| 1. |
- Dalal, Koustuv, 1969-, et al.
(författare)
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Economic burden of disability adjusted life years (DALYs) of injuries
- 2015
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Ingår i: Health. - Irvine, USA : Scientific Research Publishing. - 1949-4998 .- 1949-5005. ; 7, s. 487-494
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Tidskriftsartikel (refereegranskat)abstract
- Economic burdens of injuries at the country level are unknown. In the current study we tried to explore the economic burden of DALYs loss due to injuries at the country level, then distributed according to the World Bank’s income groups. Methods: Data from the World Bank and the World Health Organization websites were used. Disability adjusted life year (DALY) and gross domestic product (GDP) per capita were used to estimate the economic loss for RTIs. Estimates of economic burdens were presented in tables and figures.Results: The total economic loss of the world during 2004 by means of DALYs due to injuries was 613. 144 billion USD, corresponding value of 848.205 billion USD in 2014. DALYs burden of injuries were concentrated (almost 75%) among low and lower middle income countries. Economic burdens of injuries were concentrated (over 80%) among higher middle and high income countries. Iraq had lost almost one-fifth of its GDP due to injuries. The USA had the highest amount of economic loss for injuries (169.136 billion USD) among all countries.Conclusion: Injuries are highly expensive and they account for heavy losses to GDP. Injury prevention should be prioritized in order to save such losses to life and economies.
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| 2. |
- Dalal, Koustuv, 1969-, et al.
(författare)
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Economics of global burden of road traffic injuries and their relationship with health system variables
- 2013
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Ingår i: International Journal of Preventive Medicine. - : Wolters Kluwer. - 2008-7802 .- 2008-8213. ; 4:12, s. 1442-1450
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To estimate the economic loss due to road traffic injuries (RTIs) of the World Health Organization (WHO) member countries and to explore the relationship between the economic loss and relevant health system factors.METHODS: Data from the World Bank and the WHO were applied to set up the databases. Disability-adjusted life year (DALY) and gross domestic product per capita were used to estimate the economic loss relating to RTIs. Regression analysis was used. Data were analyzed by IBM SPSS Statistics, Versions 20.0.RESULTS: In 2005, the total economic loss of RTIs was estimated to be 167,752.4 million United States Dollars. High income countries (HIC) showed the greatest economic losses. The majority (96%) of the top 25 countries with the greatest DALY losses are low and middle income countries while 48% of the top 25 countries with the highest economic losses are HIC. The linear regression model indicates an inverse relationship between nurse density in the health system and economic loss due to RTI.CONCLUSIONS: RTIs cause enormous death and DALYs loss in low-middle income countries and enormous economic loss in HIC. More road traffic prevention programs should be promoted in these areas to reduce both incidence and economic burden of RTIs.
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| 3. |
- Dalal, Koustuv, et al.
(författare)
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Intimate Partner Violence against Women in Nepal : An Analysis through Individual, Empowerment, Family and Societal Level Factors
- 2014
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Ingår i: Journal of Research in Health Sciences. - Hamadan, Iran : Hamadan University of Medical Sciences. - 1682-2765 .- 2228-7795 .- 2228-7809. ; 14:4, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The current study estimated the national prevalence rate of intimate partner violence against women (IPVAW) in Nepal. Besides, the individual level, empowerment level, family and societal level factors were assessed to relate with the victims of IPAVW in Nepal.METHODS: Nationally representative sample of 4210 women of reproductive age (15-49 yr) were included in the study. Household surveys using two stage sampling procedures, face to face interview with pre-tested questionnaires were performed. Emotional, physical and sexual violence were target variables. A violence variable was constructed from these three types of violence. Individual level factors were measured by age, residency, education, religion and husband's education. Empowerment factors included employment status and various decision making elements. Family and societal factors included economic status, neighborhood socioeconomic disadvantage index, history of family violence, husband's controlling behavior and other issues. Cross tabulation with chi-square tests and multivariate logistic regression were employed.RESULTS: Prevalence of emotional IPVAW was 17.5%, physical IPAVW 23.4% and sexual IPAVW 14.7%. Overall the prevalence of IPVAW in Nepal was 32.4%. Joint decision making for contraception, husband's non-controlling behavior to wives and friendly feelings were emerged as less likely to be IPVAW perpetration.CONCLUSIONS: The findings have immense policy importance as a nationally representative study and indicating necessity of more gender equality.
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| 4. |
- Grahn Kronhed, Ann-Charlotte, 1954-
(författare)
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Community-based osteoporosis prevention: Physical activity in relation to bone density, fall prevention, and the effect of training programmes : The Vadstena Osteoporosis Prevention Project
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is based on studies of the ten-year community-based intervention programme entitled, the Vadstena Osteoporosis Prevention Project (VOPP). The specific aims of the research were to describe the effects of physical activity and training programmes on bone mass and balance performance in adults, to determine whether a fall risk prevention programme could motivate personal actions among the elderly, to ascertain whether the intervention programme could reduce the incidence of forearm and hip fractures.Two studies addressed training programmes for middle-aged and old people. First, VOPP participants who were aged 40–70 years and had low forearm bone mineral density (BMD) values were invited to take part in a one-year weight-bearing training study. Thirty of those individuals were included in the investigation. Additional bone mass measurements were performed at the hip and the lumbar spine, and balance and aerobic capacity were also tested. The training programme was performed twice a week (I). In the second study, healthy persons aged 70–75 years were invited to participate in a balance-training study. Fifteen persons joined an exercise group, and another fifteen were controls. The training programme comprised specific balance exercises and was carried out twice a week for nine weeks (II). The association between forearm BMD values and several lifestyle factors was explored in random samples of the population aged 20–72 years (n=880) in a cross-sectional study (III). Another study explored the association between calcaneal stiffness, forearm BMD, and lifestyle factors amongst participants aged 20–79 years (n=956) at the final registration of the VOPP (V). Effects of the VOPP interventions directed at environmental risk factors for falls and the promotion of physical activity were examined in people aged ≥ 65 years (IV). The incidence of forearm and hip fractures was studied amongst middle-aged and elderly individuals in the intervention and the control communities during the study period 1987–2001 (VI).The exercise group (n=15) in the weight-bearing training study showed increases in BMD at the greater trochanter (p<0.01), one-leg stance balance with the eyes closed and coordination tests (p<0.05), and aerobic capacity (p<0.05). No significant difference was found when the groups were compared concerning changes in the different tests during the intervention period (I). In the balance-training study, the exercise group showed post-training improvement in the following tests: standing on the right leg with eyes closed (p<0.01), standing on the right leg (p<0.01) and on the left leg (p<0.05) while turning the head, and walking 30 metres (p<0.01). There were significant differences between the groups in these tests when changes were compared at the post-intervention test (II). Age (p<0.0001) and body mass index (p≤.0001) were associated with forearm BMD in both sexes. Reported moderate physical activity levels in men were positively associated with forearm BMD (p<0.05) (III). In both sexes, reported moderate (p<0.05) and high (women p<0.05 and men p<0.001) physical activity levels were positively associated with calcaneal stiffness. The correlation coefficient between forearm BMD and calcaneal stiffness was 0.58 in women and 0.34 in men (V). Persons aged ≥ 65 years at the follow-up in 1994 reported more use of shoe/cane spikesand moderate physical activity levels compared to controls (IV). There was no change in the general incidence of forearm and hip fractures between the communities for the study period. However, there was a tendency towards decreasing incidence of forearm and trochanteric hip fracture in both sexes during the late intervention period in the intervention community (VI).A community-based intervention programme aimed at reducing the incidence of osteoporotic fractures must be regarded as a long-term project and should preferably be monitored over an extended post-intervention period.
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| 5. |
- Hang, Hoang Minh, et al.
(författare)
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Community-based assessment of unintentional injuries: a pilot study in rural Vietnam
- 2003
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905 .- 1403-4956. ; 31:Supplement 62, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Although unintentional injuries are recognised as a major public health problem globally, little is known about their patterns and rates at the community level in most low-income countries. Rapid social development, leading to increased traffic and industrialization, may be changing patterns of injury. Injuries within the home environment have not so far been recognized to the same extent as traffic and work-related injuries in Vietnam, largely because they have not been effectively counted. This study took place in northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi, as a pilot project aiming to determine the community incidence of unintentional injury and to explore appropriate methods for community-based injury surveillance. METHODS: An initial study population of 23,807 was identified and asked about their experience of injury in the preceding three months. RESULTS: Overall 450 new injuries were detected over 5,952 person-years, a rate of 76 per 1,000 person-years. Males were injured at 1.6 times the rate of females, and home and road traffic accidents were most common. Most injuries occurred during unpaid household tasks. Cutting and crushing injuries occurred most frequently. Of 221 deaths from all causes in the FilaBavi population during 1999 among 43,444 person-years, 25 were attributed to unintentional injuries and two to suicide. Unintentional injury was the third leading cause of death in this community, with a case-fatality rate of 0.8%. DISCUSSION: The findings suggest that greater attention needs to be directed toward the prevention of injuries occurring in the home in rural Vietnam. On the basis of this pilot study, a one-year study using the same approach is under way to characterize the patterns of unintentional injury in more detail, including any seasonal variation.
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| 6. |
- Hang, Minh Hang, et al.
(författare)
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Incidence and seasonal variation of injury in rural Vietnam : a community-based survey
- 2004
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Ingår i: Safety Science. - : Elsevier BV. - 0925-7535 .- 1879-1042. ; 42:8, s. 691-701
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Tidskriftsartikel (refereegranskat)abstract
- Study objective: To describe seasonal effects on injury incidence at the community level and to assess the relative merits of cross-sectional or longitudinal surveillance for injuries in such a setting. Population and methods: This study took place in Bavi district, northern Vietnam, in the context of a longitudinal community surveillance site called FilaBavi. All non-fatal unintentional injuries which occurred in a sample of 24,776 people living in 5801 households were recorded during 2000. Four interview surveys per household were conducted continuously during 2000, each covering a 3-month period of recall. Injury morbidity data were analysed according to gender, age and circumstances of injury. Statistical analyses were based on monthly, quarterly and annual incidence rates with 95% confidence intervals. Significant differences between incidence rates were noted where the 95% confidence interval of the rate ratio excluded unity. Results: There were 1917 persons who experienced a total of 2079 new non-fatal injuries during the period of observation, corresponding to an incidence of 89/1000 person-years. Seasonal variations were found in all types of injury. Overall, the highest incidence rates were observed in July and April, while the lowest monthly rates were found in May and November. Peaks were observed in February and April for traffic injuries, June for work-related injuries, July, August and October for home injuries. A significantly higher incidence rate was found in the third quarter survey (103/1000 person-years, p<0.05). Conclusion: There can be interesting and significant seasonal variations in injury incidence within a community such as seen here in rural Vietnam and these variations have important implications for the design and planning of injury surveillance activities. Seasonal effects may cause invalid assessments of an injury problem if only cross-sectional household surveys are used, demonstrating the need for longitudinal approaches to injury incidence surveillance.
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| 7. |
- Hermansson, Frida, 1988, et al.
(författare)
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Climate impact and energy use of structural battery composites in electrical vehicles—a comparative prospective life cycle assessment
- 2023
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Ingår i: International Journal of Life Cycle Assessment. - 1614-7502 .- 0948-3349. ; 28:10, s. 1366-1381
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Structural battery composites (SBCs) are multifunctional carbon fibre composites that can be used as structural elements in battery electric vehicles to store energy. By decreasing the weight of the vehicle, energy consumption in the use phase can be reduced, something that could be counteracted by the energy-intensive carbon fibre production. The purpose of this study is to shed light on such life-cycle considerations. Method: Prospective life cycle assessment is used to compare the future cradle-to-grave climate impact and energy use of SBCs in battery electric vehicles to conventional metals and lithium-ion batteries. Additionally, the influences from differ- ent technology development routes, primarily related to the carbon fibre production, are assessed. The functional unit is the roof, hood, and doors of a battery electric vehicle with maintained flexural stiffness used for 200,000 km. To capture the multifunctionality of the material, the lithium-ion battery is also included in the functional unit. Results and discussion: Results show that SBCs have a large potential to decrease the life cycle climate impact and energy use of battery electric vehicles, especially following routes focusing on decreasing the use of fossil resources, both for raw materials and as energy sources. The comparative assessment of multifunctional or recycled materials to conventional mate- rials introduces several methodological challenges, such as defining the functional unit and choice of allocation approach for distributing burdens and benefits between life cycles in recycling. This study illustrates the importance of using both the cut-off and end-of-life recycling allocation approaches to capture extremes and to not provide biased results. This study also highlights the importance of considering the ease of repairability in comparative studies, as damages to car parts made from SBCs are likely more difficult to repair than those made from conventional materials. Conclusions: SBCs have the potential to reduce the life cycle climate impact and energy use for most scenarios compared to conventional materials. Three main methodological challenges were found: the comparison to a material with a well- established recycling system throughout its life cycle, the need for expanding the system boundaries to include the lithium-ion battery, and the difference in repairability of SBCs compared to the conventional material.
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| 8. |
- Hermansson, Frida, 1988, et al.
(författare)
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Structural batteries in electric road vehicles -When is it a good idea?
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Structural batteries, SBs, are composites that can be used as structural elements in electrical vehicles to store energy while also decreasing their weight and, consequently, their energy consumption. However, research has shown that a transition to SBs does not automatically provide environmental benefits (Hermansson et al., 2021), and that efforts need to be made to assess when the use of SBs will in fact decrease the environmental impact of electrical vehicles. This presentation will include early prospective LCA results of SBs in vehicles and discuss when their use is a good idea, as well as potential improvement opportunities. References Hermansson, F., Berg, I., Sandberg, K., Asp, L. E., Janssen, M., & Svanström, M. (2021). The environmental benefits and challenges of a composite car with structural battery materials. Paper presented at the Resource Efficient Vehicles Conference, Stockholm.
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| 9. |
- Hermansson, Frida, 1988, et al.
(författare)
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The environmental benefits and challenges of a composite car with structural battery materials
- 2021
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Ingår i: REV 2021 Proceedings.
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Konferensbidrag (refereegranskat)abstract
- One way to reduce the environmental impact of an electric vehicle is to reduce the vehicle’s mass. This can be done by substitution of conventional materials such as steel, aluminium, and plastics with carbon fibre composites, or possibly even with structural battery composite materials. In the latter case, another consequence is that the size of the vehicle battery is reduced as the structural battery composite not only provides structural integrity, but also stores energy. This study assesses the change in life cycle environmental impacts related to transitioning from a conventional battery electric vehicle to a vehicle with components made from either carbon fibre composites or structural battery composites, with the aim of identifying environmental challenges and opportunities for cars with a high share of composite materials. Results show that a transition to carbon fibre composites and structural battery composite materials today would (in most cases) increase the total environmental impact due to the energy intensive materials production processes. The two major contributors to the environmental impacts for the structural battery composite materials are energy intensive structural battery material manufacturing process and carbon fibre production process, both of which can be expected to decrease their energy consumption as the technology maturity level increases and other production and manufacturing processes are developed. For future assessments, more effort needs to be put on collecting primary data for large-scale structural battery composites production and on assessing different technology development routes.
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| 10. |
- Johansson, Lars, 1961-
(författare)
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Teenager fatalities : epidemiology and implications for prevention
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A significant number of teenagers are killed each year by unintentional or intentional injuries. A teenager is in a vulnerable phase of her/his life, going from being a child to adult. This transition often includes testing the limits of their capabilities, which can include, e.g., high speed driving, testing alcohol and other drugs, including drinking and driving. The development from child to adult includes different psychological stress factors, such as, e.g., school problems, broken love affairs and bullying. The demands – perceived or real – also increases over time and vulnerable individuals can turn to self-harm and in the most extreme case suicide.The aim of this thesis was to investigate teenager fatalities in the northern half of Sweden and to suggest preventive measures.A survey of teenager fatalities during a twenty-year period revealed that the incidence of unintentional (n=248) deaths decreased, while intentional (n=102) deaths were unaffected over time. Most unintentional deaths were transportation related (n=204) while most of the intentional deaths were suicides (n=88). Twenty-eight percent of the decedents were test-positive for alcohol at autopsy.In a series of three studies, teenager suicides were investigated in depth, firstly through an interview study with the investigating police officer in charge of the investigation of a teenager suicide. Most of the suicides occurred in rural and depopulated areas despite the fact that most teenagers live in the larger cities along the coastline. A majority of the suicides appeared to be planned. Females, contrary to males, often had a psychiatric history. One of the conclusions was that police officers provide essential information concerning the circumstances around a teenager suicide.Parents who had lost a child through suicide, and in some cases siblings, were interviewed 15-25 months after the suicide. It was striking how the life of the surviving family members were still affected by the devastating trauma of the suicide; most parents testified that they were still struggling with the question “why?” and that they were thinking of their lost child every day. Post suicide support was often badly timed and insufficient, especially for the younger siblings. The family doctor has an important role as a co-ordinator of a long-term individually formulated support scheme for the bereaved.Evidence of suicide contagion and suicide cluster formation, i.e., one teenager suicide led to another suicide, was found in these studies, and two suicide clusters were identified, with links between the victims in each cluster. Both clusters occurred within a geographical and timely proximity. Everyone involved in the well-being of the young should be aware of the risk of contagion and suicide cluster formation.The fifth study concerned 12,812 teenagers who visited the Emergency Room at Umeå University Hospital due to an injury during 1993 through 2006. Sixty-one of these were found dead through 2007, 49 by unnatural (of which 38 were included) and 12 by natural causes. The standard mortality rate for unnatural death was calculated to 1.44 (1.02-1.98), confirming an increased risk of premature death. In many of these deaths, alcohol and drugs may have contributed. By increasing the awareness among health professionals that injury can predict a premature death - primarily among those who develop substance abuse - some premature deaths may be prevented by early intervention.This thesis confirms that most teenagers die from unnatural causes, mostly in transportation-related events and by suicide. By studying these deaths, preventive measures that could save lives have been suggested.
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