1. |
- de Graauw, Th., et al.
(författare)
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The Herschel-Heterodyne Instrument for the Far-Infrared (HIFI)
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518, s. L6-
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This paper describes the Heterodyne Instrument for the Far-Infrared (HIFI) that was launched onboard ESA's Herschel Space Observatory in May 2009. Methods: The instrument is a set of 7 heterodyne receivers that are electronically tuneable, covering 480-1250 GHz with SIS mixers and the 1410-1910 GHz range with hot electron bolometer (HEB) mixers. The local oscillator (LO) subsystem comprises a Ka-band synthesizer followed by 14 chains of frequency multipliers and 2 chains for each frequency band. A pair of auto-correlators and a pair of acousto-optical spectrometers process the two IF signals from the dual-polarization, single-pixel front-ends to provide instantaneous frequency coverage of 2 × 4 GHz, with a set of resolutions (125 kHz to 1 MHz) that are better than 0.1 km s-1. Results: After a successful qualification and a pre-launch TB/TV test program, the flight instrument is now in-orbit and completed successfully the commissioning and performance verification phase. The in-orbit performance of the receivers matches the pre-launch sensitivities. We also report on the in-orbit performance of the receivers and some first results of HIFI's operations. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.
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2. |
- Gerin, M., et al.
(författare)
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Interstellar CH absorption in the diffuse interstellar medium along the sight-lines to G10.6-0.4 (W31C), W49N, and W51
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521:1, s. Article Number: L16-
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Tidskriftsartikel (refereegranskat)abstract
- We report the detection of the ground state N, J = 1, 3/2 -> 1, 1/2 doublet of the methylidyne radical CH at similar to 532 GHz and similar to 536 GHz with the Herschel/ HIFI instrument along the sight-line to the massive star-forming regions G10.6-0.4 (W31C), W49N, and W51. While the molecular cores associated with these massive star-forming regions show emission lines, clouds in the diffuse interstellar medium are detected in absorption against the strong submillimeter background. The combination of hyperfine structure with emission and absorption results in complex profiles, with overlap of the different hyperfine components. The opacities of most of the CH absorption features are linearly correlated with those of CCH, CN, and HCO+ in the same velocity intervals. In specific narrow velocity intervals, the opacities of CN and HCO+ deviate from the mean trends, giving rise to more opaque absorption features. We propose that CCH can be used as another tracer of the molecular gas in the absence of better tracers, with [CCH]/[H2] similar to 3.2 +/- 1.1 x 10-8. The observed [CN]/[CH], [CCH]/[CH] abundance ratios suggest that the bulk of the diffuse matter along the lines of sight has gas densities nH = n(H) + 2n(H2) ranging between 100 and 1000 cm-3).
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3. |
- Mookerjea, B., et al.
(författare)
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Excitation and abundance of C3 in star forming cores Herschel/HIFI observations of the sight-lines to W31C and W49N
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521:1, s. Article Number: L13 -
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Tidskriftsartikel (refereegranskat)abstract
- We present spectrally resolved observations of triatomic carbon (C-3) in several ro-vibrational transitions between the vibrational ground state and the low-energy nu(2) bending mode at frequencies between 1654-1897 GHz along the sight-lines to the submillimeter continuum sources W31C and W49N, using Herschel's HIFI instrument. We detect C-3 in absorption arising from the warm envelope surrounding the hot core, as indicated by the velocity peak position and shape of the line profile. The sensitivity does not allow to detect C-3 absorption due to diffuse foreground clouds. From the column densities of the rotational levels in the vibrational ground state probed by the absorption we derive a rotation temperature (T-rot) of similar to 50-70 K, which is a good measure of the kinetic temperature of the absorbing gas, as radiative transitions within the vibrational ground state are forbidden. It is also in good agreement with the dust temperatures for W31C and W49N. Applying the partition function correction based on the derived T-rot, we get column densities N(C-3) similar to 7-9 x 10(14) cm(-2) and abundance x(C-3) similar to 10(-8) with respect to H-2. For W31C, using a radiative transfer model including far-infrared pumping by the dust continuum and a temperature gradient within the source along the line of sight we find that a model with x(C-3) = 10(-8), T-kin = 30-50 K, N(C-3) = 1.5 x 10(15) cm(-2) fits the observations reasonably well and provides parameters in very good agreement with the simple excitation analysis.
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4. |
- Roelfsema, P. R., et al.
(författare)
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In-orbit performance of Herschel-HIFI
- 2012
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 537
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Tidskriftsartikel (refereegranskat)abstract
- Aims: In this paper the calibration and in-orbit performance of the Heterodyne Instrument for the Far-Infrared (HIFI) is described.Methods: The calibration of HIFI is based on a combination of ground and in-flight tests. Dedicated ground tests to determine those instrument parameters that can only be measured accurately using controlled laboratory stimuli were carried out in the instrument level test (ILT) campaign. Special in-flight tests during the commissioning phase (CoP) and performance verification (PV) allowed the determination of the remaining instrument parameters. The various instrument observing modes, as specified in astronomical observation templates (AOTs), were validated in parallel during PV by observing selected celestial sources.Results: The initial calibration and in-orbit performance of HIFI has been established. A first estimate of the calibration budget is given. The overall in-flight instrument performance agrees with the original specification. Issues remain at only a few frequencies. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.
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5. |
- Marseille, M. G., et al.
(författare)
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Water abundances in high-mass protostellar envelopes : Herschel observations with HIFI
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L32-
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Tidskriftsartikel (refereegranskat)abstract
- Aims: We derive the dense core structure and the water abundance in four massive star-forming regions in the hope of understanding the earliest stages of massive star formation. Methods: We present Herschel/HIFI observations of the para-H2O 111-000 and 202-111 and the para-H_218O 111-000 transitions. The envelope contribution to the line profiles is separated from contributions by outflows and foreground clouds. The envelope contribution is modeled with Monte-Carlo radiative transfer codes for dust and molecular lines (MC3D and RATRAN), and the water abundance and the turbulent velocity width as free parameters. Results: While the outflows are mostly seen in emission in high-J lines, envelopes are seen in absorption in ground-state lines, which are almost saturated. The derived water abundances range from 5×10-10 to 4×10-8 in the outer envelopes. We detect cold clouds surrounding the protostar envelope, thanks to the very high quality of the Herschel/HIFI data and the unique ability of water to probe them. Several foreground clouds are also detected along the line of sight. Conclusions: The low H2O abundances in massive dense cores are in accordance with the expectation that high densities and low temperatures lead to freeze-out of water on dust grains. The spread in abundance values is not clearly linked to physical properties of the sources. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation of NASA.Appendix (pages 6 to 7) is only available in electronic form at http://www.aanda.org
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6. |
- Roelfsema, P. R., et al.
(författare)
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SPICA-A Large Cryogenic Infrared Space Telescope : Unveiling the Obscured Universe
- 2018
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Ingår i: Publications Astronomical Society of Australia. - : Cambridge University Press (CUP). - 1323-3580 .- 1448-6083. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Measurements in the infrared wavelength domain allow direct assessment of the physical state and energy balance of cool matter in space, enabling the detailed study of the processes that govern the formation and evolution of stars and planetary systems in galaxies over cosmic time. Previous infrared missions revealed a great deal about the obscured Universe, but were hampered by limited sensitivity. SPICA takes the next step in infrared observational capability by combining a large 2.5-meter diameter telescope. cooled to below 8 K, with instruments employing ultra-sensitive detectors. A combination of passive cooling and mechanical coolers will be used to cool both the telescope and the instruments. With mechanical coolers the mission lifetime is not limited by the supply of cryogen. With the combination of low telescope background and instruments with state-of-the-art detectors SPICA provides a huge advance on the capabilities of previous missions. SPICA instruments offer spectral resolving power ranging from R similar to 50 through 11 000 in the 17-230 mu m domain and R similar to 28.000 spectroscopy between 12 and 18 mu m.SPICA will provide efficient 30-37 mu m broad band mapping, and small field spectroscopic and polarimetric imaging at 100, 200 and 350 mu m. SPICA will provide infrared spectroscopy with an unprecedented sensitivity of similar to 5 x 10(-20) W m (-2) (5 sigma/1 h)-over two orders of magnitude improvement over what earlier missions. This exceptional performance leap, will open entirely new domains in infrared astronomy; galaxy evolution and metal production over cosmic time, dust formation and evolution from very early epochs onwards, the formation history of planetary systems.
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7. |
- Benz, A. O., et al.
(författare)
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Hydrides in young stellar objects : Radiation tracers in a protostar-disk-outflow system
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L35-
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Tidskriftsartikel (refereegranskat)abstract
- Context. Hydrides of the most abundant heavier elements are fundamental molecules in cosmic chemistry. Some of them trace gas irradiated by UV or X-rays. Aims: We explore the abundances of major hydrides in W3 IRS5, a prototypical region of high-mass star formation. Methods: W3 IRS5 was observed by HIFI on the Herschel Space Observatory with deep integration (≃2500 s) in 8 spectral regions. Results: The target lines including CH, NH, H3O+, and the new molecules SH+, H2O+, and OH+ are detected. The H2O+ and OH+ J = 1-0 lines are found mostly in absorption, but also appear to exhibit weak emission (P-Cyg-like). Emission requires high density, thus originates most likely near the protostar. This is corroborated by the absence of line shifts relative to the young stellar object (YSO). In addition, H2O+ and OH+ also contain strong absorption components at a velocity shifted relative to W3 IRS5, which are attributed to foreground clouds. Conclusions: The molecular column densities derived from observations correlate well with the predictions of a model that assumes the main emission region is in outflow walls, heated and irradiated by protostellar UV radiation. Herschel is an ESA space observatory with science instruments provided by a European-led Principal Investigator consortia and with important participation from NASA.Appendix (page 5) is only available in electronic form at http://www.aanda.org
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8. |
- Decin, L., et al.
(författare)
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Water content and wind acceleration in the envelope around the oxygen-rich AGB star IK Tauri as seen by Herschel/HIFI
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521:1, s. Article Number: L4-
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Tidskriftsartikel (refereegranskat)abstract
- During their asymptotic giant branch evolution, low-mass stars lose a significant fraction of their mass through an intense wind, enriching the interstellar medium with products of nucleosynthesis. We observed the nearby oxygen-rich asymptotic giant branch star IK Tau using the high-resolution HIFI spectrometer onboard Herschel. We report on the first detection of (H2O)-O-16 and the rarer isotopologues (H2O)-O-17 and (H2O)-O-18 in both the ortho and para states. We deduce a total water content (relative to molecular hydrogen) of 6.6 x 10(-5), and an ortho-to-para ratio of 3:1. These results are consistent with the formation of H2O in thermodynamical chemical equilibrium at photospheric temperatures, and does not require pulsationally induced non-equilibrium chemistry, vaporization of icy bodies or grain surface reactions. High-excitation lines of (CO)-C-12, (CO)-C-13, (SiO)-Si-28, (SiO)-Si-29, (SiO)-Si-30, HCN, and SO have also been detected. From the observed line widths, the acceleration region in the inner wind zone can be characterized, and we show that the wind acceleration is slower than hitherto anticipated.
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9. |
- Kristensen, L. E., et al.
(författare)
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Water in low-mass star-forming regions with Herschel . HIFI spectroscopy of NGC 1333
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L30-
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Tidskriftsartikel (refereegranskat)abstract
- “Water In Star-forming regions with Herschel” (WISH) is a key programme dedicated to studying the role of water and related species during the star-formation process and constraining the physical and chemical properties of young stellar objects. The Heterodyne Instrument for the Far-Infrared (HIFI) on the Herschel Space Observatory observed three deeply embedded protostars in the low-mass star-forming region NGC 1333 in several H_216O, H_218O, and CO transitions. Line profiles are resolved for five H_216O transitions in each source, revealing them to be surprisingly complex. The line profiles are decomposed into broad (>20 km s-1), medium-broad (~5-10 km s-1), and narrow (<5 km s-1) components. The H_218O emission is only detected in broad 110-101 lines (>20 km s-1), indicating that its physical origin is the same as for the broad H_216O component. In one of the sources, IRAS4A, an inverse P Cygni profile is observed, a clear sign of infall in the envelope. From the line profiles alone, it is clear that the bulk of emission arises from shocks, both on small (⪉1000 AU) and large scales along the outflow cavity walls (~10 000 AU). The H2O line profiles are compared to CO line profiles to constrain the H2O abundance as a function of velocity within these shocked regions. The H2O/CO abundance ratios are measured to be in the range of ~0.1-1, corresponding to H2O abundances of ~10-5-10-4 with respect to H2. Approximately 5-10% of the gas is hot enough for all oxygen to be driven into water in warm post-shock gas, mostly at high velocities. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.Tables 2 and 3 (page 6) are only available in electronic form at http://www.aanda.org
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10. |
- Wampfler, S. F., et al.
(författare)
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Herschel observations of the hydroxyl radical (OH) in young stellar objects
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L36-
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Tidskriftsartikel (refereegranskat)abstract
- Aims: “Water In Star-forming regions with Herschel” (WISH) is a Herschel key program investigating the water chemistry in young stellar objects (YSOs) during protostellar evolution. Hydroxyl (OH) is one of the reactants in the chemical network most closely linked to the formation and destruction of H2O. High-temperature (T ⪆ 250 K) chemistry connects OH and H2O through the OH + H2 Leftrightarrow H2O + H reactions. Formation of H2O from OH is efficient in the high-temperature regime found in shocks and the innermost part of protostellar envelopes. Moreover, in the presence of UV photons, OH can be produced from the photo-dissociation of H2O through H2O + γUV Rightarrow OH + H. Methods: High-resolution spectroscopy of the 163.12 μm triplet of OH towards HH 46 and NGC 1333 IRAS 2A was carried out with the Heterodyne Instrument for the Far Infrared (HIFI) on board the Herschel Space Observatory. The low- and intermediate-mass protostars HH 46, TMR 1, IRAS 15398-3359, DK Cha, NGC 7129 FIRS 2, and NGC 1333 IRAS 2A were observed with the Photodetector Array Camera and Spectrometer (PACS) on Herschel in four transitions of OH and two [O i] lines. Results: The OH transitions at 79, 84, 119, and 163 μm and [O i] emission at 63 and 145 μm were detected with PACS towards the class I low-mass YSOs as well as the intermediate-mass and class I Herbig Ae sources. No OH emission was detected from the class 0 YSO NGC 1333 IRAS 2A, though the 119 μm was detected in absorption. With HIFI, the 163.12 μm was not detected from HH 46 and only tentatively detected from NGC 1333 IRAS 2A. The combination of the PACS and HIFI results for HH 46 constrains the line width (FWHM ⪆ 11 km s-1) and indicates that the OH emission likely originates from shocked gas. This scenario is supported by trends of the OH flux increasing with the [O i] flux and the bolometric luminosity, as found in our sample. Similar OH line ratios for most sources suggest that OH has comparable excitation temperatures despite the different physical properties of the sources. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.Appendices (page 6) are only available in electronic form at http://www.aanda.org
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11. |
- Wyrowski, F., et al.
(författare)
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Variations in H2O+/H2O ratios toward massive star-forming regions
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L34-
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Tidskriftsartikel (refereegranskat)abstract
- Early results from the Herschel Space Observatory revealed the water cation H2O+ to be an abundant ingredient of the interstellar medium. Here we present new observations of the H2O and H2O+ lines at 1113.3 and 1115.2 GHz using the Herschel Space Observatory toward a sample of high-mass star-forming regions to observationally study the relation between H2O and H2O+. Nine out of ten sources show absorption from H2O+ in a range of environments: the molecular clumps surrounding the forming and newly formed massive stars, bright high-velocity outflows associated with the massive protostars, and unrelated low-density clouds along the line of sight. Column densities per velocity component of H2O+ are found in the range of 10(12) to a few 10(13) cm(-2). The highest N(H2O+) column densities are found in the outflows of the sources. The ratios of H2O+/H2O are determined in a range from 0.01 to a few and are found to differ strongly between the observed environments with much lower ratios in the massive (proto) cluster envelopes (0.01-0.1) than in outflows and diffuse clouds. Remarkably, even for source components detected in H2O in emission, H2O+ is still seen in absorption.
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12. |
- Hartogh, P., et al.
(författare)
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HIFI observations of water in the atmosphere of comet C/2008 Q3 (Garradd)
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 518:Article Number: L150
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Tidskriftsartikel (refereegranskat)abstract
- High-resolution far-infrared and sub-millimetre spectroscopy of water lines is an important tool to understand the physical and chemical properties of cometary atmospheres. We present observations of several rotational ortho- and para-water transitions in comet C/2008 Q3 (Garradd) performed with HIFI on Herschel. These observations have provided the first detection of the 2(12)-1(01) (1669 GHz) ortho and 1(11)-0(00) (1113 GHz) para transitions of water in a cometary spectrum. In addition, the ground-state transition 1(10)-1(01) at 557 GHz is detected and mapped. By detecting several water lines quasi-simultaneously and mapping their emission we can constrain the excitation parameters in the coma. Synthetic line profiles are computed using excitation models which include excitation by collisions, solar infrared radiation, and radiation trapping. We obtain the gas kinetic temperature, constrain the electron density profile, and estimate the coma expansion velocity by analyzing the map and line shapes. We derive water production rates of 1.7-2.8 x 10(28) s(-1) over the range r(h) = 1.83-1.85 AU.
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15. |
- Teyssier, D., et al.
(författare)
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Herschel/HIFI In-flight commissioning and performance
- 2010
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Ingår i: 21st International Symposium on Space Terahertz Technology 2010, ISSTT 2010; Oxford; United Kingdom; 23 March 2010 through 25 March 2010. - 9781617823626 ; , s. 23-28
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Konferensbidrag (refereegranskat)abstract
- The Herschel Space Observatory was successfully launched on the 14th of May, 2009, lifting into space the Heterodyne Instrument for the Far-Infrared (HIFI). After the standard early orbit operations on the Space-craft, the instrument was switched on for the first time on the 24th of May, kicking off an instrument Commissioning period of more than a month and a half. We present here the outcome of this Commissioning campaign, including the measured in-flight performance of the instrument. Among the challenges encountered during this period was the need to optimize the stability of the signal provided by the Local Oscillator (LO) chains in some of the frequency bands, in particular that covering the singly Ionized Carbon (C+) line at the upper edge of the HIFI range, and one of the backbones of the science program of the instrument. The same concept also allowed significant improvements in the upper end of the 3b LO chain. Another noticeable achievement was the very good co-alignment measured between the mixer beams in the respective H and V polarizations offered by HIFI, allowing for more than a simple build-in redundancy, as the observing efficiency will really benefits from the combination of the two mixers.
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16. |
- Yildiz, U. A., et al.
(författare)
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Herschel/HIFI observations of high-J CO lines in the NGC 1333 low-mass star-forming region
- 2010
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 521, s. L40-
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Tidskriftsartikel (refereegranskat)abstract
- Herschel/HIFI observations of high-J lines (up to J(u) = 10) of (CO)-C-12, (CO)-C-13 and (CO)-O-18 are presented toward three deeply embedded low-mass protostars, NGC 1333 IRAS 2A, IRAS 4A, and IRAS 4B, obtained as part of the Water In Star-forming regions with Herschel (WISH) key program. The spectrally-resolved HIFI data are complemented by ground-based observations of lower-J CO and isotopologue lines. The (CO)-C-12 10-9 profiles are dominated by broad (FWHM 25-30 km s(-1)) emission. Radiative transfer models are used to constrain the temperature of this shocked gas to 100-200 K. Several CO and (CO)-C-13 line profiles also reveal a medium-broad component (FWHM5-10 km s(-1)), seen prominently in H2O lines. Column densities for both components are presented, providing a reference for determining abundances of other molecules in the same gas. The narrow (CO)-O-18 9-8 lines probe the warmer part of the quiescent envelope. Their intensities require a jump in the CO abundance at an evaporation temperature around 25 K, thus providing new direct evidence for a CO ice evaporation zone around low-mass protostars.
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17. |
- Chang, A. Y., et al.
(författare)
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Past, present, and future of global health financing : A review of development assistance, government, out-of-pocket, and other private spending on health for 195 countries, 1995-2050
- 2019
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 393:10187, s. 2233-2260
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Tidskriftsartikel (refereegranskat)abstract
- Background: Comprehensive and comparable estimates of health spending in each country are a key input for health policy and planning, and are necessary to support the achievement of national and international health goals. Previous studies have tracked past and projected future health spending until 2040 and shown that, with economic development, countries tend to spend more on health per capita, with a decreasing share of spending from development assistance and out-of-pocket sources. We aimed to characterise the past, present, and predicted future of global health spending, with an emphasis on equity in spending across countries. Methods: We estimated domestic health spending for 195 countries and territories from 1995 to 2016, split into three categories-government, out-of-pocket, and prepaid private health spending-and estimated development assistance for health (DAH) from 1990 to 2018. We estimated future scenarios of health spending using an ensemble of linear mixed-effects models with time series specifications to project domestic health spending from 2017 through 2050 and DAH from 2019 through 2050. Data were extracted from a broad set of sources tracking health spending and revenue, and were standardised and converted to inflation-adjusted 2018 US dollars. Incomplete or low-quality data were modelled and uncertainty was estimated, leading to a complete data series of total, government, prepaid private, and out-of-pocket health spending, and DAH. Estimates are reported in 2018 US dollars, 2018 purchasing-power parity-adjusted dollars, and as a percentage of gross domestic product. We used demographic decomposition methods to assess a set of factors associated with changes in government health spending between 1995 and 2016 and to examine evidence to support the theory of the health financing transition. We projected two alternative future scenarios based on higher government health spending to assess the potential ability of governments to generate more resources for health. Findings: Between 1995 and 2016, health spending grew at a rate of 4.00% (95% uncertainty interval 3.89-4.12) annually, although it grew slower in per capita terms (2.72% [2.61-2.84]) and increased by less than $1 per capita over this period in 22 of 195 countries. The highest annual growth rates in per capita health spending were observed in upper-middle-income countries (5.55% [5.18-5.95]), mainly due to growth in government health spending, and in lower-middle-income countries (3.71% [3.10-4.34]), mainly from DAH. Health spending globally reached $8.0 trillion (7.8-8.1) in 2016 (comprising 8.6% [8.4-8.7] of the global economy and $10.3 trillion [10.1-10.6] in purchasing-power parity-adjusted dollars), with a per capita spending of US$5252 (5184-5319) in high-income countries, $491 (461-524) in upper-middle-income countries, $81 (74-89) in lower-middle-income countries, and $40 (38-43) in low-income countries. In 2016, 0.4% (0.3-0.4) of health spending globally was in low-income countries, despite these countries comprising 10.0% of the global population. In 2018, the largest proportion of DAH targeted HIV/AIDS ($9.5 billion, 24.3% of total DAH), although spending on other infectious diseases (excluding tuberculosis and malaria) grew fastest from 2010 to 2018 (6.27% per year). The leading sources of DAH were the USA and private philanthropy (excluding corporate donations and the Bill & Melinda Gates Foundation). For the first time, we included estimates of China’s contribution to DAH ($644.7 million in 2018). Globally, health spending is projected to increase to $15.0 trillion (14.0-16.0) by 2050 (reaching 9.4% [7.6-11.3] of the global economy and $21.3 trillion [19.8-23.1] in purchasing-power parity-adjusted dollars), but at a lower growth rate of 1.84% (1.68-2.02) annually, and with continuing disparities in spending between countries. In 2050, we estimate that 0.6% (0.6-0.7) of health spending will occur in currently low-income countries, despite these countries comprising an estimated 15.7% of the global population by 2050. The ratio between per capita health spending in high-income and low-income countries was 130.2 (122.9-136.9) in 2016 and is projected to remain at similar levels in 2050 (125.9 [113.7-138.1]). The decomposition analysis identified governments’ increased prioritisation of the health sector and economic development as the strongest factors associated with increases in government health spending globally. Future government health spending scenarios suggest that, with greater prioritisation of the health sector and increased government spending, health spending per capita could more than double, with greater impacts in countries that currently have the lowest levels of government health spending. Interpretation: Financing for global health has increased steadily over the past two decades and is projected to continue increasing in the future, although at a slower pace of growth and with persistent disparities in per-capita health spending between countries. Out-of-pocket spending is projected to remain substantial outside of high-income countries. Many low-income countries are expected to remain dependent on development assistance, although with greater government spending, larger investments in health are feasible. In the absence of sustained new investments in health, increasing efficiency in health spending is essential to meet global health targets. © 2019 The Author(s).
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25. |
- Dieleman, J., et al.
(författare)
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Evolution and patterns of global health financing 1995-2014 : Development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries
- 2017
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Ingår i: The Lancet. - : Lancet Publishing Group. - 0140-6736 .- 1474-547X. ; 389:10083, s. 1981-2004
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Tidskriftsartikel (refereegranskat)abstract
- Background: An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. Methods: We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Findings: Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3.0%. The largest health spending growth rates were in upper-middle-income (5.9) and lower-middle-income groups (5.0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4.6%, and health spending increased from $51 to $120 per capita. In 2014, 59.2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29.1% and 58.0% of spending was OOP spending and 35.7% and 3.0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1.8%, and reached US$37.6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount. Interpretation: Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage. © The Author(s). Published by Elsevier Ltd.
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- Forner, L. E., et al.
(författare)
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Hyperbaric oxygen treatment of mandibular osteoradionecrosis: Combined data from the two randomized clinical trials DAHANCA-21 and NWHHT2009-1
- 2022
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Ingår i: Radiotherapy and Oncology. - : Elsevier BV. - 0167-8140. ; 166, s. 137-144
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Osteoradionecrosis (ORN) of the mandible is a serious complication of head and neck radiotherapy. This study aims to investigate the effect of hyperbaric oxygen (HBO) treatment on ORN in two randomized, controlled multicentre trials. Methods and materials: Patients with ORN with indication for surgical treatment were randomised to either group 1: surgical removal of necrotic mandibular bone supplemented by 30 pre- and 10 postoperative HBO exposures at 243 kPa for 90 min each, or group 2: surgical removal of necrotic bone only. Primary outcome was healing of ORN one year after surgery evaluated by a clinically adjusted version of the Common Toxicity Criteria of Adverse Events (CTCAE) v 3.0. Secondary outcomes included xerostomia, unstimulated and stimulated whole salivation rates, trismus, dysphagia, pain, Activities of Daily Living (ADL) and quality of life according to EORTC. Data were combined from two separate trials. Ninety-seven were enrolled and 65 were eligible for the intent-to-treat analysis. The 33% drop-out was equally distributed between groups. Results: In group 1, 70% (21/30) healed compared to 51% (18/35) in group 2. HBO was associated with an increased chance of healing independent of baseline ORN grade or smoking status as well as improved xerostomia, unstimulated whole salivary flow rate, and dysphagia. Due to insufficient recruitment, none of the endpoints reached a statistically significant difference between groups. ADL data could only be obtained from 50 patients. Conclusion: Hyperbaric oxygen did not significantly improve the healing outcome of osteoradionecrosis after surgical removal of necrotic bone as compared to standard care (70% vs. 51%). This effect is not statistically significant due to the fact that the study was underpowered and is therefore prone to type II error. © 2021 The Authors
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29. |
- Woodward, A, et al.
(författare)
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Scaling up task-sharing psychological interventions for refugees in Jordan: a qualitative study on the potential barriers and facilitators
- 2023
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Ingår i: Health policy and planning. - : Oxford University Press (OUP). - 1460-2237. ; 38:3, s. 310-320
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Tidskriftsartikel (refereegranskat)abstract
- Training nonspecialists in providing evidence-based psychological interventions (i.e. task-sharing) can effectively increase community access to psychological support. However, task-sharing interventions for this purpose are rarely used at scale. The aim of this study was to examine the factors influencing the potential for scaling up (i.e. scalability) of a task-sharing psychological intervention called Problem Management Plus (PM+) for Syrian refugees in Jordan. Semi-structured individual (n = 17) and group interviews (n = 20) were conducted with stakeholders knowledgeable about PM+ and the mental health system for Syrian refugees in Jordan. Using ‘system innovation perspective’, this study conceptualized the context as landscape developments, and systemic considerations were divided into culture (shared ways of thinking) and structure (ways of organizing). Political momentum was identified as a landscape trend likely facilitating scaling up, while predicted reductions in financial aid was regarded as a constraint. In terms of culture, the medicalized approach to mental health, stigma and gender were reported barriers for scaling up PM+. Using non-stigmatizing language and offering different modalities, childcare options and sessions outside of working hours were suggestions to reduce stigma, accommodate individual preferences and increase the demand for PM+. In relation to structure, the feasibility of scaling up PM+ largely depends on the ability to overcome legal barriers, limitations in human and financial resources and organizational challenges. We recommend sustainable funding to be made available for staff, training, supervision, infrastructure, coordination, expansion and evaluation of ‘actual’ scaling up of PM+. Future research may examine the local feasibility of various funding, training and supervision models. Lessons learned from actual scaling up of PM+ and similar task-sharing approaches need to be widely shared.
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