| 1. |
- Fritzell, Peter, et al.
(författare)
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Cost-effectiveness of lumbar fusion and nonsurgical treatment for chronic low back pain in the Swedish lumbar spine study : A multicenter, randomized, controlled trial from the Swedish Lumbar Spine Study Group
- 2004
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Ingår i: Spine. - : Lippincott Williams & Wilkins. - 0362-2436 .- 1528-1159. ; 29:4, s. 421-434
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Tidskriftsartikel (refereegranskat)abstract
- Study Design. A cost-effectiveness study was performed from the societal and health care perspectives. Objective. To evaluate the costs-effectiveness of lumbar fusion for chronic low back pain (CLBP) during a 2-year follow-up. Summary of Background Data. A full economic evaluation comparing costs related to treatment effects in patients with CLBP is lacking. Patients and Methods. A total of 284 of 294 patients with CLBP for at least 2 years were randomized to either lumbar fusion or a nonsurgical control group. Costs for the health care sector ( direct costs), and costs associated with production losses ( indirect costs) were calculated. Societal total costs were identified as the sum of direct and indirect costs. Treatment effects were measured using patient global assessment of improvement, back pain ( VAS), functional disability (Owestry), and return to work. Results. The societal total cost per patient ( standard deviations) in the surgical group was significantly higher than in the nonsurgical group: Swedish kroner (SEK) 704,000 ( 254,000) vs. SEK 636,000 ( 208,000). The cost per patient for the health care sector was significantly higher for the surgical group, SEK 123,000 ( 60,100) vs. 65,200 ( 38,400) for the control group. All treatment effects were significantly better after surgery. The incremental cost-effectiveness ratio ( ICER), illustrating the extra cost per extra effect unit gained by using fusion instead of nonsurgical treatment, were for improvement: SEK 2,600 ( 600 - 5,900), for back pain: SEK 5,200 ( 1,100 - 11,500), for Oswestry: SEK 11,300 ( 1,200 - 48,000), and for return to work: SEK 4,100 ( 100 21,400). Conclusion. For both the society and the health care sectors, the 2-year costs for lumbar fusion was significantly higher compared with nonsurgical treatment but all treatment effects were significantly in favor of surgery. The probability of lumbar fusion being cost-effective increased with the value put on extra effect units gained by using surgery.
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| 2. |
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| 3. |
- Wessling, C., et al.
(författare)
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Influence of ?-tocopherol concentration on the stability of linoleic acid and the properties of low-density polyethylene
- 2000
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Ingår i: Packaging technology & science. - 0894-3214 .- 1099-1522. ; 13:1, s. 19-28
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Tidskriftsartikel (refereegranskat)abstract
- In food packaging applications where low-density polyethylene (LDPE) film containing ?-tocopherol is used, the antioxidant may have a dual function, i.e. to protect the polymer from oxidative degradation during processing, and to delay the onset of oxidation of the packaged foodstuff during storage. Incorporation of high levels of ?-tocopherol into LDPE film was found to inhibit oxidation of a linoleic acid emulsion stored in contact with the film at 6°C. However, the presence of 360 ppm caused changes in mechanical properties and an increase in oxygen transmission. Levels as high as 3400 ppm ?-tocopherol also caused yellowing and reduction in crystallinity of the material. Thus, the use of high amounts of ?-tocopherol in LDPE, which might be needed in active packaging applications, requires careful consideration of the protective requirements for each specific food and the maintenance of the desired properties of the packaging material.
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| 4. |
- Wessling, C., et al.
(författare)
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Influence of trace metals, acids and ethanol in food-simulating liquids on the retention of ?-tocopherol in low-density polyethylene film
- 2000
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Ingår i: Food Additives and Contaminants. - 0265-203X .- 1464-5122. ; 17:8, s. 713-719
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Tidskriftsartikel (refereegranskat)abstract
- The retention of ?-tocopherol (vitamin E) in low-density polyethylene (LDPE) film was investigated when in contact with different food-simulating liquids. Variations of the aqueous food simulants approved by the EU for testing of interactions between packaging materials and food, and an alternative fatty food simulant (95% aqueous ethanol) were used to study the influence of trace metals and acids, as well as variation in pH and ethanol concentration, on the stability of ?-tocopherol in the LDPE film. The presence of trace metals in aqueous media accelerated loss of ?-tocopherol from the film, while the addition of citric or ascorbic acid counteracted this loss. In contact with aqueous ethanol at a concentration of 50% or higher, the less of ?-tocopherol from the film was total. However, with solutions containing less than 50% ethanol, the antioxidant was almost completely retained in the film, unless the temperature was increased from 6 to 40°C. For contact with solutions containing ethanol or trace metals, an increase in temperature resulted in a greater loss of ?-tocopherol from the LDPE film.
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| 5. |
- Wessling, C., et al.
(författare)
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Mobility of ?-tocopherol and BHT in LDPE in contact with fatty food simulants
- 1998
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Ingår i: Food Additives and Contaminants. - 0265-203X .- 1464-5122. ; 15:6, s. 709-715
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Tidskriftsartikel (refereegranskat)abstract
- The migration/sorption behaviour of butylated hydroxytoluene (BHT) and ?-tocopherol was studied in packaging material in contact with fatty food simulants. Two low-density polyethylene (LDPE) films, containing either BHT or ?-tocopherol as antioxidants, were stored in contact with sunflower oil or 95% (v/v) ethanol. The antioxidant content was monitored in the films throughout a period of 7 weeks. The migration of ?-tocopherol into the food simulants was slower than that of BHT. Since ?-tocopherol was transferred from the film to the simulant to a lesser extent, it is considered to be a more stable antioxidant than BHT when used in an LDPE film in contact with 95% ethanol or sunflower oil.
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| 6. |
- Wessling, C., et al.
(författare)
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Retention of ?-tocopherol in low-density polyethylene (LDPE) and polypropylene (PP) in contact with foodstuffs and food-simulating liquids
- 1999
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Ingår i: Journal of the Science of Food and Agriculture. - 0022-5142 .- 1097-0010. ; 79:12, s. 1635-1641
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Tidskriftsartikel (refereegranskat)abstract
- Alpha-tocopherol occurs as a natural antioxidant in many foods and has also found use as a stabiliser in polymeric packaging materials. During storage of a food in contact with a plastic material, ?-tocopherol may be released from the packaging material and transferred into the food. An active packaging application with the transfer of a substance, such as an antioxidant, from a packaging material to a food may help to prolong the shelf-life of the food. In this study, the retention of ?-tocopherol in low-density polyethylene (LDPE) and polypropylene (PP) was investigated for contact with liquid foods with different fat contents and food simulants with different ethanol contents. The PP film exhibited excellent retention of ?-tocopherol when in contact with all media, whereas some losses were observed from the LDPE film. A number of factors including fat, alcohol and organic acid contents of the various foodstuffs seemed to influence the loss of ?-tocopherol from the LDPE film.
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| 7. |
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