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- Baroudi, Mazen, et al.
(author)
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Preteen children’s health related quality of life in Sweden: changes over time and disparities between different sociodemographic groups
- 2019
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In: BMC Public Health. - : BioMed Central. - 1471-2458. ; 19
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Journal article (peer-reviewed)abstract
- Background: Assessing disparities in health-related quality of Life (HRQoL) is important as a part of health-related disparities in the society. The aim of this study was to explore HRQoL among 12-year-olds in Sweden in terms of differences between years 2005 and 2009 and disparities related to sociodemographic background.Methods: During the school years 2005 and 2009, a total of 18,325 sixth grade students in Sweden were invited to a celiac disease screening study; 13,279 agreed to participate. Jointly with the celiac screening, the children answered a questionnaire that included EuroQol 5 Dimensions-youth (EQ-5D-Y) and their parents responded to separate questionnaires about their own and their child’s country of birth, family structure, their employment status, occupation, and education. In total 11,009 child-parent questionnaires were collected. Logistic regression was used to study differences in HRQoL between 2005 and 2009, and between various sociodemographic subgroups.Results: Compared with 2005, children in 2009 reported more pain (OR: 1.20, 95% CI: 1.1–1.3) and more mood problems (OR: 1.35, 95% CI: 1.2–1.5). In general, girls reported more pain and mood problems and had more disparities than boys. There were no significant differences based on parents’ occupation, however, children of parents with low or medium education levels reported less “mood problems” than those of parents with high education levels (OR: 0.65, 95% CI: 0.46–0.92) and (OR: 0.84, 95% CI: 0.73–0.96), respectively. A slight variation was seen in HRQoL between children with different migration background. Girls living in small municipalities reported more pain (OR: 1.51, 95% CI: 1.14–2.01), and problems performing usual activities (OR: 3.77, 95% CI: 2.08–6.84), compared to girls living in large municipalities. In addition, children living with two parents had less mood problems than children living in other family constellations.Conclusion: More children reported pain and mood problems in 2009 compared with 2005. To study future trends, health outcomes among children in Sweden should continue to be reported periodically. More efforts should be invested to increase the awareness of health-related disparities as highlighted in this study especially for girls living in small municipalities and children of parents with high education level.
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- Cameron, David, et al.
(author)
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On what basis are medical cost-effectiveness thresholds set? Clashing opinions and an absence of data : a systematic review
- 2018
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In: Global Health Action. - Abingdon : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 11:1
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Research review (peer-reviewed)abstract
- BACKGROUND: The amount a government should be willing to invest in adopting new medical treatments has long been under debate. With many countries using formal cost-effectiveness (C/E) thresholds when examining potential new treatments and ever-growing medical costs, accurately setting the level of a C/E threshold can be essential for an efficient healthcare system.OBJECTIVES: The aim of this systematic review is to describe the prominent approaches to setting a C/E threshold, compile available national-level C/E threshold data and willingness-to-pay (WTP) data, and to discern whether associations exist between these values, gross domestic product (GDP) and health-adjusted life expectancy (HALE). This review further examines current obstacles faced with the presently available data.METHODS: A systematic review was performed to collect articles which have studied national C/E thresholds and willingness-to-pay (WTP) per quality-adjusted life year (QALY) in the general population. Associations between GDP, HALE, WTP, and C/E thresholds were analyzed with correlations.RESULTS: Seventeen countries were identified from nine unique sources to have formal C/E thresholds within our inclusion criteria. Thirteen countries from nine sources were identified to have WTP per QALY data within our inclusion criteria. Two possible associations were identified: C/E thresholds with HALE (quadratic correlation of 0.63), and C/E thresholds with GDP per capita (polynomial correlation of 0.84). However, these results are based on few observations and therefore firm conclusions cannot be made.CONCLUSIONS: Most national C/E thresholds identified in our review fall within the WHO's recommended range of one-to-three times GDP per capita. However, the quality and quantity of data available regarding national average WTP per QALY, opportunity costs, and C/E thresholds is poor in comparison to the importance of adequate investment in healthcare. There exists an obvious risk that countries might either over- or underinvest in healthcare if they base their decision-making process on erroneous presumptions or non-evidence-based methodologies. The commonly referred to value of 100,000$ USD per QALY may potentially have some basis.
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- Hu, Qitao, et al.
(author)
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Current gain and low-frequency noise of symmetric lateral bipolar junction transistors on SOI
- 2018
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In: 2018 48th European Solid-State Device Research Conference (ESSDERC). - 9781538654019 - 9781538654002 - 9781538654026 ; , s. 258-261
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Conference paper (peer-reviewed)abstract
- This paper presents a comprehensive study of symmetric lateral bipolar junction transistors (LBJTs) fabricated on SOI substrate using a CMOS-compatible process; LBJTs find many applications including being a local signal amplifier for silicon-nanowire sensors. Our LBJTs are characterized by a peak gain (β) over 50 and low-frequency noise two orders of magnitude lower than what typically is of the SiO 2 /Si interface for a MOSFET. β is found to decrease at low base current due to recombination in the space charge region at the emitter-base junction and at the surrounding SiO 2 /Si interfaces. This decrease can be mitigated by properly biasing the substrate.
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- Johansson, Katarina, et al.
(author)
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Celiac Dietary Adherence Test simplifies Determining Adherence to a Gluten-Free Diet in Swedish Adolescents
- 2019
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In: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - : Wolters Kluwer. - 0277-2116 .- 1536-4801. ; 69:5, s. 575-580
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Journal article (peer-reviewed)abstract
- Objectives: The aims of the study were to ascertain whether the Celiac Dietary Adherence Test (CDAT) could contribute in determining adherence to a gluten-free diet in celiac disease patients and to evaluate the diet adherence and well-being of a study population five years after a celiac disease screening known as “Exploring the Iceberg of Celiacs in Sweden”.Methods: Through the screening, 90 adolescents (born 1997) were diagnosed with biopsy-proven celiac disease at twelve-years of age. Of them, 70 (78%) came to a five-year follow-up where anti–tissue transglutaminase antibodies 2 (TG2-IgA) was tested and a questionnaire was filled in, including CDAT, which consists of seven questions related to adherence. Non-parametrical tests were utilized to determine associations between adherence measures.Results: Among the adolescents, 86% were adherent to a gluten-free diet five years after screening, 38% reported their general well-being as excellent, 50% very well, and 12% well. Statistically significant associations were seen between TG2-IgA and the CDAT score (p=0.033), and the self-reported adherence question and the CDAT score (p < 0.001).Conclusions: The screening-detected adolescents reported a high level of well-being and adherence to a gluten-free diet five years after screening. We conclude that the CDAT can be used in clinical practice as an estimation of adherence to a gluten-free diet. It would be most suitable to use in conjunction with currently used adherence measures, but can also be used as a stand-alone method when others are not accessible.
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- Mardani, Shabnam, 1983-, et al.
(author)
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Electromigration behavior of Cu metallization interfacing with Ta versus TaN at high temperatures
- 2016
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In: Journal of Vacuum Science & Technology B. - : American Vacuum Society. - 1071-1023 .- 1520-8567. ; 34:6
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Journal article (peer-reviewed)abstract
- High-temperature stability of Cu-based interconnects is of technological importance for electronic circuits based on wide band gap semiconductors. In this study, different metal stack combinations using Ta or TaN as capping- and/or barrier-layer, in the configuration cap/Cu/barrier, are evaluated electrically and morphologically prior to and after high-temperature treatments. The symmetric combinations Ta/Cu/Ta and TaN/Cu/TaN are characterized by a low and stable sheet resistance after annealing up to 700 °C. Asymmetric combinations of Ta/Cu/TaN and TaN/Cu/Ta, however, display an increase in sheet resistance values after annealing at 500 °C and above. This increase in sheet resistance is considered to result from Ta diffusion into the grain boundaries of the Cu film. The preliminary electromigration studies on the TaN/Cu/Ta and TaN/Cu/TaN structures show a twofold higher activation energy and a tenfold longer lifetime for the former, thus suggesting an important role of the interface between Cu and the cap and/or barrier.
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- Neumann, Anne, et al.
(author)
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The cost-effectiveness of interventions targeting lifestyle change for the prevention of diabetes in a Swedish primary care and community based prevention program
- 2017
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In: European Journal of Health Economics. - : Springer Berlin/Heidelberg. - 1618-7598 .- 1618-7601. ; 18:7, s. 905-919
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Journal article (peer-reviewed)abstract
- Background: Policymakers need to know the cost-effec-tiveness of interventions to prevent type 2 diabetes (T2D). The objective of this study was to estimate the cost-effectiveness of a T2D prevention initiative targeting weight reduction, increased physical activity and healthier diet in persons in pre-diabetic states by comparing a hypothetical intervention versus no intervention in a Swedish setting. Methods: A Markov model was used to study the cost-effectiveness of a T2D prevention program based on lifestyle change versus a control group where no prevention was applied. Analyses were done deterministically and probabilistically based on Monte Carlo simulation for six different scenarios defined by sex and age groups (30, 50, 70 years). Cost and quality adjusted life year (QALY) differences between no intervention and intervention and incremental cost-effectiveness ratios (ICERs) were estimated and visualized in cost-effectiveness planes (CE planes) and cost-effectiveness acceptability curves (CEA curves). Results: All ICERs were cost-effective and ranged from 3833 € /QALY gained (women, 30 years) to 9215 € /QALY gained (men, 70 years). The CEA curves showed that the probability of the intervention being cost-effective at the threshold value of 50,000 € per QALY gained was very high for all scenarios ranging from 85.0 to 91.1%. Discussion/conclusion: The prevention or the delay of the onset of T2D is feasible and cost-effective. A small investment in healthy lifestyle with change in physical activity and diet together with weight loss are very likely to be cost-effective.
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- Norström, Albert V., et al.
(author)
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Guiding coral reef futures in the Anthropocene
- 2016
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In: Frontiers in Ecology and the Environment. - : Wiley. - 1540-9295 .- 1540-9309. ; 14:9, s. 490-498
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Research review (peer-reviewed)abstract
- Anthropogenic changes to the Earth now rival those caused by the forces of nature and have shepherded us into a new planetary epoch - the Anthropocene. Such changes include profound and often unexpected alterations to coral reef ecosystems and the services they provide to human societies. Ensuring that reefs and their services endure during the Anthropocene will require that key drivers of coral reef change fishing, water quality, and anthropogenic climate change - stay within acceptable levels or safe operating spaces. The capacity to remain within these safe boundaries hinges on understanding the local, but also the increasingly global and cross-scale, socioeconomic causes of these human drivers of change. Consequently, local and regional management efforts that are successful in the short term may ultimately fail if current decision making and institution-building around coral reef systems remains fragmented, poorly coordinated, and unable to keep pace with the escalating speed of social, technological, and ecological change.
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10. |
- Norström, Elin, et al.
(author)
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Micro-fossil analysis of Mesolithic human dental calculus, Motala, Sweden - Indications of health status and paleo-diet
- 2019
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In: Journal of Archaeological Science. - : Elsevier BV. - 2352-409X .- 2352-4103. ; 26
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Journal article (peer-reviewed)abstract
- We analysed microfossil remains in human dental calculus sampled from an individual of the Mesolithic burials at Strandvägen, Motala, central Sweden. The analysis was targeted on phytoliths, diatoms and fungal spores. The composition of the phytolith assemblage suggests that plant micro-fossils found in the dental calculus partially stem from reeds of Phragmites. This suggests that the studied individual was consuming and/or manipulating reeds with his teeth. Spherical fungal spores were abundant in the calculus, possibly indicating weak health status, although it cannot be excluded that they originate from natural long-term accumulations. The diatom composition in the dental calculus was dominated by Cyclotella distinguenda, a species which is strongly linked to waters of the nearby Lake Vättern. This suggests that the studied individual primarily used water, and/or aquatic flora/fauna, from Lake Vättern.
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