| 1. |
- Toren, Kjell, et al.
(författare)
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Vital capacity and COPD : the Swedish CArdioPulmonary bioImage Study (SCAPIS)
- 2016
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Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease. - : DOVE MEDICAL PRESS LTD. - 1176-9106 .- 1178-2005. ; 11, s. 927-933
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Tidskriftsartikel (refereegranskat)abstract
- Background: Spirometric diagnosis of chronic obstructive pulmonary disease (COPD) is based on the ratio of forced expiratory volume in 1 second (FEV1)/vital capacity (VC), either as a fixed value <0.7 or below the lower limit of normal (LLN). Forced vital capacity (FVC) is a proxy for VC. The first aim was to compare the use of FVC and VC, assessed as the highest value of FVC or slow vital capacity (SVC), when assessing the FEV1/VC ratio in a general population setting. The second aim was to evaluate the characteristics of subjects with COPD who obtained a higher SVC than FVC. Methods: Subjects (n=1,050) aged 50-64 years were investigated with FEV1, FVC, and SVC after bronchodilation. Global Initiative for Chronic Obstructive Lung Disease (GOLD) COPDFVC was defined as FEV1/FVC <0.7, GOLDCOPD(VC) as FEV1/VC <0.7 using the maximum value of FVC or SVC, LLNCOPDFVC as FEV1/FVC below the LLN, and LLNCOPDVC as FEV1/VC below the LLN using the maximum value of FVC or SVC. Results: Prevalence of GOLDCOPD(FVC) was 10.0% (95% confidence interval [CI] 8.2-12.0) and the prevalence of LLNCOPDFVC was 9.5% (95% CI 7.8-11.4). When estimates were based on VC, the prevalence became higher; 16.4% (95% CI 14.3-18.9) and 15.6% (95% CI 13.5-17.9) for GOLDCOPD(VC) and LLNCOPDVC, respectively. The group of additional subjects classified as having COPD based on VC, had lower FEV1, more wheeze and higher residual volume compared to subjects without any COPD. Conclusion: The prevalence of COPD was significantly higher when the ratio FEV1/VC was calculated using the highest value of SVC or FVC compared with using FVC only. Subjects classified as having COPD when using the VC concept were more obstructive and with indications of air trapping. Hence, the use of only FVC when assessing airflow limitation may result in a considerable under diagnosis of subjects with mild COPD.
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| 2. |
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| 3. |
- Andernord, D., et al.
(författare)
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Contact allergy to haptens in the Swedish baseline series: Results from the Swedish Patch Test Register (2010 to 2017)
- 2022
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 86:3, s. 175-188
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Tidskriftsartikel (refereegranskat)abstract
- Background Allergic contact dermatitis has considerable public health impact and causative haptens vary over time. Objectives To report the prevalence of contact allergy to allergens in the Swedish baseline series 2010 to 2017, as registered in the Swedish Patch Test Register. Methods Results and demographic information for patients tested with the Swedish baseline series in 2010 to 2017 were analysed. Results Data for 21 663 individuals (females 69%) were included. Females had significantly more positive patch tests (54% vs 40%). The reaction prevalence rates were highest for nickel sulfate (20.7%), fragrance mix I (7.1%), Myroxylon pereirae (6.9%), potassium dichromate (6.9%), cobalt chloride (6.8%), methylchloroisothiazolinone/methylisothiazolinone (MCI/MI; 6.4%), MI (3.7%), colophonium (3.5%), fragrance mix II (3.2%), and formaldehyde (3.2%). Myroxylon pereirae reaction prevalence increased from 5% in 2010 to 9% in 2017 and that for methyldibromo glutaronitrile from 3.1% to 4.6%. MCI/MI and MI reactions decreased in prevalence after 2014. Nickel reaction prevalence decreased among females aged 10 to 19 years. Conclusions Nickel remains the most common sensitizing agent, with reaction prevalence decreasing among females younger than 20 years. The changes in MCI/MI and MI reaction prevalence mirrored those in Europe. The register can reveal changes in contact allergy prevalence over time among patients patch tested in Sweden.
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| 4. |
- Andersson, Anders, et al.
(författare)
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Describing fish passage in a river confluence with telemetry and CFD
- 2016
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Konferensbidrag (refereegranskat)abstract
- The confluence between hydropower tailrace and the old river bed in Stornorrfors in the river Umeälven in the northern part of Sweden has shown to be the largest obstacle for upstream migrating salmon and sea trout during the migrating season. Fish are attracted to the high flow rate from the tailrace and will not migrate upstream in the old river bed being the passage to the fishway leading past the hydropower dam. By triangulating the movements of radio tagged fish using eight antennas in the confluence, it is here possible to describe the individual fish tracks left by radio tagged fish during the migrating season. These tracks are then compared with three-dimensional Computational Fluid Dynamics (CFD) simulations of the confluence. By simulating the most common combinations of turbine flow and spill flow in the old river bed it is then possible to find correlations between individual fish movements and flow parameters such as velocity, turbulence intensity or vorticity for different flow combinations. It was previously assumed that fish had trouble locating the old river bed, the results of the triangulation however shows that most fish finds the old river bed within a few days but does not chose to migrate until several days (or weeks) later. The main issue to be solved is therefore not how to attract the fish to the old river bed but rather how to create favorable conditions in the old river bed so that migrating fish are more inclined to take that path upstream.
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| 5. |
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| 6. |
- Andersson, Henrik, et al.
(författare)
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Economic Analysis and Investment Priorities in Sweden's Transport Sector
- 2018
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Ingår i: Journal of Benefit-Cost Analysis. - : Cambridge University Press. - 2194-5888 .- 2152-2812. ; 9:1, s. 120-146
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Tidskriftsartikel (refereegranskat)abstract
- Beginning as a planning tool within Sweden's national road administration some 50 years ago, benefit-cost analysis (BCA) has come to be a pillar of the national transport policy because of subsequent strategic choices made by the national parliament. These choices made it necessary to widen the analysis of costs to include also externalities and a foregone conclusion was that efficient investment priorities should be made based on BCA. But no one asked whether the political decision makers or the BCA models were up to that task. This paper reviews the institutional framework and practice of BCA in Sweden for transport infrastructure investment, and considers design issues that have been and still are debated, such as whether the discount rate should include a risk term and how to account for the marginal cost of public funds. A main concern with BCA results is the underestimation of construction costs, making transport sector projects look better than they are. Several ex post analyses have established that a higher NPV ratio increases the probability of being included in the investment program proposal prepared by the agency. The requirement to let projects undergo BCA seems to make planners trim project proposals by trying to reduce investment costs without significantly reducing benefits. This relationship is weaker among profitable projects. Moreover, there is no correlation between rate of return and the probability of being included in the final program, which is established on political grounds.
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| 7. |
- Andersson, Henrik, et al.
(författare)
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Private and public WTP for safety : a validity test
- 2018
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Konferensbidrag (refereegranskat)abstract
- In order to mitigate adverse health effects policy makers can, broadly speaking, choose between private and public safety measures. For instance, whereas legislation on seat-belt usage can be considered a private good for which the individual bares the costs and benefits, public investments to improve the standard of a road that increases safety will benefit all who travels on that road.Since safety comes at a cost, policies that increase safety need to be evaluated. In order to secure an efficient resource allocation, policy makers often rely on benefit-cost analysis (BCA). To facilitate the BCA, it is common to use a common metric in form of monetary values for both the costs and the benefits. However, many of the effects induced by safety policies do not have easily obtainable monetary values and for those effects policy makers turn to non-market evaluation methods, such as revealed (RP) and stated preference (SP) methods.Since SP methods do not rely on the existence of actual market data they are more flexible than RP methods. However, SP methods are based on hypothetical scenarios and it has been found that they often are flawed by several biases such as hypothetical and strategic bias, as well as scale insensitivity. Therefore, the hypothetical setting necessitates tests of construct validity, i.e. tests of whether the results are in accordance with expectations, based on economic theory and/or empirical findings.One area where SP methods have been used, is to estimate willingness to pay (WTP) for public safety measures, for which tradeoffs based on actual decisions are usually not available. If individual WTP for private and public safety measures is identical, there would be no need to derive them separately. Since WTP depends on the context and the affected population there is a no a priori ground to believe that they are identical, though. The empirical evidence also suggests that private and public WTP differ. Therefore, policy makers may need different values when evaluating private and public safety policies.The aim of this study is to describe a validity test for private and public WTP for safety. We use a framework with a mortality risk and the motive for this study is findings on differences in WTP for private and public road safety. It is a well-established fact that SP studies that estimate WTP to reduce mortality risk, with few exceptions, fail the test of strong scale, an important test of the validity of the WTP estimates. The validity of WTP estimates for public and private safety measures has, to the best knowledge of the authors, so far not formally been tested, however. The importance of such a test is supported by the empirical estimates of public and private WTP for road safety, since these estimates would fail the test.
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| 8. |
- Andersson, Stig J, et al.
(författare)
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General practitioners' conceptions about treatment of depression and factors that may influence their practice in this area. A postal survey
- 2005
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Ingår i: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 6:21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The way GPs work does not appear to be adapted to the needs of depressive patients. Therefore we wanted to examine Swedish GPs' conceptions of depressive disorders and their treatment and GPs' ideas of factors that may influence their manner of work with depressive patients. METHODS: A postal questionnaire to a stratified sample of 617 Swedish GPs. RESULTS: Most respondents assumed antidepressive drugs effective and did not assume that psychotherapy can replace drugs in depression treatment though many of them looked at psychotherapy as an essential complement. Nearly all respondents thought that clinical experiences had great importance in decision situations, but patients' own preferences and official clinical guidelines were also regarded as essential. As influences on their work, almost all surveyed GPs regarded experiences from general practice very important, and a majority also emphasised experiences from private life. Courses arranged by pharmaceutical companies were seen as essential sources of knowledge. A majority thought that psychiatrists did not provide sufficient help, while most respondents perceived they were well backed up by colleagues. CONCLUSION: GPs tend to emphasize experiences, both from clinical work and private life, and overlook influences of collegial dealings and ongoing CME as well as the effects of the pharmaceutical companies' marketing activities. Many GPs appear to need more evidence based knowledge about depressive disorders. Interventions to improve depression management have to be supporting and interactive, and should be combined with organisational reforms to improve co-operation with psychiatrists.
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