| 1. |
- Akerstedt, Torbjorn, et al.
(författare)
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Predicting long-term sickness absence from sleep and fatigue.
- 2007
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Ingår i: J Sleep Res. - : Wiley. - 0962-1105 .- 1365-2869. ; 16:4, s. 341-5
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Predicting long-term sickness absence from sleep and fatigue.Akerstedt T, Kecklund G, Alfredsson L, Selen J.Institute for Psychosocial Medicine, Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. torbjorn.akerstedt@ipm.ki.seDisturbed or shortened sleep is prospectively related to disease. One might also expect that sickness absence would be another consequence but very little data seem to exist. The present study used 8300 individuals in a national sample to obtain information on reports of disturbed sleep and fatigue 1 year and merged this with data on long-term sickness absence 2 years later. A logistic regression analysis was applied to the data with adjustments for demographic and work environment variables. The results showed that individuals without registered sickness absence at the start had a higher probability of entering a period of long-term (>/=90 days, odds ratio [OR] = 1.24 with 95% confidence interval [CI] = 1.02-1.51) sickness absence 2 years later if they reported disturbed sleep at the start. The figure for fatigue was OR = 1.35 (CI = 1.14-1.60). When fatigue or disturbed sleep was separately excluded the OR increased to OR = 1.44 and OR = 1.47, respectively. Intermediate sickness absence (14-89 days) showed similar but slightly weaker results. The results indicate that disturbed sleep and fatigue are predictors of long-term absence and it is suggested that impaired sleep may be part of a chain of causation, considering its effects on fatigue.PMID: 18036078 [PubMed - in process]
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| 2. |
- Bjerre, Bo, et al.
(författare)
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Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders
- 2007
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Ingår i: Addiction. - : John Wiley & Sons. - 0965-2140 .- 1360-0443. ; 102:11, s. 1771-1781
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. Setting: As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants: are liable for all costs themselves. Design: Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Finding: Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over €1000 (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. Conclusions: The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)
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| 3. |
- Granbom, Per-Olof, et al.
(författare)
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Strategin för effektivareenergianvändningoch transporter, EET : Underlag till Miljömålsrådets fördjupadeutvärdering av miljökvalitetsmålen
- 2007
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Strategin för effektivare energianvändning och transporter, EET, ska föreslå vilkastyrmedelsförändringar som krävs för att begränsa transport- och energisektorernasmiljöpåverkan så att miljökvalitetsmålenBegränsad klimatpåverkan, Bara naturligförsurning, Ingen övergödning, Frisk luft och God bebyggd miljöuppnås. Strateginska också bidra till att nå de transport- och energipolitiska målen.För att uppnå delmålen krävs följande insatser jämfört med prognoserna:oMinska utsläppen av CO2-ekvivalenter med minst 17 Mton till 2020,oMinska NOx-utsläppen med strax under 10 kton till 2015,oHalvera SO2-utsläppen och minska NOx-utsläppen från sjöfarten till 2015,oMinska utsläppen av luftföroreningar så att målen för frisk luft uppnås 2015,oMinska trafikbullret med ytterligare åtgärder till 2020.EET-strategin är i flera avseenden beroende av omvärlden för att uppnå de utpekadenationella miljömålen. Strategin har därför genomgående ett internationellt perspektiv.För att anta dessa utmaningar prioriteras inom EET-strategin en generell energieffektivisering.Det är en kostnadseffektiv åtgärd som har en positiv påverkan påsamtliga utpekade mål, utom möjligen buller. Effektivisering kan ske både genomspecifika åtgärder och på systemnivå genom t.ex. hur samhällsstrukturen ser ut.För att minska växthuspåverkan krävs att användningen av fossila bränslen minskar.Förnybara och flödande energikällor som sol- och vindkraft är högst prioriteradeföljt av bioenergi som har en stor potential. Förnybar energi prioriteras framförandra koldioxideffektiva energikällor som inte är långsiktigt hållbara.Modellberäkningar visar att utsläppen av luftföroreningar minskar genom klimatåtgärderna.Om koldioxidutsläppen i Sverige skulle reduceras med 25 % till 2020skulle som effekt av samma åtgärder även utsläppen av SO2 och NOx minskas medca 19 respektive 6 % jämfört med prognosen till 2020. För att nå försurnings- ochövergödningsmålen på kortare sikt krävs dock att utsläppen av kväve och svavelmåste minska genom reningsåtgärder. Speciellt gäller det sjöfarten.Målet för Frisk luft kan dra nytta av dessa åtgärder men kräver även ytterligareåtgärder. För luftkvaliteten är det särskilt viktigt var utsläppsminskningarna sker.Trafikbullret kräver också riktade åtgärder för att målen ska uppnås.Det finns flera synergieffekter mellan åtgärderna och alla delar av strategin är därförviktiga. Många av åtgärderna i energi- och transportsystemet har också mycketlång livslängd. Därför behövs ett längre tidsperspektiv, till 2050, i arbetet medmiljömålen.I strategin presenteras ett 50-tal förslag på nya eller förändrade styrmedel. Deninnehåller inga utvärderingar eller genomgångar av existerande styrmedel. Förslagenhar i varierande grad konsekvensbeskrivits och en sammanställning av konsekvensbeskrivningarnaåterfinns i en fristående rapport. Styrmedelsförslagen pekarpå vad Sverige bör driva i olika internationella organ, vad staten kan göra och i vissmån vad kommunerna kan göra. Syftet är att skapa goda förutsättningar för privatoch offentlig sektor att agera i linje med miljömålen och därmed möjliggöra systemförändringar.Styrmedelsförslag ges för ökad energieffektivisering inom industrin, bostäder ochservice samt för personresor och godstransporter på väg; förslag på energieffektiviseringgenom transporteffektivt samhällsbyggande och infrastruktur, inom luft- ochsjöfart, för järnväg samt för arbetsmaskiner. Förutom en skärpning av handelssystemetpå 6-10 Mton CO2 minskar dessa styrmedel koldioxidutsläppen med minst 5Mton och kväveoxidutsläppen med i storleksordningen 9 kton per år.Förslag presenteras för minskad klimatpåverkan genom en större andel förnybarenergi inom tillförsel av el och värme samt drivmedel till transportsektorn. De harden sammanlagda effekten av minst ytterligare 1 Mton CO2 per år.Styrmedelsförslag ges för bättre rening av kväveoxidutsläppen från stationära källor,vägtransporter och arbetsmaskiner samt för minskade kväve- och svaveloxidutsläppfrån sjöfarten. Dessa riktade styrmedel har stor potential, men miljöeffektenberor på hur kraven ställs och när de kan implementeras.Förslag ges till ytterligare styrmedel för åtgärder som leder till lägre halter av luftföroreningargenom minskade utsläpp från småskalig vedeldning och från transportsektorn.Den sammanlagda miljöeffekten av dessa styrmedel är svår att kvantifiera.Styrmedelsförslag ges dessutom för åtgärder som leder till minskat trafikbullermen även här är effekten är svår att bedöma.En övergripande konsekvensbedömning av förslagen visar på både positiva ochnegativa konsekvenser för näringsliv och konsumenter. Inom näringslivet kan väntasen marginellt ökad sysselsättning men sämre konkurrenskraft för vissa branscher.Hushållen får en kostnadsökning som kan mildras genom anpassning. Detstatsfinansiella utfallet är positivt för staten.Slutsatsen från strategin är att de styrmedel som föreslås ser ut att räcka för att nådelmålen till 2015 och 2020, men att ytterligare styrmedel kommer att krävas föratt stärka en långsiktigt hållbar utveckling. Eftersom EET-sektorerna karakteriserasav starka drivkrafter krävs även kraftfulla styrmedel för att förändra utvecklingen.För att nå de långsiktiga miljömålen räcker det inte enbart med tekniska effektivitetsökningar,förnybar energi och reningsutrustning. Beteendeförändringar måsteockså inkluderas i en resurseffektiv åtgärdsmix.
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| 4. |
- Murray, Christopher J. L., et al.
(författare)
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Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
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Tidskriftsartikel (refereegranskat)abstract
- Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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| 5. |
- Popovsk, Petar, et al.
(författare)
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EU FP7 INFSO-ICT-317669 METIS, D1.1 Scenarios, requirements and KPIs for 5G mobile and wireless system
- 2013
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- This deliverable introduces generic scenarios based on fundamental challenges, and the specific problem description of test cases that will be relevant for beyond future radio access. Specific characteristics of each scenario and each test case include the key assumptions regarding requirements and key performance indicators. In order not to constrain the potential solutions, the requirements are specified from an end-user perspective. The deliverable will not only serve as the guideline for the technical work and system concept design in METIS, but also can serve in external research communities to help to harmonize the work towards the future radio access system including the new generation system of 5G
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| 6. |
- Selén, Jan, et al.
(författare)
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Wage and compensation inequality
- 2011
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Ingår i: Journal of Insurance Markets and Companies: Analyses and Actuarial Computations. - Ukraine : "Business Perspectives" Publishing Company. ; 2:2, s. 14-19
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Tidskriftsartikel (refereegranskat)abstract
- Wages are not the only compensation for gainful employment. In particular, many employees also enjoy pension benefitsand sickness benefit insurance. The paper compares the distribution of individuals' wage income to the distributionof labor compensation when important non-wage benefits are included. In the study for Sweden the focus is on pensionbenefits. The authors address the importance of earnings-related pensions for the distribution of labor compensation.The estimations are based on a representative sample of the Swedish adult population. It is found that inequality increaseswhen compensation is considered instead of wage income, that there are differences between men and womenand across socio-economic groups in the way benefits affect inequality. This is in agreement with earlier studies in theU.S. The results also indicate that defined contribution pension schemes are more equally distributed than definedbenefit schemes. This might be of interest because pension systems are being modified in many parts of the world andmany countries have swapped a defined benefit system for a defined contribution one.
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| 7. |
- Selén, Jan, et al.
(författare)
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Welfare State's Redistributive Effect Is Exaggerated
- 2011
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Ingår i: Review of European Studies. - : Canadian Center of Science and Education (CCSE). - 1918-7173 .- 1918-7181. ; 3:1, s. 71-78
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Tidskriftsartikel (refereegranskat)abstract
- This article questions traditional analysis of the redistributive effect of the welfare state and investigates how large the effect would be with a realistic alternative for comparison. The most commonly used reference point is the zero-government counterfactual that measures redistributive effect of social policy against distribution of pre-tax and pre-transfer income. But it is impossible to ignore the fact that some form of transfer is necessary. The elderly and sick, for example, must have their means of support organised in a way other than via the public transfers under investigation. This article shows that when using an adequate alternative for comparison, social policy impact on income distribution is significantly smaller.
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Vos, Theo, et al.
(författare)
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Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
- 2015
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 386:9995, s. 743-800
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Tidskriftsartikel (refereegranskat)abstract
- Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-communicable diseases, with prevalence estimates for asymptomatic permanent caries and tension-type headache of 2.4 billion and 1.6 billion, respectively. The distribution of the number of sequelae in populations varied widely across regions, with an expected relation between age and disease prevalence. YLDs for both sexes increased from 537.6 million in 1990 to 764.8 million in 2013 due to population growth and ageing, whereas the age-standardised rate decreased little from 114.87 per 1000 people to 110.31 per 1000 people between 1990 and 2013. Leading causes of YLDs included low back pain and major depressive disorder among the top ten causes of YLDs in every country. YLD rates per person, by major cause groups, indicated the main drivers of increases were due to musculoskeletal, mental, and substance use disorders, neurological disorders, and chronic respiratory diseases; however HIV/AIDS was a notable driver of increasing YLDs in sub-Saharan Africa. Also, the proportion of disability-adjusted life years due to YLDs increased globally from 21.1% in 1990 to 31.2% in 2013. Interpretation Ageing of the world's population is leading to a substantial increase in the numbers of individuals with sequelae of diseases and injuries. Rates of YLDs are declining much more slowly than mortality rates. The non-fatal dimensions of disease and injury will require more and more attention from health systems. The transition to non-fatal outcomes as the dominant source of burden of disease is occurring rapidly outside of sub-Saharan Africa. Our results can guide future health initiatives through examination of epidemiological trends and a better understanding of variation across countries.
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| 12. |
- Åkerstedt, Torbjörn, et al.
(författare)
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Disturbed sleep and fatigue as predictors of return from long-term sickness absence
- 2010
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Ingår i: Industrial Health. - : National Institute of Industrial Health. - 0019-8366 .- 1880-8026. ; 48:2, s. 209-14
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Tidskriftsartikel (refereegranskat)abstract
- Long-term sickness absence has doubled in Sweden, as has complaints of disturbed sleep. The present study sought to investigate the prospective link between long-term sickness absence and disturbed sleep or fatigue. Sleep and fatigue from a representative national sample was followed up 1.5-2 yr later in terms of return from long-term (>or=90 d) and intermediate term (14-89 d) sickness absence. 8,300 individuals participated in the survey, out of which 372 were on long-term and 1,423 were on intermediate term sick leave. The data was analyzed using logistic regression analysis with adjustment for background and work environment variables. Separate analyses were carried out for disturbed sleep and fatigue since they were correlated. The results showed that those with disturbed sleep at the start had an Odds Ratio (OR) of 0.56 (95% Confidence Interval (CI)=0.35-0.90) for returning from long-term sickness absence. For fatigue the results were OR=0.56 (CI=0.34-0.90). Intermediate term sickness absence showed similar, but slightly weaker, results. The results indicate that disturbed sleep and fatigue are predictors of lack of return from long term and intermediate term sickness absence.
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| 13. |
- Åkerstedt, Torbjörn, et al.
(författare)
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Early morning work--prevalence and relation to sleep/wake problems : a national representative survey.
- 2010
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Ingår i: Chronobiology International. - : Informa UK Limited. - 0742-0528 .- 1525-6073. ; 27:5, s. 975-86
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Tidskriftsartikel (refereegranskat)abstract
- Very little is known about the prevalence of morning work and its relationship with sleep and fatigue. The present study obtained data from a representative sample of the Swedish population (N = 5489) to address this limitation in the literature. The results show that 15% of the population commenced work, at least occasionally, before 05:30 h and approximately 2% did so most of the time. With the increasing phase advance of the start time, the time of rising also advanced, but bedtime changed very little. Thus, early start times were not compensated with earlier bedtimes. Total sleep time decreased as the work start time was advanced; sleep duration was <5 h for work start times between 03:00 and 04:30 h. The results also indicated that advanced start times were linked with increased fatigue, feelings of not being well rested, and reports of early start times as a rather large or very large problem. However, difficulties in waking and disturbed sleep did not change with advanced start times. It was concluded that early start times are common and are associated with sleep problems and fatigue.
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