| 1. |
- Berg, Lotta, et al.
(författare)
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Digital tillsynsteknik i djurhållning utomhus
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I enlighet med Jordbruksverkets förfrågan behandlar denna rapport tre områden för digital teknik vid övervakning och kontroll av djur som vistas utomhus på stora ytor: (1) kamerateknologi, t.ex. användning av drönare, (2) positioneringsteknologi som GPS och (3) teknologi för att styra djurens rörelser, som drivning med drönare och användning av s.k. virtuella stängsel. De tre teknikområdena överlappar delvis varandra. Digital tillsyn av utegående djur är beroende av att sensorer mäter det man tror att de mäter med tillräcklig noggrannhet och att data kan överföras och bearbetas till information som lagras och analyseras på ett säkert och korrekt sätt. Sådana teknologier benämns med samlingsnamnet ’Precision Livestock Farming’ (PLF). Användningen av informationen är avgörande för teknikens användbarhet i tillsyns- och djurskyddsarbete. Tillämpningarna är till viss del reglerade av gällande lagstiftning, exempelvis genom krav på tillsyn, begränsad användning av elektricitet för att styra djurs beteende, användning av obemannade luftfarkoster, d.v.s. drönare, samt åtgärder för att förhindra att utrustning skadar djuren eller påverkar deras hälsa och beteende. Inom PLF används en rad olika sensorer som direkt eller indirekt kan mäta djurens miljö och djurens beteende och fysiologiska tillstånd. Den teknologiska utvecklingen har främst varit inriktad på mjölkkor, fjäderfän och grisar och endast i liten utsträckning berört häst, får och get. För djur på bete är överföringen av data från en enhet på eller vid djuret till en mottagare särskilt problematisk p.g.a. stora avstånd, men det sker en snabb teknisk utveckling mot effektivare överföring. PLF-teknologin innebär i de flesta fall att djuren övervakas kontinuerligt och att avvikelser i t.ex. deras hälsotillstånd och välfärd i princip kan upptäckas i realtid, vilket ska ställas mot nuvarande lagkrav på tillsyn minst en eller två gånger dagligen. Sensorer kan ge information om ett stort antal fysiologiska tillstånd och beteenden. En av de vanligaste teknikerna är sensorer för aktivitet. Indirekt kan de också ge information om idissling, liggtid, stegantal och ättid och utlösa larm om exempelvis brunst, hälsoproblem, hälta och kalvning. Sensorer kan även placeras i förmagen hos idisslare (s.k. våmbolus) där de mäter våm-pH och kan larma om störningar i magfunktionen, eller utformas som termometrar som kan larma om hälsostörningar, kalvning och vattenintag eller mikrofoner som kan mäta idissling och larma om brunst, kalvning och onormalt idisslingsmönster. Med kamerateknik kan man mäta aktivitet, kroppsform och hudtemperatur, vilket kan ge information om ketosstatus, hull, hälta och juverhälsa. Kameror monterade på drönare kan användas för att lokalisera och räkna djur, bestämma deras position, habitatval och till viss del deras beteende, särskilt när djuren rör sig över stora arealer. Det finns flera elektroniska positioneringsteknologier varav passiv ’Radio Frequency Identification RFID’ är den vanligaste. Räckvidden är kort med denna teknik men den kan vara användbar om man t.ex. vill mäta hur ofta djuren besöker en vattenpost. Andra teknologier kan med hjälp av antenner följa djurens positioner i realtid. GPS-enheter monterade i halsband kan regelbundet registrera djurens geografiska position. Användningen av GPS har blivit relativt vanlig i renskötseln vilket tycks ha lett till en förbättrad arbetssituation för renskötarna. Positionering med GPS ger inte alltid exakta uppgifter men tekniken har visat sig användbar för studier av habitatval, sociala interaktioner och gruppdynamik. Med positionerna från GPS har man också kunnat styra djur till områden med bättre betestillgång. Med en tillräckligt frekvent bestämning av position med hjälp av GPS (ca en gång per minut) är det möjligt att bestämma betestiden för nötkreatur på ett tillförlitligt sätt. En användning av drönare i djurskötsel och djurtillsyn kan vara att med hjälp av kamera lokalisera djuren över stora ytor. Denna användning begränsas dock av nuvarande bestämmelser om att föraren måste ha ögontakt med drönaren. I renskötseln har drönare börjat användas för att förflytta djur men denna tillämpning är ännu inte juridiskt reglerad. Virtuella stängsel är strukturer som bestäms med kartkoordinater eller elektronisk sändare på marken. Stängslen fungerar som inhägnader, hinder eller gränser. Djuren mottar signaler (vanligen ljud) och stimuli (vanligen elstötar från ett halsband) som gör det möjligt för dem att lära sig var stängslet finns. I vetenskapliga studier har man med varierande framgång lyckats lära djuren att associera ljudsignaler och elstötar med en gräns som inte får passeras. Förmågan att lära sig skiljer mellan olika djurslag, liksom mellan individer. Det finns fortfarande många obesvarade frågeställningar om hur djur kan anpassa sig till virtuella stängselsystemet, liksom hur de påverkas, både under inlärningsfas och bruksfas.
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| 2. |
- Berhan, Yonas, et al.
(författare)
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Five-region study finds no evidence of undiagnosed type 2 diabetes in Swedish 11- to 13-year-olds
- 2014
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 103:10, s. 1078-1082
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Tidskriftsartikel (refereegranskat)abstract
- AimChildhood obesity is now an established public health problem in most developed countries, and there is concern about a parallel increase of type 2 diabetes. The aim of this study was to estimate the prevalence of undiagnosed type 2 diabetes in overweight Swedish school children from 11 to 13years of age. MethodsBody mass index (BMI) was measured in 5528 schoolchildren in the 6th grade, from 11 to 13years of age, in five different regions in Sweden. Overweight was defined by international age- and sex-specific BMI cut-offs, corresponding to adult BMI cut-offs of 25kg/m(2) at 18years of age (ISO-BMI 25, n=1275). Haemoglobin A1c (HbA1c) was measured in 1126 children with ISO-BMI 25. Children with a Diabetes Control and Complications Trial aligned HbA1c 6.1% on two occasions underwent an oral glucose tolerance test (OGTT) to establish the diabetes diagnosis. ResultsOf 1126 children with ISO-BMI 25, 24 (2.1%) had at least one HbA1c value 6.1%. Three of them had HbA1c 6.1% on two occasions, and all of them had a normal OGTT. ConclusionIn this cross-sectional, population-based screening study of a high-risk group of 11- to 13-year-old Swedish school children, we found no indication of undiagnosed diabetes or impaired glucose tolerance.
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| 3. |
- Berhan, Yonas, 1970-, et al.
(författare)
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Screening for undiagnosed type-2 diabetes in Swedish 6th grade school children
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aims: To estimate the prevalence of undiagnosed type-2 diabetes in overweight Swedish school children 11-13 years old.Methods: BMI was measured in 5 528 school-children (11-13 years of age) attending the 6th grade, in five different regions in Sweden. Overweight was defined by international age-sex specific BMI cut-offs, corresponding to adult BMI cut-offs of 25 kg/m² at 18 years of age (ISO-BMI ≥25, n=1 275). Haemoglobin A1c (HbA1c) was measured in 1 126 children with ISO-BMI ≥25. Children with a DCCT-aligned HbA1c ≥ 6.1% on two occasions underwent an oral glucose-tolerance test (OGTT) to establish diabetes diagnosis.Results: Twenty four children (2.1%) had at least one HbA1c-value ≥6.1%. Three of them had HbA1c ≥6.1% on two occasions and all of them had a normal OGTT.Conclusion: In this cross-sectional population-based screening study of a high risk group of 11-13 years old Swedish school children we found no indication of undiagnosed diabetes or impaired glucose tolerance.Key
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| 4. |
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| 5. |
- Ellberg, Lotta, et al.
(författare)
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Maternity care options influences readmission of newborns
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:5, s. 579-583
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To analyse morbidity and mortality in healthy newborn infants in relation to various routines of post-natal follow-up. Design: cross-sectional study. Setting: maternity care in Sweden. Population: healthy infants born at term between 1999 and 2002 (n = 197 898).Methods: Assessment of post-natal follow-up routines after uncomplicated childbirth in 48 hospitals and data collected from the Swedish Medical Birth Register, Hospital Discharge Register and Cause-of-Death Register. Main outcome measure: neonatal mortality and readmission as proxy for morbidity.Results: During the first 28 days, 2.1% of the infants were readmitted generally because of infections, jaundice and feeding-related problems. Infants born in hospitals with a routine neonatal examination before 48 h and a home care programme had a readmission rate [OR, 1.3 (95% CI, 1.16–1.48)] higher than infants born in hospitals with routine neonatal examination after 48 h and 24-h care. There were 26 neonatal deaths.Conclusion: Post-delivery care options and routines influence neonatal morbidity as measured by hospital readmission rate. A final infant examination at 49–72 h and an active follow-up programme may reduce the risk of readmission.
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| 6. |
- Ellberg, Lotta, 1959-
(författare)
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Postnatal care - outcomes of various care options in Sweden
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In high-income countries, hospital length of stay after a normal birth has gradually decreased correspondingly to length of stay in care of other patients. A short stay provides a greater opportunity for autonomy and an increased sense of participation, but it may involve great challenges satisfying parental guidance as well as on the possibility of preventing, discovering, and treating neonatal medical conditions. Aim: This study evaluates postnatal care based on cost calculations, risk assessments, and parents’ satisfaction with care. Methods: Questionnaires were sent to 1 122 new mothers and her partner during 1998-1999. For the summary of utilization of health care services during the first 28 days postdelivery, the participants were linked with registry data from the hospital administration system for mothers and newborns (n= 773). The answers were also used to describe new parents’ experiences with postnatal care (n = 1 479). The costs for five postnatal care models were estimated, including three care options: Maternity Ward, Family Suite, and Early Discharge. Data about neonatal readmissions and death within 28 days was retrieved from the Swedish Medical Birth Register, the Swedish Hospital Discharge Registry, and the Swedish Cause-of-Death Register between 1999 and 2002 (n = 197 898). This data was related to data about postnatal follow-up practices from all 48 Swedish delivery wards. Results: The readmission rate for the mothers was similar among the various care options, and there was no difference in utilization of health care or breastfeeding outcome due to type of maternity care. As a proxy for morbidity, the readmission rate for the newborns was influenced by postdelivery follow-up routines as routine neonatal examination timing. Depending on the proportion of mothers receiving care at the Maternity Ward, the costs differed significantly between the various care models, while parents’ preferences complied with the cost-minimizing option Family Suite. Most mothers and fathers (70%) were satisfied with the overall impression of the postnatal care, but 72% were dissatisfied with at least one particular topic. A main finding was that the parents experienced a close emotional attachment, an affinity that was not always supported by the staff. The father was not treated as a principal character even though the parents wanted the father’s to be involved and recognized. Conclusions: Since the postnatal care options are not always the most cost minimizing and postnatal routines influence neonatal morbidity and parental satisfaction, the postnatal services need to be improved. Without increasing risks or costs, every postnatal care option ought to meet the families’ need for support, security, autonomy, and attachment with each other.
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| 7. |
- Ellberg, Lotta, et al.
(författare)
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Satisfying parents' preferences with regard to various models of postnatal care is cost-minimizing
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:2, s. 175-181
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study describes three options for postnatal care in Sweden and contains a cost analysis of the options in various combinations. The aim of the study was to calculate the cost of a postnatal care model according to new parents' preferences. METHODS: Staff costs were calculated for various models of postnatal care, comprising the maternity ward, the family suite, and/or the early discharge program. One of the models was based on answers from 342 parents who specified their preferences with regard to postnatal care in the event of another birth. RESULTS: Comparing costs for five different models of postnatal care showed that the proportion of mothers receiving care at the maternity ward crucially influences the total costs. The staff costs differed significantly between the models, ranging from US$448 000 to US$778 000 per 1500 mother-child dyads. MAIN OUTCOME MEASURES: Cost calculation of various care models and parents' preferences for postnatal care. CONCLUSIONS: Because the parents' preferences with regard to postnatal care created one of the most cost-minimizing care models in the study, it would be possible to better meet parent's desires and, at the same time, reduce costs, without increasing risks in comparison with the early discharge program.
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| 8. |
- Ellberg, Lotta, et al.
(författare)
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“We feel like one, they see us as two” : new parents' discontent with postnatal care
- 2010
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138 .- 1532-3099. ; 26:4, s. 463-468
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Tidskriftsartikel (refereegranskat)abstract
- Objective postnatal care has gone through remarkable changes, such as reducing the length of hospital stay and increasing the parents’ responsibility. Focusing on dissatisfaction, this study describes how new parents experience postpartum care.Design cross-sectional, population-based study, based on questionnaires.Participants 1474 parents.Measurements and findings the questionnaires, posted six months after childbirth, addressed how parents experienced postnatal care. The data were analysed with descriptive statistics and content analysis.Key conclusions a main finding was that the close emotional attachment between the parents was not always supported by staff. The father was treated as an outsider and the care was described as ‘a woman's world’. The asymmetric encounter between parents and staff was pronounced with respect to decision-making, and some designated this as ‘paternalism’. A great deal of the discontent with health care may be due to organisational failure, and the postnatal care should be more prioritised in the health-care organisation.Implications for practice midwives should acknowledge that parents, irrespective of gender, should have equal opportunities as parents during postpartum care as parenting is a joint project.
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| 9. |
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| 10. |
- Grodzinsky, Ewa, 1958-, et al.
(författare)
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IgA endomysium antibodies : an early predictor for celiac disease in children without villous atrophy
- 2008
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 97:7, s. 972-976
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate possible differences between children with anti-endomysium antibodies (EMA) positivity and normal small bowel mucosa and children with positive EMA and an enteropathy diagnosed as celiac disease (CD).Methods: Children with suspected CD and positive EMA (≥1/10) undergoing small bowel biopsy during 1996 to 2002, were investigated (n = 133). Data registered were: year and month of birth, timing of the first biopsy, sex, heredity for CD, dermatitis herpetiformis and diabetes mellitus and outcome of the anti-gliadin antibody test (AGA). The case group, with EMA positivity and normal histology (n = 39; 59% female, mean age at the first biopsy 7.3 years, range 1.4–16), was compared with the disease control group, with positive EMA and a biopsy suggestive and further on diagnosed as CD (n = 94; 56% female; mean age 7.6 years at the first biopsy, range 0.70–17).Results: AGA positivity and heredity for CD were found to predict the outcome of a pathological jejunal mucosa. Nineteen of the 39 children in the case group were rebiopsied of whom 11 had developed an enteropathy during a follow-up period of 2–7 years (median 4.5 years).Conclusions: EMA positivity in the absence of small bowel enteropathy could be a very early predictor for later overt CD, and necessitates further follow-up, especially if the child is AGA positive and there is a family history of CD.
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