| 1. |
- Ringborg, A., et al.
(författare)
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Prevalence and incidence of Type 2 diabetes and its complications 1996-2003 : estimates from a Swedish population-based study
- 2008
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 25:10, s. 1178-1186
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Tidskriftsartikel (refereegranskat)abstract
- AIMS To determine the prevalence and incidence of Type 2 diabetes and its complications in Uppsala county, Sweden between 1996 and 2003. METHODS Retrospective population-based study of patients with Type 2 diabetes identified in computerized medical records at 26 county primary care centres. Prevalence and incidence of Type 2 diabetes were estimated in the population aged 30-39, 40-49, 50-59, 60-69, 70-79 and > or = 80 years. Mortality, prevalence and incidence of complications in patients with Type 2 diabetes were determined through linkage to national inpatient, uraemia and cause-of-death registers. RESULTS Crude prevalence of Type 2 diabetes increased from 2.2 to 3.5% between 1996 and 2003. In the population aged > or = 30 years, the age- and sex-adjusted period increase was 53%[odds ratio (OR) 1.53, 95% confidence interval (CI) 1.47-1.58]. Crude population incidence was approximately stable after 1997 (3.7 cases/1000 residents in 1997 compared with 3.8/1000 in 2003). Age- and sex-adjusted mortality rates in Type 2 diabetic patients decreased by 4% per year (OR 0.96, 95% CI 0.94-0.97). Prevalence rates of cardiovascular disease in Type 2 diabetic patients were essentially stable, affecting 13.8% of females and 18.0% of males in 2003. No trend was detected for prevalence of renal failure or incidence of acute myocardial infarction, stroke and amputation. CONCLUSIONS Prevalence of Type 2 diabetes increased in Uppsala county between 1996 and 2003 as a consequence of approximately stable incidence since 1997 and declining mortality. Rates of diabetes-related complications, notably cardiovascular disease, continued to impose a substantial burden.
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| 2. |
- Ringborg, A., et al.
(författare)
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Resource use and costs of type 2 diabetes in Sweden : estimates from population-based register data
- 2008
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Ingår i: International journal of clinical practice (Esher). - : Hindawi Limited. - 1368-5031 .- 1742-1241. ; 62:5, s. 708-716
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Tidskriftsartikel (refereegranskat)abstract
- AIMS To examine medical resource use of Swedish patients with type 2 diabetes during 2000-2004 and to estimate annual costs of care. METHODS Retrospective population-based cohort study of patients with type 2 diabetes identified in computerised medical records at 26 primary care centres in Uppsala county, Sweden. Annual quantities of medical resources were determined for prevalent cases during 2000-2004 using register data from outpatient primary care, outpatient hospital care, the National Inpatient Register and a national register for treatment of uraemia. Average costs of care of patients with type 2 diabetes were estimated based on year 2004 resource quantities of 8230 prevalent study cases. RESULTS Annual quantities of medical resource use were stable in outpatient primary care and outpatient hospital care, with patients making an average of two General Practitioner visits and 3.5 outpatient hospital visits each year. Higher rates of hospitalisation [12% in 2000 (n = 6711) compared with 16% in 2004 (n = 8230)] led to an increase in the mean (SD) number of inpatient days from 2.3 (11.8) to 2.7 (11.9) (p = 0.040) between 2000 and 2004. Mean (SD) total costs of care in 2004 were EUR 3602 (EUR 9537). Inpatient care was the major contributor to costs, accounting for 57% of total costs while drug costs accounted for an average 7%. CONCLUSIONS Swedish type 2 diabetic patients in this large sample from Uppsala county required steady annual amounts of outpatient care and increasing amounts of inpatient care during 2000-2004. The associated costs in 2004 were substantial, with inpatient care identified as the most important component.
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| 3. |
- Ringborg, A., et al.
(författare)
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Time to insulin treatment and factors associated with insulin prescription in Swedish patients with type 2 diabetes
- 2010
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Ingår i: Diabetes & Metabolism. - : Elsevier BV. - 1262-3636 .- 1878-1780. ; 36:3, s. 198-203
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Tidskriftsartikel (refereegranskat)abstract
- Aims. - The purpose of this study was to investigate the time between the start of OAD treatment and the initiation of insulin therapy and to identify the factors associated with insulin prescription among Swedish patients with type 2 diabetes in Uppsala County. Methods. - Retrospective, population-based, primary-care data gathered within the Swedish RECAP-DM study were used to identify type 2 diabetic patients who initiated OAD treatment. A Kaplan-Meier survival estimate for time to initiation of insulin therapy was generated and factors associated with insulin prescription were tested using a Cox proportional-hazards model. Results. - Within 6 years of starting OAD treatment, an estimated 25% of Swedish patients with type 2 diabetes will be prescribed insulin (95% CI: 0.23-0.26) and, within 10 years, this figure will rise to 42% (95% CI: 0.39-0.45). The probability of insulin prescription was increased in patients aged less than 65 years (HR = 1.24, 95% CI: 1.03-1.50) and in those who initiated OAD treatment with more than one agent (HR = 2.71, 95% CI: 2.15-3.43). HbA(1c) at the time of starting OAD treatment was also related to the probability of insulin prescription (HR = 1.20, 95% CI: 1.146-1.25). Conclusion. - Many type 2 diabetic patients who begin treatment with an OAD will eventually be prescribed insulin. An, disease severity and the type of prior treatment may affect the rate of the transition.
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| 4. |
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| 5. |
- Hasvold, L. P., et al.
(författare)
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Diabetes and CVD risk during angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment in hypertension : a study of 15 990 patients
- 2014
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Ingår i: Journal of Human Hypertension. - : Springer Science and Business Media LLC. - 0950-9240 .- 1476-5527. ; 28:11, s. 663-669
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Tidskriftsartikel (refereegranskat)abstract
- Differences in clinical effectiveness between angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) in the primary treatment of hypertension are unknown. The aim of this retrospective cohort study was to assess the prevention of type 2 diabetes and cardiovascular disease (CVD) in patients treated with ARBs or ACEis. Patients initiated on enalapril or candesartan treatment in 71 Swedish primary care centers between 1999 and 2007 were included. Medical records data were extracted and linked with nationwide hospital discharge and cause of death registers. The 11 725 patients initiated on enalapril and 4265 on candesartan had similar baseline characteristics. During a mean follow-up of 1.84 years, 36 482 patient-years, the risk of new diabetes onset was lower in the candesartan group (hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.69-0.96, P = 0.01) compared with the enalapril group. No difference between the groups was observed in CVD risk (HR 0.99, 95% CI 0.87-1.13, P = 0.86). More patients discontinued treatment in the enalapril group (38.1%) vs the candesartan group (27.2%). In a clinical setting, patients initiated on candesartan treatment had a lower risk of new-onset type 2 diabetes and lower rates of drug discontinuation compared with patients initiated on enalapril. No differences in CVD risk were observed.
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| 6. |
- Henriksson, M., et al.
(författare)
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Health-care costs of losartan and candesartan in the primary treatment of hypertension
- 2011
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Ingår i: Journal of Human Hypertension. - : Springer Science and Business Media LLC. - 0950-9240 .- 1476-5527. ; 25:2, s. 130-136
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Tidskriftsartikel (refereegranskat)abstract
- A recent study of two widely used angiotensin receptor blockers reported a reduced risk of cardiovascular events (-14.4%) when using candesartan compared with losartan in the primary treatment of hypertension. In addition to clinical benefits, costs associated with treatment strategies must be considered when allocating scarce health-care resources. The aim of this study was to assess resource use and costs of losartan and candesartan in hypertensive patients. Resource use (drugs, outpatient contacts, hospitalizations and laboratory tests) associated with losartan and candesartan treatment was estimated in 14 100 patients in a real-life clinical setting. We electronically extracted patient data from primary care records and mandatory Swedish national registers for death and hospitalization. Patients treated with losartan had more outpatient contacts (+15.6%), laboratory tests (+13.8%) and hospitalizations (+13.8%) compared with the candesartan group. During a maximum observation time of 9 years, the mean total costs per patient were 10 369 Swedish kronor (95% confidence interval: 3109-17 629) higher in the losartan group. In conclusion, prescribing candesartan for the primary treatment of hypertension results in lower long-term health-care costs compared with losartan.
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| 7. |
- Holmqvist Andersson, Elisabeth, et al.
(författare)
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Epidemiology of traumatic brain injury : a population based study in western Sweden.
- 2003
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Ingår i: Acta Neurologica Scandinavica. - 0001-6314 .- 1600-0404. ; 107:4, s. 256-259
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study on traumatic brain injury (TBI) is based on prospective and retrospective population based data from a head injury register in Boras. METHODS: Data was collected from the hospital emergency unit, the discharge register, the regional neurosurgical clinic and the coroner's records during 1 year. This district is mixed urban and rural with a population of 138 000. RESULTS: The 753 cases identified represent an incidence of 546 per 100 000 which includes deaths (0.7%), hospital admissions (67%) and attendance at the emergency department in patients not admitted (32%). Males (644 per 100 000), had 1.46 higher overall rate than females (442 per 100 000). The external causes were dominated by fall from same level (31%) and fall from different level (27%) followed by traffic accidents (16%) and persons hit by objects (15%). CONCLUSIONS: The incidence of TBI found in this study is high but well in accordance with earlier published Swedish studies.
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| 8. |
- Kjeldsen, S. E., et al.
(författare)
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Effects of losartan vs candesartan in reducing cardiovascular events in the primary treatment of hypertension
- 2010
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Ingår i: Journal of Human Hypertension. - : Springer Science and Business Media LLC. - 0950-9240 .- 1476-5527. ; 24:4, s. 263-273
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Tidskriftsartikel (refereegranskat)abstract
- Although angiotensin receptor blockers have different receptor binding properties no comparative studies with cardiovascular disease (CVD) end points have been performed within this class of drugs. The aim of this study was to test the hypothesis that there are blood pressure independent CVD-risk differences between losartan and candesartan treatment in patients with hypertension without known CVD. Seventy-two primary care centres in Sweden were screened for patients who had been prescribed losartan or candesartan between the years 1999 and 2007. Among the 24 943 eligible patients, 14 100 patients were diagnosed with hypertension and prescribed losartan (n = 6771) or candesartan (n = 7329). Patients were linked to Swedish national hospitalizations and death cause register. There was no difference in blood pressure reduction when comparing the losartan and candesartan groups during follow-up. Compared with the losartan group, the candesartan group had a lower adjusted hazard ratio for total CVD (0.86, 95% confidence interval (CI) 0.77-0.96, P = 0.0062), heart failure (0.64, 95% CI 0.50-0.82, P = 0.0004), cardiac arrhythmias (0.80, 95% CI 0.65-0.92, P = 0.0330), and peripheral artery disease (0.61, 95% CI 0.41-0.91, P = 0.0140). No difference in blood pressure reduction was observed suggesting that other mechanisms related to different pharmacological properties of the drugs may explain the divergent clinical outcomes.
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| 9. |
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| 10. |
- Raymond, Christopher, et al.
(författare)
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Mosaic governance A multi-method approach for engaging diverse groups in the planning of green spaces and meeting spots
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this synthesis fact sheet is to present a sustainable spatial planning framework for revitalising green spaces and meeting spots for social inclusion, biodiversity and well-being, including safety and security. We provide important insights for city planners about how new partnerships can be established between social entrepreneurs, NGOs, municipalities and marginalised groups, with a view to achieve social inclusion, biodiversity and well-being outcomes in green spaces and associated meeting spots. This work is supported by VIVAPLAN, an international research consortium funded by FORMAS, The Swedish Research Council for Sustainable Development.
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| 11. |
- Ringborg, Anna, et al.
(författare)
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The impact of acute myocardial infarction and stroke on health care costs in patients with type 2 diabetes in Sweden
- 2009
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Ingår i: European Journal of Cardiovascular Prevention & Rehabilitation. - 1741-8267 .- 1741-8275. ; 16:5, s. 576-582
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Estimates of the economic impact of cardiovascular events in patients with type 2 diabetes are scarce. The aim of this study was to determine the health care costs associated with acute myocardial infarction (AMI) and stroke in patients with type 2 diabetes in Sweden. DESIGN: Population-based open cohort study of 9941 patients with type 2 diabetes retrospectively identified in primary care records at 26 centres in Uppsala County. METHODS: Episodes of AMI and stroke suffered by study patients were tracked in the Swedish National Inpatient Register. Annual per patient costs of health care were computed for the years 2000-2004 using register data covering inpatient care, outpatient hospital care, primary care and drugs. Panel data regression was applied to determine the impact of suffering a first or repeat AMI or stroke on health care costs during the year of the event and in subsequent years. RESULTS: Total health care costs of patients suffering a first AMI/stroke increased by 4.1/6.5 during the year of the event [95% confidence interval (CI): 3.1-5.4/4.9-8.5] and by 1.1/1.4 during subsequent years (95% CI: 1.0-1.3/1.2-1.6), controlling for age, sex, the event of amputation and presence of renal failure, heart failure and diabetic eye disease. Total health care costs of patients suffering a first or repeat AMI/stroke increased by 4.1/6.4 during the year of an event (95% CI: 3.2-5.2/5.0-8.1) but were not significantly higher during subsequent years. CONCLUSION: Estimates of the costs related to major cardiovascular complications of type 2 diabetes are critical input to economic evaluations.
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| 12. |
- Stålhammar, Marcus, et al.
(författare)
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Emergent Chern-Simons interactions in 3+1 dimensions
- 2024
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Ingår i: Physical Review B. - : American Physical Society (APS). - 2469-9950 .- 2469-9969. ; 109:6
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Tidskriftsartikel (refereegranskat)abstract
- Parity-violating superconductors can support a low-dimension local interaction that becomes, upon condensation, a purely spatial Chern-Simons term. Solutions to the resulting generalized London equations can be obtained from solutions of the ordinary London equations with a complex penetration depth, and suggest several remarkable physical phenomena. The problem of flux exclusion by a sphere brings in an anapole moment, the problem of current-carrying wires brings in an azimuthal magnetic field, and the problem of vortices brings in currents along the vortices. We demonstrate that interactions of this kind, together with a conceptually related dimensionally reduced Chern-Simons interaction, can arise from physically plausible microscopic interactions.
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| 13. |
- Wamsler, Christine, et al.
(författare)
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Environmental and climate policy integration: Targeted strategies for overcoming barriers to nature-based solutions and climate change adaptation
- 2020
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Ingår i: Journal of Cleaner Production. - : Elsevier BV. - 0959-6526. ; 247, s. 119-154
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Tidskriftsartikel (refereegranskat)abstract
- Nature-based adaptation planning is a challenging endeavor, not least because it requires transdisciplinary approaches to unite different actors' efforts and capacities. However, empirical knowledge on associated governance processes is scarce and fragmented. Against this background, this paper examines the integration of nature-based approaches for climate change adaptation into municipalities’ daily planning practices and associated governance. A city-to-city learning lab was established to systematically analyze selected urban development projects step-by-step, from the initial idea, to comprehensive and detailed planning, procurement, implementation, maintenance and follow-up. The results show the numerous constraints municipal staff face and how they use targeted strategies to overcome them and tap into existing drivers. We identify five, complementary strategies: i) targeted stakeholder collaboration; ii) strategic citizen involvement; iii) outsourcing; iv) the alteration of internal working structures; and v) concealed science–policy integration. Importantly, these strategies reveal an increasing need for relational approaches that, in turn, require individuals to develop the cognitive/emotional capacity to establish trust, communicate inclusively and promote social learning, while at the same time dealing with an increasingly complex and uncertain working environment. We conclude that tapping into the potential of nature-based solutions for climate adaptation governance requires more financial and human resources, and capacity development to support personal development, systematic mainstreaming and, ultimately, more sustainable development.
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