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- Fadl, Helena, 1965-, et al.
(författare)
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Changing diagnostic criteria for gestational diabetes in Sweden-a stepped wedge national cluster randomised controlled trial-the CDC4G study protocol
- 2019
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Ingår i: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The optimal criteria to diagnose gestational diabetes mellitus (GDM) remain contested. The Swedish National Board of Health introduced the 2013 WHO criteria in 2015 as a recommendation for initiation of treatment for hyperglycaemia during pregnancy. With variation in GDM screening and diagnostic practice across the country, it was agreed that the shift to new guidelines should be in a scientific and structured way. The aim of the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) in Sweden () is to evaluate the clinical and health economic impacts of changing diagnostic criteria for GDM in Sweden and to create a prospective cohort to compare the many long-term outcomes in mother and baby under the old and new diagnostic approaches. Methods This is a stepped wedge cluster randomised controlled trial, comparing pregnancy outcomes before and after the switch in GDM criteria across 11 centres in a randomised manner. The trial includes all pregnant women screened for GDM across the participating centres during January-December 2018, approximately two thirds of all pregnancies in Sweden in a year. Women with pre-existing diabetes will be excluded. Data will be collected through the national Swedish Pregnancy register and for follow up studies other health registers will be included. Discussion The stepped wedge RCT was chosen to be the best study design for evaluating the shift from old to new diagnostic criteria of GDM in Sweden. The national quality registers provide data on the whole pregnant population and gives a possibility for follow up studies of both mother and child. The health economic analysis from the study will give a solid evidence base for future changes in order to improve immediate pregnancy, as well as long term, outcomes for mother and child.
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| 2. |
- Rämgård, Margareta, et al.
(författare)
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Developing health and social care planning in collaboration
- 2015
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Ingår i: Journal of Interprofessional Care. - : Informa Healthcare. - 1356-1820 .- 1469-9567. ; 29:4, s. 354-358
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Tidskriftsartikel (refereegranskat)abstract
- Collaboration between different professions in community care for older people is often both difficult and complex. In this project, a participatory action research (PAR) was conducted in order to support the professions involved in the care for older people to develop individualized health and social care plans. Cases from daily work were discussed in different professional groups over a period of one year. A key finding was that lack of knowledge regarding the other professions' field of expertise and their underlying professional culture and values was a barrier in their collaboration. However, as the continuous reflective dialogue process progressed, the participants began to reflect more about the importance of collaboration as a prerequisite to achieve the best possible care for the recipient. This process of reflection led to the often complex needs of the care recipients being given a more central position and thus care plans being better tailored to each person's needs.5
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| 5. |
- Bendix, Marie, et al.
(författare)
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Insulin and glucagon in plasma and cerebrospinal fluid in suicide attempters and healthy controls
- 2017
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 81, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Mental disorders and related behaviors such as suicidality and violence have been associated to dysregulation of e g carbohydrate metabolism. We hypothesized that patients after suicide attempt, compared to healthy controls, would have higher insulin and lower glucagon levels in plasma and cerebrospinal fluid and that these changes would be associated to violent behavior. Twenty-eight medication-free patients (10 women, 18 men), hospitalized after suicide attempt, and 19 healthy controls (7 women, 12 men) were recruited with the aim to study risk factors for suicidal behavior. Psychological/psychiatric assessment was performed with SCID I and II or the SCID interview for healthy volunteers respectively, the Karolinska Interpersonal Violence Scale (KIVS) for assessment of lifetime violence expression behavior, the Montgomery-Asberg-Depression-Scale (MADRS) and the Comprehensive Psychological Rating Scale (CPRS) for symptomatic assessment of depression and appetite. Fasting levels of insulin and glucagon were measured in plasma (P) and cerebrospinal fluid (CSF). Suicide attempters had higher insulin- and lower glucagon-levels in plasma- and CSF compared to controls. Except for P-glucagon these associations remained significant after adjusting for age and/or BMI. Patients reported significantly more expressed interpersonal violence compared to healthy volunteers. Expressed violence was significantly positively correlated with P- and CSF-insulin and showed a significant negative correlation with P-glucagon in study participants. These findings confirm and extend prior reports that higher insulin and lower glucagon levels in plasma and cerebrospinal fluid are associated with suicidal behavior pointing towards a potential autonomic dysregulation in the control of insulin and glucagon secretion in suicidal patients.
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| 6. |
- Bendix, Marie, et al.
(författare)
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Plasma oxytocin and personality traits in psychiatric outpatients
- 2015
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Ingår i: Psychoneuroendocrinology. - : Elsevier. - 0306-4530 .- 1873-3360. ; 57, s. 102-110
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Tidskriftsartikel (refereegranskat)abstract
- The oxytocin system is regarded as being of relevance for social interaction. In spite of this, very few studies have investigated the relationship between oxytocin and personality traits in clinical psychiatric populations. We assessed the relationship between personality traits and plasma oxytocin levels in a population of 101 medication-free psychiatric outpatients (men = 37, women = 64). We used the Karolinska Scale of Personality (KSP) and diagnostic and symptomatic testing. Plasma oxytocin levels were analysed with a specific radioimmunoassay at inclusion and after one month for testing of stability. Plasma oxytocin levels were stable over time and did not differ between patients with or without personality disorders, nor were they related to severity of depressive or anxiety symptoms. The KSP factors Impulsiveness and Negative Emotionality were significant independent predictors of plasma oxytocin. A subscale analysis of these personality factors showed significant positive correlations between baseline plasma oxytocin and the KSP subscales monotony avoidance and psychic anxiety. The significant association between the KSP factor Impulsiveness and oxytocin levels observed at baseline was observed also one month later in men. These findings suggest that personality traits such as Impulsiveness and Negative emotionality which are linked to social functioning in several psychiatric disorders seem to be associated with endogenous plasma oxytocin levels. These variations in oxytocin levels might have an impact on social sensitivity or social motivation with possible gender differences.
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| 7. |
- Dawson, Victoria, et al.
(författare)
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Periapical status of root-filled teeth restored with composite, amalgam, or full crown restorations : a cross-sectional study of a Swedish adult population
- 2016
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Ingår i: Journal of Endodontics. - : Elsevier. - 0099-2399 .- 1878-3554. ; 42:9, s. 1326-1333
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The aim was to compare the periapical status of root-filled teeth restored with resin composite, laboratory-fabricated crowns, or amalgam in a Swedish adult population. METHODS: The subjects consisted of 440 individuals from a randomly selected sample of 1000 adult residents of a Swedish county. The type, material, and quality of the restorations were recorded for all root-filled teeth by using clinical examination and intraoral clinical photographs. Periapical status, root-filling quality, and marginal bone loss were evaluated on panoramic radiographs. The association between periapical status and type, material, and quality of the restorations was analyzed by using the χ2 test and logistic regression. RESULTS: No difference in the frequency of apical periodontitis (AP) between teeth restored with resin composite, laboratory-fabricated crowns, or amalgam (29.7%, 26.2%, and 43.1%, respectively) of adequate quality was found. No association between AP and resin composite restorations was disclosed; however, there was an association between AP and inadequate root-filling quality and marginal bone loss >1/3 of the root length. CONCLUSIONS: The results did not indicate any association between AP and resin composite restorations. Neither the type nor the material of the restoration was of significance for periapical status as long as the quality was adequate.
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| 8. |
- Degerman, Erik, et al.
(författare)
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Long term trends of fish after liming of Swedish streams and lakes
- 2016
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Ingår i: Atmospheric Environment. - : Elsevier BV. - 1352-2310. ; 146, s. 245-251
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Tidskriftsartikel (refereegranskat)abstract
- Thousands of Swedish acidified lakes and streams have been regularly limed for about 30 years. Standard sampling of fish assemblages in lakes and streams was an important part of monitoring the trends after liming, i.e. sampling with multi-mesh gillnets in lakes (EN 14757) and electrofishing in streams (EN 14011). Monitoring data are nationally managed, in the National Register of Survey test-fishing and the Swedish Electrofishing Register. We evaluated long-term data from 1029 electrofishing sites in limed streams and gillnet sampling in 750 limed lakes, along with reference data from 195 stream sites and 101 lakes with no upstream liming in their catchments. The median year of first liming was 1986 for both streams and lakes. The proportion of limed stream sites with no fish clearly decreased with time, mean species richness and proportion of sites with brown trout (Salmo trutta) recruits increased. There were no consistent trends in fish occurrence or species richness at non-limed sites, but occurrence of brown trout recruits also increased in acid as well as neutral reference streams. Abundance of brown trout, perch (Perca fluviatilis) and roach (Rutilus rutilus) increased significantly more at limed sites than at non-limed reference sites sampled before and after 1986. The mean species richness did not change consistently in limed lakes, but decreased in low alkalinity reference lakes, and fish abundance decreased significantly in limed as well as in non-limed lakes.
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