Swedish Rating Research Articles

Urban soundscape categorization based on individual recognition, perception, and assessment of sound environments

This study proposes soundscape recognition models by clustering people based on differences in sound source perceptions. We investigated the effect of sound source identification differences on urban soundscape perception by categorizing people’s environmental sound recognition in outdoor environments. Virtual reality technology employing audio-visual stimuli collected in various urban environments replicated actual environments. Fifty participants’ subjective responses regarding sound source identification, perceived affective quality (8 typical (ISO scale) and 116 extensive attributes (Swedish rating scale)), and overall quality were surveyed. Their categorizations by sound source identification were divided into three clusters: Cluster 1–Attentive to traffic noise and other noises, Cluster 2–Less attentive to the sound environment, and Cluster 3–Attentive to natural and human sounds. Even in identical spaces, participants identified different sound sources, as each cluster focused on different sounds. The soundscape perceptual components were derived differently for each cluster; Cluster 2 extracted additional perception dimensions, i.e., tranquil and relaxed soundscapes. The results showed that each sound source that received an attentive reaction had a positive effect on soundscape perception, showing that appropriate human activities can be encouraged to improve relaxation via soundscape enhancements. The overall quality assessment by cluster revealed similar results, but the resulting indicators’ effects varied. The study’s different soundscape recognition models for each cluster, based on the relationship between soundscape indicators and descriptors, present a new perspective for interpreting urban soundscape perception and can also be used effectively in urban planning design.

Omphalocele: national current birth prevalence and survival

PurposeThe increase in prenatal diagnosis together with the high rates of associated anomalies in omphalocele has led to increased rates of termination of pregnancies. The aim of this study was to examine the national Swedish birth prevalence and survival rates among these patients.MethodsThis study is based on a nationwide population-based cohort of all children born in Sweden between 1/1/1997 and 31/12/2016. All omphalocele cases were identified though the Swedish National Patient Register and the Swedish Medical Birth Register. Outcome of malformations and deaths were retrieved from the Swedish Birth Defects Register and the Swedish Causes of Death Register.ResultsThe study included 207 cases of omphalocele (42% females). The birth prevalence for omphalocele was 1/10,000 live births. About 62% of the cases had associated malformations and/or genetic disorders; most common was ventricular septal defect. The mortality within the first year was 13%. The rate of termination of pregnancy was 59%.ConclusionThe national birth prevalence for omphalocele in Sweden is 1/10,000 newborn, with high termination rates. Over half of the pregnancies with prenatally diagnosed omphalocele will be terminated. Among those who continue the pregnancy, 1-year survival rates are high.Type of studyNational register studyLevel of evidenceIII.

Incidence trends in bladder and lung cancers between Denmark, Finland and Sweden may implicate oral tobacco (snuff/snus) as a possible risk factor

BackgroundThe dominant risk factor for urinary bladder cancer has been cigarette smoking, but, as smoking prevalence is decreasing in many populations, other risk factors may become uncovered. Such new risk factors could be responsible for halting the declining incidence of bladder cancer. We hypothesize that snuff use by Swedish men may increase the rate for bladder cancer, as snuff contains carcinogenic nitrosamines.MethodsWe carried out an ecological study by comparing incidence trends in lung and bladder cancers between Danish, Finnish and Swedish men in order to test if the Swedish bladder cancer rate deviates from the Danish and Finnish ones. We used the NORDCAN database for cancer data from 1960 through 2016 to test the hypothesis.ResultsIn the three countries, the incidence of lung cancer started to decrease after a peak incidence, and this was later followed by declining incidence in bladder cancer in Denmark from 1990 to 2016 by 14.3%, in Finland by 8.3% but not in Sweden (the decline of 1.4% was not significant). The difference in trends can be partly explained by the increasing incidence in Swedish men aged 70 or more years. Sweden differs from the two other countries by low male smoking prevalence but increasing use of snuff recorded by various surveys.ConclusionThe stable bladder cancer trend for Swedish men was opposite to the declining trends in Denmark, Finland and globally. We suggest that this unusual finding may be related to the increasing use of snuff by Swedish men. Average users of snuff are exposed to at least 3 times higher levels of carcinogenic tobacco-specific nitrosamines than a smoker of one daily pack of cigarettes.

Validation of the modified Sk\xe5ne emergency department assessment of patient load (mSEAL) model for emergency department crowding and comparison with international models; an observational study

BackgroundEmergency Department crowding is associated with increased morbidity and mortality but no measure of crowding has been validated in Sweden. We have previously derived and internally validated the Skåne Emergency Department Assessment of Patient Load (SEAL) score as a measure of crowding in Emergency Departments (ED) in a large regional healthcare system in Sweden. Due to differences in electronic health records (EHRs) between health care systems in Sweden, all variables in the original SEAL-score could not be measured reliably nationally. We aimed to derive and validate a modified SEAL (mSEAL) model and to compare it with established international measures of crowding.MethodsThis was an observational cross sectional study at four EDs in Sweden. All clinical staff assessed their workload (1–6 where 6 is the highest workload) at 5 timepoints each day. We used linear regression with stepwise backward elimination on the original SEAL dataset to derive and internally validate the mSEAL score against staff workload assessments. We externally validated the mSEAL at four hospitals and compared it with the National Emergency Department Overcrowding Score (NEDOCS), the simplified International Crowding Measure in Emergency Department (sICMED), and Occupancy Rate. Area under the receiver operating curve (AuROC) and coefficient of determination was used to compare crowding models. Crowding was defined as an average workload of 4.5 or higher.ResultsThe mSEAL score contains the variables Patient Hours and Time to physician and showed strong correlation with crowding in the derivation (r2 = 0.47), internal validation (r2 = 0.64 and 0.69) and in the external validation (r2 = 0.48 to 0.60). AuROC scores for crowding in the external validation were 0.91, 0.90, 0.97 and 0.80 for mSEAL, Occupancy Rate, NEDOCS and sICMED respectively.ConclusionsThe mSEAL model can measure crowding based on workload in Swedish EDs with good discriminatory capacity and has the potential to systematically evaluate crowding and help policymakers and researchers target its causes and effects. In Swedish EDs, Occupancy Rate and NEDOCS are good alternatives to measure crowding based on workload.

An Economic Instrument to Reduce the Crime Rate in Sweden

Objectives
 Crime is one of the most important social problems, affecting public safety, children’s development, and adult socioeconomic status. The Naturally Optimised Revenue Demand in Communities, the NORDIC model was applied to reduce the crime rate.
 Methods
 The NORDIC model that formed the basis of my study, was adapted to crime prevention. The approach was tested in a realistic case study on the crime rates in Sweden.
 Results
 Governments obtained a tool to monitor, manage, and evaluate criminality. End-users including law enforcement authorities and politicians could also use the tool to redesign the crime policy. The launched model produced constructed shadow costs to induce economic incentives to reduce the crime rate. The model considered the public’s awareness of the crime.
 Conclusions
 This paper introduced a practical, economic instrument for improved management of the crime rates. The NORDIC model could be used to reduce the Swedish crime rates and its danger to health as well as to raise the public’s awareness of crime issues.

A note on the stability of the Swedish Phillips curve

We use Bayesian techniques to estimate bivariate VAR models for Swedish unemployment rate and inflation. Employing quarterly data from 1995Q1 to 2018Q3 and new tools for model selection, we compare models with time-varying parameters and/or stochastic volatility to specifications with constant parameters and/or covariance matrix. The evidence in favour of a stable dynamic relationship between the unemployment rate and inflation is mixed. Model selection based on marginal likelihood calculations indicates that the relation is time varying, whereas the use of the deviance information criterion suggests that it is constant over time; we do, however, note consistent evidence in favour of stochastic volatility. An out-of-sample forecast exercise is also conducted, but similarly provides mixed evidence regarding which model to favour. Importantly though, even if time-varying parameters are allowed for, our results do not suggest that the Phillips curve has been flatter in more recent years. This finding thereby questions the explanation that a flatter Phillips curve is the cause of the low inflation that Sweden has experienced in recent year.

Abstract 4: Variation in Published Stroke Rates Results in Wide Variation in the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation

Background: The risk of ischemic stroke without anticoagulation for a given CHA 2 DS 2 -VASc score varies significantly across published cohorts. The resulting impact on the net clinical benefit of anticoagulation in atrial fibrillation (AF) is not known. We aimed to determine the effect of variation in published stroke rates on the net clinical benefit of anticoagulation. Methods: A decision analysis study. We used ischemic strokes rates corresponding to CHA 2 DS 2 -VASc scores from four studies - ATRIA study, SPORTIF, Swedish AF study, and the Danish National Patient Registry - in a 28-state Markov state transition model that compared the benefit of oral anticoagulation vs. no anticoagulation. During each monthly cycle, patients face a chance of stroke and hemorrhage, either of which may lead to death, neurologic sequelae, or symptom resolution. The simulation ran for the entire life expectancy of the patient. We applied this decision analytic model to a cohort of 33434 patients with incident AF (Jan 06 to Jun 09) in the Kaiser Permanente Northern and Southern California integrated health care delivery systems. Results: Of the 33434 patients, 27122 had a CHA 2 DS 2 -VASc score ≥2. Among those with CHA 2 DS 2 -VASc score ≥2, use of ATRIA Study stroke rates yielded the lowest population benefit (2576 QALYs, 0.06 expected median per person, IQR -0.02 to 0.18), while the Danish National Patient Registry stroke rates yielded the greatest population benefit (28934 QALYs, 0.70 expected median per person, IQR 0.38 to 1.47). The CHA 2 DS 2 -VASc threshold at or above which the population derives the greatest net clinical benefit from anticoagulation varies based on the stroke rates used: CHA 2 DS 2 -VASc ≥3 using ATRIA Study stroke rates, ≥2 using Swedish AF study stroke rates, ≥1 using SPORTIF and ≥0 using the Danish National Patient Registry stroke rates. Conclusion: Using current guidelines, variation in published off-anticoagulation stroke rates results in tenfold variation in the estimated net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty of the current approach that uses a CHA 2 DS 2 -VASc threshold to recommend anticoagulation.

Are central banks really breaking the (policy) rules?

▀ Looking at the strength of the global economy, it's no surprise that simple policy rules suggest that interest rates in some advanced economies are much too low and/or that several rate hikes would be needed in 2018 to avoid falling further behind the curve. Nonetheless, we expect central banks to respond cautiously and we see a slower pace of tightening than the consensus view. ▀ Policy rules, such as the Taylor Rule, have long been considered a useful guide to the potential path for policy rates. But while it suggests that current US, Eurozone and Australian central bank rates are broadly appropriate, it signals that UK, Canadian, and Swedish rates should be substantially higher. Based on our economic forecasts, Taylor Rules suggest that the central banks in the US, Eurozone, Canada and Australia will all need to raise intertest rates by around 100bps by end‐2018. ▀ However, there are several reasons not to draw strong conclusions from such point estimates. First, the Taylor Rule requires estimates of two unobservable variables – the output gap and the natural rate of interest – which cannot be estimated precisely. ▀ Second, using models that were designed to predict US policy responses in the 1990s to forecast central banks' behaviour today is likely to be misleading. Meanwhile, inferring central banks' reaction functions from recent policy rate moves to assess the future policy path is fraught with difficulties. Not only have interest rates been broadly unchanged for the bulk of the post‐financial crisis period, but policymakers have provided other forms of policy support. ▀ Third, outside the US at least, Taylor Rules have historically pointed to persistently different policy rates from those observed, yet inflation has been well anchored. ▀ The upshot of all this is that we expect central banks in the advanced economies to err on the side of caution and anticipate interest rates rising less quickly than the consensus amongst economists.

Incidence of acute pulmonary embolism, related comorbidities and survival; analysis of a Swedish national cohort

BackgroundThe aim of the study was to determine the incidence of acute pulmonary embolism (PE) in Sweden and any regional differences. To assess short- and long-term survival analysis after an episode of PE, before and after excluding patients with known malignancies, and to determine the most common comorbidities prior to the PE event.MethodsAll in-hospital patients, including children, diagnosed with acute PE in 2005 were retrieved from the Swedish National Patient Registry (NPR) and incidence rates were calculated. All registered comorbidities from 1998 until the index events were collected and survival up to 4 years after the event were calculated and compared to matched controls.ResultsThere were 5793 patients of all ages diagnosed with acute PE in 2005 resulting in a national incidence of 0.6/1000/year. The mean age was 70 years and 52% were women. The most frequent comorbidities were cardiac-, vascular-, infectious- and gastrointestinal diseases, injuries and malignancies. The mortality rates were more than doubled in patients with recent PE compared to that in a matched control group (49.1% vs 21.9%), and the excess mortality remained after exclusion of deaths occurring within one year and after exclusion of patients with any malignancy prior to the event.ConclusionsPE is associated with high age as well as with multiple comorbidities, and with an increased short- and long-term mortality. This study highlights the importance of a proper follow-up after an acute PE.

Validation of surgical site infection registration in colorectal surgery

Background: Surgical site infection (SSI) represents almost 40% of nosocomial infections. Risk for SSI is most prominent following colorectal surgery. There is no Swedish standard SSI classification or surveillance. We have failed to find validation of SSI surveillance programs presently in use. This study investigates SSI registration routines at Halmstad County Hospital, Sweden (HCH) as well as Swedish surgery departments’ SSI classification and reporting practices.Methods: We requested information regarding SSI surveillance routines from all surgical departments performing colorectal surgery in Sweden. The reliability of SSI data collected routinely at HCH between 1999 and 2008 was approximated by comparing routine reports with data from a prospective study on infection prophylaxis. We calculate how much the reported SSI frequency must change for detection with current surveillance routines.Results: In all, 36 of 56 surgical departments answered a questionnaire; 24 have active SSI registration. Most commonly, SSI is detected with a combination of postoperative control in the outpatient unit and review of medical records after discharge. The department of surgery at HCH reported, from 1999 to 2008, an average SSI rate of 12.7% including emergency surgery. Compared to prospective registration, the routine provided a sensitivity of 0.56 and a specificity of 1.0. A reported frequency of 26% is required to detect a statistically significant increase in SSI.Conclusion: Swedish hospital SSI rates cannot be compared, there is neither uniform SSI surveillance nor classification system. The SSI monitoring routine explored in this study is uncertain. Methods must be developed further to obtain reliable data.

Temporal Variation in Rates of Multiple Maternities in Denmark, 1850-2012.

In this study, the temporal trends in the rates of multiple maternities in Denmark were analyzed and an association between the rates of multiple maternities and the socioeconomic variations in Denmark was obtained. The findings are compared with the results obtained in studies of Swedish rates. Obtained temporal differences in the twinning rates (TWRs) were similar to the results presented by Fellman and Eriksson (2014). Temporal variation in rates of multiple maternities in Sweden (1751-2000). JP Journal of Biostatistics, 11, 2, 143-156.

The Effect of the Zero Lower Bound, Forward Guidance and Unconventional Monetary Policy on Interest Rate Sensitivity to Economic News in Sweden

We study whether the sensitivity of Swedish interest rates to economic news was affected by the zero lower bound and the Riksbank's monetary policies. Our results suggest that the sensitivity of interest rate swaps to Swedish macroeconomic news was reduced at the effective zero lower bound at short maturities but not at longer maturities. We also find that the sensitivity of interest rate swaps to this news was not significantly affected at any maturity by forward guidance. Finally, we conclude that the sensitivity of interest rate swaps to news was not significantly affected at any maturity by unconventional monetary policy.

Co-ethnic preferences in a cooking game: a study based on Come Dine With Me in Sweden

This study examines ethnic preferences using data from the television cooking show Come Dine With Me in Sweden. Amateur chefs compete by hosting dinner parties. Contestants rate each others' performance and the host with the highest ratings wins a cash prize. The show gives an unorthodox opportunity to study ethnic preferences in a high-stakes game environment. The analysis of the collected data shows that native Swedish contestants rate co-ethnic hosts significantly more favourably than they rate other hosts, demonstrating the existence of co-ethnic preferences. This observation seems to be an outcome of own-group favouritism rather than dislike against other groups. Also, the observed co-ethnic preference is assumed to be subtle or non-conscious based on the nature of the analysed data.

Prediction of water and wastewater networks rehabilitation based current age and material distribution

Ageing drinking water, stormwater and sewer pipe networks imply an increased degree of rehabilitation. The need for rehabilitation can be predicted using lifetime distribution functions together with current network age and material distribution. In Sweden, current age and material distribution is neither documented on a national level, nor for many water utilities on a local level. In this study, current network age and material distribution was provided through a questionnaire sent to Swedish water and wastewater utilities and the data provided were extrapolated to cover the whole of Sweden. The data were then combined with lifetime distribution functions to provide predictions. One limitation is that for newer materials the lifetime is still uncertain. Predictions were made for different scenarios to reflect local differences and the medium scenario shows that while the Swedish rehabilitation rate is stable, investments in monetary terms need to double in the next 60 years. The rehabilitation rate is also dependent on the extent to which the network is expanded. This method can be used to calculate national investment needs, and the results can also provide a basis for estimates for Swedish utilities with data scarcity.

Is the introduction of anonymous delivery associated with a reduction of high neonaticide rates in Austria? A retrospective study

To assess rates of neonaticide after the implementation of a preventative 'anonymous delivery' law in mid-2001 in Austria. Women are allowed to access antenatal care and give birth in a hospital anonymously, without showing any ID and free of charge. Retrospective study. A complete census of police-reported neonaticides was obtained from the police statistics of Austria, Sweden and Finland. All neonaticides reported to the police, 1991-2009. Neonaticide rates before (1991-2001) and after (2002-2009) the introduction of anonymous delivery legislation per 100000 births. The Mann-Whitney U-test for two independent samples was used to compare neonaticide rates in the period before the new law was introduced with the rates observed after the implementation of the new law for each country. On average the rate of police-reported neonaticides was 7.2 per 100000 births (SD 3.5, median 7.1) in Austria prior to the new law being passed, and 3.1 per 100000 births (SD 2.1, median 2.6) after the law was passed. A significant decrease in neonaticide was observed in Austria after the implementation of anonymous delivery (Mann-Whitney U-test P=0.017). Whereas the Finnish and Swedish rates were lower than the Austrian rates before and after the implementation of the Austrian law, they remained unchanged over the study period. Our data demonstrate a significant decrease in the number of police-reported neonaticides in Austria after the implementation of anonymous delivery. Even though underlying factors associated with neonaticide are complex, the findings could indicate an effect of anonymous delivery in the prevention of this crime.

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Testing Parameter Constancy in Unit Root Autoregressive Models Against Multiple Continuous Structural Changes

This article considers tests for logistic smooth transition autoregressive (LSTAR) models accommodating multiple time dependent transitions between regimes when the data generating process is a random walk. The asymptotic null distributions of the tests, in contrast to the standard results in Lin and Teräsvirta (1994), are nonstandard. Monte Carlo experiments reveal that the tests have modest size distortions and satisfactory power against LSTAR models with multiple smooth breaks. The tests are applied to Swedish unemployment rates and the hysteresis hypothesis is over-turned in favour of an LSTAR model with two transitions between extreme regimes.