| 1. |
- Andersson, Karolina, 1978, et al.
(författare)
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Do policy changes in the pharmaceutical reimbursement schedule affect drug expenditures? Interrupted time series analysis of cost, volume and cost per volume trends in Sweden 1986-2002.
- 2006
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Ingår i: Health policy (Amsterdam, Netherlands). - : Elsevier BV. - 0168-8510. ; 79:2-3, s. 231-43
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Tidskriftsartikel (refereegranskat)abstract
- The last decades increasing pharmaceutical expenditures in Sweden and other western countries have created a need for reforms to reduce the trend. The aim was to analyse if reforms concerning the pharmaceutical reimbursement scheme in Sweden during the years 1986-2002 were associated with changes in cost, volume and cost per volume of pharmaceuticals. Effects of changes in the reimbursement schedule during the study period were evaluated for all registered pharmaceuticals in Sweden and for five indicator drug groups. Five policy changes during the study period were assessed. Three concerned increased patient co-payment (January 1, 1991; January 1, 1995 and June 1, 1999), one the introduction of reference based pricing and increased co-payment (January 1, 1993) and one a new structure of the reimbursement schedule (January 1, 1997). The National Corporation of Swedish Pharmacies provided pharmaceutical delivery data for all Swedish pharmacies. Possible breaks in the trend associated with the investigated reforms were analysed with linear segmented regression analysis. This showed that increased co-payments were not associated with changed level or slope of cost and volume. The new reimbursement schedule was associated with a decreased level of cost and volume, both for all drugs combined and for several of the indicator drug groups. It was also associated with an increased slope for both volume and cost in some indicator drug groups and for all drugs. Introduction of reference based pricing was associated with a reduced slope of cost/defined daily doses (DDD) in all of the indicator drug groups and for all drugs. The analysis showed that major changes in the reimbursement system such as the introduction of a new reimbursement schedule and reference based pricing were associated with reductions in cost and volume for the new reimbursement schedule and cost per volume for reference based pricing.
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| 4. |
- Angervall, Petra, Professor, 1970-, et al.
(författare)
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Challenges in developing professional knowledge, education, and practices in Swedish higher education
- 2023
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Ingår i: Book of All Abstracts and Papers. - Birmingham. ; , s. 199-198-199
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Konferensbidrag (refereegranskat)abstract
- The formation of professionals and professions is, simultaneously, a core function of contemporary universities and a field of contestation where different worldviews, rationalities and aspirations meet. In this symposium, we will present an interdisciplinary research collaboration, called PHE (Professional knowledge in Higher Education), between four academic institutions in Sweden. These institutions regularly collaborate on research activities concerning professional knowledge, professional education and learning addressing core issues for the welfare state, for social justice, sustainable development, and higher education pedagogy. We will present the main motivations for this collaboration, its goals, and examples of its ongoing interdisciplinary research.The symposium will situate our collaboration in current public and academic debates on the growing societal demand for strong, flexible, and pluralistic professional programs in higher education and in doing so, also address pressing issues related to welfare, the knowledge economy, and the labour market. Such demands pose new challenges for universities today in regard to, for example, the need for expertise and pedagogy. Central to this collaborative project is a new interdisciplinary research school, SPETS (Studies in Professional Education and Training for Society), with doctoral students from all four institutions and inter-institutional supervision. In the symposium, five ongoing doctoral projects that represent current challenges and tensions in Swedish professional education and development will be presented. In Matilda B Svensson’s research, she highlights the policy turns of teacher education in Sweden and how they affect understandings of professional knowledge. Per Holmgren and Yihua Zhang examine how digitalization impacts what is seen as valuable knowledge and pedagogy in HE today and how digitalization is used to address some of the key issues in professional programs. Reghan Borer’s study concerns how public engagement is addressed in Swedish doctoral education, and Sara Svensson discusses the use of arts-based pedagogies to facilitate personal and professional development across a range of professional education programs. In Amoni Kitooke’s work, he explores community-oriented aspects of professional education, particularly praxis and knowledge issues in teacher education.These doctoral projects, in parallel with other joint activities and meeting points in this collaborative endeavour, address issues that include highly relevant intersections between digitalization, internationalisation, equity, policy and quality assurance, economic disparities, migration, and community welfare, which point to some of the challenges of developing professional knowledge, education and practices in higher education today.
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| 5. |
- Ask, Anna, et al.
(författare)
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Studenters uppmärksamhet under föreläsningar
- 2009
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Ingår i: Proceedings utvecklingskonferens 09 Lunds Universitet. - 9789197797429 ; , s. 112-120
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Konferensbidrag (refereegranskat)abstract
- Föreläsningar är vanlig undervisningsform på Lunds Tekniska Högskola (LTH). Deras stora fördel är att information överförs ekonomiskt och effektivt till många studenter samtidigt men de har även sina begränsningar. Kritiker menar att information överförs till passivt mottagande studenter och att bristande uppmärksamhet och engagemang hos studenterna begränsar mängden kunskap som faktiskt tas emot. En intervju- och litteraturstudie har genomförts för att dels inventera vilka metoder som finns för att hålla studenternas uppmärksamhet uppe och dels vilka som tillämpas av föreläsare vid LTH. Variation och olika former av aktivering framstår såväl i litteraturen som i intervjuerna som viktiga metoder. I artikeln presenteras även inspiration kring hur man kan använda variation, och andra aktiviteter för att engagera och aktivera studenterna samt hur man kan strukturera en föreläsning. De flesta av de intervjuade föreläsarna uppger att de utvecklat sina strategier genom erfarenhet medan knappt hälften nämner pedagogiska kurser.
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| 6. |
- Bergman, Eva, 1959-, et al.
(författare)
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Relative growth estimated from self-administered symphysis fundal measurements
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:2, s. 179-185
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To establish absolute-and relative-growth reference curves for the detection of intrauterine growth restriction from weekly self-administered symphysis-fundus (SF) measurements and to assess the influence of fetal sex, maternal obesity and parity. Design. Prospective longitudinal study. Setting. Pregnant women from six primary antenatal care centres. Population. Three hundred women with singleton ultrasound dated pregnancies. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were obtained. A linear mixed longitudinal model was used to estimate the absolute SF growth using the natural logarithm (lnSF). Relative lnSF growth was calculated as the lnSF measurement in one gestational week subtracted by the lnSF measurement in the previous gestational week. The influence of fetal sex, maternal obesity and parity was assessed in regression models and by a graphical display. Main Outcome Measures. Absolute lnSF and relative lnSF growth curves and influence of fetal sex, maternal obesity and parity on these. Results. SF measurements from 191 women were used to establish an SF-growth reference. The absolute lnSF growth was influenced by maternal obesity, and for fetal sex and parity, borderline significance was recorded; while there was no evidence that the relative lnSF growth could depend on these variables. Conclusions. Weekly self-administered SF measurements can be obtained and used to estimate SF growth. Relative growth of the lnSF height seems to be independent of fetal sex, maternal obesity and parity.
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| 7. |
- Bergman, Eva, et al.
(författare)
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Self-administered measurement of symphysis-fundus heights
- 2007
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 86:6, s. 671-677
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Tidskriftsartikel (refereegranskat)abstract
- Background. Antenatal identification of infants small for gestational age (SGA) improves their perinatal outcome. Repeated measurements of the symphysis-fundus (SF) heights performed by midwives is the most widespread screening method for detection of SGA. However the insufficiency of this method necessitates improved practices. Earlier start and more frequent SF measurements, which could be acomplished by self-administered measurements, might improve the ability to detect deviant growth. The present study was set up to evaluate wether pregnant wome can reliable perform SF measurements by themself. Method. Forty healthy women with singelton and ultrasound-dated pregancies from 2 antenatal clinics in Uppsala, Sweden, were asked to perform 4 consecutive SF measureemnts once a week, from 20 to 25 weeks of gestation until delivery. The self-administered SF measurements were recorded and systematically compared with midwives' SF measurements. Results. Thirty-three pregnant women performed self-administered SF measurements over a 14-week period (range 1-21). The SF curves constructed from self-admiinistered SF measurements had the same shape as previously constructed population-based reference curves. The variance for self-admiinistered SF measurements was higher than that of the midwives. Conclusions. Pregnant women are capable of measuring SF heights by themselves, but with a higher individual variance than midwives. Repeated measurements at each occasion can compensate for the higher variance. The main advantage of self-administered SF measurements is the opportunity to follow fetal growth earlier and more frequently.
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| 8. |
- Bergman, Eva, 1959-, et al.
(författare)
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Self-administered symphysis-fundus measurements analyzed with a novel statistical method for detection of intrauterine growth restriction : a clinical evaluation
- 2011
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 90:8, s. 890-896
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To assess the ability of self-administered symphysis fundus measurements used with the Shiryaev-Roberts statistical method (SR method) to identify growth-restricted (IUGR) fetuses and compare it with the traditional SF method (symphysis fundus measurements used with a population-based reference curve). Design. Longitudinal study. Setting. Pregnant women attending primary antenatal care centres. Population. From a population of 1 888 women with singleton ultrasound-dated pregnancies, we analyzed data from 1 122 women. Methods. Weekly self-administered SF measurements from gestational week 25 until delivery were analyzed according to the SR method. Neonatal morbidity and small for gestational age (SGA) were used as proxies for IUGR. Small for gestational age was defined as a birthweight less than two standard deviations (SD) and <10th percentile. We assessed the sensitivity of the SR and the SF methods to detect neonatal morbidity and SGA. Main Outcome Measures. Birth-related mortality, respiratory distress, hypoglycemia, Apgar score <= 6 at five minutes, pH <= 7.00 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress and SGA. Results. For the SR method, the sensitivity for neonatal morbidity was between 6.0 and 36.4%, for SGA <2SD 36.8%, and for SGA <10th percentile 20.9%. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, 52.3% for SGA <2SD and 28.6% for SGA <10th percentile. Conclusions. The SR and the SF methods had low sensitivities for neonatal morbidity.
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| 9. |
- Bergman, Eva, et al.
(författare)
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Symphysis-fundus measurements for detection of small for gestational age pregnancies
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:4, s. 407-412
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Tidskriftsartikel (refereegranskat)abstract
- Background. In Sweden measurements of the symphysis-fundus (SF) distance are used to detect small for gestational age (SGA) pregnancies. The aim of this study was to evaluate the efficiency of Swedish ultrasound-based SF reference curves in detecting SGA pregnancies. Methods. To assess the sensitivity for detection of SGA pregnancies we performed a case-control study. Through the Swedish Medical Birth Register we identified all singleton SGA infants born in Uppsala in 1993-1997 and randomly recruited non-SGA singleton infants as controls. We included 169 term and 73 preterm SGA cases and 296 controls, all born at term. The reference curves constructed by Steingrimsdottir (S curve) and Kieler (K curve) were evaluated. Gestational age at the first alarm in the preterm SGA group was recorded. Results. In term pregnancies the S curve showed a sensitivity of 32% and specificity of 90% at a cut-off of -2 SDs. The corresponding values for the K curve were 51% and 83%, respectively. In preterm SGA pregnancies the sensitivity of the S curve was 49% and of the K curve 58%. The first alarm below 2 SDs was noted before 32 weeks in 37% with the S curve and 43% with the K curve for preterm SGA pregnancies. Conclusions. Both tested Swedish SF reference curves had low sensitivities for term SGA pregnancies. Sensitivity was higher for the preterm group and SF measurements seem to be better for detecting the most severe cases of SGA.
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| 10. |
- Bergman, Eva, 1959-, et al.
(författare)
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Symphysis Fundus Measurements used with a novel Statistical Method for detection of Intrauterine Growth Retardation; a Clinical Evaluation.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The statistical method of Shiryaev-Roberts (SR method), using altered growth speed, in combination with symphysis fundus (SF) measurements has theoretically a potential to improve antenatal detection of intrauterine growth restricted (IUGR) fetuses. The main objective of the present study was to compare the ability of the SR method and the SF method (SF measurements compared with a population based reference curve) to identify IUGR and small for gestational age (SGA) fetuses. Design: A longitudinal study design. Setting: Pregnant women from 27 primary antenatal care centres in 4 counties. Population: One thousand eight hundred and eighty eight women with singleton ultrasound dated pregnancies. Methods: Weekly self-administered SF measurements from gestational week 25 until delivery were analysed according to the SR method. Neonatal morbidity was used as a proxy for IUGR. SGA was defined as a birth weight < -2 standard deviations (SD) or < 10th percentile. Sensitivity for neonatal morbidity and SGA were assessed for alarms given for 5 to 30 % of the study population according to the SR-method and compared with the SF method. Main outcome measures: Respiratory distress, hypoglycaemia, Apgar < 7 at 5 min, pH < 7.01 in the umbilical artery, neonatal care, preterm delivery, operative delivery for fetal distress, SGA and any neonatal morbidity. Results: SF measurements from 1122 pregnant women were evaluated. For the SR method sensitivity for neonatal morbidity was between 6.0 and 36.4 %, for SGA (< -2 SD) 36.8 %, and for SGA (< 10th percentile) 20.9 %. The SF method had a sensitivity between 6.0 and 13.8% for neonatal morbidity, for SGA (< -2 SD) 52.3 % and for SGA (< 10th percentile) 28.6 %. Neonates classified as SGA (< -2SD and < 10th percentile) had increased morbidity. Neonates suspected to be SGA before delivery by the SF method had lower morbidity than those not suspected. Conclusions: The SR method was not found to improve detection of fetuses with increased morbidity or SGA neonates in this study. SGA neonates defined as < – 2 SD or < 10th percentile have increased neonatal morbidity.
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