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Aims: Human papillomavirus (HPV) vaccination plays a key role in the prevention of cervical cancer. Yet, disparities in HPV vaccination in Sweden have persisted. Previous research on such disparities has typically focused on singular sociodemographic variables and measures of average risk. Using a multi-categorical approach and drawing on intersectionality theory, this study aimed to provide a more precise mapping of HPV non-vaccination among girls in different sociodemographic groups and geographical areas in Sweden during 2013–2020. Methods: Using nationwide register data, we conducted a multi-categorical analysis of individual heterogeneity and discriminatory accuracy complemented by a multilevel geographical analysis. We mapped HPV non-vaccination prevalence across 54 strata defined by parental income, education and country of birth, and urban versus rural place of residence. We also disentangled municipal and regional influences on HPV non-vaccination. Results: HPV non-vaccination was more common in groups with a low income, a low education and an immigration background, whereas among those with an immigration background, the association between income, education and HPV non-vaccination was more complex. Geographical differences were found between municipalities. However, the discriminatory accuracy of the sociodemographic and geographical groups was weak, and 50% of the non-vaccination cases were observed in eight strata, of which some are among those with low risk. Conclusions: Our findings underscore the importance of universal yet tailored approaches, including providing adequate information about HPV vaccination in Swedish and other languages, and of health-care professionals displaying sensitivity to patients’ and parents’ questions or needs.

Introduction: The Nursing Activities Score has been used mainly in Intensive Care Units as an instrument to measure nursing activities since this is the unit that receives the most complex patients. For this reason, this scoping review aims to establish the workload using the Nursing Activities Score and the factors related to it in Intensive Care Units. Methods: Qualitative scoping review using the PRISMA statement. Searches were conducted in CINAHL, LILACS, Scopus, Science Direct, SciELO, and PubMed databases. Results: The final sample consists of 87 texts published between 2007 and 2021. They were classified into five categories: ICU workload, inter-unit comparison, workload related to nursing staff, workload related to patient characteristics, and workload consequences. Discussion: The review reveals a workload greater than 50% in most of the studies due to different factors, but mainly to patients’ particular characteristics. No significant difference was observed between general and specialized units; high workloads are a risk factor for adverse events. Conclusions: This review shows that nurses are constantly exposed to high workloads. It is possible for workloads to affect or be influenced by various factors, such as the characteristics of patients being cared for, or to impact the quality of nursing care positively or negatively. How to cite this article: Cruz López Laura Nathalie, Quintero Osorio Jenny Fernanda, Melo Roa Juan David, Henao Castaño Ángela María. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. Revista Cuidarte. 2023;14(1):e2680. http://dx.doi.org/10.15649/cuidarte.2680, Introdução: O Nursing Activities Score tem sido usado como um instrumento principalmente na Unidade de Tratamentos Intensivos para medir as atividades de enfermagem, sendo essa a unidade que lida com os pacientes mais complexos para o cuidado. Por esta razão, o objetivo desta scoping review é estabelecer a carga de trabalho, conforme avaliado pelo Nursing Activities Score, e fatores relacionados em Unidades de Cuidados Intensivos. Metodologia: Revisão quantitativa usando scoping Review, utilizando o método PRISMA. Pesquisa nos bancos de dados CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO e PUBMED. Resultados: A amostra final consistiu em 87 textos, variando de 2007 a 2021. Eles foram classificados em cinco categorias: carga de trabalho na UTI, comparação entre unidades, carga de trabalho relacionada ao pessoal de enfermagem, carga de trabalho relacionada às características dos pacientes e consequências da carga de trabalho. Discussão: A revisão revela uma carga de trabalho superior a 50% na maioria dos estudos, isto devido a diferentes fatores: principalmente as características particulares dos pacientes, nenhuma diferença significativa foi observada entre unidades gerais e especializadas, altas cargas de trabalho são um fator de risco para a ocorrência de eventos adversos. Conclusões: Os resultados desta revisão comprovam que o pessoal de enfermagem está constantemente exposto a altas cargas de trabalho. Esta carga de trabalho pode ser influenciada ou influenciada por vários fatores, tais como as características dos pacientes atendidos ou pode afetar positiva ou negativamente a qualidade dos cuidados de enfermagem. Como citar este artigo: Cruz López Laura Nathalie, Quintero Osorio Jenny Fernanda, Melo Roa Juan David, Henao Castaño Ángela María. Carga laboral de profesionales de enfermería en Unidad de Cuidado Intensivo según Nursing Activities Score. Revista Cuidarte. 2023;14(1):e2680. http://dx.doi.org/10.15649/cuidarte.2680, Highlights: La NAS es una herramienta que toma relevancia al momento de evaluar la carga de trabajo de los profesionales de enfermería. Se evidencia que el personal de enfermería está expuesto a altas cargas de trabajo que, en la mayoría de casos, supera lo sugerido por Consejos y Asociaciones de enfermería. Algunos factores que pueden afectar la carga de trabajo son el tipo de turnos de trabajo, sexo del profesional, tipo de UCI, el número de pacientes a cargo, entre otros. Es necesario evaluar la implementación de la NAS en distintos tipos de servicios para entender la situación y trabajo actual de los profesionales de enfermería. Introducción: Nursing Activities Score ha sido utilizada como un instrumento principalmente en la Unidad de Cuidados Intensivos para medir las actividades de enfermería, siendo esta la unidad que maneja pacientes de mayor complejidad para el cuidado. Objetivo: establecer la carga de trabajo, evaluada por Nursing Activities Score, y factores relacionados a la misma en Unidades de Cuidado Intensivo. Metodología: Revisión cualitativa tipo scoping Review, utilizando el método PRISMA. Búsqueda en las bases de datos CINAHL, LILACS, SCOPUS, SCIENCE DIRECT, SCIELO y PUBMED. Resultados: La muestra final se compone de 87 textos, que van desde el año 2007 hasta 2021. Se clasificaron en cinco categorías: Carga de trabajo en UCI, comparación entre unidades, carga de trabajo relacionada al personal de enfermería, carga de trabajo relacionada a las características de los pacientes y consecuencias de la carga de trabajo. Discusión: La revisión revela una carga de trabajo mayor al 50% en la mayoría de los estudios, esto debido a diferentes factores: principalmente las características particulares de los pacientes, no se observó una diferencia significativa entre unidades generales y especializadas, las cargas de trabajo elevadas suponen un factor de riesgo para la ocurrencia de eventos adversos. Conclusiones: Los resultados de esta revisión permiten evid

Knowledge about risks for overuse of psychoactive analgesics in patients having primary surgery for carpal tunnel syndrome (CTS) or ulnar nerve entrapment (UNE), or both, is limited. We investigated if patients with those nerve entrapment disorders have a higher risk of overuse of psychoactive analgesics (i.e., opioids and gabapentinoid drugs) before, after, and both before and after surgery than observed in the general population after accounting for demographical and socioeconomic factors. Using a large record linkage database, we analysed 5,966,444 individuals (25-80 years), residing in Sweden December 31st, 2010-2014, of which 31,380 underwent surgery 2011-2013 for CTS, UNE, or both, applying logistic regression to estimate relative risk (RR) and 95% confidence interval (CI). Overall, overuse of the psychoactive analgesics was low in the general population. Compared to those individuals, unadjusted RR (95% CI) of overuse ranged in patients between 2.77 (2.57-3.00) with CTS after surgery and 6.21 (4.27-9.02) with both UNE and CTS after surgery. These risks were only slightly reduced after adjustment for demographical and socioeconomic factors. Patients undergoing surgery for CTS, UNE, or both, have a high risk of overuse of psychoactive analgesics before, after, and both before and after surgery., Funding Agencies|Swedish Research Council [2017-01321, 2022-01942]; Swedish Diabetes Foundation [DIA2020-492]; Region Skane; Lund University [2018-Projekt 0104]; Skane University Hospital [2019-659]; Elly Olssons Foundation; Stig and Ragna Gorthon Foundation; Almroth Foundation; Kockska foundation; Magnus Bergvall Foundation [2020-03612]

Aims: Swedish public health reports have repeatedly provided information about socio-economic inequalities in sedentary leisure time, despite that, in the interest of health equity, physical activity should be equally distributed in the population. Such public health reports, however, neither consider the intersection of multiple socio-demographic factors nor the individual heterogeneity around group averages. Drawing on intersectionality theory, this study aimed to revisit previous findings on sedentary leisure time from Swedish public health surveys and demonstrate how the analysis of individual heterogeneity and discriminatory accuracy (AIHDA) can be used for analysing complex health inequalities. Methods: Using data from Swedish national public health surveys (2004–2015), we applied the AIHDA to define 72 intersectional groups by categories of age, gender, educational achievement, migration status and household composition. We then calculated (a) the absolute and relative risk of sedentary leisure time and (b) the discriminatory accuracy (DA) of the intersectional grouping. Results: The average risk of sedentary leisure time ranged from 5.8% among native-born, highly educated, young women living alone to 41.0% among immigrated young men, living alone, with low education. The risk was higher in strata comprising immigrated people with low education and lower in strata including native-born, highly educated people. However, the DA of the grouping was poor, indicating a substantial overlap of individual risk between groups. Conclusions: Using the AIHDA and drawing on intersectionality, this study provides an improved mapping of the socio-economic distribution of sedentary leisure time in Sweden, with the poor DA suggesting universal rather than targeted physical activity interventions.

We aimed to study psychological health, as approximated by the use of psychotropic drugs, in a population diagnosed and surgically treated for carpal tunnel syndrome (CTS) or ulnar nerve entrapment (UNE), or both, also considering the demographic and socioeconomic factors of the individuals. Linking data from five large national registers, use of psychotropics (at least one dispensation during the first year after the surgery or the baseline date) was examined in around 5.8 million people 25-80 years old residing in Sweden 2010. Among these individuals, 9728 (0.17%), 890 (0.02%) and 149 (0.00%) were identified as diagnosed and surgically treated for CTS, UNE, or both, respectively. As much as 28%, 34% and 36% in each group, respectively, used psychotropic drugs, compared with 19% in the general population. Regression analyses showed a general higher risk for use of psychotropics related to these nerve compression disorders, to higher age, being a woman, and having low income or low occupational qualification level. Individuals born outside of Sweden had a lower risk. We conclude that surgically treated individuals with a nerve compression disorder have an increased risk of impaired psychological health. Caregivers should be aware of the risk and provide necessary attention., Funding Agencies|Swedish Research Council [2017-01321, 2022-01942]; Swedish Diabetes Foundation [DIA2020492]; Region Skane and Lund University [2018-Projekt0104]; Skane University Hospital [2019-659]; Almroth Foundation; Kockska foundation; Magnus Bergvall Foundation [2020-03612]; Stig and Ragna Gorthon Foundation; Elly Olssons Foundation for scientific research

Intimate partner violence against women (IPVAW) poses severe threats to women’s health and rights. This study investigates the role of country context and gender equality in shaping individual perceptions of the severity of IPVAW. Multilevel logistic regression analyses of a Eurobarometer survey on attitudes toward IPVAW from 27 EU states showed that male gender, young age, low education, low self-assessed social position and particularly perceiving IPVAW as uncommon were associated with perceiving IPVAW as less severe. The likelihood of perceiving IPVAW as less severe was higher in countries with low gender equality. Between-country variance accounted for 14% of the variability, while country-level gender equality accounted for 22% of the between-country variance. We conclude that efforts toward strengthening perceptions of IPVAW as a severe issue should focus on awareness-raising and on increasing country-level gender equality., Published online: 09 Nov 2020

Aims: Antimicrobial resistance presents an increasingly serious threat to global public health, which is directly related to how antibiotic medication is used in society. Actions aimed towards the optimised use of antibiotics should be implemented on equal terms and according to the needs of the population. Previous research results on differences in antibiotic use between socio-economic and demographic groups in Sweden are not entirely coherent, and have typically focused on the effects of singular socio-economic variables. Using an intersectional approach, this study provides a more precise analysis of how the dispensation of antibiotic medication was distributed across socio-economic and demographic groups in Sweden in 2016-2017. Methods: Using register data from a nationwide cohort and adopting an intersectional analysis of individual heterogeneity and discriminatory accuracy, we map the dispensation of antibiotics according to age, sex, country of birth and income. Results: While women and high-income earners had the highest antibiotic dispensation prevalence, no large differences in the dispensation of antibiotics were identified between socio-economic groups. Conclusions: Public-health interventions aiming to support the reduced and optimised use of antibiotics should be directed towards the whole Swedish population rather than towards specific groups. Correspondingly, an increased focus on socio-economic or demographic factors is not warranted in interventions aimed at improving antibiotic prescription patterns among medical practitioners., Funding Agencies|Pufendorf Institute for Advanced Studies, Lund University (Theme: Post-Antibiotic Futures), Vetenskapsradet [2017-01321]