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This health economic evaluation simulated a cohort to compare hydrophilic-coated to non-coated catheters for intermittent catheterization. By using a Markov model, lifetime costs and catheter-related complications were investigated. Results determined that the use of hydrophilic-coated catheters save money and reduce treatment-related complications. [ABSTRACT FROM AUTHOR]

This article presents results from an electronic survey completed by intermittent catheterization users who were registered members of a global web-based database. The results provide data on complication rates, health care utilization, and benefits from using hydrophilic-coated urinary catheters isotonic to urine. [ABSTRACT FROM AUTHOR]

Background: Trends in obesity have been reported to level off in several Western countries. The aim of this study was to investigate trends in body mass index (BMI) and prevalence of obesity between 2002 and 2010 in Stockholm County, Sweden. Methods: Three cross-sectional questionnaires from the Stockholm Health Surveys were used for this study. A total of 31 182, 34 707 and 30 767 men and women aged between 18 and 64 years completed the questionnaire regarding sociodemographic factors, health parameters, physical activity, smoking habits and anthropometry in 2002, 2006 and 2010, respectively (response rate: 62.5, 61.3 and 55.6%, respectively). Linear regression was used to investigate changes in mean BMI. Relative risk regression models were used to investigate changes in prevalence of obesity, defined as BMI ≥ 30 kg/m2. All analyses were stratified on age and further adjusted for smoking, education and socioeconomic position. Results: Between 2002 and 2006, a stabilization was found in BMI and prevalence of obesity in both men and women. But from 2006 to 2010, BMI and prevalence of obesity had increased, also among the young. In 2010, the prevalence of obesity was 12.2% among men and 10.3% among women. Conclusion: After a period of stabilization in 2002–06, BMI and prevalence of obesity are increasing in Stockholm County, Sweden. [ABSTRACT FROM PUBLISHER]

Background: Sick-leave is an important source of productivity losses to society. The objective of this study was to investigate the association between body mass index (BMI) status in young adulthood and future sick-leave. Methods: A nation-wide cohort of 43 989 Swedish men (18.7 ± 0.5 years) performing military conscription tests in 1969–70 were followed between 1986 and 2005 regarding sick-leave. BMI was used to define underweight (<18.5), normal weight (18.5–24.9), overweight (25.0–29.9) and obesity (&geq;30.0). Relative risks of sick-leave were estimated with Cox proportional hazards models adjusted for smoking, socio-economic index and muscular strength, using normal weight as the reference. Results: During 803 684 person-years of follow-up, 488 570 sick-leave episodes were recorded. On average, one short-term (&leq;7 days) episode occurred every eight person-months, one intermediate-term (8–30 days) every five person-years and one long-term (>30 days) episode every 15 person-years. Overweight was associated with 20% and obesity with >30% risk elevation for episodes ranging from 8 to 30 days [hazard ratio (HR) 1.20; 95% CI 1.15–1.24 and HR 1.35; 95% CI 1.24–1.47, respectively] as well as for episodes >30 days (HR 1.19; 95% CI 1.15–1.23 and HR 1.34; 95% CI 1.24–1.47, respectively) compared to normal weight. Obesity was also associated with an increased risk of sick-leave episodes &leq;7 days (HR 1.13; 95% CI 1.09–1.16), but the corresponding risk increase for overweight was very small (HR 1.02; 95% CI 1.00–1.03). Underweight showed increased risk only for short-term episodes (HR 1.05; 95% CI 1.04–1.07). Discussion: Overweight and obesity are associated with increased risk for sick-leave compared to normal weight, especially for sick-leave episodes of longer duration. [ABSTRACT FROM PUBLISHER]

Aim: To investigate the cost-effectiveness of palivizumab vs. no prophylaxis for respiratory syncytial virus (RSV) infection in preterm infants in Sweden. Methods: A probabilistic Markov model was populated using a nationwide register linkage and data from the literature. Cost-effectiveness was investigated from a societal perspective over a lifetime for infants born at <29 weeks of gestation. Palivizumab was modelled using assumptions for its direct effect on RSV hospitalization risk and an indirect effect (via decreased RSV hospitalization) on subsequent asthma and mortality during the epidemic. Costs and effects were discounted by 3%. Results: In the base case, prophylaxis resulted in an additional 0.102 quality-adjusted life-year (QALY) at a cost of 20 000 SEK relative to no prophylaxis (incremental cost-effectiveness ratio [ICER] 195 000 SEK/QALY). The probability of prophylaxis being cost-effective was 99% at a willingness-to-pay of 500 000 SEK/QALY. Assumptions about a causal association between RSV infection and subsequent asthma had a moderate impact, while exclusion of the indirect prophylaxis effect on mortality increased the ICER to 492 000 SEK/QALY. When excluding both of these, prophylaxis was not cost-effective. Conclusion: Based on a willingness-to-pay of 500 000 SEK/QALY, palivizumab was found to be cost-effective compared with no prophylaxis for infants born at <29 weeks if severe RSV infection was assumed to increase subsequent asthma or mortality risk. [ABSTRACT FROM AUTHOR]

Effects of land use changes are starting to be included in estimates of life-cycle greenhouse gas (GHG) emissions, so-called carbon footprints (CFs), from food production. Their omission can lead to serious underestimates, particularly for meat. Here we estimate emissions from the conversion of forest to pasture in the Legal Amazon Region (LAR) of Brazil and present a model to distribute the emissions from deforestation over products and time subsequent to the land use change. Expansion of cattle ranching for beef production is a major cause of deforestation in the LAR. The carbon footprint of beef produced on newly deforested land is estimated at more than 700 kg CO2-equivalents per kg carcass weight if direct land use emissions are annualized over 20 years. This is orders of magnitude larger than the figure for beef production on established pasture on non-deforested land. While Brazilian beef exports have originated mainly from areas outside the LAR, i.e. from regions not subject to recent deforestation, we argue that increased production for export has been the key driver of the pasture expansion and deforestation in the LAR during the past decade and this should be reflected in the carbon footprint attributed to beef exports. We conclude that carbon footprint standards must include the more extended effects of land use changes to avoid giving misleading information to policy makers, retailers, and consumers. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence of violent crime conviction among Swedish military veterans after deployment to Afghanistan versus non-deployed comparators. The main outcome was first conviction of a violent crime, retrieved from the Swedish National Council for Crime Prevention Register until December 31, 2013.Methods: This was a cohort study of military veterans identified through personnel registers regarding deployment to Afghanistan between 2002 and 2013 (n = 5894). To each military veteran, up to five non-deployed comparators identified via the Military Service Conscription Register were matched by age, sex, conscription year, cognitive ability, psychological assessment, self-reported mental health, body mass index, antidepressants/anxiolytics prescriptions and self-harm (fully matched comparators; n = 28 895). Multivariable adjustment was made for substance abuse and previous health care visits with psychiatric diagnoses. An additional comparator group matched only for age, sex and conscription year was also used (age-sex-matched comparators; n = 29 410).Results: During 21 898 person-years of follow-up (median = 3.6 years) there were 26 events among deployed military veterans compared with 98 in non-deployed fully matched comparators [12 vs 9 per 10 000 person-years, adjusted hazard ratio (aHR) 1.36; 95% confidence interval (CI) 0.88-2.10]. Among non-deployed age-sex-matched comparators there were 170 violent crime convictions (16 per 10 000 person-years; aHR 0.85; 95% CI 0.56-1.29). Factors associated with greater risk of violent crime convictions were younger age, lower scores on cognitive ability tests and psychological assessment, and convictions preceding deployment.Conclusion: The violent crime conviction rate after returning from military deployment to Afghanistan was not different compared with non-deployed comparators in individuals without history of violent crime convictions. [ABSTRACT FROM AUTHOR]

Aim: To investigate the probability of marriage and divorce among Swedish military veterans deployed to Afghanistan relative to non-deployed matched comparators. Study design and setting: Matched cohort study in Sweden. Participants: Military veterans were identified through Swedish military personnel registers regarding foreign deployments, and comparators from the Military Service Conscription Register (1969–2013). Of 1,882,411 eligible conscripts, 7041 had served in Afghanistan at some point in time between 2002 and 2013. To each military veteran, up to 5 non-deployed comparators who underwent conscription were matched by age, sex, psychological assessment, cognitive ability, psychiatric history and social characteristics. After matching there were 4896 (82%) unmarried and 1069 (18%) married deployed military veterans. The main outcome was marriage or divorce after deployment to Afghanistan. Data on marital status were retrieved from Statistics Sweden until December 31, 2014. Results: During a median follow-up of 4.1 years after deployment of married individuals, 124 divorces were observed among deployed military veterans and 399 in the matched non-deployed comparator cohort (277 vs. 178 per 10,000 person-years; adjusted hazard ratio 1.61, 95%CI 1.31–1.97). During a median follow-up of 4.7 years after deployment in the unmarried cohort, 827 new marriages were observed among deployed military veterans and 4363 in the matched non-deployed comparators cohort (399 vs. 444 per 10,000 person-years; adjusted hazard ratio 0.89, 95%CI 0.83–0.96). Conclusion: Military veterans were more likely to divorce and less likely to marry after deployment compared with matched non-deployed comparators. [ABSTRACT FROM AUTHOR]