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  • 51. Johansson, L
    et al.
    Björeland, A
    Wickman, G
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Distribution of radioactive caesium in the population of northern Sweden. A follow-up study1999In: Radiation protection dosimetry, ISSN 0144-8420, Vol. 86, no 1, p. 59-62Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    After the Chernobyl accident in 1986, the uptake of radioactive caesium has been studied in several population groups in northern Sweden. During the period 1988-1993 the 137Cs content in the population of northern Sweden was followed by measurements of 137Cs concentration in tissue samples from medico-legal autopsies. From these studies an "ecological" half-time for 137Cs in the population was estimated. A follow-up made on samples taken 1995-1996 is presented here. The results from this prolongation of the period indicates a significantly longer half-time. This new half-time gives a better representation of the retention of 137Cs in the population of northern Sweden at times longer from the deposition.

  • 52.
    Johansson, Lars
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
    Teenager injury panorama in northern Sweden.2001In: International journal of circumpolar health, ISSN 1239-9736, Vol. 60, no 3, p. 380-90Article in journal (Other academic)
    Abstract [en]

    OBJECTIVES: To study non-fatal unintentional injuries among teenagers and to suggest preventive measures. SETTING: The emergency care unit of the University Hospital, Umea, Sweden. METHODS: All injured teenagers (N = 1044) attending the emergency care unit during 1991 were asked to answer a questionnaire focusing on when, where and how the injury occurred. All available medical records were examined. Data were coded according to the Nordic Medico-Statistical Committees Classification for Accident Monitoring, NOMESCO, and to the Abbreviated Injury Scale, AIS. RESULTS: 1,043 teenagers were treated with sports and transportation related injuries as the most common ones. Most injuries were minor (AIS 1), transportation related injuries had the highest proportion of non-minor injuries (AIS > or = 2), 139 teenagers were admitted for in-patient care. Most injuries occurred during leisure/school time. CONCLUSIONS: Sports and transportation related injuries were most frequent. Body weight and length differs among teenagers, we suggest that teenagers should exercise and play together, not only by age, but also to some extent, to height and weight. Curfew laws, a compulsory bicycle helmet law are other injury reducing measures suggested.

  • 53.
    Johansson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Lindqvist, Per
    Division of Forensic Psychiatry, Dept. of Clinical Neuroscience, Karolinska Institute, Stockholm university, Sweden.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Teenage suicide cluster formation and contagion: implications for primary care2006In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 17, no 7, p. 32-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We have previously studied unintentional as well as intentional injury deaths among teenagers living in the four northernmost counties, forming approximately 55% of Sweden with 908,000 inhabitants in 1991. During this work, we found what we suspected to be a suicide cluster among teenagers and we also suspected contagion since there were links between these cases. In this present study, we investigate the occurrence of suicide clustering among teenagers, analyze cluster definitions, and suggest preventive measures. METHODS: A retrospective study of teenager suicides autopsied at the Department of Forensic Medicine in Umea, Sweden, during 1981 through 2000. Police reports, autopsy protocols, and medical records were studied in all cases, and the police officers that conducted the investigation at the scene were interviewed in all cluster cases. Parents of the suicide victims of the first cluster were also interviewed. Two aggregations of teenager suicides were detected and evaluated as possible suicide clusters using the US Centers for Disease Control definition of a suicide cluster. RESULTS: Two clusters including six teenagers were confirmed, and contagion was established within each cluster. CONCLUSION: The general practitioner is identified as a key person in the aftermath of a teenage suicide since the general practitioner often meet the family, friends of the deceased, and other acquaintances early in the process after a suicide. This makes the general practitioner suitable to initiate contacts with others involved in the well-being of the young, in order to prevent suicide cluster formation and para-suicidal activities.

  • 54.
    Johansson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Bylund, Per-Olof
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    ER visits predict premature death among teenagers2012In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 48, no S1, p. 397-400Article in journal (Refereed)
    Abstract [en]

    Background: The purpose of this study was to investigate if teenagers visiting an emergency room because of injury have an increased risk of premature death ahead and, if so, identify possible risk factors and suggest preventive measures. Methods: In January 2010, the personal identity numbers of 12,812 teenagers who had visited the emergency room at the University Hospital in Umea. Sweden, during 1993 through 2006 because of injury were checked against the National Cause of Death Register in Sweden. Standardised mortality ratio and confidence intervals were calculated. For the unnatural deaths that took place in Sweden, the police report, autopsy protocol, and hospital records, if present, were studied. Results: Thirty-eight fatalities were included giving a standardised mortality ratio of 1.44 (95% CI: 1.02-1.98). A majority of the decedents were males (n = 32, 84%) and the median age at the time of death was 21 years. Twenty-three deaths were caused by unintentional injuries and ten by intentional injuries (all suicides), while five deaths were categorised as undetermined whether intentional or not. Seventy-four percent tested positive for either alcohol or drugs or a combination at the post mortem examination. Nine males and one female committed suicide, five tested positive for alcohol (one also for drugs), while four tested negative at the post mortem examination. One died abroad and in this case we lack information on alcohol and drugs. Conclusion: Teenagers visiting an emergency room due to injury experience an increased risk of premature death by unnatural cause and those at risk are especially males. The use of alcohol and drugs often seems to contribute to their untimely deaths. Identifying those at risk when they visit the emergency room for an injury and to take preventive actions at this stage could be a way to reduce the number of fatalities. (C) 2012 Elsevier Ltd. All rights reserved.

  • 55.
    Johansson, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    A survey of teenager unnatural deaths in northern Sweden 1981-20002005In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 37, no 2, p. 253-258Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To survey unnatural deaths among teenagers in northern Sweden and to suggest preventive measures.

    SETTING: The four northernmost counties (908,000 inhabitants, 1991), forming 55% of the area of Sweden.

    MATERIAL AND METHODS: All unnatural teenager deaths from 1981 through 2000 were identified in the databases of the Department of Forensic Medicine in Umea, National Board of Forensic Medicine. Police reports and autopsy findings were always studied, social and hospital records if present.

    RESULTS: Three hundred and fifty-five deaths were found, of which 267 (75%) were males and 88 (25%) females. Ninety out of 327 (28%) tested positive for alcohol. Two hundred and forty-eight (70%) were unintentional and 102 (30%) were intentional deaths, and five (1%) were categorized as undetermined manner of death. Unintentional deaths decreased while the incidence of intentional deaths remained unaffected by time.

    CONCLUSIONS: Injury-reducing measures have been effective concerning unintentional deaths and the fall in young licensed drivers due to the economical recess have probably also contributed to the decrease. However, there were no signs of decreasing numbers of suicides during the study period, which calls for resources to be allocated to suicide prevention.

  • 56. Johansson, Åsa
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Gezelius, Christer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Att möta döden: omvårdnad vid livets slut2014Book (Other academic)
    Abstract [sv]

    Hur hanterar människan de existentiella utmaningar vi utsätts för vid livets slut? Hur kan vården underlätta för de drabbade och deras närstående? Den här boken försöker besvara dessa frågor med utgångspunkt i forskningsresultat och samtal med närstående och vårdpersonal.I Att möta döden intervjuas vårdpersonal om hanteringen av den döda kroppen, vad som händer med kroppen då vi dör och hur en obduktion kan se ut. Forskare och erfaren personal går även in på hur ett så kallat brytpunktssamtal kan gå till och vad som kan vara bra att tänka på i samtal med barn som närstående.

  • 57. Jonsson, Anna Kristina
    et al.
    Söderberg, Carl
    Espnes, Ketil Arne
    Ahlner, Johan
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Reis, Margareta
    Druid, Henrik
    Sedative and hypnotic drugs-fatal and non-fatal reference blood concentrations2014In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 236, p. 138-145Article in journal (Refereed)
    Abstract [en]

    In postmortem investigations of fatal intoxications it is often challenging to determine which drug/s caused the death. To improve the interpretation of postmortem blood concentrations of sedative and hypnotic drugs and/or clonazepam, all medico-legal autopsies in Sweden - where these drugs had been detected in femoral vein blood during 1992-2006 - were identified in the databases of the National Board of Forensic Medicine. For each drug, concentrations in postmortem control cases - where the cause of death was not intoxication and where incapacitation by drugs could be excluded - were compiled as well as the levels found in living subjects; drugged driving cases and therapeutic drug monitoring cases. Subsequently, fatal intoxications were assessed with regards to the primary substances contributing to death, and blood levels were compiled for single and multiple drug intoxications. The postmortem femoral blood levels are reported for 16 sedative and hypnotic drugs, based on findings in 3560 autopsy cases. The cases were classified as single substance intoxications (N = 498), multiple substance intoxications (N = 1555) and postmortem controls (N = 1507). Each autopsy case could be represented more than once in the group of multiple intoxications and among the postmortem controls if more than one of the included substances were detected. The concentration ranges for all groups are provided. Overlap in concentrations between fatal intoxications and reference groups was seen for most substances. However, the concentrations found in single and multiple intoxications were significantly higher than concentrations found in postmortem controls for all substances except alprazolam and triazolam. Concentrations observed among drugged drivers were similar to the concentrations observed among the therapeutic drug monitoring cases. Flunitrazepam was the substance with the highest number of single intoxications, when related to sales. In summary, this study provides reference drug concentrations primarily to be used for improving interpretation of postmortem drug levels in obscure cases, but which also may assist in drug safety work and in pharmacovigilance efforts.

    (C) 2014 Elsevier Ireland Ltd. All rights reserved.

  • 58.
    Junuzovic, Mensura
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Accidental firearm deaths during hunting2012In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 18, p. 97-97Article in journal (Refereed)
  • 59.
    Junuzovic, Mensura
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Unintentional firearm hunting deaths in Sweden2012In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 216, no 1-3, p. 12-18Article in journal (Refereed)
    Abstract [en]

    This study examined all unintentional firearm fatalities while hunting that occurred in Sweden between 1983 through 2008. The circumstances as well as the impact of the hunter's exam on fatality frequency were analysed. During these 26 years, there were 48 such fatalities, representing 53% of all (n = 90) unintentional firearm deaths during the same period. The average annual number of fatalities decreased over the last few decades. Very restrictive firearm legislation in Sweden combined with the introduction of a mandatory hunter's exam since 1985 accounted, at least partly, for this finding. Moose hunting accounted for 46% of the fatalities and small game hunting for the remaining cases. The mean age of the victims was 50 years and 96% of them were males; all shooters were males. During moose hunting, most of the victims were mistaken for game, whereas in small game hunting most of the fatalities were related to falls and improper handling of the weapon. Human error was thus the main cause of these fatalities.

  • 60.
    Junuzovic, Mensura
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Midlöv, Patrik
    Larsson Lönn, Sara
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Swedish hunters' safety behaviour and experience of firearm incidents2013In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 60, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Since any firearm injury is potentially lethal, it is of great interest to prevent firearm incidents. This study investigated such incidents during hunting and Swedish hunters' safety behaviour. A 48-item questionnaire was posted to a random sample of 1000 members of the Swedish Association for Hunting and Wildlife Management. The questions considered demographics, hunting experience/hunting habits/safety behaviour/attitudes and experience of careless weapon handling, hunters' weapons and safety behaviour relating to weapons, health status, firearm incidents and their preventability, and personal comments on the questionnaire. The response rate was almost 50%. The mean age of the responders was 54 years; 5% were females. Almost none (1%) reported hunting under the influence of alcohol. Young age and male sex were positively associated with risk behaviour, although the presence of multiple risk behaviours in the same responder was not common. A very high degree of compliance with Swedish laws regarding weapon storage was reported. One-quarter of the responders had witnessed a firearm incident caused by another hunter, which in most situations did not result in human injury or death. An unsafetied weapon was the most common reported "cause" of these incidents. Experience of a firearm incident was not uncommon and the majority of the responders considered the incident in question to be preventable. This study provides a picture of the possible risk behaviour among hunters and the results suggest that future prevention work should target safer weapon handling.

  • 61.
    Junuzovic, Mensura
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine. Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Rietz, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Jakobsson, Ulf
    Lunds universitet.
    Midlöv, Patrik
    Lunds universitet.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Firearm deaths in Sweden2019In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 29, no 2, p. 351-358Article in journal (Refereed)
    Abstract [en]

    Background: Sweden’s firearm legislation obligates physicians to report patients that are deemed unsuitable to possess a firearm. This study aimed to explore the involvement of firearm use in firearm fatalities and to evaluate physician reporting concerning cases of firearm deaths.

    Methods: Fatal firearm suicides and homicides in Sweden were studied for the years 2012–2013, accidental deaths and undetermined manner of deaths for the period 1987–2013. Police reports and autopsy protocols were collected from the National Board of Forensic Medicine, healthcare data in 1 year before the fatality from the National Board of Health, and information about physician reports and firearm licences from the Swedish Police.

    Results: A total of 291 firearm deaths (213 suicides, 52 accidental deaths, 23 solved homicides and 3 cases with undetermined manner of death) were identified. Firearm suicides were positively correlated with the number of licensed firearm owners. Legal firearm use predominated in firearm suicides and accidental deaths, illegal in homicides. No suicide victim or shooter in an accidental death was previously reported by a physician to the police according to the firearm law. The majority of the shooters in accidental deaths and suicides had no registered health care visits. Less than half (42%) of all suicide victims had a previous health care contact due to mental health problems. Conclusions: Not one single suicide victim nor any shooter in accidental deaths in the present study had been reported according to the firearm law, bringing the evidence of a suboptimal framework.

  • 62.
    Junuzovic, Mensura
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine. Center for Primary Health Care Research, Department of Clinical Sciences in Malmö, Skåne University Hospital, Lund University.
    Sjöberg, Ameli
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Unintentional non-hunting firearm deaths in Sweden, 1983-20122016In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 61, no 4, p. 966-971Article in journal (Refereed)
    Abstract [en]

    We examined the association between unintentional nonhunting firearm deaths and changes in firearm legislation in Sweden. There were 43 fatalities during the study time frame 1983-2012, representing 46% of all unintentional firearm deaths during the same period. The victims were predominantly young males (mean age 25 years). Slightly more than half of the deaths were caused by another person and were inflicted at close range. The main cause of the incidents was human error. The majority of the involved firearms were legal; however, most victims killed with illegal firearms were under the influence of alcohol and/or drugs at the time. The death rate decreased significantly following the introduction of the hunter's examination in 1985. Education and training associated with the hunter's examination was at least partially responsible for the decline in fatalities after 1985. Future prevention should target the availability of illegal firearms.

  • 63. Jönsson, Anna
    et al.
    Brundin, Lars
    Ahlner, Johan
    Hedenmalm, Karin
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Antipsychotics associated with pulmonary emboli in a Swedish medico-legal autopsy series2007In: The International Association of Forensic Toxicologists and International Council on Alcohol, Drugs and Traffic Safety: 8th Ignition Interlock Symposium, 2007, p. 135-Conference paper (Other academic)
  • 64.
    Kronstrand, Robert
    et al.
    National Board of Forensic Medicine.
    Roman, Markus
    National Board of Forensic Medicine.
    Thelander, Gunilla
    National Board of Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Unintentional fatal intoxications with mitragynine and O-Desmethyltramadol from the herbal blend krypton2011In: Journal of Analytical Toxicology, ISSN 0146-4760, E-ISSN 1945-2403, Vol. 35, no 4, p. 242-247Article in journal (Refereed)
    Abstract [en]

    The leaves of Kratom, a medicinal plant in Southeast Asia, have been used as an herbal drug for a long time. At least one of the alkaloids present in Kratom, mitraynine, is a mu-receptor agonist. Both Kratom and an additional preparation called Krypton are available via the internet. It seems to consist of powdered Kratom leaves with another mu-receptor agonist, O-desmethyltramadol added. O-desmethyltramadol is an acitve metabolite of tramadol, a commonly prescribed analgesic. We present nine cases of intoxication, occurring in a period of less than one year, where both mitragynine and O-desmethyltramadol were detected in the postmortem blood samples. neither tramadol nor N-desmethyltramadol was present in these samples, which implies that the ingested drug was O-desmethyltramadol. The blood concentrations of mitragynine, determined by ultra-performance liquid chromatography-tandem mass spectrometry, ranged from 0.02 to 0.18 μg/g, and O-desmethyltramadol concentrations, determined by gas chromatogtraphy with nitrogen-specific detection, ranged from 0.4 to 4.3 μg/g. We believe that the addition of the potent mu-receptor agonist O-desmethyltramadol to powdered leaves from Kratom contributed to the unintentional death of the nine cases presented and conclude that intake of Krypton is not as harmless as it often is described on internet websites.  

  • 65.
    Lindqvist, Per
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Jonsson, Anders
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Hedelin, Annika
    Björnstig, Ulf
    Surgical and Perioperative Sciences.
    Are suicides by jumping off bridges preventable? An analysis of 50 cases from Sweden.2004In: Accident; analysis and prevention, ISSN 0001-4575, Vol. 36, no 4, p. 691-4Article in journal (Refereed)
    Abstract [en]

    This is a community-based sequential case series of 50 individuals who committed suicide by jumping from bridges in two regions of Sweden. Of the 50 subjects, 32 were men and 18 women, with a median age of 35 years. At least 40 had psychiatric problems. The frequency of suicide was highest during the summer months and during the weekends. A total of 27 bridges were used, with a total length of just under 9 km. Three bridges accounted for almost half of all suicides. Limiting the availability of one method of committing suicide is reported to reduce the overall suicide rate; why suicide and injury suicide preventive measures might be considered. Since this study demonstrates that few bridges attract suicide candidates, this injury mechanism needs to be acknowledged by the road system owners and included in the safety work.

  • 66. Lindqvist, Per
    et al.
    Leifman, Anders
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Mortality among homicide offenders: a retrospective population-based long-term follow-up.2007In: Criminal behaviour and mental health, ISSN 0957-9664, Vol. 17, no 2, p. 107-12Article in journal (Refereed)
    Abstract [en]

    Background Empirical data on homicide and homicide offenders are needed in the ongoing discussion on violence and crime prevention. One issue, insufficiently investigated, is the post-trial life course of homicide offenders.Aim To examine whether the mortality rate, as well as cause and manner of death, of homicide offenders is different from the general population.Method An incidence cohort of Swedish homicide offenders from 1970 to 1980 (n = 153) was re-examined by computerized record linkage with the National Cause-of-Death Register for the period between trial and 1 October 2002, i.e. 22-32 years after the offence. Death certificates were analysed, and standard procedures for calculating Standard Mortality Rate (SMR) and survival analysis were employed.Results Half of the study subjects had died by 2002. The overall mortality rate was about three times higher than that of the general population. In particular, the risk of suicide was salient.Implications It can be argued that offenders' self-neglect and self-contempt merge with public and professional views, predisposing to an increased risk of premature death. Copyright (c) 2007 John Wiley & Sons, Ltd.

  • 67. Lindström, Richard
    et al.
    Bylund, Per-Olof
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Accidental deaths caused by electricity in Sweden, 1975-2000.2006In: Journal of forensic sciences, ISSN 0022-1198, Vol. 51, no 6, p. 1383-8Article in journal (Refereed)
    Abstract [en]

    This study analyzes accidental fatalities caused by electricity--at work and during leisure time--to evaluate risk factors, the role of alcohol, and to identify possible preventive strategies. In Sweden, data on fatalities by electrocution from 1975 through 2000 were collected from the National Cause-of-Death Register. Additional cases were found in the archives of The Swedish National Electrical Safety Board. Suicides and deaths by lightning were excluded. Two hundred and eighty-five deaths were found, including occupational (n=132), leisure time (n=151), and unknown (n=2). Most deaths were caused by aerial power lines, and the most common place for an electrical injury was a railway area or residential property. Postmortem blood from 20% (n=47) of the tested cases was found positive for alcohol, and these persons were killed mainly during leisure time. During the study period, the overall incidence of electricity-related fatalities has decreased, in spite of increased use of electricity. This indicates that safety improvements have been successful.

  • 68.
    Lindström, Richard
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Bylund, Per-Olof
    Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Surgery.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Elektricitetsorsakade dödsfall i Sverige, 1975-20002003In: XV Nordisk kongress i rättsmedicin, 2003Conference paper (Other academic)
  • 69. Lynoe, N.
    et al.
    Olsson, D.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Is Delayed Speech Development a Long-Term Sequela of Birth-Related Subdural Hematoma?2019In: American Journal of Neuroradiology, ISSN 0195-6108, E-ISSN 1936-959X, Vol. 40, no 2, p. E10-E10Article in journal (Refereed)
  • 70. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    A misunderstanding. Response to Dr Bilo et al2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1046-1046Article in journal (Other academic)
  • 71. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Authors' overarching reply to all the responses received to the systematic literature review on shaken baby syndrome2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1031-1031Article in journal (Other academic)
  • 72. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Conflicts of interest issues. Response to Lucas et al.2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1036-1036Article in journal (Other academic)
  • 73. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Insufficient evidence for 'shaken baby syndrome' - a systematic review2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1021-1027Article, review/survey (Refereed)
    Abstract [en]

    Shaken baby syndrome has typically been associated with findings of subdural haematoma, retinal haemorrhages and encephalopathy, which are referred to as the triad. During the last decade, however, the certainty with which the triad can indicate that an infant has been violently shaken has been increasingly questioned. The aim of this study was to determine the diagnostic accuracy of the triad in detecting that an infant had been shaken. The literature search was performed using PubMed, Embase and the Cochrane Library up to October 15, 2015. Relevant publications were assessed for the risk of bias using the QUADAS tool and were classified as having a low, moderate or high risk of bias according to predefined criteria. The reference standards were confessions or witnessed cases of shaking or accidents. The search generated 3773 abstracts, 1064 were assessed as possibly relevant and read as full texts, and 30 studies were ultimately included. Of these, 28 were assessed as having a high risk of bias, which was associated with methodological shortcomings as well as circular reasoning when classifying shaken baby cases and controls. The two studies with a moderate risk of bias used confessions and convictions when classifying shaken baby cases, but their different designs made a metaanalysis impossible. None of the studies had a low risk of bias. Conclusion: The systematic review indicates that there is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence). It was also demonstrated that there is limited scientific evidence that the triad and therefore its components can be associated with traumatic shaking (low-quality evidence).

  • 74. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    The scientific evidence regarding retinal haemorrhages. Response to Hellgren et al. and Levin2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1041-1042Article in journal (Other academic)
  • 75. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    The shaken baby syndrome report was not the result of a conspiracy. Response to Dr. Narang et al2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1050-1051Article in journal (Other academic)
  • 76. Lynoe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    What are acceptable conclusions?: Response to Dr. Ludvigsson2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1032-1032Article in journal (Other academic)
  • 77. Lynoe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    May the fear of being falsely accused of having shaken a baby increase parents' demands for scheduled Caesareans?2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1052-1052Article in journal (Refereed)
  • 78. Lynoe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    The Swedish systematic review of traumatic shaking is not flawed and should not be ignored2019In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, no 2, p. 381-381Article in journal (Refereed)
  • 79. Lynoe, Niels
    et al.
    Rosen, Mans
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Vinchon's responses raise additional questions about the shaken baby-study2018In: Child's nervous system (Print), ISSN 0256-7040, E-ISSN 1433-0350, Vol. 34, no 1, p. 11-13Article in journal (Refereed)
  • 80. Lynøe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Easier to see the speck in your critical peers' eyes than the log in your own? Response to Debelle et al.2018In: Archives of Disease in Childhood, ISSN 0003-9888, E-ISSN 1468-2044, Vol. 103, no 7, p. 714-Article in journal (Refereed)
  • 81. Lynøe, Niels
    et al.
    Elinder, Göran
    Hallberg, Boubou
    Rosén, Måns
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Is accepting circular reasoning in shaken baby studies bad science or misconduct?2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 9, p. 1445-1446Article in journal (Other academic)
  • 82. Lynøe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    A diagnostic test can prove anything if you use incorrect assumptions and circular reasoning2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 12, p. 2051-2053Article in journal (Refereed)
  • 83. Lynøe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Consensus should be adapted to the evidence and not vice-versa2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 8, p. 1476-1476Article in journal (Refereed)
  • 84. Lynøe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Is focusing on the triad in suspected child abuse cases really irrelevant and of no practical use?2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 10, p. 1675-1676Article in journal (Refereed)
  • 85. Lynøe, Niels
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Skakvåld mot spädbarn: läkarens rollmåste särskiljas från rättsväsendetsroll2019In: Tidsskrift for Den norske lægeforening, ISSN 0029-2001, E-ISSN 0807-7096, Vol. 139, no 3, p. 226-227Article in journal (Other academic)
  • 86. Lynøe, Niels
    et al.
    Juth, Niklas
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    From Child Protection to Paradigm Protection-The Genesis, Development, and Defense of a Scientific Paradigm2019In: Journal of Medicine and Philosophy, ISSN 0360-5310, E-ISSN 1744-5019, Vol. 44, no 3, p. 378-390Article in journal (Refereed)
    Abstract [en]

    A scientific paradigm typically embraces research norms and values, such as truth-seeking, critical thinking, disinterestedness, and good scientific practice. These values should prevent a paradigm from introducing defective assumptions. But sometimes, scientists who are also physicians develop clinical norms that are in conflict with the scientific enterprise. As an example of such a conflict, we have analyzed the genesis and development of the shaken baby syndrome (SBS) paradigm. The point of departure of the analysis is a recently conducted systematic literature review, which concluded that there is very low scientific evidence for the basic assumption held by Child Protection Teams: when certain signs are present (and no other "acceptable" explanations are provided) the infant has been violently shaken. We suggest that such teams have developed more value-based than scientific-based criteria when classifying SBS cases. Further, we suggest that the teams are victims of "groupthink," aggravating the difficulties in considering critics' questioning the criteria established by the teams.

  • 87. Lynøe, Niels
    et al.
    Rosén, Måns
    Elinder, Göran
    Hallberg, Boubou
    Sundgren, Pia
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Pouring out the dirty bathwater without throwing away either the baby or its parents: commentary to Saunders et al.2018In: Pediatric Radiology, ISSN 0301-0449, E-ISSN 1432-1998, Vol. 48, no 2, p. 284-286Article in journal (Refereed)
  • 88.
    Mellberg, Caroline
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Johansson, Lars
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Mörner, Stellan
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Idrottsrelaterade plötsliga dödsfall hos unga i Sverige2005In: Svenska läkaresällskapets riksstämma, 2005Conference paper (Other academic)
  • 89. Norberg, Johannnes
    et al.
    Nilsson, Tomas
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Hardcastle, Tim
    The costs of a bullet: inpatient costs of firearm injuries in South Africa2009In: SAMJ South African Medical Journal, ISSN 0256-9574, E-ISSN 2078-5135, Vol. 99, p. 442-445Article in journal (Refereed)
  • 90. Ortiz-Reyes, Ruben
    et al.
    Dragovic, Ljubisa
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Sudden unexpected death resulting from previously nonsymptomatic subependymoma.2002In: The American journal of forensic medicine and pathology : official publication of the National Association of Medical Examiners, ISSN 0195-7910, Vol. 23, no 1, p. 63-7Article in journal (Refereed)
    Abstract [en]

    A 34-year-old, previously healthy man died suddenly and unexpectedly. The autopsy showed brain and pulmonary edema, numerous small meningeal meningiomas, bilateral and symmetrical juxtaventricular meningiomas, and a well-demarcated gray tan tumor in the medulla oblongata and upper cervical spinal cord. The latter tumor was a subependymoma with features of ependymoma in places. The authors describe and discuss the characteristics of this rare central nervous system tumor, its histogenesis, and its coexistence with other intracranial tumors. The possible mechanisms of death in the present case include compression of vital centers and acute obstruction of the cerebrospinal fluid flow.

  • 91.
    Palmcrantz, Johan
    et al.
    Umeå University, Faculty of Medicine.
    Hardcastle, Timothy C
    Naidoo, Steven R
    Muckart, David J
    Ahlm, Kristin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Pelvic fractures at a new level 1 trauma centre: who dies from pelvic trauma?: The Inkosi Albert Luthuli Central Hospital Experience2012In: Orthopaedic surgery, ISSN 1757-7861, Vol. 4, no 4, p. 216-221Article in journal (Refereed)
    Abstract [en]

    Objective: To identify the incidence of pelvic trauma, causes of death and factors predicting death with pelvic fractures.

    Methods: All pelvic fractures were retrospectively identified from a registry spanning from March 2007 to August 2009. Data was captured on a proforma. Data for survivors, non-survivors and a subgroup with pelvic injury as the underlying cause of death were compared.

    Results: Pelvic fracture incidence was 16% of major trauma cases. Patient with pelvic fractures had 31% mortality and 9% pelvic fracture-induced mortality. Motor vehicle collisions were the commonest external cause of pelvic fractures (59%); however, the highest mortality was from falls >6 m. The Injury Severity Score (ISS) was 29 in survivors, 36 in non-survivors, and 54 in the pelvic death subgroup. Type C fracture was a predictor of mortality (P = 0.135). 53% of the cases required transfusion in the first 24 hours. The pelvic death subgroup received a mean of 10.7 units of blood, versus 4 units for survivors and 3.7 units for non-survivors (P = 0.259).

    Conclusion: The overall incidence of pelvic fracture and associated mortality were higher than previously reported. Fracture severity and falls from heights are associated with additional injuries (higher ISS) and mortality. More severe fractures cause deaths directly attributable to the pelvic injury. The requirement for major blood transfusions for pelvic fracture hemorrhage was related to mortality. Female patients appeared to fare worse than males.

  • 92. Persson, Sven-Åke
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Hallgren, Niclas
    Eklund, A
    Berkowicz, Adam
    Druid, Henric
    GHB--dangerous, addictive and uncontrollable party drug2001In: Läkartidningen, ISSN 0023-7205, Vol. 98, no 38, p. 4026-31, 4033Article in journal (Refereed)
    Abstract [sv]

    This report reviews the pharmacology, toxicity and abuse pattern of gamma-hydroxybutyrate (GHB). The legislative changes pertaining to this substance are also addressed. Examples of abuse, driving under the influence and fatal intoxication are given. It is concluded that GHB is widely abused, particularly among the younger generation, and that further cases of severe intoxication are likely to occur as long as the substance is easily available from countless sources, including via the Internet. Despite the classification of GHB as a narcotic in Sweden and several other countries, continued problems are expected since the precursors gamma-butyrolactone (GBL) and 1,4-butanediol (BD) are widely--and legally--available.

  • 93.
    Pettersson, Gisela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    ABC om handläggning av dödsfall2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 48, p. 2164-2168Article in journal (Refereed)
  • 94.
    Pettersson, Gisela
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Forensic medicine in legal decision making2012In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 18, p. 110-110Article in journal (Other academic)
  • 95. Pettersson, Gisela
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Onaturliga dödsfall måste utredas bättre - risk att brott missas: granskning av polisens och sjukvårdens dödsfallshandläggning i tre län2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, article id CZP7Article in journal (Refereed)
    Abstract [en]

    In 2008 only 55 % of all deaths not deemed to be natural in Sweden underwent a medicolegal autopsy. In the present study we describe and compare the characteristics of unnatural deaths in three counties through review of death certificates for unnatural deaths and, when applicable, corresponding police reports. The majority of unnatural deaths that were not reported to the police were among elderly decedents, with the deaths most often resulting from a fall-related fracture or head injury. One subgroup among these deaths that were not recognized as reportable by the involved physician, estimated by extrapolation to a total of approximately 300 annually, nationwide, was considered to be at elevated risk for a criminal death (homicide). The causes of death in this group were due to, for example, high energy or sharp force trauma, gunshot injury, asphyxia, and drug and/or alcohol intoxication. We conclude that additional training in the handling of unnatural deaths is indicated for Swedish physicians.

  • 96.
    Rietz, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Loose bodies in body cavities2015In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 21, no 1, p. 85-85Article in journal (Other academic)
  • 97.
    Rodhe, Axel
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Sauna deaths in Sweden, 1992-2003.2008In: American Journal of Forensic Medicine and Pathology, ISSN 0195-7910, E-ISSN 1533-404X, Vol. 29, no 1, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Deaths from 1992 through 2003 related to sauna bathing in Sweden were collected from a national computer data base comprising all medicolegal autopsies, generating 77 cases included in this study. Of all deaths, 82% were men, most of them middle-aged. The geographic distribution seemed to be roughly related to the population density. Most bathers died on a weekend, and 84% were found dead in a sauna. In 69 cases, the blood alcohol concentration was determined; 49 (71%) of these tested positive, often with high concentrations. In 65 cases, a major disease/state that could explain death was identified; 34 (44%) of these deaths were related to alcohol and 18 (23%) cardiovascular. Other causes of death were drowning, CO poisoning, O2 deprivation, amphetamine intoxication, and burn injuries. In 13 cases, the cause of death remained undetermined. The results indicate that sauna habits in Sweden are similar to those in Finland but probably less common. The most important risk group is middle-aged men, especially those with heavy alcohol consumption. Among the cases found dead in a sauna, all but 2 were found alone. Obviously, bathing alone is a risk factor that can easily be avoided and should perhaps be emphasized more.

  • 98. Rosen, M.
    et al.
    Lynoe, N.
    Elinder, G.
    Hallberg, B.
    Sundgren, P.
    Eriksson, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Shaken baby syndrome and the risk of losing scientific scrutiny2017In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 12, p. 1905-1908Article, review/survey (Refereed)
    Abstract [en]

    A systematic review of shaken baby syndrome by the Swedish Agency for Health Technology Assessment and Assessment of Social Services generated numerous reactions from professional organisations, even before the review was published. There was also a lively debate after a paper summarising its findings were published in Acta Paediatrica The various responses are worth debating further, as they raise several important issues with regard to research ethics, having an open debate and publishing scientific findings. Conclusion. The responses to the shaken baby syndrome report indicate that scientific scrutiny risks being lost when researchers and organisations are not open to challenging established ideas.

  • 99. Rosen, S
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Rättsmedicinalverket får ansvaret för rättsintyg2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 28-29, p. 2084-Article in journal (Other academic)
  • 100. Rosen, Sara
    et al.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Krantz, Peter
    Rammer, Lennart
    The National Board of Forensic Medicine will be responsible for legal certification2005In: Läkartidningen, ISSN 0023-7205, Vol. 102, no 28-29, p. 2084-Article in journal (Other academic)
123 51 - 100 of 115
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