A new study from Karolinska Institutet shows that healthcare workers in Sweden have a higher risk of suicide compared to other occupational groups with similar professional levels. The study highlights the risks for physicians, registered nurses, and assistant nurses in particular.
The study, published in Acta Psychiatrica Scandinavica, shows that healthcare workers, especially those working in patient care, have a significantly higher risk of suicide compared to other professions with similar professional qualifications.
Registered nurses had a 61% higher risk of suicide compared to non-healthcare workers.
Physicians had a 57% higher risk, and among them, psychiatrists stood out with an almost threefold increase in risk.
”Previous studies have mostly focused on physicians and often compared them to the general population, which may have underestimated their risk due to socio-economic differences. This study compared individuals with similar professional levels, which showed that physicians have a significantly higher risk of suicide,” says first author Alicia Nevriana, postdoctoral researcher at the Institute of Environmental Medicine, Karolinska Institutet.
The study included many different occupational roles within healthcare, including administrative staff. The study also highlights that administrative staff in healthcare do not have a higher risk of suicide.
In a study conducted in Uganda and published in JAMA Surgery, researchers from Karolinska Institutet evaluated a new surgical method for treating groin hernias in women. The method could become an alternative in resource-limited settings where laparoscopic techniques are not generally available.
Groin hernia repair is the most common general surgical procedure in the world. Groin hernias are more common in men, but women are more likely to experience complications due to this condition.
Many women in low- and middle-income countries who need surgery for groin hernias lack access to laparoscopy (keyhole surgery). To evaluate a new method using open surgery, the researchers conducted a randomised clinical trial at two publicly funded hospitals in Uganda. The study included 200 women who underwent groin hernia surgery and were followed up after two weeks and after one year.
There are two main types of groin hernias, called inguinal and femoral hernias. The evaluation showed that the new surgical method was effective for both femoral and inguinal groin hernias.
Its effectiveness for both types is particularly important as the study also showed that nearly 45% of the women had femoral hernias, which carry a higher risk of complications.
“The fact that so many of the women had femoral hernias was unexpected and highlights the need to develop effective, safe and accessible methods,” says Alphonsus Matovu, PhD at the Department of Molecular Medicine and Surgery, Karolinska Institutet and first author of the article.
Millions of women affected
The results are promising as the new method could be developed into a viable alternative where access to advanced laparoscopic surgery is limited.
“Women with groin hernias can suffer serious and even fatal complications and therefore need access to effective surgical methods,” says Jenny Löfgren, docent at the same department and last author of the article. “The new method could become a valuable tool to improve care for millions of women”.
The method needs further evaluation, and the researchers will also follow up with the study participants five years after surgery to ensure long-term results. To improve treatment, the new method will also be compared with other surgical methods, both open and laparoscopic.
By Matimba Ngobeni, Country Head: Value & Access, Novartis South Africa
28 July 2025, Johannesburg South Africa – South Africa’s healthcare system stands at a crossroads. Despite the promise of progress outlined in the Budget Speech and the Presidential Health Compact, the reality on the ground reveals persistent and growing barriers to accessing innovative medicines.
Economic pressures, funding constraints, and infrastructure gaps continue to undermine equitable healthcare delivery, particularly for vulnerable communities. What’s more, recent international developments—such as U.S. President Donald Trump’s cuts to funding that supported healthcare initiatives in South Africa—threaten to exacerbate these challenges, potentially limiting access to life-saving advanced therapies.[1]
Economic pressures
The cost of advanced therapies remains out of reach, and the structural inequalities in our healthcare system persist. While top-tier medical plans still provide access to advanced medicines, we are seeing a shift. Patients are moving to lower-tier plans or into the public system, simply because they cannot afford more. And with that shift, their access to advanced therapies disappears. [2]This is not a uniquely South African problem.
Globally, we see the same story repeat: private healthcare becomes a fortress that only those who can pay the toll may enter. Everyone else is left to rely on an overburdened public system, strained by funding shortfalls, infrastructure gaps, and critical workforce shortages. The public healthcare system, already overburdened, struggles to absorb this increased demand. Rising healthcare costs combined with limited household budgets create a perfect storm where affordability becomes the biggest barrier to accessing cutting-edge treatments.
Funding constraints and infrastructure challenges
Both private and public sectors face severe funding constraints. Innovative medicines, especially advanced therapies, come with high price tags that strain budgets and limit availability. At the same time, infrastructure and skills gaps hinder the effective delivery of these treatments. Investments in healthcare infrastructure, workforce training, and data management are urgently needed to support the growing demand for advanced therapies.
While it may seem like all hope is lost, the Presidential Health Compact offers a promising framework aimed at transforming South Africa’s healthcare landscape through infrastructure development and improved data surveillance[3]. However, it stops short of directly addressing access to innovative medicines. This gap underscores the need for stronger collaboration between public and private stakeholders to ensure that patients do not bear the financial burden alone.
Towards equitable access: Collaboration is imperative
Another way forward is through a robust, transparent Health Technology Assessment (HTA) process, where medicines are evaluated not only on their cost but on their ability to save lives, improve quality of life, and reduce the long-term burden on the health system.
Inclusive HTAs, where payers and pharmaceutical companies work together, are essential for reimagining access to advanced therapies. If we only look at the upfront cost of innovation, we miss the bigger picture of societal value.
Globally, risk-sharing models and outcome-based pricing agreements are helping bridge the affordability gap[4]. South Africa could benefit from more flexible legislation to enable these models, ensuring that innovation doesn’t remain locked behind prohibitive price tags.
South Africa’s healthcare future depends on what we choose to prioritise: short-term financial gains or long-term societal wellbeing. Too often, systems have been designed around protecting profits rather than protecting lives. Healthcare should never be a luxury. Yet in South Africa, and across much of the world, the reality is stark: exclusion is the norm, not the exception.
If we want a future where access to life-saving medicines is a reality for all, we need to break down the barriers of affordability, infrastructure, and policy inertia. And we need to do it together — governments, healthcare companies, funders, and civil society — because lives are at stake.
All hope is not lost. But we cannot wait for crisis to be our catalyst. The time for bold, collaborative action is now.
**About Novartis:**
Novartis is an innovative medicines company. Every day, we work to reimagine medicine to improve and extend people’s lives so that patients, healthcare professionals and societies are empowered in the face of serious disease. Our medicines reach more than 250 million people worldwide.
Novartis South Africa (Pty) Ltd, Magwa Crescent West, Waterfall City, Jukskei View, 2090. Co. Reg. No. 1946/020671/07. Tel. No. +27 (0) 11 347 6600.
Disclaimer: The presentation may include data on formulations, products, indications, and dosages not yet approved by the South African Health Products Regulatory Authority. This information is not intended to be promoting nor recommending any formulation, indication, dosage, or other claim not covered in the approved Professional Information. Novartis South Africa (Pty) Ltd recommends the use of their products in accordance with the locally approved Professional Information. Views and opinions of speakers do not necessarily reflect those of Novartis.
Research from ICES, Sunnybrook Research Institute and U of T’s Temerty Faculty of Medicine highlights the potential of using team design to improve patient outcomes
Photo by Jafar Ahmed on Unsplash
The odds of patient complications following high-risk surgeries is lower when the surgeon and anaesthesiologists have prior experience working together, according to a new study by researchers at ICES, Sunnybrook Research Institute and the University of Toronto.
The findings come from an analysis of data from hundreds of thousands of high-risk surgeries in Ontario over a 10-year period, along with information on the surgeon and anesthesiologist for each procedure and how often the pair had worked together in the previous four years.
The study, which was recently published in JAMA Surgery, highlights the potential of using team design to improve patient outcomes.
“Team design is used in a lot of other fields like business and sports, but it’s overlooked in health care,” says lead author Julie Hallet, a scientist at Sunnybrook Research Institute and an associate professor of surgery at U of T’s Temerty Faculty of Medicine. “Health care is one of the only areas where we expect people who have never worked together – who sometime have never met before – to perform at peak levels in the most stressful circumstances.”
As a surgeon, Hallet knows first-hand how the environment in an operating room can change depending on team members’ familiarity with each other. It’s something that she and her colleagues have all observed but until recently, lacked the data to describe.
To study this question, Hallet and colleagues analysed population-based health-care data from 711 005 high-risk elective surgeries performed in Ontario between 2009 and 2019, and corresponding information on surgeon-anaesthesiologist teams.
They found that for surgeries related to the gastrointestinal tract, spine and gynaecological cancers, there was an association between surgeon-anaesthesiologist familiarity and the odds of severe complications in the 90 days after surgery – for each additional procedure performed by the same surgeon-anaesthesiologist pair, the likelihood of experiencing a severe complication decreased by three to eight per cent.
“Those are meaningful differences because severe post-operative complications can lead to additional surgeries, ICU stays or even death,” says Hallet.
The researchers also noted that for most procedures, the average surgeon-anaesthesiologist pair were in the operating room together three times a year or less. The exceptions were orthopaedic and cardiac surgery, where surgeons teamed up with the same anaesthesiologist for an average of eight and nine procedures each year, respectively.
These procedures had greater team stability because anaesthesiologists require specialized training to participate in cardiac surgeries and orthopaedic surgeries are often done at dedicated centres like Sunnybrook’s Holland Centre.
“In those particular procedures where they’ve achieved team stability, we do not see an association because the team already has a high degree of familiarity,” says Hallet.
The findings show that unlike expensive new technologies or drugs, optimising the makeup of surgical teams to foster consistency and familiarity could be a no-cost way to improve patient outcomes.
Hallet acknowledges that there are challenges and potential drawbacks to adopting a team design-centred approach to organising and scheduling surgeries. One possible consequence could be that anaesthesiologists, most of whom are currently considered generalists, become increasingly specialised and less comfortable stepping in to cover other procedures.
In the next phase of this project, the researchers are looking at this and other factors that can support the implementation of more stable teams in the operating room.
The team is currently interviewing anaesthesiologists and surgeons to understand their perspectives about the different models of care and what concerns need to be addressed to enable adoption of this new approach. They’re also doing a cost analysis to determine how much money hospitals and health systems could save by having more familiar surgical teams and fewer post-operative complications.
“You can’t put team stability or team familiarity in a bottle or replicate its effects through protocols or processes,” says Hallet.
“The only way that you can get that effect is by putting people together more often and having them work and succeed together.”
Prediabetes affects a third of people in the United States and most of them will develop Type 2 diabetes, yet effective dietary intervention strategies remain limited. Pistachios have shown promise in improving markers of diet quality, yet little is known about how they influence the gut microbiome – a key player in glucose regulation and inflammation.
A new study led by Kristina Petersen, associate professor of nutritional sciences at Penn State, determined that nighttime pistachio consumption affects gut bacteria in adults with prediabetes. Though the potential therapeutic implications of the findings remain unclear, according to Petersen, they may prove significant for people who are working to improve their metabolic health.
The findings, published in the journal Current Developments in Nutrition, suggested that replacing a traditional carbohydrate-based bedtime snack with pistachios may reshape the gut microbiome. A previous study by these researchers demonstrated that pistachios have a similar effect on blood glucose as 15 to 30 grams of carbohydrates.
“Pistachios seem to be able to meaningfully shift the gut microbial landscape in adults with prediabetes especially when consumed as a nighttime snack.”
Kristina Petersen, associate professor of nutritional sciences at Penn State
“A common dietary recommendation for individuals with prediabetes is to consume a nighttime snack consisting of 15 to 30 grams of carbohydrates to help regulate overnight and morning blood glucose levels,” said Terrence Riley, lead author of this research who earned his doctorate in nutritional sciences at Penn State and currently works as a postdoctoral research fellow at Louisiana State University. “As an example, you could eat one or two slices of whole grain bread.”
Researchers observed that consuming about two ounces of pistachios each night for 12 weeks resulted in significantly different stool microbial community profiles compared to those who consumed the recommended 15 to 30 grams of a carbohydrate snack. Specific bacterial groups, including Roseburia and members of the Lachnospiraceae family – known as “good” bacteria that produces beneficial short-chain fatty acids like butyrate – were more abundant following the pistachio condition.
According to Petersen, butyrate serves as a primary energy source for colon cells, helps maintain the gut barrier and supports anti-inflammatory processes.
“Pistachios seem to be able to meaningfully shift the gut microbial landscape in adults with prediabetes especially when consumed as a nighttime snack,” Petersen said. “These microbiome changes may offer other long-term health benefits – potentially helping to slow the development of Type 2 diabetes or to reduce systemic inflammation – which we hope to explore in future research.”
The study involved 51 adults with prediabetes and was conducted over two 12-week periods separated by a break, so the effects of the first part of the trial would not affect the second part. By the end of the study, all participants received both treatments. Stool samples were collected and analysed using 16S rRNA gene sequencing, a technique that can help classify bacteria based on their genetic makeup.
Petersen noted that participants who ate pistachios also experienced reductions in several bacterial groups that have been linked to less favorable metabolic outcomes.
“Levels of Blautia hydrogenotrophica – a bacterium that helps produce compounds that can build up in the blood and harm kidney and heart health – were lower after pistachio consumption,” Petersen said. “Levels of Eubacterium flavonifractor, which breaks down beneficial antioxidant compounds from foods like pistachios, also decreased.”
Petersen added that the strength of this study is the design used – a randomised crossover clinical trial, in which all participants receive both treatments in a randomised order. By including all participants in the pistachio group and the standard care group, the study helped the researchers better understand how specific foods like pistachios can influence the gut microbiome.
While the study demonstrated shifts in gut bacteria, it remains unclear whether these changes directly translate to improvements in health – a question that requires further research, Petersen said.
