Classification of Diseases, 9th revision [ICD9] codes 410) occurring among 30 to 74-year-old residents of the Minneapolis-St. Paul metropolitan area in 1990 and Göteborg, Sweden, in 1990 to 1991 were identified and their medical records examined. There were dramatic differences in medical care during the index hospitalization of AMI patients between Minneapolis-St. Paul and Göteborg. Use of thrombolytic therapy, coronary angioplasty, bypass surgery, calcium antagonists and lidocaine was more common in Minneapolis-St. Paul; beta blockers were more frequently used in Göteborg, and aspirin use was similar. Despite these large differences, neither 28-day nor 1-year mortality of hospitalized AMI patients differed significantly. The marked differences found in the early treatment of AMI between Minneapolis-St. Paul and Göteborg, combined with the negligible differences observed in short- and long-term mortality, raise questions about the most effective and efficient allocation of medical resources.

Adult↗
PubMed1999

ITS2 sequences of Dictyocaulus species from cattle, roe deer and moose in Sweden: molecular evidence for a new species.

Total DNA was isolated from adult lungworms of the genus Dictyocaulus, collected from cattle, moose (Alces alces) and roe deer (Capreolus capreolus) in Sweden. The second ribosomal internal transcribed spacer was amplified with PCR, and DNA sequences were determined from nine individual worms that all came from different hosts in order to avoid analysis of siblings. The sequence data obtained were aligned and compared with similar data derived from German lungworm isolates from cattle and fallow deer (Cervus dama). These analyses clearly showed that specimens of the cattle lungworm, Dictyocaulus viviparus, were almost identical irrespective of their geographical origin. However, when the second internal transcribed spacer sequence of D. viviparus was compared with that of lungworms from moose and roe deer, major differences were noticed. Although lungworms collected from these cervids had identical second internal transcribed spacer sequences, they proved to be genetically different from Dictyocaulus eckerti of German fallow deer, displaying a 66.5% similarity. In an evolutionary tree, inferred by maximum likelihood analysis, the Dictyocaulus species from cattle and wild cervids clustered as compared with Dictyocaulus filaria from sheep. The study has thus demonstrated that A. alces and C. capreolus in Sweden are parasitised with a Dictyocaulus species that is different from D. viviparus and D. eckerti, indicating that we are dealing with a new species in moose and roe deer.

Animals↗
PubMed2003

Identification of the genotypes causing hypertrophic cardiomyopathy in northern Sweden.

Hypertrophic cardiomyopathy (HCM) is a heterogenous disease, with variable genotypic and phenotypic expressions, often caused by mutations in sarcomeric protein genes. The aim of this study was to identify the genotypes and associated phenotypes related to HCM in northern Sweden. In 46 unrelated individuals with familial or sporadic HCM, mutation analysis of eight sarcomeric protein genes was performed; the cardiac beta-myosin heavy chain, cardiac myosin-binding protein C, cardiac troponin T, alpha-tropomyosin, cardiac essential and regulatory myosin light chains, cardiac troponin I and cardiac alpha-actin. A total of 11 mutations, of which six were novel ones, were found in 13 individuals. Seven mutations were located in the myosin-binding protein C gene, two in the beta-myosin heavy chain gene and one in the regulatory myosin light chain and troponin I genes, respectively. This is the first Swedish study, where a population with HCM has been genotyped. Mutations in the cardiac myosin-binding protein C gene were the most common ones found in northern Sweden, whereas mutations in the beta-myosin heavy chain gene were less frequent than previously described. There are differences in the phenotypes mediated by these genes characterised by a more late-onset disease for the myosin-binding protein C gene mutations. This should be taken into consideration, when evaluating clinical findings in the diagnosis of the disease, especially in young adults in families with HCM, where penetrance can be expected to be incomplete in the presence of a myosin-binding protein C gene mutation.

Adult↗