In Sweden, injuries due to falls are the most common cause of injury-related hospitalization and injury-related death amongst elderly. Also, during the 20th century, increasing trends in fall-related injuries have been observed in many high-income countries. Whilst fall-related injury trends have been reported from national studies in other comparable countries, no studies from Sweden using national data have been published, despite this issue sometimes being pointed out as one of the most important emerging societal risks both in Sweden and elsewhere. With large individual and societal costs, as well as prognosticated continued increases in high-income countries, the aim of this thesis is to update the knowledge on the trends of fall-related injuries amongst elderly in Sweden and to determine whether the issue is still to be considered an emerging risk. National injury morbidity and mortality data from Sweden can show that with regards to all hospitalized fall-related injuries as well as hip fractures, the risk is decreasing. However, diverging trends are observed in age- and sex-specific groups, with younger elderly now having considerably lower rates of fall-related injuries, whilst older elderly are increasingly hospitalized due to minor fall-related injuries. Also, amongst older elderly, increasing hip fracture mortality trends are observed. With regards to sex-specific groups, although fall-related injuries in general are more common amongst women, the injury trends for women are generally decreasing at a quicker rate than for men. Also, contradictorily to almost all fall-related injury morbidity, hip fracture mortality risk is higher amongst men. This thesis can show a change in trend in fall-related injuries amongst elderly in Sweden since the turn of the century, apart from amongst older elderly and with regards to hip fracture mortality. The implications on prognoses needs to be studied further as do the underlying causes behind this shift in trend. / BAKSIDESTEXT Injuries due to falls are the most common cause of injury-related hospitalization and injury-related death amongst elderly. During the 20th century, although increasing trends in fall-related injuries have been reported from other high-income countries, no studies from Sweden using national data have been published, despite this issue being pointed out as one of the most important emerging societal risks in Sweden. National injury morbidity and mortality data from Sweden can show that in terms of hospitalized fall-related injuries as well as hip fractures, the risk is decreasing. However, diverging trends are observed in age- and sex-specific groups, with younger elderly now having considerably lower rates of fall-related injuries, whilst older elderly are increasingly hospitalized due to minor fall-related injuries. Also, amongst older elderly, increasing hip fracture mortality trends are observed. This thesis can show a change in trend in fall-related injuries amongst elderly in Sweden since the turn of the century, apart from amongst older elderly and with regards to hip fracture mortality. The implications on future prognoses needs to be studied further as do the underlying causes behind this shift in trend.

The safety of antipsychotic use in elderly persons has recently been questioned. The incidence of adverse events (AEs) (extrapyramidal syndromes (EPS), cerebrovascular and cardiac events, and all-cause mortality) in the elderly users of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) was compared. Risks of AEs in antipsychotic-exposed persons and non-exposed individuals were also assessed. A population-based retrospective cohort study was conducted in the elderly Manitoba residents who received their first antipsychotic medication between April 1, 2000 and March 31, 2007. Cox proportional hazards models were built to compare risks of AEs in FGA and SGA users, as well as in non-exposed subjects. SGAs were associated with a lower risk of all-cause mortality (adjusted HR 0.683, 95% CI 0.577–0.809) and a higher risk of myocardial infarction (1.614 [1.024–2.543]) compared to FGAs. No significant differences between FGAs and SGAs were found for cerebrovascular events, cardiac arrhythmia and congestive heart failure (CHF) but a higher incidence of EPS was observed for FGAs compared to risperidone. Both FGA and SGA users were at a higher risk of cerebrovascular events (FGAs 1.415 [1.114–1.797]; SGAs 1.611 [1.388–1.869]) and CHF (FGAs 1.228 [0.893–1.689]; SGAs 1.242 [1.003–1.536]) compared to non-exposed subjects. Only FGA-users were at a higher risk of death compared to non-exposed subjects (FGAs 1.387 [1.065–1.805]; SGAs 0.824 [0.708–0.959]). Both FGA and risperidone use were associated with a higher risk of EPS (FGAs 3.503 [2.271–5.403]; risperidone 1.733 [1.214–2.472]). Both classes of antipsychotics might lead to potentially life-threatening AEs. Neither FGAs nor SGAs seem to have a superior overall safety profile. Antipsychotic pharmacotherapy should be prescribed in elderly persons after careful consideration of all risks and benefits.

Perceived control (PC), the degree to which individuals believe they have direct influence over events in their life, is often found to be associated with emotional well-being. Moreover, for over three decades, research has demonstrated that PC fosters health in advanced age. The mediational role of health in the PC and emotion relationship was investigated. Community-dwelling older adults (n = 232) were examined via secondary data analysis from the Aging in Manitoba (AIM) project and the Successful Aging Study (SAS). Separate mediational models were assessed for two different health mediators, self-rated health and health-related restrictions, and for positive and negative emotions. PC was found to benefit both physical and emotional well-being. The evidence of mediation was most compelling in the prediction of negative emotions and health-related restrictions. Findings have implications for treatment interventions in hopes to foster PC which in turn, should promote health and enhance later life emotional well-being.

This thesis presents the notion that paid elder care work is often more involved with ordering individuals, than caring for them. It discusses this issue via ethnographic data about care assistant and nursing auxiliary work, which was collected in two elder care homes: Hazelford Lodge residential home and Bracken Court nursing home. The thesis uses care, control, and knowledge as the main themes for the discussion of work in both homes. The first chapter sites the thesis within the context of the academic literature on the discourses of the body, the nature of care work and residential care. It focuses especially upon care work as body labour. Chapter two presents the ethnographic methodological approach of the thesis, in two sections. Firstly, the use of the Foucauldian notion of discourse is explained, and secondly, the research process and research relationships are explored through a reflexive account. Chapters two and three present social, structural and spatial aspects of the two settings. They discuss the different ways in which the homes were organised, and that spaces were utilised and had different meanings, within the homes. Chapters four and five are based upon data from Hazelford Lodge residential home, and illustrate the care assistants' work as centred upon created order in the home, based upon the typification of residents and others. Chapters six and seven explore the auxiliaries' work in Bracken Court and present three control issues as central to their jobs. Firstly the overt ordering of patients around spaces in the home. Secondly, the normalisation of individuals into patient, and objects, of body work. Thirdly, the auxiliaries' resistance to heir role and status. Chapter eight compares the work of the assistants and auxiliaries in terms of resident and patient construction, the nature of the two forms of work, their knowledge, and lastly, their constructions of place and status. The thesis argues that both groups of workers are involved in ordering bodies that they perceive to be problematic and degenerating. In Hazelford Lodge order and discipline is practised as care and in Bracken Court the auxiliaries use more overt forms of control, but both 'caring' and controlling are effective methods of creating order. By introducing notions of body labour and ordering, the thesis presents a unique critique of paid care.

国立情報学研究所で電子化したコンテンツを使用している。

Diss. (sammanfattning) Stockholm : Stockholms universitet, 2008. / Härtill 5 uppsatser.

Thesis (Ph.D.)--University of California, Irvine, 2008. / Adviser: Judith K. Treas. Includes bibliographical references.

Thesis (M.S.W.)--University of Hong Kong, 1994. / Includes bibliographical references (leaves 105-110).

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 2000. / Includes bibliographical references.

Thesis (Ph. D.)--University of Florida, 1984. / Description based on print version record. Typescript. Vita. Includes bibliographical references (leaves 154-164).