| 1. |
- Gustavsson, Anders, et al.
(author)
-
Cost of disorders of the brain in Europe 2010.
- 2011
-
In: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
-
Journal article (peer-reviewed)abstract
- BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
|
|
| 2. |
- Trumberg, Anders, Forskare, 1976-, et al.
(author)
-
Struggling to counter school segregation- a typology of local initiatives in Sweden
- 2024
-
In: Scandinavian Journal of Educational Research. - : Routledge. - 0031-3831 .- 1470-1170. ; 68:2, s. 246-259
-
Journal article (peer-reviewed)abstract
- Swedish compulsory schools are committed to work for equality and social cohesion. Increasing school segregation, however, challenges this commitment. Based on survey data from Swedish municipalities, this article maps and analyses local initiatives that counteract school segregation. We identify three main types of initiatives-reinforcement, dispersal, and merging-and the exogenous (school external) and endogenous (school internal) drivers involved in each of them. The analysis reveals several gaps between the national level, the municipal level and local schools that hamper local efforts to counter school segregation. This article contributes to increased knowledge on how local initiatives of counteracting segregation are constrained by national policies about school choice and independent versus municipal schools, but also how local initiatives tend to focus on organizational dynamics rather than on social and pedagogical processes.
|
|
| 3. |
- Bergh, Andreas, et al.
(author)
-
Explaining the rise of populism in European democracies 1980-2018 : The role of labor market institutions and inequality
- 2022
-
In: Social Science Quarterly. - : Blackwell Publishing. - 0038-4941 .- 1540-6237. ; 103:7, s. 1719-1731
-
Journal article (peer-reviewed)abstract
- Objectives: This article aims to find country-level factors that explain the rise of populist parties in European democracies. While populism is often connected to inequality, we not that right-wing populist parties tend to thrive on fear, including fear of job loss. If flexible labor markets mean that unemployment is dedramatized because finding a new job is easier, labor market flexibility could dampen populism and inequality may be less important.Methods: We run country-level fixed effects regressions on populist party vote shares in 26 European countries from 1980 to 2018. We use two different classifications of right-wing and left-wing populist parties and control for employment protection strictness as measured by OECD, Gini coefficients of disposable income, and a large set of control variables.Results: Unemployment is positively associated with left-wing populism. Strict employment protection is positively associated with right-wing populism. Gini inequality of income is unrelated to (both types of) populism.Conclusion: Strong employment protection and low-income inequality may not be the most efficient way to combat right-wing populism. A strategy that promotes flexible labor markets, and job upgrading may be an alternative. More research on the link between labor market institutions and (in particular, right-wing) populism is needed.
|
|
| 4. |
- Bergh, Andreas, et al.
(author)
-
Globalization and populism in Europe
- 2021
-
In: Public Choice. - : Springer. - 0048-5829 .- 1573-7101. ; 189:1-2, s. 51-70
-
Journal article (peer-reviewed)abstract
- Recent micro-level studies have suggested that globalization-in particular, economic globalization and trade with China-breeds political polarization and populism. This study examines whether or not those results generalize by examining the country-level association between vote shares for European populist parties and economic globalization. Using data on vote shares for 267 right-wing and left-wing populist parties in 33 European countries during 1980-2017, and globalization data from the KOF institute, we find no evidence of a positive association between (economic or other types of) globalization and populism. EU membership is associated with a 4-6-percentage-point larger vote share for right-wing populist parties.
|
|
| 5. |
- Bergh, Ingrid, 1956, et al.
(author)
-
Descriptions of pain in elderly patients following orthopaedic surgery.
- 2005
-
In: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 19:2, s. 110-8
-
Journal article (peer-reviewed)abstract
- The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'rad(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.
|
|
| 6. |
- Andersson, Fredrik N G, et al.
(author)
-
Riksbanken feltolkar lagen i sin syn på inflationsmålet
- 2016
-
In: Dagens nyheter (DN debatt). - 1101-2447. ; , s. 6-6
-
Journal article (pop. science, debate, etc.)abstract
- Mot lagens anda. Riksbanken tycks ha feltolkat sitt uppdrag. Riksbankslagen erbjuder flexibilitet, trots det håller Riksbanken fast vid 2-procentmålet till nästan vilket pris som helst. Dessutom bryter man mot lagens anda när man köper statsobligationer för mångmiljardbelopp, skriver Fredrik NG Andersson, Andreas Bergh och Anders Olshov.
|
|
| 7. |
- Arneback, Emma, 1974-, et al.
(author)
-
En skola i integration? Lärdomar från Örebro kommuns arbete med styrd skolintegration
- 2021
-
Reports (other academic/artistic)abstract
- Skolsegregationens negativa konsekvenser har på senare år kommit alltmer i fokus. Den här rapporten har studerat Örebro kommuns arbete med integration och måluppfyllelse vid kommunens skolor, och då specifikt nedläggningen av högstadiet på Vivallaskolan och dess omorganisering till fyra anvisningsskolor i kommunen under 2017–2020.Forskarna har följt arbetet på de fyra skolorna under två och ett halvt års tid och intervjuat 128 personer: elever, lärare, skolpersonal, skolledning, politiker och tjänstemän – tillsammans bildar de en väv av röster som beskriver från en rad olika perspektiv hur omorganiseringen av Vivallaskolan har uppfattats och vilka effekter det har fått på olika nivåer.Rapporten visar på både möjligheter och utmaningar att lära av, och genom det kastar den ljus över vilka processer som har bidragit till minskad segregation, samt ökad integration och måluppfyllelse. I en förlängning kan kunskap om dessa processer komma att gynna alla elevers lärande och utveckling.
|
|
| 8. |
- Bergh, Andreas, et al.
(author)
-
Municipally Owned Enterprises as Danger Zones for Corruption? : How Politicians Having Feet in Two Camps May Undermine Conditions for Accountabilit
- 2019
-
In: Public Integrity. - : Routledge. - 1099-9922 .- 1558-0989. ; 21:3, s. 320-352
-
Journal article (peer-reviewed)abstract
- The market-inspired reforms of New Public Management have been particularly pronounced in Swedish local government. Notably, municipally owned enterprises (MOEs) have rapidly grown in numbers. Principal-agent theory gives rise to the hypothesis that the massive introduction of MOEs has impacted negatively on the conditions for accountability in Swedish local government. To study this, social network analysis was employed in mapping networks for 223 MOEs in 11 strategically chosen municipalities, covering a total of 732 politicians. The analysis reveals substantial overlaps between principals (representatives of the ultimate stakeholders, citizens) and agents (the boards of the MOEs). Hence, corporatization of public services seems to imply worrisome entanglements between the politicians who are set to steer, govern, and oversee MOEs on the one hand, and the board members of MOEs on the other. The increasing numbers of MOEs may therefore have adverse effects on accountability in important and growing parts of Swedish local government.
|
|
| 9. |
- Bergh, Ingrid, et al.
(author)
-
An application of pain rating scales in geriatric patients
- 2000
-
In: Aging Clinical and Experimental Research. - : Elsevier. - 1594-0667 .- 1720-8319. ; 12:5, s. 380-7
-
Journal article (peer-reviewed)abstract
- This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.
|
|
| 10. |
- Bergh, Ingrid, 1956, et al.
(author)
-
Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.
- 2001
-
In: Aging (Milan, Italy). - : Kurtis. - 0394-9532. ; 13:5, s. 355-361
-
Journal article (peer-reviewed)abstract
- Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.
|
|
