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  • 1.
    Bień, Barbara
    et al.
    Medical University of Bialystok, Department of Geriatrics, Poland.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Döhner, H.
    3 University Medical Centre Hamburg-Eppendorf, Centre for Psychosocial Medicine, Department of Medical Sociology and Health Economics, Germany.
    Triantafillou, J.
    50plus Hellas Athens, Member of the Administrative Council, Greece.
    Lamura, G.
    INRCA, Department of Post-Acute and Transitional Care, Centre for Socio-Economic Research on Ageing, Ancona, Italy.
    Doroszkiewicz, H.
    Medical University of Bialystok, Department of Geriatrics, Poland.
    Krevers, B.
    Linköping University, Department of Medical and Health Sciences, Linköping, Sweden.
    Kofahl, C.
    University Medical Centre Hamburg-Eppendorf, Centre for Psychosocial Medicine, Department of Medical Sociology and Health Economics, Germany.
    Disabled older people’s use of health and social care services and their unmet care needs in six European countries2013In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 6, p. 1032-1038Article in journal (Refereed)
    Abstract [en]

    Background: The national health and social care systems in Europe remain poorly integrated with regard to the care needs of older persons. The present study examined the range of health and social care services used by older people and their unmet care needs, across six European countries. 

    Methods: Family carers of older people were recruited in six countries via a standard protocol. Those providing care for disabled older people (n = 2629) provided data on the older person’s service use over a 6-month period, and their current unmet care needs. An inventory of 21 services common to all six countries was developed. Analyses considered the relationship between older people’s service use and unmet care needs across countries. 

    Results: Older people in Greece, Italy and Poland used mostly health-oriented services, used fewer services overall and also demonstrated a higher level of unmet care needs when compared with the other countries. Older people in the United Kingdom, Germany and Sweden used a more balanced profile of socio-medical services. A negative relationship was found between the number of different services used and the number of different areas of unmet care needs across countries. 

    Conclusions: Unmet care needs in older people are particularly high in European countries where social service use is low, and where there is a lack of balance in the use of health and social care services. An expansion of social care services in these countries might be the most effective strategy for reducing unmet needs in disabled older people.

  • 2.
    Flacking, Renée
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hedberg Nyqvist, Kerstin
    Ewald, Uwe
    Effects of socioeconomic status on breastfeeding duration in mothers of preterm and term infants2007In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 17, no 6, p. 579-584Article in journal (Refereed)
    Abstract [en]

    Background: The propensity to breastfeed is not only of importance with regard to the beneficial effects on the individual, but is also of concern as an indicator of health behaviour related to social conditions. Thus, our aim was to investigate the impact of socioeconomic status (SES) on breastfeeding duration in mothers of preterm and term infants.

    Methods: Prospective population based cohort study. Data for infants registered in breastfeeding databases of two Swedish counties 1993–2001 were matched with data from two national registries—the Medical Birth Registry and Statistics Sweden. A total of 37 343 mothers of 2093 preterm and 35 250 term infants participated.

    Results: All socioeconomic factors; maternal educational level, maternal unemployment benefit, social welfare and equivalent disposable income, were strongly associated with breastfeeding when examined individually in mothers of preterm and term infants. Some of the associations attenuated when investigated simultaneously. Independently of SES and confounders, mothers of preterm infants were at higher risk of weaning before the infant was 2 months (adjusted odds ratio (OR) 1.70; 95% confidence interval ((CI) 1.46–1.99)), 4 months (OR 1.79; CI 1.60–2.01), 6 months (OR 1.48; CI 1.33–1.64), and 9 months old (OR 1.19; CI 1.06–1.34), compared with mothers of term infants.

    Conclusions: In Sweden, despite its social welfare support system and a positive breastfeeding tradition, SES clearly has an impact on the breastfeeding duration. Mothers of preterm infants breastfeed for a shorter time compared with mothers of term infants, even when adjustments are made for SES and confounders.

  • 3. Wändell, Per
    et al.
    Carlsson, Axel C
    Gasevic, Danijela
    Holzmann, Martin J
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Sundquist, Jan
    Sundquist, Kristina
    Socioeconomic factors and mortality in patients with atrial fibrillation-a cohort study in Swedish primary care2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no 6, p. 1103-1109Article in journal (Refereed)
    Abstract [en]

    Background: Preventing ischaemic stroke attracts significant focus in atrial fibrillation (AF) cases. Less is known on the association between socioeconomic factors and mortality and cardiovascular outcomes in patients with AF.

    Methods: Our study population included adults (n=12 283) ≥45 years diagnosed with AF at 75 primary care centres in Sweden 2001-07. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for the association between the exposures educational level, marital status, neighbourhood socioeconomic status and the outcomes all-cause mortality, after adjustment for age, and comorbid cardiovascular conditions.

    Results: During a mean of 5.8 years (SD 2.4) of follow-up, 3954 (32.3%) patients had died; 1971 were women (35.0%) and 1983 were men (29.8%). Higher educational level was associated with a reduced mortality in fully adjusted models: HR 0.85 (95% CI 0.77-0.96) for secondary school in men, HR 0.73 (95% CI 0.60-0.88) for college/university in women, and HR 0.82 (95% CI 0.71-0.94) for college/university in men, compared to primary school. Unmarried men and divorced men had an increased risk of death, compared with married men: HR 1.25 (95% CI 1.05-1.50), and HR 1.23 (95% CI 1.07-1.42), respectively. College/university education level was also associated with lower risk of myocardial infarction in men and women, and lower risk of congestive heart failure in women.

    Conclusion: More attention could be paid to individuals of lower levels of formal education, and unmarried men, in order to provide timely management for AF and prevent its debilitating complications.

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