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Search Results: 1 - 10 of 494160 matches for " B Burstr m "
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Determinants of social inequalities in child mortality in Mozambique: What do we know? What could be done?*
G Macassa, B Burstr m
African Journal of Health Sciences , 2006,
Abstract: Health inequalities are no longer an issue only for developed countries. In recent years there is agreement that all countries present health inequalities regardless of their level of wealth. In low-income countries and especially in sub-Saharan Africa where the majority of the poor people live as well as their children, research on child health inequalities is still scarce. This review of evidence suggests that if Mozambique is to achieve the millennium development goals (MDGs) by 2015 further research on important determinants of disparities in child mortality is urgently needed. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 139-143
Nerve conduction in relation to vibration exposure - a non-positive cohort study
Helena Sandén, Andreas Jonsson, B Gunnar Wallin, Lage Burstrm, Ronnie Lundstr?m, Tohr Nilsson, Mats Hagberg
Journal of Occupational Medicine and Toxicology , 2010, DOI: 10.1186/1745-6673-5-21
Abstract: The study group consisted of 155 male office and manual workers at an engineering plant that manufactured pulp and paper machinery. The study has a longitudinal design regarding exposure assessment and a cross-sectional design regarding the outcome of nerve conduction. Hand-arm vibration dose was calculated as the product of self-reported occupational exposure, collected by questionnaire and interviews, and the measured or estimated hand-arm vibration exposure in 1987, 1992, 1997, 2002, and 2008. Distal motor latencies in median and ulnar nerves and sensory nerve conduction over the carpal tunnel and the finger-palm segments in the median nerve were measured in 2008. Before the nerve conduction measurement, the subjects were systemically warmed by a bicycle ergometer test.There were no differences in distal latencies between subjects exposed to hand-arm vibration and unexposed subjects, neither in the sensory conduction latencies of the median nerve, nor in the motor conduction latencies of the median and ulnar nerves. Seven subjects (9%) in the exposed group and three subjects (12%) in the unexposed group had both pathological sensory nerve conduction at the wrist and symptoms suggestive of carpal tunnel syndrome.Nerve conduction measurements of peripheral hand nerves revealed no exposure-response association between hand-arm vibration exposure and distal neuropathy of the large myelinated fibers in a cohort of male office and manual workers.Peripheral neuropathy is one of the principal clinical disorders in workers with hand-arm vibration syndrome (HAVS). In vibration-associated neuropathy, conceivable target structures could be peripheral sensory receptors, large or thin myelinated nerve fibers, and the small-caliber, non-myelinated C fibers. Electrophysiological studies aimed at defining the nature of the vibration injury have provided conflicting results [1]. Fractionated nerve conduction velocity of the median nerve across the carpal tunnel on vibration-expose
Determinants of social inequalities in child mortality in Mozambique: what do we know? What could be done?
Gloria Macassa, Bo Burstr m
African Journal of Health Sciences , 2005,
Abstract: Health inequalities are no longer an issue only for developed countries. In recent years there is agreement that all countries present health inequalities regardless of their level of wealth. In low-income countries and especially in sub-Saharan Africa where the majority of the poor people live as well as their children, research on child health inequalities is still scarce. This review of evidence suggests that if Mozambique is to achieve the millennium development goals (MDGs) by 2015 further research on important determinants of disparities in child mortality is urgently needed. African Journal of Health Sciences Vol. 12(3-4) 2005: 118-121
Poverty and child mortality in different contexts: can Mozambique learn from the decline in mortality at the turn of the 19th century in Stockholm?
Gloria Macassa, Bo Burstr m
African Journal of Health Sciences , 2005,
Abstract: Child mortality has declined in many low-income countries. However, in Sub-Saharan Africa, childhood mortality is still a major public health problem, which is worsening with some countries experiencing new increases in mortality due to HIV/AIDS. This lack of success in reducing child mortality is not only due to HIV/AIDS, but also to high numbers of deaths in other causes of death such as diarrhoea, pneumonia and neonatal causes, for which there are effective curative and preventative interventions. One problem seems to be in the access, coverage and implementation of these interventions, particularly among the poorer sections of the population. A related problem is the interventions that sometimes, when implemented, take place in environments in which they can only be expected to have limited effects. On the other hand in many developed countries infant and child mortality declined as social and economic changes of modernisation took place. However, the mechanisms that did bring about the decline are still not well understood. This paper discuss whether analyses of the historical decline of mortality in industrialised countries could contribute to knowledge in reducing the high child mortality in poor countries today, based on studies of child mortality in different social contexts in Mozambique 1973-1997 and Stockholm 1878-1925. African Journal of Health Sciences Vol. 12(1-2) 2005: 31-36
Incidence of Raynaud's phenomenon in relation to hand-arm vibration exposure among male workers at an engineering plant a cohort study
Mats Hagberg, Lage Burstrm, Ronnie Lundstr?m, Tohr Nilsson
Journal of Occupational Medicine and Toxicology , 2008, DOI: 10.1186/1745-6673-3-13
Abstract: The baseline population consisted of 94 office and 147 manual workers at an engineering plant. Raynaud's phenomenon (RP) was assessed at baseline and at follow up (at 5, 10 and 15 years). A retrospective and a prospective cohort analysis of data were done. Hand-arm vibration exposure dose was defined as the product of exposure duration and the weighted hand-arm vibration exposure value according to ISO 5349-1.The retrospective/prospective incidence of Raynaud's phenomenon was 16/14 per 1000 exposure years among exposed and 2.4/5.0 per 1000 years among the not exposed. The retrospective dose response curve based on 4 dose classes showed that class 2, 3 and 4 had similar response and showed higher incidence than the not-exposed. The dose with RP response to hand-arm vibration corresponded to a 10 year A(8) value between 0.4–1.0 m/s2.The results indicate that the EU directive on an action value for hand-arm vibration of 2.5 m/s2 is not too low. Rather, it suggests that employers should take on actions even at exposure values of 1 m/s2A(8).Raynaud's phenomenon (RP) is cold provoked episodes of well-demarcated distal blanching (whiteness) in one or more fingers [1,2]. It occurs idiopathic more often among women than men [3]. Vibration induced white finger (VWF) is defined as first appearance of RP after start of professional exposure to hand-arm vibration and no other probable causes of RP [1,2]. The pathogenic mechanism of VWF is not completely understood but digital artery vasospasm is a probable cause. Both central and local mechanisms have been suggested for this vasospasm. The central mechanism may be an overactivity of the central sympathic nervous system and the local a digital vascular fault [1]. Anamnestic diagnostics by medical interview and questionnaire are widely accepted [1]. Cold induced digital artery vasospasm can also be measured by cold provocation tests [1].Despite the number of studies published concerning VWF, the form of the exposure-response relat
Living on social assistance with chronic illness: Buffering and undermining features to well-being
Anneli Marttila, Eva Johansson, Margaret Whitehead, Bo Burstrm
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-754
Abstract: Seventeen in-depth interviews were carried out with chronically ill people who had received social assistance for several years. Grounded theory informed the design of the study.The study showed that different strategies (living one day at a time, taking steps forwards and backwards and making attempts to find ways out of the situation) were employed by social assistance recipients to maintain or improve their well-being. Contextual features like the prevailing welfare system, public services and the local neighbourhood could buffer or undermine these strategies and their overall well-being. These features together influenced how interviewees perceived their situation, the possible ways out of the situation and the consequences for their well-being.From this study it is evident that the way in which individuals on social assistance interact with services and how they are treated by professionals plays an important role in their well-being, in combination with what kind of help and support is available for recipients through the welfare system. In this respect, persons living on social assistance with chronic illness are particularly vulnerable. This study suggests that more effort should be made to find long term solutions concerning income support, rehabilitation and other services provided to this group.In Sweden, the social security and sickness insurance systems are comprehensive and aim to provide people whose illness prevents them from earning their own living with sufficient income, either through sickness benefits or through disability pension, based on the principle of income replacement [1]. Nevertheless, as the system is designed to cater for those who have worked for some time, there is a proportion of the population who do not qualify for such benefits. Their last resort is social assistance, provided by the municipal social services. Young people, single mothers and people with an immigrant background are common groups among recipients of social assist
Keep going in adversity – using a resilience perspective to understand the narratives of long-term social assistance recipients in Sweden
Marttila Anneli,Johansson Eva,Whitehead Margaret,Burstrm Bo
International Journal for Equity in Health , 2013, DOI: 10.1186/1475-9276-12-8
Abstract: Introduction In Sweden, means-tested social assistance serves as a temporary, last resort safety net. However, increasing numbers of people are receiving it for longer periods and about a third has assistance for more than a year. The aim of this study was to explore the ways social assistance recipients manage long lasting adversity and their roles as active, rather than passive, agents in this process, using a resilience perspective. Method The study is based on thirteen in-depth interviews with long-term social assistance recipients from diverse areas in Stockholm County. The interviews were guided by narrative inquiry to interpret and construct stories of experiences and are part of a larger qualitative study exploring experiences of living on social assistance in Sweden. Results Experiences of cumulative adversity during many years compounded recipients’ difficulties in finding ways out of hardship. They had different strategies to deal with adversities, and many had underlying “core problems”, including mental health problems, which had not been properly resolved. Recipients’ showed resistance in adverse situations. Some made attempts to find ways out of hardship, whereas others struggled mainly to achieve a sense of mastering life. They received important support from individual professionals in different authorities, but mostly the help from the welfare system was fragmented. Conclusions Social assistance recipients in this study demonstrated agency in ways of managing long lasting difficulties, sometimes caused by “core problems”, which were often accumulated into complex difficulties. Resilience was about keeping going and resisting these difficulties. To find ways out of social assistance required help from different welfare agencies and professionals and was hindered by the fragmentation of services. This study shows that there is a need for more long-term personalised, comprehensive support, including interventions both to increase individual well-being and self-esteem and to open up opportunities for education and employment. Adequate benefit levels and overall quality of welfare services such as health and social care, day care and schools, are of major importance for those in greatest need.
Gender-related mental health differences between refugees and non-refugee immigrants - a cross-sectional register-based study
Anna-Clara Hollander, Daniel Bruce, Bo Burstrm, Solvig Ekblad
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-180
Abstract: A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders.The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1.40).Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers.Being an immigrant in a high-income country is a risk factor for severe mental ill health such as schizophrenia[1] and suicide[2], and moderate mental ill health[3]. Studies on mental ill health among immigrants have found signif
Cross-national agreement on disability weights: the European Disability Weights Project
Micha?l Schwarzinger, Marlies EA Stouthard, Kristina Burstrm, Erik Nord, the European Disability Weights Group
Population Health Metrics , 2003, DOI: 10.1186/1478-7954-1-9
Abstract: Disability weights for fifteen disease stages were elicited empirically in panels of health care professionals or non-health care professionals with an academic background following a strictly standardised procedure. Three valuation methods were used: a visual analogue scale (VAS); the time trade-off technique (TTO); and the person trade-off technique (PTO). Agreement among England, France, the Netherlands, Spain, and Sweden on the three disability weight sets was analysed by means of an intraclass correlation coefficient (ICC) in the framework of generalisability theory. Agreement among the two types of panels was similarly assessed.A total of 232 participants were included. Similar rankings of disease stages across countries were found with all valuation methods. The ICC of country agreement on disability weights ranged from 0.56 [95% CI, 0.52–0.62] with PTO to 0.72 [0.70–0.74] with VAS and 0.72 [0.69–0.75] with TTO. The ICC of agreement between health care professionals and non-health care professionals ranged from 0.64 [0.58–0.68] with PTO to 0.73 [0.71–0.75] with VAS and 0.74 [0.72–0.77] with TTO.Overall, the study supports a reasonably high level of agreement on disability weights in Western European countries with VAS and TTO methods, which focus on individual preferences, but a lower level of agreement with the PTO method, which focuses more on societal values in resource allocation.Summary measures of population health combine information on mortality and non-fatal health outcomes in order to represent the health of a particular population as a single measure [1]. They are used traditionally for comparative judgements of average levels of population health between populations and over time. Summary measures of population health were recently used with an explicit link to health resource allocation, e.g. disability-adjusted life expectancies (DALE) computed among other measures for the evaluation of the performance of health systems in the World Health Repor
Cross-national comparability of burden of disease estimates: the European Disability Weights Project
Essink-Bot,Marie-Louise; Pereira,Joaquin; Packer,Claire; Schwarzinger,Michael; Burstrm,Kristina; ,;
Bulletin of the World Health Organization , 2002, DOI: 10.1590/S0042-96862002000800009
Abstract: objective: to investigate the sources of cross-national variation in disability-adjusted life-years (dalys) in the european disability weights project. methods: disability weights for 15 disease stages were derived empirically in five countries by means of a standardized procedure and the cross-national differences in visual analogue scale (vas) scores were analysed. for each country the burden of dementia in women, used as an illustrative example, was estimated in dalys. an analysis was performed of the relative effects of cross-national variations in demography, epidemiology and disability weights on daly estimates. findings: cross-national comparison of vas scores showed almost identical ranking orders. after standardization for population size and age structure of the populations, the daly rates per 100000 women ranged from 1050 in france to 1404 in the netherlands. because of uncertainties in the epidemiological data, the extent to which these differences reflected true variation between countries was difficult to estimate. the use of european rather than country-specific disability weights did not lead to a significant change in the burden of disease estimates for dementia. conclusions: sound epidemiological data are the first requirement for burden of disease estimation and relevant between-countries comparisons. daly estimates for dementia were relatively insensitive to differences in disability weights between european countries.
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