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The authors regret < Published PDF is correct including the corrections we did because of the comments from the reviewers. But the abstract including keywords is missing in the published version of the article. > The authors would like to apologise for any inconvenience caused. Abstract Introduction: In the EU, the number of seriously injured road users has fallen more slowly than that of fatalities, and fatalities have fallen more slowly for single motor-vehicle crashes than multi-crashes. Instead, the number of injured vulnerable road users such as cyclists and pedestrians has increased and there are calls to promote walking and cycling. The study aims to increase the knowledge about serious injuries in single crashes/falls and to study the differences within and between pedestrians, cyclists, car occupants and motorcyclists. Methods: Data was retrieved from national registries (Strada; National Road Database) for all seriously injured road users on roads, tracks and pavements in Sweden 2016–2019 together with speed limits for crash locations. Statistical analysis used descriptive statistics, multiple logistic regression and multiple linear regression. Results: More road users sustained serious injuries in single crashes than in multi-crashes. Nearly four out of five were injured where the speed limit was 30–50 km/h, or in areas without any speed limit. The mean Injury Severity Scores (ISS) for pedestrians and cyclists were slightly higher than the definition of a seriously injured road user, while car occupants and motorcyclists had mean scores three to four points higher. The most frequently injured body region for cyclists and pedestrians was the lower extremities, and for car occupants and motorcyclists it was the thorax. Higher age increased the probability of these injuries. Male pedestrians and cyclists had higher ISS scores than their female counterparts. Conclusions: Pedestrians and cyclists are the largest groups of road users who are seriously injured in single crashes. Pedestrian falls on pavements, tracks and roads need to be included in road-safety efforts for all road users. The road space will define the pedestrian fall as a crash. Keywords single crash, fall, walking, cycling, ISS.

I ett drygt decennium har det varit möjligt för statliga och enskilda högskolor i Sverige att ansöka om att få inrätta forskarutbildning inom ett specifikt område. Fram till 2020 har 38 tillstånd beviljats och åtta av dessa har koppling till området hälsa och/eller välfärd. Sedan läsåret 2012/13 finns vid Mälardalens högskola (MDH) forskarutbildning inom detta område. Syftet med denna artikel är att beskriva och diskutera en granskning av hur området hälsa och välfärd återspeglas i de första 15 avhandlingarna. En kvalitativ deduktiv innehållsanalys genomfördes samt en bibliometrisk undersökning av innehållet i avhandlingarnas introduktion och diskussion. Utifrån granskningen diskuteras resultatet men också hur den metodik som tillämpats kan vara relevant för granskning av avhandlingar även vid andra högskolor med ett specifikt forskarutbildningsområde.   

Breast cancer is the most common cancer type among women globally. To facilitate early detection,all 40–74-year-old female residents of Sweden are invited to participate in a population-based mammographic screening programme. Approximately 20% of all invited women decline the offer, and if this is due to systematic differences that can be adjusted, it can indicate inequity in healthcare. Assessment of and being updated about the health and healthcare of the residents are largely the responsibilities of the self-governed regions in Sweden. The understanding of the residents’ health serves as a basis for decision making and priority setting. This study aims todescribe how politicians representing a region in Sweden perceive women’s participation in mammographic screening and the politicians’ own possibility to promote such participation.Methods: Qualitative thematic analysis was conducted on the data obtained from individual semi-structured interviews held in 2019. The interviewees comprised ten politicians (six women and four men, 38–71 years old) representing a sub-committee focusing on public health and healthcare issues.Results: Two main themes have been identified: 1) expected actions and 2) expected conditions for acting,including a total of four sub-themes. According to the politicians, the expected actions, such as obtaining information and being updated about matters regarding mammographic screening, concern both the women invited to the screening and the politicians themselves. Additionally, for both the individual and the healthcare organisation, here represented by the politicians, expected actions entail a shared commitment to maintain health.The expected conditions for acting refer to the politician’s awareness of the factors influencing the women’s decision to undergo or refuse the screening and having the resources to enable taking actions to facilitate participation. Conclusions: Expected actions and expected conditions for acting are tightly connected and entail some form of prioritisation by the politicians. Setting the priorities can be based on information about the purpose of thescreening and an understanding of social determinants’ impacts on women’s decision to refrain frommammographic screening, as well as available resources.

Background

The number of seriously injured unprotected road users has increased during implementation of a road safety policy Vision Zero. The aim of the study is to identify factors associated with the increase in serious injuries among cyclists and pedestrians (even single pedestrian accidents) that occurred in an urban road space in a Swedish region 2003–17. The urban road space includes roads, pavements and tracks for walking and cycling.

Methods

Data were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) and NVDB (National Road Database). Descriptive statistics and logistic regression with odds ratios for sex, age and part of road space were assessed.

Results

The number of seriously injured cyclists and pedestrians more than doubled from 2003 to 2017, with the greatest increase for pedestrians. Older age increased the probability of serious injury since 2012 for the group ≥ 80 years and since 2015 for the group 65–79 years. No significant effect of sex. Most injuries occur in areas not transformed by Vision Zero.

Conclusions

An increasing number of elderly persons in the generation born in the 1940s and increased life expectancy are important factors. There is a need to increase road safety measures that also promote active mobility.

In 1997 the Swedish Parliament adopted the Vision Zero road safety policy, which since 2009 is included in a consideration goal (road safety, environment, health) as one of two goals under an overall transport goal. The target of achieving Vision Zero is not specified for different authorities. Investments in infrastructure are a common way of designing a safe system. Plans for regional transport infrastructure are therefore tools to achieve the national target.

The aim of the study is to analyse how Vision Zero has been applied by regional authorities as a term, a goal or a clarification in justifying measures in county plans for regional transport infrastructure in the period 2014–2025 in Sweden. Ten of twenty-one plans were included in the analysis as they selected costs for road safety measures for both state and municipal roads. The plans were analysed using directed and summative content analysis.

The consideration goal is rarely in evidence. Measures are most often justified by accessibility and public transport, walking and cycling, as clarifications of the functional goal (accessibility). It is likely that the imbalance between the functional goal and the consideration goal reflects a lack of governance by the Vision Zero road safety policy.Fulfilling a national road safety target requires well-adapted sub-targets for the organizations concerned.

Understanding women’s life conditions regarding their non-participation in different health-promoting and disease-preventing activities is important as it may draw attention to potential areas for improvement in the healthcare sector. Mammographic screening, a disease-preventing service, facilitates early detection of any potential malignancies and consequently prompts initiation of treatment. The reasons for non-participation in mammographic screening can be understood from different perspectives, such as socioeconomic and lifestyle-related determinants of health. This study aims to gain a deeper understanding of women’s experiences and perceptions about non-participation in mammographic screening in a Swedish region with a single mammographic facility.

Methods

Data from individual semi-structured interviews, conducted in 2018 with eleven women between the ages of 48 and 73, were analysed by a qualitative content analysis.

Results

The findings reveal three main categories: 1) doubts regarding mammographic screening and its organisation, 2) sense and sensibility in the decision to refrain from mammographic screening, and 3) dependency and options. These three categories indicate aspects, such as the individual’s life situation, accessibility to the offered service, and the flexibility of the healthcare system, that need to be considered to improve the organisation of mammographic screening.

Conclusion

Listening to the women’s voices regarding their experiences and perceptions about mammographic screening is important as individual characteristics and social circumstances interact with healthcare and affect the degree of participation.

Objectives

The aim of the study is to examine what types of injuries that seriously injured pedestrians and cyclists received in urban road spaces from 2003 to 2017 in the Swedish region of Västmanland, when the road safety policy Vision Zero was implemented.

Study design

This is a cross-sectional data annually collected over a period of fifteen years.

Methods

Data from health care for 403 seriously injured pedestrians and cyclists were retrieved from the registry STRADA (Swedish Traffic Accident Data Acquisition) and cross-referenced with the National Road Database to see if any Vision Zero measures had previously been implemented at the crash location. The study includes injuries from both single and multiple crashes on roads, pavements, and tracks for walking and cycling (road space). Statistical analysis was performed by descriptive statistics, chi-square tests, and multiple logistic regression analyses.

Results

Pedestrians were seriously injured in lower extremities more than cyclists, whereas more cyclists were seriously injured in the head. During the period, pedestriansꞌ head injuries decreased significantly, but injuries in lower extremities increased significantly. In addition, for cyclists, there was a shift from decreased probability of head injuries to increased probability of injuries in lower extremities related to increased age. For pedestrians, pavements/tracks were associated with a decreased probability of a majority of injury outcomes but for cyclists only for severe injury outcomes.

Conclusions

From 2003 to 2017, there was a shift among seriously injured pedestrians, with head injuries decreasing and injuries in lower extremities increasing. This shift was probably related to an ageing population in the region, given that increased age among both pedestrians and cyclists was associated with a decreased probability of head injuries but increased probability of injuries in lower extremities. On Vision Zero roads, there was a decreased probability of pedestrians receiving serious injury to more than one bodily region. An increased number of older people combined with policies for more active mobility such as walking and cycling are a challenge for road authorities in urban areas.

Background: Since 1997 Sweden has a policy for road safety called Vision Zero. Given that Vision Zero is mainly used to reduce fatalities among car occupants, the question has been raised by the research community whether a Vision Zero approach promotes health for all road traffic users. The objective is to measure target fulfilment of the national road safety policy for a Swedish region by examining incidence of serious injury during 2003-2014 in rural and urban road spaces with or without implemented measures. Methods: Data on seriously injured road users, defined as ISS > 8 (Injury Severity Score), were retrieved from STRADA (Swedish Traffic Accident Data Acquisition) together with data from NVDB (National Road Database). These data are used to describe where road users are seriously injured in relation to implemented national policy and using a conceptual model of a road space comprising roads, pavements and tracks for walking and cycling. Seriously injured road users in single and multiple crashes with and without vehicles are included. The development of the incidence is analysed for different road users and places in the road space. Results: Despite implemented road safety measures in the region, the incidence of seriously injured road users per 100,000 inhabitants in rural areas increased from 7.8 in 2003 to 9.3 in 2014 but doubled in urban areas from 8.0 in to 16.3 respectively. In areas not transformed by Vision Zero, only 36% were injured in rural areas while 64% were injured in urban areas. In contrast, in transformed areas 61% of injuries occurred in rural areas, whereas 39% occurred in urban areas. While the incidence decreased for car occupants on transformed national roads in rural areas, the incidence of serious injuries increased among unprotected road users in urban areas, in particular on pavements and tracks for cycling and walking than on the roads where Vision Zero had been implemented. Conclusion: The reduction in the incidence for car occupants in the region may not be adequate to contribute to fulfilling the national target. More needs to be done, especially in the urban areas, where more active mobility is desired.