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- Alkmark, Mårten, 1973, et al.
(författare)
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Induction of labour at 41weeks of gestation versus expectant management and induction of labour at 42weeks of gestation: a cost-effectiveness analysis
- 2022
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Ingår i: BJOG: An International Journal of Obstetrics and Gynaecology. - : Wiley. - 1470-0328 .- 1471-0528. ; 129:13, s. 2157-2165
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the cost-effectiveness of induction of labour (IOL) at 41weeks of gestation compared with expectant management until 42weeks of gestation. Design: A cost-effectiveness analysis alongside the Swedish Post-term Induction Study (SWEPIS), a multicentre, randomised controlled superiority trial. Setting: Fourteen Swedish hospitals during 2016–2018. Population: Women with an uncomplicated singleton pregnancy with a fetus in cephalic position were randomised at 41weeks of gestation to IOL or to expectant management and induction at 42weeks of gestation. Methods: Health benefits were measured in life years and quality-adjusted life years (QALYs) for mother and child. Total cost per birth was calculated, including healthcare costs from randomisation to discharge after delivery, for mother and child. Incremental cost-effectiveness ratios (ICERs) were calculated by dividing the difference in mean cost between the trial arms by the difference in life years and QALYs, respectively. Sampling uncertainty was evaluated using non-parametric bootstrapping. Main outcome measures: The cost per gained life year and per gained QALY. Results: The differences in life years and QALYs gained were driven by the difference in perinatal mortality alone. The absolute risk reduction in mortality was 0.004 (from 6/1373 to 0/1373). Based on Swedish life tables, this gives a mean gain in discounted life years and QALYs of 0.14 and 0.12 per birth, respectively. The mean cost per birth was €4108 in the IOL group (n=1373) and €4037 in the expectant management group (n=1373), with a mean difference of €71 (95%CI −€232 to €379). The ICER for IOL compared with expectant management was €545 per life year gained and €623 per QALY gained. Confidence intervals were relatively wide and included the possibility that IOL had both lower costs and better health outcomes. Conclusions: Induction of labour at 41weeks of gestation results in a better health outcome and no significant difference in costs. IOL is cost-effective compared with expectant management until 42weeks of gestation using standard threshold values for acceptable cost per life year/QALY. Tweetable abstract: Induction of labour at 41weeks of gestation is cost-effective compared with expectant management until 42weeks of gestation.
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| 2. |
- Jensen Wolfhechel, Ola, 1965-, et al.
(författare)
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Norrlands vattenanknutna kulturmiljöer – en förstudie : rapport från ett FoU-projekt
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med föreliggande förstudie har varit att ta fram ett underlag inför ett kommande tvärvetenskapligt forsknings- och digitaliseringsprojekt. Bakgrunden är att Riksantikvarieämbetet under 1940-1980-talen genomförde omfattande arkeologiska, men även naturvetenskapliga och etnologiska, undersökningar vid Norrlands älvar och sjöar som ett led i vattenkraftsutbyggnaden. Materialet kom under 1960-1980-talen att bearbetas tillsammans med Stockholms universitet inom ramen för det tvärvetenskapliga projektet Norrlands Tidiga Bebyggelse. Insatserna resulterade i ett rikt material som idag förvaras i Riksantikvarieämbetets arkiv. Då stora delar av Norrland alltjämt är antikvariskt eftersatta utgör det ett mycket viktigt källmaterial för både forskning och förvaltning av dess kulturmiljöer.Det långsiktiga målet med förstudien och det kommande projektet är att skapa ett kunskapsunderlag för forskning och redskap för landskapsanalyser som leder till ett hållbart bevarande och förvaltning av Norrlands vattenanknutna kulturmiljöer. Inom förstudien har en rad viktiga forsknings- och förvaltningsområden identifierats. För att ta fram ett adekvat underlag inför ansökan har den bland annat mynnat ut i olika förslag på strategier för det kommande projektets genomförande och finansiering, en fördjupning av frågor som rör förvaltning av vattenanknutna kulturmiljöer, utvecklat tvärvetenskapliga forskningsfrågor, tagit fram en digitaliseringsstrategi, formaliserat ett nätverk och en referensgrupp, genomfört en behovsanalys samt en inventering för att identifiera relevant arkivmaterial inom projektdeltagarnas respektive institutioner. Med förstudien har vi således lagt grunden till ett tvärvetenskapligt forsknings- och digitaliseringsprojekt som inkluderar kulturmiljöförvaltning, arkeologi, etnologi, sociologi och naturveten-skapliga ämnen, däribland miljö- och klimatforskning.
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| 4. |
- Russell Jonsson, Kenisha, 1980, et al.
(författare)
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The clustering of multiple health and lifestyle behaviors among Swedish adolescents: a person-oriented analysis
- 2023
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Ingår i: Frontiers In Public Health. - 2296-2565. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundKnowledge of the distribution, prevalence, and clustering of multiple health and lifestyle related behaviors (HLBs) among adolescents can inform the development of effective health-promoting policies and interventions. We assessed the clustering of multiple HLBs among 11, 13 and 15-year-old Swedish adolescents and examined the socioeconomic and demographic correlates for the identified clusters. MethodsWe used data from the 2017/2018 Swedish Health Behaviour in School-aged children (HBSC) study to conduct sex and age-stratified latent class analysis (LCA). The LCA was based on five HLBs: eating behavior and habits (EBH), physical activity (PA), tobacco usage (TU), alcohol consumption (AC) and sleeping habits and patterns (SHPs). Multinomial logistic regression models were used to assess the associations between the identified clusters and the socioeconomic and demographic characteristics of adolescents and their parents. ResultsHealth behaviors varied by sex and age. Four distinct clusters were identified based on sex: cluster 1 (Mixed eating behaviors and habits, physical activity and low alcohol consumption), cluster 2 (Healthy lifestyle behaviors), cluster 3 (Unhealthy lifestyle behaviors), and cluster 4 (Breakfast, low alcohol consumption and tobacco usage). In the age-stratified analyzes, three clusters were identified: cluster 1 (Unhealthy lifestyle behaviors), cluster 2 (Moderately healthy lifestyle behaviors) and cluster 3 (Healthy lifestyle behaviors). The multinomial analysis showed that sex, age, family situation and perceived family wealth were strong predictors of health behaviors. Unhealthy behaviors were most commonly associated with socioeconomic disadvantage, having a migrant background, and living in reconstructed families or single-parent households. ConclusionHealth behaviors vary significantly based on socioeconomic and demographic circumstances. Targeted policies and intervention programs are necessary to improve HLBs among vulnerable and at-risk adolescents.
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| 5. |
- Wallin, Pontus, et al.
(författare)
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Att lära demokrati
- 2022
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Bok (övrigt vetenskapligt/konstnärligt)
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