| 1. |
- Gustavsson, Anders, et al.
(författare)
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Corrigendum to “Cost of disorders of the brain in Europe 2010” [Eur. Neuropsychopharmacol. 21 (2011) 718–779]
- 2012
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Ingår i: European Neuropsychopharmacology. - : Elsevier BV. - 0924-977X .- 1873-7862. ; 22:3, s. 237-238
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Tidskriftsartikel (refereegranskat)abstract
- The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.
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| 2. |
- Gustavsson, Anders, et al.
(författare)
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Cost of disorders of the brain in Europe 2010.
- 2011
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Ingår i: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
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| 3. |
- Ekman, A. -K., et al.
(författare)
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Systemic Up-Regulation of TLR4 Causes Lipopolysaccharide-Induced Augmentation of Nasal Cytokine Release in Allergic Rhinitis
- 2012
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Ingår i: International Archives of Allergy and Immunology. - : S. Karger AG. - 1423-0097 .- 1018-2438. ; 159:1, s. 6-14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Allergic rhinitis is a systemic disorder, and it is clinically well recognized that it can be aggravated by infection. Activation of the innate immune system constitutes a critical element in the process. Toll-like receptors (TLRs) comprise a part of the innate immune system, and lipopolysaccharide (LPS)-induced activation of TLR4 represents bacterial-induced interactions in various model systems. The present study examines how TLR2 and TLR4 expression is affected by symptomatic allergic rhinitis, and if LPS added upon allergen affects nasal cytokine release. Methods: In patients with pollen-induced allergic rhinitis and healthy non-allergic volunteers, nasal lavage (NAL), peripheral blood and bone marrow were sampled before and during the pollen season. TLR2 and TLR4 expression was determined flow cytometrically. Changes in the TLR receptor expression pattern were evaluated by a nasal challenge with allergen followed by LPS, or vice versa. Symptoms along with cells and cytokines in NAL were analyzed. Results: TLR4 expression increased in leukocytes in NAL, peripheral blood and bone marrow during symptomatic allergic rhinitis. A similar increase was seen for TLR2 in neutrophils in blood. Nasal challenge with allergen followed by LPS augmented the release of IL-4, IL-5, IL-10, IL-13, IFN-gamma and TNF-alpha. Conclusion: A systemic up-regulation of TLR4 in symptomatic allergic rhinitis may explain why LPS preceded by allergen increases nasal cytokine release. Copyright (C) 2012 S. Karger AG, Basel
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| 6. |
- Ekman, Mattias, 1974-
(författare)
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Alternative Media in the World Social Forum
- 2011
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Ingår i: Encyclopedia of social movement media. - Thousand Oaks, Calif. : Sage Publications. - 9780761926887 ; , s. 30-34
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Bokkapitel (populärvet., debatt m.m.)
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| 7. |
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| 8. |
- Ekman, Mattias, 1974-
(författare)
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Den globala rättviserörelsen i svenska medier : Hegemoniska formationer i relationen mellan journalistik och kapitalism
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The mobilisations against global summits towards the end of the last millennium, and the creation of the World Social Forum (WSF) in 2001, made an emerging global network of social movements visible. This thesis analyses media representations of the global justice movement, with the intention of exploring the relation between journalism and hegemonic formations in the capitalist system. The analysis includes representations of social mobilisations against global summits between 1999 and 2007, and the WSF between 2001 and 2007, in all Swedish daily newspapers. The analysis draws on theories of journalism as a social institution, and Gramsci’s concept of hegemonic formations.Using critical discourse analysis (CDA), the dissertation reveals that the representation of protests subordinates political aspects to violence, and that discursive violence presupposes physical violence. The protests are generally defined from of a hegemonic position of the political, but sometimes protest emerges in relation to legitimate political departure points. Simultaneously it is also downplayed as anti-political. The representation of WSF is more heterogeneous. It is portrayed as: an alternative, an anti-movement, and a carnival. Some aspects of violence are also highlighted through the presence of absent violence. The representations both reproduce a hegemonic order, and in some cases highlight hegemonic struggle.The thesis concludes that the global justice movement actualizes relations between dominance and resistance in the global system, but that the distance between the social mobilization and the Swedish context, transforms the protests and the WSF to temporary and partly isolated events. The historical continuity in the relations between social mobilization and news journalism shows that social movements cannot rely upon conventional news coverage.
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| 9. |
- Ekman, Mattias, et al.
(författare)
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Kostnader för bipolär sjukdom, depression, schizofreni och ångest. Rätt behandlingar kan få stora positiva samhällsekonomiska effekter. : Costs of bipolar disorder, depression, schizophrenia and anxiety. The right treatments can have significant positive socio-economic effects.
- 2014
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Ingår i: Läkartidningen. - 0023-7205. ; 111:34-35, s. 1362-4
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Tidskriftsartikel (refereegranskat)abstract
- Kunskap om både kostnader och hälsoeffekter behövs för att samhället ska kunna prioritera hur begränsade hälso- och sjukvårdsresurser bäst ska användas. Den totala samhällsekonomiska kostnaden för de fyra studerade psykiatriska sjukdomarna uppgick till 75 miljarder kronor. Kostnaden per patient var 259 000 kronor för bipolär sjukdom, 159 000 kronor för depression, 156 000 kronor för ångest och 509 000 kronor för schizofreni under år 2008. De indirekta kostnaderna för sjukfrånvaro svarade för hela 75 procent av den totala samhällskostnaden, vilket troligen ändå är en underskattning. Behandlingar som förbättrar funktionsnivå och arbetsförmåga kan få stora positiva samhällsekonomiska effekter.
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| 10. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Mediatized interdependency : Mediated interaction between journalists and politicians on Twitter
- 2014
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Ingår i: Rethinking the Mediatization of Politics.
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Konferensbidrag (refereegranskat)abstract
- The emergence of social media raises new questions concerning the relationship between journalists and politicians and between news media and political communication. A key trajectory in the relationship between news media institutions and political institutions is related to the changing practices of media production. The interconnections between journalists and politicians have been increasingly complex after the rise of political communication on and through social media platforms. Both politicians and journalists become dependent on factors that pertain to the communicative infrastructure and practices of social media. For example, communication on Twitter is characterised by high velocity, immediacy, and the public interactivity between politicians and journalists. This paper suggest that power relations between journalists and political actors are most fruitfully explored from the perspective of mediatized interdependency, where both parties are reliant on each other in order to get their work done properly. For example, the relations between politicians and journalists on social media platforms such as Twitter and Facebook, could be understood as negotiation (Berkowitz, 2009) or as a struggle (Broersma et. al., 2013). However, the struggle is no longer so much about what ‘could’ be published, but about an on-going discursive battle that takes place in the digital public space. Political actors often make official statements through Twitter, where they ‘correct’ publications they consider problematic. When doing so, they become media producers, which, in turn, use journalism as source and vehicle for promoting their own agenda. Consequently, media logic in the digital era is not restricted to the ground principles of journalistic work, but to a much broader set of opportunities, available to political and commercial institutions in society as well as to the broader public. In order to empirically assess the concept of mediatized interdependency the paper draws on several examples of politicians- journalists interactivity on Twitter.
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