| 1. |
- Almkvist, Henrik, et al.
(författare)
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Kvalitetsbokslut minskade läkemedelskostnaderna i primärvården : Stockholms läns landstings modell för decentraliserat kostnadsansvar
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:42, s. 2930-2934
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Tidskriftsartikel (refereegranskat)abstract
- Increasing drug expenditures have resulted in various models to increase cost consciousness among prescribing doctors. In the County of Stockholm, Sweden, a model for quality assessment of prescribing was introduced in 2006. In all, 139 of 154 primary healthcare centres (PHCs) signed a contract linking extra payment to the adherence to the Drug and Therapeutics Committee guidelines if they analysed their prescribing behaviour in an annual quality report. During the first year, the adherence to guidelines increased from 80 to 83%, substantially higher than the 0-2% annual increase that had been observed previous years. The increase was similar for those PHCs not participating in the program. Qualitative analyses of all written quality reports indicate that the incentive scheme has resulted in an increased interest in quality assessment of drug prescribing. In total, 20 million SEK was spent on incentives, with estimated savings of 100 million SEK on drug expenditures.
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| 2. |
- Drakvik, Elina, et al.
(författare)
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Priorities for research on environment, climate and health, a European perspective
- 2022
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Ingår i: Environmental Health. - : Springer Science and Business Media LLC. - 1476-069X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Climate change, urbanisation, chemical pollution and disruption of ecosystems, including biodiversity loss, affect our health and wellbeing. Research is crucial to be able to respond to the current and future challenges that are often complex and interconnected by nature. The HERA Agenda, summarised in this commentary, identifies six thematic research goals in the environment, climate and health fields. These include research to 1) reduce the effects of climate change and biodiversity loss on health and environment, 2) promote healthy lives in cities and communities, 3) eliminate harmful chemical exposures, 4) improve health impact assessment and implementation research, 5) develop infrastructures, technologies and human resources and 6) promote research on transformational change towards sustainability. Numerous specific recommendations for research topics, i.e., specific research goals, are presented under each major research goal. Several methods were used to define the priorities, including web-based surveys targeting researchers and stakeholder groups as well as a series of online and face-to-face workshops, involving hundreds of researchers and other stakeholders. The results call for an unprecedented effort to support a better understanding of the causes, interlinkages and impacts of environmental stressors on health and the environment. This will require breakdown of silos within policies, research, actors as well as in our institutional arrangements in order to enable more holistic approaches and solutions to emerge. The HERA project has developed a unique and exciting opportunity in Europe to consensuate priorities in research and strengthen research that has direct societal impact.
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| 3. |
- Ejlertsson, Jörgen, et al.
(författare)
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Anaerobic Degradation of Nonylphenol Mono- and Diethoxylates in Digestor Sludge, Landfilled Municipal Solid Waste, and Landfilled Sludge
- 1999
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 1086-931X .- 1520-6912 .- 0013-936X .- 1520-5851. ; 33:2, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the extent to which anaerobic digestor sludge, landfilled sludge, and landfilled municipal solid waste (MSW) degrade NPEOs under methanogenic conditions. NPEO1 and NPEO2 (NPEO1-2), used in a mixture, were chosen as model compounds. Anaerobic experimental bottles were amended with 100% digestor sludge at three different concentrations of NPEO1-2: 2, 60, and 308 mg L-1. [U-14C]-NPEO1-2 was used to detect any possible decomposition of the aromatic moiety of the NPEO1-2. All inoculates used degraded NPEO1-2 at 2 mg L-1, with nonylphenol (NP) forming the ultimate degradation product. The NP formed was not further degraded, and the incubations with labeled NPEO showed that the aromatic structure remained intact. Both landfill inoculates also transformed NPEO1-2 at 60 mg L-1. CH4 production was temporarily hampered in bottles with MSW landfill inoculum at 60 and 308 mg L-1. With 2 mg L-1 of NPEO, CH4 production closely followed that in the controls. Both NP and NPEO1-2 interacted with the organic matter which resulted in sorption to the solid phase.
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| 4. |
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| 5. |
- Lind, Lars, et al.
(författare)
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Uppsala Consensus Statement on Environmental Contaminants and the Global Obesity Epidemic
- 2016
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Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 124:5, s. A81-A83
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Tidskriftsartikel (refereegranskat)abstract
- From the lectures presented at the 2nd International Workshop on Obesity and Environmental Contaminants, which was held in Uppsala, Sweden, on 8–9 October 2015, it became evident that the findings from numerous animal and epidemiological studies are consistent with the hypothesis that environmental contaminants could contribute to the global obesity epidemic. To increase awareness of this important issue among scientists, regulatory agencies, politicians, chemical industry management, and the general public, the authors summarize compelling scientific evidence that supports the hypothesis and discuss actions that could restrict the possible harmful effects of environmental contaminants on obesity.
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| 6. |
- vom Saal, Frederick S., et al.
(författare)
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The Conflict between Regulatory Agencies over the 20,000-Fold Lowering of the Tolerable Daily Intake (TDI) for Bisphenol A (BPA) by the European Food Safety Authority (EFSA)
- 2024
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Ingår i: Journal of Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 132:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: The European Food Safety Authority (EFSA) recommended lowering their estimated tolerable daily intake (TDI) for bisphenol A (BPA) 20,000-fold to 0.2 ng/kg body weight (BW)/day. BPA is an extensively studied high production volume endocrine disrupting chemical (EDC) associated with a vast array of diseases. Prior risk assessments of BPA by EFSA as well as the US Food and Drug Administration (FDA) have relied on industry-funded studies conducted under good laboratory practice protocols (GLP) requiring guideline end points and detailed record keeping, while also claiming to examine (but rejecting) thousands of published findings by academic scientists. Guideline protocols initially formalized in the mid-twentieth century are still used by many regulatory agencies. EFSA used a 21st century approach in its reassessment of BPA and conducted a transparent, but time-limited, systematic review that included both guideline and academic research. The German Federal Institute for Risk Assessment (BfR) opposed EFSA’s revision of the TDI for BPA.Objectives: We identify the flaws in the assumptions that the German BfR, as well as the FDA, have used to justify maintaining the TDI for BPA at levels above what a vast amount of academic research shows to cause harm. We argue that regulatory agencies need to incorporate 21st century science into chemical hazard identifications using the CLARITY-BPA (Consortium Linking Academic and Regulatory Insights on BPA Toxicity) nonguideline academic studies in a collaborative government–academic program model.Discussion: We strongly endorse EFSA’s revised TDI for BPA and support the European Commission’s (EC) apparent acceptance of this updated BPA risk assessment. We discuss challenges to current chemical risk assessment assumptions about EDCs that need to be addressed by regulatory agencies to, in our opinion, become truly protective of public health. Addressing these challenges will hopefully result in BPA, and eventually other structurally similar bisphenols (called regrettable substitutions) for which there are known adverse effects, being eliminated from all food-related and many other uses in the EU and elsewhere.
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