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Biomedical subjects

L Svanström

Publications and source records attributed to L Svanström.

At least 37 records · Page 2Linked to original sources
PubMed1995

The Lidköping Accident Prevention Programme--a community approach to preventing childhood injuries in Sweden.

OBJECTIVES: In Sweden about 100 children 0-14 years die from accidental injuries every year, roughly 40 girls and 60 boys. To reduce this burden the Safe Community concept was developed in Falköping, Sweden in 1975. Several years later a second programme was initiated in Lidköping. The objectives of this paper are to describe the programme in Lidköping and to relate it to changes in injury occurrence. SETTING: The Lidköping Accident Prevention Programme (LAPP) was compared with four bordering municipalities and to the whole of Skaraborg County. METHODS: The programme included five elements: surveillance, provision of information, training, supervision, and environmental improvements. Process evaluation was based mainly on notes and reports made by the health planners, combined with newspaper clippings and interviews with key people. Outcome evaluation was based on information from the hospital discharge registry. RESULTS: In Lidköping there was an on average annual decrease in injuries leading to hospital admissions from 1983 to 1991 of 2.4% for boys and 2.1% for girls compared with a smaller decline in one comparison area and an increase in the other. CONCLUSION: Because the yearly injury numbers are small there is a great variation from year to year. However, comparisons over the nine year study period with the four border municipalities and the whole of Skaraborg County strengthen the impression that the programme has had a positive effect. The findings support the proposition that the decrease in the incidence of childhood injuries after 1984 could be attributed to the intervention of the LAPP. Nevertheless, several difficulties in drawing firm conclusions from community based studies are acknowledged and discussed.

Accident Prevention↗
PubMed1993

Socioeconomic differences in smoking in an urban Swedish population. The bias introduced by non-participation in a mailed questionnaire.

Stockholm Health of the Population Study is a cross-sectional study carried out from 1984-85. Postal questionnaires, telephone interviews and health interviews were used to get information from a sample of 5,199 persons, 18-64 years of age, on health status, risk exposures, healthcare consumption and social factors. Non-participation with respect to the postal questionnaire was 36.8%. With subsequent telephone interviews and an invitation to a health interview, non-participation was reduced to 17.8%. The estimated prevalence of daily smoking increased from 36.1% to 38.7. The non-responders had a higher prevalence of daily smoking in all sub-groups. This effect of the efforts to reduce non-participation differed socially. The prevalence of smoking for men, 40-64 years of age, who were reached by telephone was 60.3%. Male professionals and intermediate non-manual workers, 40-64 years of age reached by telephone had a prevalence of smoking, which was twice as high as for the responders of the questionnaire (62.5 and 26.8%, respectively). In the younger age-group, non-responders had the same socioeconomic pattern in smoking as the responders. Independent of socioeconomic group, there was a tendency of ill or disabled smokers to respond more quickly than healthy smokers. Using a postal questionnaire with a high non-response rate might lead to an overestimation of socioeconomic differences and an underestimation of smoking prevalence.

Adolescent↗
PubMed1992

The relationship between stressful working conditions and high alcohol consumption and severe alcohol problems in an urban general population.

The relationship between 15 measures of stressful working conditions and high alcohol consumption (35 g 100% ethanol per day or more for men and 25 g or more for women) was studied, using cross-sectional data from a general population survey of 1344 males and 1494 females; the ages 25-64 years in metropolitan Stockholm in 1984. In a longitudinal component of the study, hospitalization and mortality with alcohol-related diagnosis was assessed during 1984-90, and also the association between previous experience of unemployment and high alcohol consumption. Some of the associations, expressed as age-adjusted odds ratios, were positive and some were negative when high alcohol consumption was the endpoint, but there was a clear variation by sex and social class. Generally the positive associations were stronger among male non-manual employees. Among males, there was a clear association between stressful working conditions and subsequent risk of severe medical alcohol-related problems, but the precision of the estimates was low due to low number of cases. The odds ratio was 6.18 (95% confidence interval 1.86, 20.61) for twisted working positions and 6.74 (95% confidence interval 1.67, 27.19). Previous unemployment among males was associated with increased risk for high alcohol consumption, with an odds ratio of 5.71 (95% CI 1.39, 15.97) among those who had been unemployed more than once, and 1.67 (95% CI 0.76, 3.64) among those who had been unemployed once during the previous 5 years. Those and other increased odds ratios were lower when subjects with an alcohol diagnosis at inpatient care during 1980-84 were excluded in the analyses. On the whole, our findings are not conclusive. The strong, but imprecise associations between stressful working conditions and severe alcohol problems, are however challenging, and warrants further studies, preferably with longitudinal design and repeated measurements of both working condition and alcohol habits.

Adult↗
PubMed1991

Injury surveillance at emergency departments in an urban area. Methodology and quality control.

An injury surveillance system has been developed and tested in a pilot study at two emergency departments in the Stockholm area. The object was to develop an all-age, all-injury registration at all hospital emergency departments and primary care units treating injured patients. The information will be used at the local level for preventive measures, and on a national level for comparison with other areas. All injured patients were given a record-sheet that served both as a registration form and a medical record. The NOMESKO-code was used as a basis for classifying intent, activity, type of location, and injury mechanism. Altogether, 11,327 injured patients were registered. One day each month was randomly selected from the registration for control of registry completeness. The drop-out rate was on average 13%. The reasons were that patients had not been provided with the injury form, or that the copy of the form had not been sent to, or had not reached the Epidemiological Unit where data entry was performed. 6% of the injuries occurred in patients living outside the Stockholm area. The average shortfall-rate in filling in the NOMESKO-code on the registration form was 10%. The rate of registry drop-outs and incomplete forms should decrease when registration has become a routine procedure, provided that the staff can be engaged in the preventive work and the registration procedure can be adjusted to the routines of trauma management in each emergency department.

Emergency Service, Hospital↗
PubMed1990

Simply osteoporosis--or multifactorial genesis for the increasing incidence of fall injuries in the elderly? The need for a scientific approach to reducing injuries.

Both the high and rising incidence of injuries in old age and a situation where accidents are looked upon as "super-human" events, impossible to prevent, call for a scientific approach to the problem. Another strong reason for stressing the scientific approach is the complex aetiological origin of injuries in the elderly. Individual factors as well as factors overrepresented in the injured population must find a developed model as site for their importance compared to agent factors and environmental factors. If not, there will be an everlasting contradiction between the discussion on monofactorial "causes" of injuries like osteoporosis, lacking physical exercise, environmental risks, etc. Still another reason is that the present serious situation with an increasing incidence of injuries in the elderly call for urgent preventive programmes as well as development of operation methods, rehabilitation methods and environmental changes. Unfortunately, in spite of the importance and magnitude of the number of injuries as a public health problem, relative little scientific attention has been given to the area of injury control. In the paper it is concluded that there is a need for model development. These models should combine an epidemiological approach with a behavioural scientific method as well as a system-oriented model. Such models are available in occupational injury prevention and should as well be tested in prevention of injuries in the elderly.

Accidental Falls↗
PubMed1989

Evaluation of a system for injury surveillance in Swedish emergency care.

A system for continuous and periodic injury surveillance in Swedish emergency care has been evaluated based on a case study of accidental injuries on 2,454 farms during a one year period. The evaluation procedure comprised registry completeness, measurement errors, trend analysis and calculation of risk. The results indicate that the structure of the registry system permits analysis of registry completeness, but further development is needed concerning the staffing and organising problem. The importance of registry inclusion criteria when one is comparing different injury surveillance systems was noted. Limitations applied to calculation of accident frequency rates per million hours work. The results show that there will be a high drop-out rate if the collection of data is not simultaneously combined with an injury control programme. The registry system could serve as a basis for periodic surveys and trend analysis. Further development of a continuous system based on reporting immediately at the injury reception centre should be considered. A coordinated system involving both continuous and periodic data seems to leave the flexibility both to identify certain risk environments or risk groups and to analyse the circumstances involved of specific accidental injuries, e.g. in agriculture.

Accidents, Occupational↗
PubMed1988

Contributions of social medicine and systems analysis to formulating objectives for a community-based cancer prevention programme.

In the part of Stockholm Cancer Prevention Programme, that is focussing on diet and cancer, the contribution of social medicine has been based on its concern for the relationships between individuals, populations, the environment and the socio-political structure. This has led to the choice of the community intervention approach, based on geographically defined populations, and involving the participation of organisations already active within the relevant areas. The contribution of systems analysis has been based on its concern for explicit models of the processes of cause and effect that lead from intervention to outcome, as a basis for debate and common understanding among the various participants. The combination of the two approaches has helped to clarify the objectives and has shaped the planned pattern of intervention.

Community Health Services↗
PubMed1988

Development of a community intervention programme on miners' health and working environment in Nicaragua.

Since 1983, a broad research and development programme has been carried out with the support of Sweden through the Swedish Agency for Research Cooperation in Developing Countries (SAREC). One of the medical research and development projects deals with the environment and state of health of the population of an entire village, and is referred to as the Abdon Vega project. It is pursued by the Department of Social and Preventive Medicine of the University of León, Nicaragua, with the support of the Department of Social Medicine at the Karolinska Institute in Stockholm. The project comprises two stages. The first one centres on the state of health of the workers and the mining environment. This article reports on the objectives of the project and the study area. It presents experience from the development work up to now and the difficulties encountered.

Community Health Services↗
PubMed1988

Participation of primary health care personnel in the Stockholm Health of the Population Study--a preliminary report.

The 1984/85 Stockholm Health of the Population Study (HPS) was a cross sectional study including a questionnaire and a health examination. It was conducted through the ordinary health personnel of four Primary Health Care (PHC) districts in the Stockholm County. The main objective was to broaden the scope for planning health care. One of the goals of the study was to involve those working in PHC in planning their activities after local needs and to use more time for prevention work. The main effort to reach this objective was through involvement of the PHC personal from the early planning phase. This strategy was very time consuming but, on the other hand experiences from the HPS have led to both new screening activities of e.g high consumers of alcohol and the elderly, and preventive work aimed at those with smoking and overweight problems in the local PHC area. In the implementation process and through education the scientific approach level and interest in primary health care increased. A keen interest of survey data for local planning is obvious.

Attitude of Health Personnel↗
PubMed1987

A model for registration and mapping of accident cases in health care.

Accidents occur in all social environments and constitute also in Sweden an important causal morbidity and mortality factor. The official accident statistics are in several respects deficient and do not describe injuries in necessary detail for enabling preventive measures to be taken, especially not on the local community level. Since 1 January 1978 a continuous registration of all emergency visits in primary as well as secondary medical care has been pursued in a test and control area in Skaraborg county in Western Sweden. The registration system enables a mapping-out and in-depth studies of accidents in order to provide basic information for preventive measures at local level, i.e. community intervention. The all-age-injury reporting system used in this connection is described in the article.

Accidents↗
PubMed1986

One-year incidence of home accidents in a rural Swedish municipality.

Since 1978 a continuous registration of acute in-patient and out-patient visits, has been conducted in a municipality in Skaraborg County in western Sweden as a part of the evaluation of an intervention programme. Such a comprehensive community oriented intervention programme has never been reported before. A special focus has been directed at accident cases divided up by environment: home, work, traffic, and other. A total of 20 440 inhabitants in the municipality were registered in health and medical care centres over a six-year period because of injuries. Since 23.5% of all accidents happen in the home, cases of home accidents have been mapped out in more detail with the help of standardized and structured surveys via telephone interviews. All of these were completed with a review of hospital records and death certificates. Because of the comprehensive registration we were able for the first time in Sweden to calculate the distribution of home accidents down to very small geographical areas. The thinly populated areas show significantly higher levels of home accidents when compared to the densely populated areas. In addition to geographical differences, there were incidence differences regarding sex, age group, and type of housing. The majority of home accidents (76.5%) occurred in connection with moving, play, and hobbies. Injuries from blows, cuts, and collisions are the most common type of accidents for men, while injuries from falls are the most dominant types for women. The dominating types of injuries are: contusions, fractures, and wounds. A significantly higher incidence of accident cases among the elderly exists in all of the old age homes/service houses in the study area.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Home↗
PubMed1986

One-year incidence of occupational accidents in a rural Swedish municipality.

A continuous all embracing registration of acute, in-patient and out-patient visits at hospitals and primary health care centres, has been conducted since 1978 in Skaraborg County in western Sweden. A special focus has been directed at accident cases which account for 20% of the total number of acute visits. The accidents have been divided up by environment: home, work, traffic and other. Cases of work-related accidents have been mapped out in more detail with the help of standardized and structured surveys via telephone interviews, information from hospital records, and death certificates. This study aims at achieving increased understanding and knowledge about the accident pattern in the working environment in a municipality. This mapping of cases of work-related accidents in a defined population is also a part of evaluation of an intervention programme. Such a comprehensive community-oriented intervention programme has never been reported before. A total of 20,440 inhabitants in the municipality were registered in health and medical care centres over a six-year period because of injuries. Out of this total, 3,729 or 18.2% occurred on the job. A significant over-representation of work-related accidents existed for men, those in the 16-34 year age group, and those in manufacturing or farming. High incidences of industrial accidents were concentrated in the months of August through November. The most common types of injuries were to the eyes, or from crushes, falls, cuts, or punctures from sharp or piercing objects.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗