Undvik vård på sjukhus eller vårdhem som drivs med vinstkrav. Landstingen bör inte sluta avtal med sådana institutioner. Det är ett par av de slutsatser som Inge Axelsson drar efter att ha gått igenom litteraturen om kvalitet och kostnad i vård med respektive utan krav på vinst.
The first studies of treatment of bronchiolitis in infants and toddlers with inhalation of hypertonic saline showed that the treatment was beneficial but later studies have challenged these results. Here, we review four systematic reviews from 2015-2017 and two more recent studies not included in the reviews. Our conclusions are that in moderately severe bronchiolitis, the benefits of treatment are small or absent and inhalations should not be routine. In severe cases, inhalation of hypertonic saline may be considered but benefits are not proven. Water is an irritant to the lower respiratory tract and saline is therefore doubtful as a placebo. We found only one study with conservative placebo (no inhalation). It showed no benefit of hypertonic NaCl and should be repeated.
Minnesotamodellen har i den svenska debatten ibland framstått som en behandlingsmodell för socialt väletablerade alkoholister främst från socialgrupp 1 och 2. Vid Runnagården i Örebro tillämpas modellen även på tvångsomhändertagna och socialt utslagna alkoholister. Behandlingsresultaten efter nio månader understryker betydelsen av självhjälpsgrupper för ett positivt resultat, särskilt för tvångsomhändertagna och anstaltsanpassade patienter.
A survey comprising more than 2000 patients visiting primary care units during a 2-week period in November 2008 was carried out in the county of Västernorrland, Sweden. The results show that approximately 18.5 % of the patients came on account of psychological ill health, either as sole reason (1.5%) or in combination with other cause(s). Roughly 14.7 % (309) of these scored higher or equivalent to clinically meaningful cut off scores on scales measuring anxiety, depression and exhaustion (burnout). An additional 322 of the remaining sample (27 % of the females and 16 % of the males) had high scores on scales measuring psychological ill health.
In a questionnaire 1073 patients from 29 randomly selected Swedish hospitals who had undergone percutaneous coronary intervention (PCI) were asked what they considered to be the cause of their coronary disease, how they experienced the information given by the medical staff and in which way had they adopted a heart-healthy lifestyle. The main outcomes were; A majority attributed the cause of the disease to non-modifiable factors, i.e. age and heredity. Merely one in four patients had perceived the information in a correct way: they still carried the coronary disease and needed to adapt their lifestyle. Half of the patient population had increased their physical activity and likewise merely half had changed their food habits. Half of the tobacco users had quit after PCI. Thus the results of this study shows that there is ample space for improving the present care of post-PCI patients.
Evidence shows that symptoms and difficulties related to Attention Deficit Hyperactivity Disorder (ADHD) can continue into adulthood. ADHD is often complicated by the presence of comorbid conditions including mood and anxiety disorders, substance abuse, and antisocial disorders. We present a brief overview of ADHD in adulthood and the Swedish translation of the Adult ADHD Self-Report Scales (ASRS). We describe the current use of the ASRS in screening studies and in clinical settings in Sweden.