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- Agnér, Ulf, et al.
(författare)
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Norra Hammarbyhamnen : Tillbaka till kvrtersstaden
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna publikation är ett resultat av läsåret 2017-2018 i kursen Restaureringskonst vid Kungl. Konsthögskolan, arkitekturavdelningen. Årets tema var bostadsarkitektur. Förvalta, förädla, förvanska? Under läsåret undersöktes bostadsarkitekturen som kulturarv, hur bostadshus och bostadsområden förvaltas, förädlas alternativt förvanskas genom restaureringsåtgärder, förtätningar och omvandlingar. II läsårets projektstudie ingick fem bostadsområden i södra Stockholm, utvalda för att representera varsin epok i 1900-talets bostadsutveckling. En projektgrupp för varje bostadsområde gjorde studier i olika skalor, från den utvalda lägenhetens detaljer, trapphuset och bostadshuset, gården och gatan till stadsdelsnivån.
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- Anderberg, Eva, et al.
(författare)
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Diabetes and pregnancy: women's opinions about the care provided during the childbearing year.
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 23:1, s. 161-170
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Tidskriftsartikel (refereegranskat)abstract
- Scand J Caring Sci; 2009 Diabetes and pregnancy: women's opinions about the care provided during the childbearing yearBackground: The extended programmes for pregnant women with diabetes, needed to improve pregnancy outcome, might negatively influence the experience of expecting a baby. Aim: To investigate opinions about care during pregnancy, childbirth and the postnatal period among women with diabetes mellitus (DM) and gestational DM (GDM). Method: A four-part questionnaire was constructed, covering the childbearing year, with a focus on treatment and information. A total of 156 women were asked to participate (53 DM, 103 GDM), three refused. The questionnaire was anonymous. Results: The reply frequency was 94%. Of all answers, 95% fell in neutral-satisfied range (Lickert scale 2-5). Three answering patterns deviated positively (care on Specialist Antenatal Clinic, accessibility, and participation-responsibility-respect). Four patterns deviated negatively (information flow, preparation, postpartum care and postpartum check-up). Increased supervision caused problems with time for the family and at work. Comments showed focus on diabetes, forcing the healthy pregnancy aspects into the background. The answers concerning treatment indicated satisfaction (4 + 5 Lickert scale). Women with GDM felt badly prepared before the glucose tolerance test. It was doubtful whether they had been able to make an informed choice about participating. Lack of knowledge among staff was pointed out. Need for more written material was expressed. Conclusion: Satisfaction with care was shown. A discussion about the implication of informed choice with both staff and mothers are needed. Sharper implementation of the diabetes-care-chain was also an area for improvement.
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- Anderberg, Eva
(författare)
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GENERAL ORAL GLUCOSE TOLERANCE TEST DURING PREGNANCY, AN OPPORTUNITY FOR IMPROVED PREGNANCY OUTCOME AND IMPROVED FUTURE HEALTH.
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Gestational diabetes mellitus (GDM) is associated with a risk of adverse pregnancy outcome and is a predictor of subsequent diabetes. The aims of this work were to describe a reliable routine to diagnose abnormal glucose tolerance during pregnancy, to investigate women’s opinions of the specialist care provided, to determine the prevalence of diabetes one year after giving birth, and to elucidate the effect of abnormal glucose tolerance on pregnancy outcome and on the women’s future health. Routines for a general decentralised oral glucose tolerance test (OGTT) at antenatal clinics, with high quality and high compliance of the patients are described. Perinatal outcome was determined and compared for the years 1995-1999 and 2000-2003, and in two geographical areas with different screening routines (OGTT and random glucose measurements, RGM). The routine use of OGTTs identified twice as many cases of GDM as RGM. Those not identified with RGM were as affected. The women’s opinions of the extended care programme were analysed using a questionnaire. The results showed great satisfaction with the care provided, especially the sound knowledge of the staff. However, a desire for better preparation before the OGTT, better information flow and more information on normal pregnancy was expressed. Women delivered in 2003-2005 who had undergone an OGTT during pregnancy participated in a follow-up study 1-2 years after delivery. Different cut-off limits were used for 2-h capillary plasma glucose concentrations at OGTT during pregnancy. GDM >10.0 mmol/L, gestational impaired glucose tolerance (GIGT) 8.6-9.9 mmol/L, and a control group <8.6 mmol/L. At follow-up, 11% (n=160) of the GDM group, 4% (n=309) of the GIGT group and none of the controls had diabetes. When diagnosed with GIGT a retest was offered. Two-thirds of the women with diabetes after GIGT were found in the group diagnosed as having GDM after retest during pregnancy. Adverse pregnancy outcome was observed in both the GDM and GIGT groups compared with the controls. Women with previous GDM were more than 3 times as likely as a group to consume health care resources in a year after delivery (odds ratio 3.5, 95% CI 2.5-5.0), leading to an average 50% higher cost (p<0.001). Annual excess cost was apparent up to 7 years after childbirth (p<0.01). A general routine OGTT during pregnancy identifies women with GDM, providing the opportunity to improve the pregnancy outcome and to make lifestyle changes that can improve the future health of both mother and child.
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- Anderberg, Eva, et al.
(författare)
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Prevalence of impaired glucose tolerance and diabetes after gestational diabetes mellitus comparing different cut-off criteria for abnormal glucose tolerance during pregnancy.
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 90, s. 1252-1258
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To determine the prevalence of diabetes and impaired glucose tolerance after gestational diabetes mellitus in relation to different categories of glucose tolerance during pregnancy. Design. Prospective study. Setting. Four delivery departments and three hospitals in southern Sweden took part in recruitment and follow-up. Population. Women undergoing a 75 g oral glucose tolerance test during pregnancy delivering in 2003-2005. Methods. At first follow-up, 1-2 years after delivery, 29% of eligible women with abnormal glucose tolerance during pregnancy had an oral glucose tolerance test; 160 with gestational diabetes, 309 with gestational impaired glucose tolerance, in addition to 167 control women. Cut-off levels defining gestational diabetes and impaired glucose tolerance were 2-hour capillary blood glucose levels 9.0 and 7.8 mmol/l or plasma glucose 10.0 and 8.6 mmol/l, respectively. Main outcome measures. Frequency of abnormal test results at follow-up. Results: Diabetes was diagnosed in 11% and impaired glucose tolerance in 24% of women with gestational diabetes vs. 4% and 23% in those with gestational impaired glucose tolerance. Combining women with abnormal test results during pregnancy revealed diabetes or impaired glucose tolerance in 29% as compared to 10% among controls; the odds ratio (95% confidence interval) for having abnormal test results was 3.3 (1.8-5.9) in a multivariate logistic regression analysis. Conclusions: Lowering the cut-off level for gestational diabetes to also include the category of impaired glucose tolerance would identify a high percentage of women with diabetes and impaired glucose tolerance postpartum, they constitute target groups for intervention and/or diabetes prevention.
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- Anderberg, Eva, et al.
(författare)
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The impact of gestational diabetes mellitus on pregnancy outcome comparing different cut-off criteria for abnormal glucose tolerance.
- 2010
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 89:12, s. 1532-1537
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. To examine pregnancy outcomes in relation to different categories of glucose tolerance during pregnancy. Design. Prospective observational cohort study. Setting. Patient recruitment and data collection were performed in four delivery departments in southern Sweden. Population. Women delivering during 2003-2005; 306 with gestational diabetes mellitus, 744 with gestational impaired glucose tolerance and 329 randomly selected controls. Methods. All women were offered a 75 g oral glucose tolerance test during pregnancy. On the basis of their capillary 2-hour plasma glucose concentrations, three groups were identified: gestational diabetes mellitus (>10.0 mmol/l), gestational impaired glucose tolerance (8.6-9.9 mmol/l) and controls (<8.6 mmol/l). Data for the groups were compared using a population-based database. Main outcome measures. Maternal and fetal outcomes. Results. For the gestational diabetes mellitus group, adjusted odds ratios (95% confidence intervals) for hypertensive disorders during pregnancy and induction of labor and emergency cesarean section were 2.7 (1.3-5.8), 3.1 (1.8-5.2) and 2.5 (1.5-4.4), respectively; and for Apgar score <7 at 5 minutes, need for neonatal intensive care >1 day and large-for-gestational age infant were 9.6 (1.2-78.0), 5.2 (2.8-9.6) and 2.5 (1.3-5.1), respectively. The increases in odds ratios for the gestational impaired glucose tolerance group were less pronounced but still significant for hypertension during pregnancy, induction of labor, large-for-gestational age infant and use of neonatal intensive care >1 day, with odds ratios (95% confidence interval) 2.0 (1.0-4.1), 1.8 (1.1-3.0), 2.1 (1.1-3.9) and 2.1 (1.1-3.8), respectively. Conclusions. These data indicate that even limited degrees of maternal hyperglycemia may affect the outcome of pregnancy.
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- Anderberg, Eva, et al.
(författare)
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Use of healthcare resources after gestational diabetes mellitus: A longitudinal case-control analysis.
- 2012
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 40:4, s. 385-390
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To analyse whether gestational diabetes mellitus (GDM) was associated with increases in healthcare utilisation after delivery. METHODS: A longitudinal case-control registry-based study of 579 women with GDM delivered in 1995-2001. Two controls for each case were selected from the Swedish National Board of Health and Welfare, matched for year of birth, year of delivery, and municipality of residence. Data regarding healthcare utilisation was provided by the Patients' Administrative System in Skåne County, Sweden, covering the period from the years of delivery up to year 2009. RESULTS: Women with previous GDM had higher mean number of contacts and total cost in the years after delivery as compared to controls, also when excluding utilisation related to subsequent pregnancies and childbirth. By year 2009, 31% of women with prior GDM were diagnosed with diabetes, compared to 1% of controls. Women diagnosed with diabetes were more likely to use health care (odds ratio 14.22, 95% confidence interval 5.87-34.45) controlling for age and time since delivery, whereas cases not diagnosed with diabetes did not differ from controls. The average annual cost of healthcare utilisation was 101% higher (p<0.001) for women with diabetes 10 years after delivery compared to controls. CONCLUSIONS: GDM was associated with higher healthcare utilisation postpartum for women who had a diabetes diagnosis. The results call for implementation of structured programmes to follow up women with GDM postpartum for early detection of diabetes and effective management, which may have the potential for improved health and savings in healthcare costs.
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- Anderberg, Mats, 1961-, et al.
(författare)
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Strukturerade intervjuer inom missbruksvården : - som en grund för kunskapsutveckling
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Anderberg, Mats & Dahlberg, Mikael (2009). Strukturerade intervjuer inom missbruksvården – som en grund för kunskapsutveckling (Structured interviews in substance abuse treatment - as a foundation for the development of knowledge). In the discussion on knowledge development in social work, structured interviews have attracted an increasing amount of attention. The aim of this thesis is to examine and analyze how structured interviews can serve as a basis in the compilation and development of knowledge for practice and research in addiction treatment. More precisely, it means a problematization of the methodological issues that are of central importance in studying treatment outcomes, in which structured interviews form the basis. The methodological aspects in focus here are scientific concepts such as reliability, validity and specific factors in the evaluation of treatment interventions. A further objective is to outline a model for analysis when compiling and evaluating treatment outcome. The five empirical studies have been conducted in their natural context, in organisations in which structured interviews with clients are carried out as an everyday routine and used for e.g. treatment planning. The structured interview DOK (a Swedish abbreviation for Documentation of clients) is used as a basis and an example for the empirical studies in this thesis. The validation studies show that the DOK interview generally attains a good level of reliability and validity, but also contains a small number of variables that do not live up to the requirements which may be imposed. Deficiencies in operationalization and question construction seem to have a large impact. Another conclusion is that it is possible to carry out validation studies, where each variable is examined separately and evaluated with the aid of both sound methodological starting points and relevant statistical theory. Another of the central questions, the thesis addresses, is how structured interviews can be used as a basis for evaluation of treatment. The two studies which highlight this issue show that it is obvious that structured interviews are suitable for such a purpose, through its standardized form and multi-dimensional nature. Validation of structured interviews or evaluation of social interventions should not be reduced to single numbers or values. The multidimensional nature of the structured interview shall also be reflected in the results and analysis. The thesis presents an analysis model for evaluating treatment outcome in relation to two empirical examples and foregoing theoretical starting points. Our view is that structured interviews can provide a link between practice and research and thus contribute to the development of knowledge in social work and substance abuse treatment.
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