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- Avdic, Daniel, et al.
(författare)
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Sex differences in sickness absence and the morbidity-mortality paradox : a longitudinal study using Swedish administrative registers
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:8
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Tidskriftsartikel (refereegranskat)abstract
- Objective To analyse whether gender-specific health behaviour can be an explanation for why women outlive men, while having worse morbidity outcomes, known as the morbidity-mortality or gender paradox. Setting The working population in Sweden. Participants Thirty per cent random sample of Swedish women and men aged 40-59 with a hospital admission in the 1993-2004 period were included. The sample for analysis consists of 233274 individuals (115430 men and 117844 women) and in total 1 867013 observations on sickness absence. Intervention Hospital admission across 18 disease categories. Main outcome measures The main outcome measures were sickness absence (morbidity) and mortality. Longitudinal data at the individual level allow us to study how sickness absence changed after a hospital admission in men and women using a difference-in-differences regression analysis. Cox regression models are used to study differences in mortality after the admission. Results Women increased their sickness absence after a hospital admission by around five more days per year than men (95% CI 5.25 to 6.22). At the same time, men had higher mortality in the 18 diagnosis categories analysed. The pattern of more sickness absence in women was the same across 17 different diagnosis categories. For neoplasm, with a 57% higher risk of death for men (54.18%-59.89%), the results depended on the imputation method of sickness for those deceased. By using the premortality means of sickness absence, men had an additional 14.47 (-16.30- -12.64) days of absence, but with zero imputation women had an additional 1.6 days of absence (0.05-3.20). Analyses with or without covariates revealed a coherent picture. Conclusions The pattern of increased sickness absence (morbidity) and lower mortality in women provides evidence on the more proactive and preventive behaviour of women than of men, which could thus explain the morbidity-mortality paradox.
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| 2. |
- Björklund, Catarina, 1981-
(författare)
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Design and Synthesis of BACE-1 Inhibitors : Novel Compounds Targeting an Aspartic Protease Important in the Pathogenesis of Alzheimer’s Disease
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis deals with the design and synthesis of protease inhibitors targeting the aspartic protease BACE-1 (β-site APP cleaving enzyme-1), an enzyme important in the pathogenesis of Alzheimer’s disease. The inhibitors are evaluated with respect to inhibition data, in a structure-activity relationship part. Alzheimer’s disease is a disabling, progressive and ultimately fatal form of dementia afflicting approximately 40 percent of the population over 80 years, with over 30 million people suffering from Alzheimer’s disease worldwide. This makes Alzheimer’s disease the most common form of dementia. The identification of the amyloid-β peptide (Aβ) as the main constituent of extracellular plaques, which characterize Alzheimer’s disease, suggests that Aβ plays a vital role in the pathology of Alzheimer’s disease. The formation of Aβ occurs when amyloid-β precursor protein (APP) is cleaved by β-secretase (BACE-1) and γ-secretase, which differ in length by 39-42 amino acids. This suggests that β-secretase is a suitable target for the development of therapeutics against Alzheimer’s disease. The synthetic work of this thesis comprises development of BACE-1 inhibitors containing a hydroxyethylene (HE) central core transition state isostere. The target molecules were readily synthesized from chiral carbohydrate starting materials. Highly potent inhibitors were produced by varying the substituents coupled to the HE central core. Selecting an aryloxymethyl P1 side-chain and a methoxy P1’ side-chain resulted in exceptionally potent BACE-1 inhibitors that also exhibit high selectivity over cathepsin D. In a further development, the ether oxygen linkage in the P1 side-chain was removed, resulting in a carba analogue, providing improved potency in a cell-based assay.
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| 4. |
- de Hoogh, Kees, et al.
(författare)
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Comparing land use regression and dispersion modelling to assess residential exposure to ambient air pollution for epidemiological studies
- 2014
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Ingår i: Environment International. - : Elsevier BV. - 0160-4120 .- 1873-6750. ; 73, s. 382-392
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Tidskriftsartikel (refereegranskat)abstract
- Background: Land-use regression (LUR) and dispersion models (DM) are commonly used for estimating individual air pollution exposure in population studies. Few comparisons have however been made of the performance of these methods. Objectives: Within the European Study of Cohorts for Air Pollution Effects (ESCAPE) we explored the differences between LUR and DM estimates for NO2, PM10 and PM2.5. Methods: The ESCAPE study developed LUR models for outdoor air pollution levels based on a harmonised monitoring campaign. In thirteen ESCAPE study areas we further applied dispersion models. We compared LUR and DM estimates at the residential addresses of participants in 13 cohorts for NO2; 7 for PM10 and 4 for PM2.5. Additionally, we compared the DM estimates with measured concentrations at the 20-40 ESCAPE monitoring sites in each area. Results: The median Pearson R (range) correlation coefficients between LUR and DM estimates for the annual average concentrations of NO2, PM10 and PM2.5 were 0.75 (0.19-0.89), 0.39 (0.23-0.66) and 0.29 (0.22-0.81) for 112,971 (13 study areas), 69,591 (7) and 28,519(4) addresses respectively. The median Pearson R correlation coefficients (range) between DM estimates and ESCAPE measurements were of 0.74(0.09-0.86) for NO2; 0.58 (0.36-0.88) for PM10 and 0.58 (0.39-0.66) for PM2.5. Conclusions: LUR and dispersion model estimates correlated on average well for NO2 but only moderately for PM10 and PM2.5, with large variability across areas. DM predicted a moderate to large proportion of the measured variation for NO2 but less for PM10 and PM2.5.
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| 5. |
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| 6. |
- Johansson, Alexandra, 1989-
(författare)
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Förhållandet mellan intern skattelagstiftning och skatteavtal : särskilt om företräde för interna skatteregler
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis addresses the relationship between domestic tax law and tax treaties in a Swedish context, particularly with the purpose of clarifying when the legal consequences of domestic tax law are to prevail over those in tax treaties. The question of primacy arises due to domestic law and tax treaties often apply to the same situation, while providing for different legal consequences. Thus, when both of these sources of law are applicable, it may well be necessary to determine which legal consequence should affect the taxation of a taxpayer.There are two overall aims of this thesis. The first aim is to identify situations when domestic Swedish tax law is to be given priority over tax treaties. To fulfil this aim, three research questions are addressed. The first research question concerns determining in what situations both domestic tax law and tax treaties are applicable, but provide for different legal consequences. The second research question regards to what extent domestic tax law is to be given priority over tax treaty rules due to special provisions regulating the relationship between domestic law and tax treaties, including a rule found in Incorporation Acts and sometimes referred to as “the golden rule”. The third research question is under what conditions rules in domestic tax law represent a clearly expressed intention that they are to be applied irrespective of tax treaties. The second aim is to highlight the balancing of interests that the relationship between domestic tax rules and tax treaties brings to the fore, by evaluating the primacy of domestic law and, in the light of this, to propose when rules in domestic tax law should be given priority. This evaluation centres on the interests of upholding constitutional principles, acting in accordance with international law, eliminating double taxation and preventing tax avoidance. To fulfil this aim, two additional research questions are addressed. The fourth research question is to what extent the primacy of domestic tax law contributes to respecting Swedish constitutional law and whether the primacy of domestic tax law is in accordance with international law. The fifth research question is whether the primacy of domestic tax law is likely to result in double taxation or in opportunities for tax avoidance.The subject of this thesis concerns a limited but fundamental part of the relationship between domestic tax rules and tax treaties in Sweden. It shines a light on the limitations that exist with regard to whether, and to what extent, tax treaties have an impact in a Swedish domestic law context. In some situations, rules in domestic law are given priority in order to hinder tax treaties from creating tax claims that do not exist in domestic law. In other situations, rules in domestic law are given priority for other reasons. In the latter case, giving priority to domestic tax rules may constitute an internationally wrongful act, which, in turn, may have economic, political and legal consequences.
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| 9. |
- Johansson, Christer, et al.
(författare)
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Impacts of air pollution and health by changing commuting from car to bicycle
- 2017
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 584-585, s. 55-63
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Tidskriftsartikel (refereegranskat)abstract
- Our study is based on individual data on people’s home and work addresses, as well as their age, sex and physical capacity, in order to establish realistic bicycle-travel distances. A transport model is used to single out data on commuting preferences in the County Stockholm. Our analysis shows there is a very large potential for reducing emissions and exposure if all car drivers living within a distance corresponding to a maximum of a 30 minute bicycle ride to work would change to commuting by bicycle. It would result in more than 111 000 new cyclists, corresponding to an increase of 209% compared to the current situation.Mean population exposure would be reduced by about 7% for both NOx and black carbon (BC) in the most densely populated area of the inner city of Stockholm. Applying a relative risk for NOx of 8% decrease in all-cause mortality associated with a 10 µg m-3 decrease in NOx, this corresponds to more than 449 (95% CI: 340 - 558) years of life saved annually for the Stockholm county area with 2.1 million inhabitants. This is more than double the effect of the reduced mortality estimated for the introduction of congestion charge in Stockholm in 2006. Using NO2 or BC as indicator of health impacts, we obtain 395 (95% CI: 172 - 617) and 185 (95% CI: 158 - 209) years of life saved for the population, respectively. The calculated exposure of BC and its corresponding impacts on mortality are likely underestimated. With this in mind the estimates using NOx, NO2 and BC show quite similar health impacts considering the 95% confidence intervals.
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| 10. |
- Johansson, Christer, et al.
(författare)
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The effects of congestions tax on air quality and health.
- 2009
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Ingår i: Atmospheric Environment. - : Elsevier BV. - 1352-2310 .- 1873-2844. ; 43:31, s. 4843-4854
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Tidskriftsartikel (refereegranskat)abstract
- The “Stockholm Trial” involved a road pricing system to improve the air quality and reduce traffic congestion. The test period of the trial was January 3–July 31, 2006. Vehicles travelling into and out of the charge cordon were charged for every passage during weekdays. The amount due varied during the day and was highest during rush hours (20 SEK = 2.2 EUR, maximum 60 SEK per day). Based on measured and modelled changes in road traffic it was estimated that this system resulted in a 15% reduction in total road use within the charged cordon. Total traffic emissions in this area of NOx and PM10 fell by 8.5% and 13%, respectively. Air quality dispersion modelling was applied to assess the effect of the emission reductions on ambient concentrations and population exposure. For the situations with and without the trial, meteorological conditions and other emissions than from road traffic were kept the same. The calculations show that, with a permanent congestion tax system like the Stockholm Trial, the annual average NOx concentrations would be lower by up to 12% along the most densely trafficked streets. PM10 concentrations would be up to 7% lower. The limit values for both PM10 and NO2 would still be exceeded along the most densely trafficked streets. The total population exposure of NOx in Greater Stockholm (35 × 35 km with 1.44 million people) is estimated to decrease with a rather modest 0.23 μg m−3. However, based on a long-term epidemiological study, that found an increased mortality risk of 8% per 10 μg m−3 NOx, it is estimated that 27 premature deaths would be avoided every year. According to life-table analysis this would correspond to 206 years of life gained over 10 years per 100 000 people following the trial if the effects on exposures would persist. The effect on mortality is attributed to road traffic emissions (likely vehicle exhaust particles); NOx is merely regarded as an indicator of traffic exposure. This is only the tip of the ice-berg since reductions are expected in both respiratory and cardiovascular morbidity. This study demonstrates the importance of not only assessing the effects on air quality limit values, but also to make quantitative estimates of health impacts, in order to justify actions to reduce air pollution.
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