How to calculate incidence rates from proportionate data

This paper describes the methodological aspects of calculation of incidence rates from incomplete data in occupational epidemiology. Proportionate measures in epidemiological studies are useful e.g. to describe the proportion of slips, trips and falls compared to other types of injury mechanisms within single age-strata. However, a comparison of proportions of slips, trips and falls among the different age-strata gives no meaning and can hamper the conclusions. Examples of a constructed example and some selected studies show how estimates of incidence rates can be calculated from the proportionate data by applying estimates of denominators available from other information. The calculated examples show how the risks based on the incidence rates in some cases differ from the risks based on the proportionate rates with the consequence of hampering the conclusions and the recommendations for prevention. In some cases the proportionate rates give good estimates of the incidence rates, but in other studies this might cause errors. It is recommended that estimates of the incidence rates should be used, where this is possible, by estimation of the size of the population. The paper is intended to be useful for students and teachers in epidemiology by using the attached Excel training file.

“I was a little surprised”: Qualitative Insights from Patients Enrolled in a 12-Month Trial Comparing Opioids to Non-Opioid Medications for Chronic Musculoskeletal Pain

Chronic musculoskeletal pain is a major public health problem. Although opioid prescribing for chronic pain has increased dramatically since the 1990s, this practice has come under scrutiny because of increases in opioid-related harms and lack of evidence for long-term effectiveness. The Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial was a pragmatic 12-month randomized trial comparing benefits and harms of opioid versus non-opioid medications for chronic musculoskeletal pain. The current qualitative study was designed to better understand trial results by exploring patients’ experiences, including perceptions of medications, experiences with the intervention, and whether expectations were met. Thirty-four participants who were purposefully sampled based on treatment group and intervention response participated in semi-structured interviews. The constant comparison method guided analysis. Results revealed that participants often held strong beliefs about opioid medications, which sometimes changed during the trial as they gained experience with medications; participants described a wide variety of experiences with treatment effectiveness, regardless of study group or their response to the intervention; and participants highly valued the personalized pain care model used in SPACE

Follow-up of citations of maritime epidemiological injury studies

Background: The article is based on a review and follow-up of the citations of 13 epidemiological studies that aimed to improve maritime health and safety. While it’s well-recognised that epidemiology is needed in occupational health and safety, the main research question: “How can epidemiology help workers to return healthy from the sea” was unanswered. Materials and methods: The 13 articles were selected as a representative sample of different epidemiological design studies intended to contribute to improving safety management in fishing, merchant shipping and offshore industry. The PubMed, Research Gate, Cochrane-Library and Google Scholar were searched for authors that had cited our articles by using full bibliographic information and the results analysed. Results: In all, 213 citation records were identified. After duplicates and records with insufficient information were removed, 123 full-text articles were eligible for evaluation with answers to the research questions: how did other authors use the studies, how has the injury epidemiology been developed, which recommendations are given for new policies and new studies and how can epidemiology help workers return safe and healthy from the sea? Conclusions: The answer to the main research question is yes, epidemiological studies are not only useful but a necessary component by providing the needed evidence for successful prevention programmes

Identitetskonstruktion på Instagram. En kvalitativ studie ur ett användarperspektiv.

Ahlquist, A. Jensen, S. Wikström Nilsson, J. Identitetskonstruktion på Instagram. En kvalitativ studie ur ett användarperspektiv. Uppsatsarbete i medie- och kommunikationsvetenskap B, 7,5 högskolepoäng. Lunds Universitet: Institutionen för kommunikation och medier, 2014. De sociala mediernas värld är snabbföränderlig och flera sociala medier tävlar om att ta plats på den gemensamma arenan. Mediernas utveckling har skapat möjligheter för individen att konstruera en identitet online som kan skilja sig från en identitet offline och att konstruera en självpresentation som tidigare inte var möjlig. Forskning kring identitetskonstruktionen på ett flertal sociala medier har gjorts. År 2010 uppkom fenomenet Instagram som tagit allt större utrymme på de sociala mediernas arena och huruvida mediet används för en identitetskonstruktion online har ännu lämnats outforskat. Vi har med vår forskning därför ämnat att studera Instagram utifrån användares perspektiv för att undersöka hur användaren av mediet resonerar kring sin onlineidentitet i förhållande till sin offlineidentitet och huruvida Instagramanvändaren anpassar sin livsstil för att konstruera en bild av sig själv och med vilken medvetenhet detta görs. Vi utförde kvalitativa intervjuer med ett urval av tre “vanliga” Instagramanvändare och tre experter, med en yrkesbakgrund inom sociala medier, för att ge analysen en ny infallsvinkeln som tidigare forskning inte behandlat. Resultatet av studien tyder på att respondenterna ofta framställer en förskönad bild av sig själv, vilket förenklas med hjälp av de verktyg Instagram erbjuder. Studien visar på att de med en yrkesbakgrund av sociala medier även har en större medvetenhet gällande de metoder som används vid Instagramanvändandet

Social security for seafarers globally

Background: The social security protection is one of the essential elements of decent work. The issue is complexand no previous epidemiological studies of the coverage among the seafarers have yet been performed.Aim: The aim was to overcome the gap of knowledge to promote the further discussion and plan the implementationof the social security for all the seafarers.Materials and methods: The seafarers completed a short questionnaire concerning their knowledge abouttheir social security status.Results: The significant disparities in the social security coverage were pointed out among the nationalities.Especially it is worth mentioning that more than half of the respondents believe they are economicallyuncovered for disability from an injury on board and from a work-related disease.Conclusions: The results confirm the ILO (Convention No. 143) statements that the significant part of theseafarers comes from the poorer countries without the substantial social security systems. The solutionssuggested are to implement the minimum requirements as recommended by the ILO 2006 Convention, tosurvey the implementation and — in the long term — to struggle for a global social equality

A model for assessment of telemedicine applications: MAST

Objectives: Telemedicine applications could potentially solve many of the challenges faced by the healthcare sectors in Europe. However, a framework for assessment of these technologies is need by decision makers to assist them in choosing the most efficient and cost-effective technologies. Therefore in 2009 the European Commission initiated the development of a framework for assessing telemedicine applications, based on the users' need for information for decision making. This article presents the Model for ASsessment of Telemedicine applications (MAST) developed in this study. Methods: MAST was developed through workshops with users and stakeholders of telemedicine. Results: Based on the workshops and using the EUnetHTA Core HTA Model as a starting point a three-element model was developed, including: (i) preceding considerations, (ii) multidisciplinary assessment, and (iii) transferability assessment. In the multidisciplinary assessment, the outcomes of telemedicine applications comprise seven domains, based on the domains in the EUnetHTA model. Conclusions: MAST provides a structure for future assessment of telemedicine applications. MAST will be tested during 2010-13 in twenty studies of telemedicine applications in nine European countries in the EC project Renewing Health