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Gustavsson, J., Bonander, C. & Nilson, F. (2018). A quasi-experimental evaluation of compliant flooring in a residential care setting. PLoS ONE, 13(7), Article ID e0201290.
Open this publication in new window or tab >>A quasi-experimental evaluation of compliant flooring in a residential care setting
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 7, article id e0201290Article in journal (Other academic) Published
Abstract [en]

Background

Fall injuries affect the lives of older people to a substantial degree. This quasi-experimental observational study investigates the potential fall injury reducing effect of a compliant flooring in a residential care setting.

Methods

The allocation of the compliant flooring was non-random. Data on fall-events and individual characteristics were collected in a residential care unit during a period of 68 months. The primary outcome was the fall injury rate per fall, and a logistic regression analysis was used to test for the effect of complaint flooring. Falls per 1000 bed days was the secondary outcome, used to measure the difference in fall risk on compliant flooring versus regular flooring.

Results

The event dataset is an unbalanced panel with repeated observations on 114 individuals, with 70% women. The mean age was 84.9 years of age, the average Body Mass Index (BMI) was 24.7, and there was a mean of 6.57 (SD: 15.28) falls per individual. The unadjusted effect estimate showed a non-significant relative risk injury reduction of 29% per fall (RR 0.71 [95% CI: 0.46–1.09]) compared to regular flooring. Re-estimating, excluding identified outliers, showed an injury risk reduction of 63% (RR 0.37 [95% CI: 0.25–0.54]). Falls per 1000 bed days showed that individuals living in apartments with compliant flooring had a fall rate of 5.3 per 1000 bed days compared to a fall rate of 8.4 per 1000 bed days among individuals living in regular apartments. This corresponds to an incidence rate ratio (IRR) of 0.63 (95% exact Poisson CI: 0.50–0.80).

Conclusion

The results of this non-randomized study indicate that compliant flooring has the potential to reduce the risk of fall injury without increasing the fall risk among older people in a Swedish residential care setting.

Place, publisher, year, edition, pages
San Francisco: PLOS, 2018
Keywords
Nursing home; Elderly care; Sports flooring; Impact absorbing flooring; frail elderly
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-66659 (URN)10.1371/journal.pone.0201290 (DOI)000439952400069 ()
Funder
Swedish Civil Contingencies Agency, 2013-4176
Note

This article was part of Johanna Gustavssons thesis (as manuscript).

Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2018-09-06
Bonander, C., Jakobsson, N. & Nilson, F. (2018). Are fire safe cigarettes actually fire safe?: Evidence from changes in US state laws. Injury Prevention, 24(3), 193-198
Open this publication in new window or tab >>Are fire safe cigarettes actually fire safe?: Evidence from changes in US state laws
2018 (English)In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, no 3, p. 193-198Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To estimate the effects of fire safe cigarette laws on fire mortality and cigarette-related fires in the USA.

METHODS: We examined the gradual implementation of the laws to identify their average effects, using difference-in-differences analysis to account for common year effects, time-invariant state effects, state-specific trends and observable time-varying state-level covariates.

RESULTS: We found no statistically significant effects on all-cause fire mortality, residential fire mortality or cigarette-caused fire rates. The estimates for cigarette-caused fire deaths were significant under some specifications, but were not robust to the inclusion of state-specific trends or comparisons to effects on other cause-determined fires.

CONCLUSIONS: Given the mixed state of our results, we conclude that previous claims regarding the effects of fire safe cigarette laws may be premature.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
Fire safety standard compliant cigarettes, Legislation, Lower ignition propensity, Outcome Evaluation, Reduced ignition propensity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-56822 (URN)10.1136/injuryprev-2017-042322 (DOI)28630083 (PubMedID)
Available from: 2017-07-04 Created: 2017-07-04 Last updated: 2018-06-12Bibliographically approved
Nilson, F., Lindberg, F., Palm, G., Lundgren, L., Rayner, D., Börjesson, M., . . . Carlström, E. (2018). Can participants predict where ambulance‐requiring cases occur at a half marathon?. Scandinavian Journal of Medicine and Science in Sports, 28(12), 2760-2766
Open this publication in new window or tab >>Can participants predict where ambulance‐requiring cases occur at a half marathon?
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2018 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 28, no 12, p. 2760-2766Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Köpenhamn: Munksgaard Forlag, 2018
National Category
Sport and Fitness Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-69463 (URN)10.1111/sms.13299 (DOI)000449842400032 ()
Available from: 2018-10-03 Created: 2018-10-03 Last updated: 2018-11-29Bibliographically approved
Nilson, F. & Börjesson, M. (2018). Mortality in long-distance running races in Sweden - 2007–2016. PLoS ONE, 13(4), Article ID e0195626.
Open this publication in new window or tab >>Mortality in long-distance running races in Sweden - 2007–2016
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 4, article id e0195626Article in journal (Refereed) Published
Abstract [en]

Background During the last decade, an increasing popularity of marathons has been seen. Although running has been shown to have considerable positive health effects, the risk of sudden death, most often due to sudden cardiac arrests, is also a risk runners expose themselves to. Whilst there are some studies on the mortality amongst long-distance runners, much of the evidence is dated. Given the increased popularity in running during the 21st century as well as the improvements in medical care at marathons, more knowledge is required on the mortality risk. Materials and method Publicly available racing and news databases were used to identify the number of entrants and finishers in half to full marathons in Sweden between 2007 and 2016 and the number of deaths that occurred in conjunction with the races. Results A total of 1,156,271 runners entered a long distance (21-42km) running race in Sweden between 2007 and 2016, and 834,412 runners finished the races (72.2%). A large majority of the finishers (677,050 (81%)) competed in distances under a full marathon. Two deaths occurred during the time period, meaning that the death rate was 0.24 (95% confidence interval 0.04–0.79) per 100,000 finishers. Conclusions This study can show that death rates in long distance running races between 2007 and 2016 in Sweden are very low, compared to previous studies. When added to the existing literature, the combined picture suggests a general downward trend in the risk of death during marathons since the 1980s. 

Place, publisher, year, edition, pages
Public Library of Science, 2018
Keywords
case report, clinical article, human, medical care, mortality rate, mortality risk, race, review, runner, running, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-67104 (URN)10.1371/journal.pone.0195626 (DOI)000429505000067 ()29630680 (PubMedID)2-s2.0-85045139675 (Scopus ID)
Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2018-08-15Bibliographically approved
Jonsson, A., Nilson, F., Bonander, C. & Huss, F. (2018). Seriously injured due to residential fires in sweden. Paper presented at World Safety Conference 2018. Injury Prevention, 24, A16-A16, Article ID PA 07-5-25.
Open this publication in new window or tab >>Seriously injured due to residential fires in sweden
2018 (English)In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, p. A16-A16, article id PA 07-5-25Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-69464 (URN)10.1136/injuryprevention-2018-safety.44 (DOI)000446617400045 ()
Conference
World Safety Conference 2018
Available from: 2018-10-03 Created: 2018-10-03 Last updated: 2019-03-07Bibliographically approved
Nilson, F., Lindberg, F., Palm, G., Lundgren, L., Rayner, D., Börjesson, M., . . . Carlström, E. (2018). Testing a novel method for identifying where serious medical encounters occur at marathons in order to improve medical preparedness and runners’ safety. Paper presented at World Safety Conference 2018. Injury Prevention, 24, A29-A29
Open this publication in new window or tab >>Testing a novel method for identifying where serious medical encounters occur at marathons in order to improve medical preparedness and runners’ safety
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2018 (English)In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, p. A29-A29Article in journal, Meeting abstract (Refereed) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Other Medical Sciences Occupational Health and Environmental Health
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-69462 (URN)10.1136/injuryprevention-2018-safety.79 (DOI)000446617400080 ()
Conference
World Safety Conference 2018
Available from: 2018-10-03 Created: 2018-10-03 Last updated: 2018-11-29Bibliographically approved
Nilson, F., Damsager, J., Lauritsen, J. & Bonander, C. (2018). The effect of breed-specific dog legislation on hospital treated dog bites in Odense, Denmark: A time series intervention study. PLoS ONE, 13(12), Article ID e0208393.
Open this publication in new window or tab >>The effect of breed-specific dog legislation on hospital treated dog bites in Odense, Denmark: A time series intervention study
2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0208393Article in journal (Refereed) Published
Abstract [en]

As dog bite injuries are a considerable problem in modern society, in order to reduce such injuries, breed-specific legislation has been introduced in a number of countries. Whilst many studies have shown a lack of effect with such legislation, the commonly used methodology is known to be flawed. Therefore, the aim of this study is to investigate the effect of the Danish breed-specific legislation on the number of dog bite injuries using more credible methods. A time series intervention method was used on a detailed dataset from Odense University Hospital, Denmark, regarding dog bite injuries presented to the emergency department. The results indicate that banning certain breeds has a highly limited effect on the overall levels of dog bite injuries, and that an enforcement of the usage of muzzle and leash in public places for these breeds also has a limited effect. Despite using more credible and sound methods, this study supports previous studies showing that breed-specific legislation seems to have no effect on dog bite injuries. In order to minimise dog bite injuries in the future, it would seem that other interventions or non-breed-specific legislation should be considered as the primary option.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2018
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-70969 (URN)10.1371/journal.pone.0208393 (DOI)000454416400018 ()30586418 (PubMedID)
Available from: 2019-02-07 Created: 2019-02-07 Last updated: 2019-04-24Bibliographically approved
Gustavsson, J., Jernbro, C. & Nilson, F. (2018). There is more to Life than Risk Avoidance: Elderly Peoples Perspectives of Falls and Compliant Flooring. International Journal of Qualitative Studies on Health and Well-being, 13(1), 1-9, Article ID 1479586.
Open this publication in new window or tab >>There is more to Life than Risk Avoidance: Elderly Peoples Perspectives of Falls and Compliant Flooring
2018 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, p. 1-9, article id 1479586Article in journal (Refereed) Published
Abstract [en]

Background. Falls are the most common cause of injury in all ages and are especiallydifficult to prevent among residential care residents. Compliant flooring has beenproposed as a measure to prevent fall-injury, however little is known regarding theimplementation aspects in clinical settings. The aim of this study was to explore thefrail elderly person's view on falls, the risk of fall-injury, prevention in general andspecifically compliant flooring as an injury preventative measure. Methods. In this qualitative study, we used the grounded theory method and conductedin depths interviews with eight elderly people in residential care.Results. The identified categories were Falling as a part of life, Fearing theconsequences and A wish to prevent falls and injuries. Through the results is was clearthat There is more to life than risk avoidance, permeated the interviews, thereforeforming the grounded theory. The interviewees viewed falls as something common andnormal, and were uninterested in focusing on the risk of falls. Although they wanted toprevent falls, it was often difficult to integrate preventative measures into their everydaylife. They embraced the idea of an injury reducing compliant flooring, but their maininterests lie elsewhere.Conclusions. The results in this paper propose explanations on the obstacles ofimplementing fall prevention measures in an elderly frail population. The findings cangive us insights as to why interest, compliance for active fall prevention measures arelow, and on various factors that have to be taken under consideration in the process ofconstructing prevention. Compliant flooring is a passive fall injury prevention measurethat does not require the target group to make active decisions, adapt or activelyparticipate in the program. Therefore, we conclude that complaint flooring, from theperspective of the residents, can work well in residential care.

Place, publisher, year, edition, pages
Taylor & Francis, 2018
Keywords
Injury Prevention; Impact-Absorbing Flooring; Low-Impact Flooring; Nursing Home;
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-66657 (URN)10.1080/17482631.2018.1479586 (DOI)000434312600001 ()
Funder
Swedish Civil Contingencies Agency, 2013-4176
Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2018-09-21Bibliographically approved
Gustavsson, J., Rahm, G., Jernbro, C. & Nilson, F. (2017). Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses. Journal of Housing for the Elderly, 31(4), 367-381
Open this publication in new window or tab >>Effects of Impact-Absorbing Flooring in Residential Care from the Perspectives of Enrolled Nurses
2017 (English)In: Journal of Housing for the Elderly, ISSN 0276-3893, E-ISSN 1540-353X, Vol. 31, no 4, p. 367-381Article in journal (Refereed) Published
Abstract [en]

Falls are a daily occurrence in nursing homes and few interventions for reducing fall-related injuries have proven to be effective. Impact absorbing flooring (IAF) in residential care has shown promising results in reducing fail-injuries and in the process of developing and implementing IAF all aspects are valuable to explore. Therefore, the aim of this qualitative study is to describe the enrolled nurses (ENs) experiences of IAF. We carried out focus group interviews with ENs and used content analysis to process the data. The ENs experienced both negative and positive aspects with the IAF. Importantly, the ENs perceived the IAF as effective in preventing fall-injuries. They also appreciated the improvements in acoustics. Negative aspects were that the flooring initially was challenging to walk on and that it made it harder to maneuver heavy equipment. A significant and transferable finding in this study was the importance of the ENs' perceived difficulty in preventing fall-injuries amongst elderly people living in nursing homes. This seemed to be a driving force to accept the intervention. Although IAF affects the working conditions in a nursing home, ENs are willing to accept these issues given the perceived effectiveness of the intervention.

Place, publisher, year, edition, pages
Routledge, 2017
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:kau:diva-65975 (URN)10.1080/02763893.2017.1335670 (DOI)000419504100004 ()
Note

Artikeln ingick i författarens licentiatuppsats, då med titeln Working in a nursing home with Impact Absorbing Flooring - a qualitative study on the experiences of licensed practical nurses.

Available from: 2018-01-25 Created: 2018-01-25 Last updated: 2018-09-07Bibliographically approved
Bonander, C. & Nilson, F. (2017). Sociodemografiska skillnader i risken för bostadsbrand, prevalens av brandskydd i hemmet och hantering av bränder: En analys av nationella enkäter 2001, 2005 och 2008.
Open this publication in new window or tab >>Sociodemografiska skillnader i risken för bostadsbrand, prevalens av brandskydd i hemmet och hantering av bränder: En analys av nationella enkäter 2001, 2005 och 2008
2017 (Swedish)Report (Other academic)
Publisher
p. 33
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Risk and Environmental Studies
Identifiers
urn:nbn:se:kau:diva-65620 (URN)
Projects
Framgångsfaktorer vid bostadsbränder
Funder
Brandforsk
Available from: 2018-01-17 Created: 2018-01-17 Last updated: 2018-05-22
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6928-0683

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