| 1. |
- Fadl, Helena, 1965-, et al.
(author)
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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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In: Bmc Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Journal article (peer-reviewed)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. |
- Bengtsson, Johan, et al.
(author)
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Ambulatory Heart Rate Variability in Schizophrenia or Depression : Impact of Anticholinergic Burden and Other Factors
- 2021
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In: Journal of Clinical Psychopharmacology. - 0271-0749 .- 1533-712X. ; 41:2, s. 121-128
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Journal article (peer-reviewed)abstract
- BACKGROUND: Heart rate variability (HRV) has been found reduced in patients with schizophrenia and depression. However, there is a lack of knowledge on how demographic, lifestyle, and pharmacological factors contribute to the reduction in HRV in these patients.METHODS: We recruited 37 patients with schizophrenia, 43 patients with unipolar depression, and 64 healthy controls. A combined chest-worn HRV and accelerometer device was used in an ambulatory measurement. Age, sex, anticholinergic burden of medication, nicotine use, body mass index, and ongoing physical activity were assessed in multiple regression models regarding their influence on HRV, measured as the standard deviation of all the RR intervals (SDNN).RESULTS: In the fully adjusted model, schizophrenia (β = -0.23, P = 0.019), depression (β = -0.18, P = 0.028), age (β = -0.34, P < 0.000), ongoing physical activity (β = -0.23, P = 0.001), and anticholinergic burden (β = -0.19, P = 0.025) influenced SDNN negatively. Sex, nicotine use, and BMI had negligible effects on SDNN.CONCLUSIONS: We show for the first time that a quantified score of anticholinergic burden of medication has a negative relationship to HRV in patients with schizophrenia or depression, but that the diagnoses themselves still exhibit an effect on HRV.
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| 3. |
- de Brun, Maryam, 1991-, et al.
(author)
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Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden : A stepped wedge cluster randomised trial
- 2024
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In: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 21:7
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Journal article (peer-reviewed)abstract
- BACKGROUND: The World Health Organisation (WHO) 2013 diagnostic criteria for gestational diabetes mellitus (GDM) has been criticised due to the limited evidence of benefits on pregnancy outcomes in different populations when switching from previously higher glycemic thresholds to the lower WHO-2013 diagnostic criteria. The aim of this study was to determine whether the switch from previous Swedish (SWE-GDM) to the WHO-2013 GDM criteria in Sweden following risk factor-based screening improves pregnancy outcomes.METHODS AND FINDINGS: A stepped wedge cluster randomised trial was performed between January 1 and December 31, 2018 in 11 clusters (17 delivery units) across Sweden, including all pregnancies under care and excluding preexisting diabetes, gastric bypass surgery, or multifetal pregnancies from the analysis. After implementation of uniform clinical and laboratory guidelines, a number of clusters were randomised to intervention (switch to WHO-2013 GDM criteria) each month from February to November 2018. The primary outcome was large for gestational age (LGA, defined as birth weight >90th percentile). Other secondary and prespecified outcomes included maternal and neonatal birth complications. Primary analysis was by modified intention to treat (mITT), excluding 3 clusters that were randomised before study start but were unable to implement the intervention. Prespecified subgroup analysis was undertaken among those discordant for the definition of GDM. Multilevel mixed regression models were used to compare outcome LGA between WHO-2013 and SWE-GDM groups adjusted for clusters, time periods, and potential confounders. Multiple imputation was used for missing potential confounding variables. In the mITT analysis, 47 080 pregnancies were included with 6 882 (14.6%) oral glucose tolerance tests (OGTTs) performed. The GDM prevalence increased from 595/22 797 (2.6%) to 1 591/24 283 (6.6%) after the intervention. In the mITT population, the switch was associated with no change in primary outcome LGA (2 790/24 209 (11.5%) versus 2 584/22 707 (11.4%)) producing an adjusted risk ratio (aRR) of 0.97 (95% confidence interval 0.91 to 1.02, p = 0.26). In the subgroup, the prevalence of LGA was 273/956 (28.8%) before and 278/1 239 (22.5%) after the switch, aRR 0.87 (95% CI 0.75 to 1.01, p = 0.076). No serious events were reported. Potential limitations of this trial are mainly due to the trial design, including failure to adhere to guidelines within and between the clusters and influences of unidentified temporal variations.CONCLUSIONS: In this study, implementing the WHO-2013 criteria in Sweden with risk factor-based screening did not significantly reduce LGA prevalence defined as birth weight >90th percentile, in the total population, or in the subgroup discordant for the definition of GDM. Future studies are needed to evaluate the effects of treating different glucose thresholds during pregnancy in different populations, with different screening strategies and clinical management guidelines, to optimise women's and children's health in the short and long term.TRIAL REGISTRATION: The trial is registered with ISRCTN (41918550).
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| 4. |
- Eriksson, Irene, et al.
(author)
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The Early Awareness and Alert System in Sweden : History and Current Status
- 2017
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In: Frontiers in Pharmacology. - : Frontiers Media S.A.. - 1663-9812. ; 8
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Research review (peer-reviewed)abstract
- The Swedish EAA System started as a regional initiative and rapidly grew to become a national level activity. An important feature of the system today is its complete integration into the national process for managed introduction and follow-up of new medicines. The system will continue to evolve as a response both to the changing landscape of health innovations and to new policy initiatives at the regional, national and international level.
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| 5. |
- Persson, Helena, 1967-, et al.
(author)
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En studie om kunskapsbetoningen i ämnesintegrerad undervisning analyserad med Bloom's reviderade taxonomi
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Other publication (other academic/artistic)abstract
- In Swedish schools science is mainly taught as chemistry, biology and physics. But it is also possible to teach the subjects as integrated science. International as well as Swedish studies, show that the concept integrated science is diversified. The study reported here, aims to investigating what types of knowledge, i.e. what cognitive process and knowledge perspective, and what content theme that is prominent in two Swedish science teachers’ work with integrated science. Also the relation between what the teachers want with the integrated lesson and what the teaching were aiming at are investigated. For analyzing the knowledge perspective the revised version of Bloom’s taxonomy was used. The results show that the knowledge emphasis of the teachers’ objectives before teaching had good alignment with the activities in the classroom. Some activities were taught as separate subjects and some as integrated science. In the integrated situations there was greater emphasis on factual and conceptual knowledge on a higher process dimension, e.g. the students were to analyze and evaluate information and make choices, standpoints, and less emphasis on procedural knowledge. The content theme in the integrated situations in both teachers’ projects were mainly environmental and energy issues.
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| 6. |
- Persson, Helena, 1967-, et al.
(author)
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En studie om lärares intentioner med och genomförande av ämnesintegrerad naturvetenskaplig undervisning i skolår 9
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Other publication (other academic/artistic)abstract
- In this paper we report a study about two teachers’ intentions with integrated science in lower secondary school and how these intentions turn out in their classrooms. The study is based on intentional analysis of interviews and classrooms observations. The teachers’ intentions are a result of internal and external factors. Internal factors for organizing teaching as integrated science were to let the students get a holistic understanding of the science content, to be able to apply knowledge and to see the relevance in their daily lives. External factors were school organization and syllabuses. In practice the teachers clearly connected to the students’ daily life while the holistic approach did not seem to be as important. In classroom reality the external factors became important and made the teachers change their actions.
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| 7. |
- Persson, Helena, 1967-
(author)
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"Handlar det om saker i vardagen, då är det ganska intressant" : - Några högstadieelevers tankar om ämnesintegrerad naturvetenskaplig undervisning
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Other publication (other academic/artistic)abstract
- The aim of this study is to contribute with knowledge about students’ views on integrated science teaching. The study is a part of a larger study about integrated science teaching in lower secondary school, grade 9. The analysis is based on data collected from group-interviews with students, student questionnaire and classroom observations. According to the students’ experience the content chosen are more important for creating interest than the teaching organisation. The students’ experience about integrated science teaching are influenced by teaching organization, content, the teacher, the students’ own work effort and if the knowledge are connected to everyday-life and useful. It is more important that teaching is connected to everyday-life and deals with useful knowledge, than if it is integrated or not. Overall the girls appreciate the integrated science teaching more than boys. The boys find it more exhausting to work with integrated science and also believe they get less concept knowledge with integrated science teaching.
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| 8. |
- Persson, Helena, 1967-
(author)
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Lärares intentioner och kunskapsfokus vid ämnesintegrerad naturvetenskaplig undervisning i skolår 7-9
- 2011
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Doctoral thesis (other academic/artistic)abstract
- De naturvetenskapliga ämnena i svenska skolan kan undervisas som separata ämnen i kemi, biologi och fysik, men också ämnesintegrerat, d.v.s. tillsammans eller med andra skolämnen. Både internationella och svenska studier visar att begreppet ämnesintegrering är mångfasetterat och saknar enhetlig definition. Avhandlingens syfte är att öka kunskaperna om ämnesintegrerad naturvetenskaplig undervisning och den består av fyra delstudier. För att ta reda på mer om hur yrkesverksamma lärare beskriver och genomför sådan undervisning intervjuades fem lärare som enligt egen utsago undervisar ämnesintegrerat i skolår 7 till 9 (13-16 år). Den andra studien presenterar två av dessa lärares intentioner med ämnesintegrerad naturvetenskap och hur dessa intentioner visar sig i klassrummet. Studien baseras på intervjuer och klassrumsobservationer som analyserats med intentionell analys. Syftet med den tredje studien är att undersöka vilken typ av kunskap, och vilket innehåll som är framträdande i de två lärarnas arbete med ämnesintegrerad naturvetenskaplig undervisning. Också relationen mellan den kunskapsbetoning som läraren säger att de vill ha i sin undervisning och den kunskapsbetoning som kommer till uttryck i undervisningen har undersökts. Som analysverktyg har Bloom’s reviderade taxonomi använts. Syftet med den fjärde studien är att undersöka elevernas syn på ämnesintegrerad undervisning i naturvetenskapliga ämnen. Analysen baseras på data som samlats in genom gruppintervjuer med elever, elevenkät och klassrumsobservationer. Lärarnas syfte med att organisera undervisningen ämnesintegrerat är att eleverna ska få en helhetssyn på det naturvetenskapliga innehållet, och att de ska kunna tillämpa sina kunskaper och se relevansen av dem i sina vardagliga liv. Ett annat skäl är att lärarna själva tycker att det är ett mer stimulerande sätt att arbeta på. Resultatet visar att ämnesintegrerad naturvetenskaplig undervisning är viktig för att ge en helhetssyn, men inte så nödvändig för att knyta undervisningen till elevernas vardag. I undervisningssituationen blev yttre faktorer viktigare än vad lärarna hade uttryckt som viktiga faktorer för deras val att ämnesintegrera och påverkade dem så att de ändrade sin undervisning. Lärarnas syfte med kunskapsbetoningen stämde väl överens med aktiviteterna i klassrummet. Vissa sammanhang undervisades ämnesspecifikt och andra sammanhang ämnesintegrerat. I de ämnesintegrerade sammanhangen fanns en större tonvikt på fakta- och begreppskunskap på en högre processdimension, t.ex. att eleverna skulle analysera och värdera information och göra val, ställningstaganden och mindre betoning på att minnas. Enligt elevernas upplevelser är undervisningens innehåll viktigare för att skapa ett intresse än undervisningens organisation. Det är viktigare att undervisningen är relaterad till deras vardag och att kunskaperna är användbara, än om den är ämnesintegrerad eller inte. Överlag uppskattar flickorna den ämnesintegrerade undervisningen mer än pojkarna. Pojkarna tycker att den är mer ansträngande att arbeta ämnesintegrerat och tror dessutom att de får mindre begreppskunskaper med den ämnesintegrerade naturvetenskapliga undervisningen.
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| 9. |
- Persson, Helena, 1967-, et al.
(author)
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Ämnesintegrerad undervisning i naturvetenskap : Vad är det?
- 2009
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In: NorDiNa. - Oslo, Norge : Naturfagsenteret. - 1504-4556 .- 1894-1257. ; 5:1, s. 47-60
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Journal article (peer-reviewed)abstract
- Biology, chemistry and physics might be taught as separate subjects, but sometimes they are taught as combined with one another or with other subjects. Nationally and internationally the concept integrated science teaching lacks a uniform definition. To find out more about how practicing teachers define and perform integrated teaching, interviews were undertaken with five teachers, teaching science in school year 7 to 9 (age 13-16) in the Swedish compulsory school. Two ways of integrating science teaching were found; one combining the science subjects and one combining the science subjects with other school subjects. Results showed differences in the ways of teaching integrated science, in the interpretation of what the teachers meant by science integrating teaching and which obstacles and possibilities they saw. Visions about working with integrated science in the future and how these visions correspond to teacher’s reality is also discussed.
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| 10. |
- Rodilla, Helena, 1982, et al.
(author)
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Applying THz Technology in Life Science
- 2014
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In: Swedish Microwave Days. Gigahertz Symposium, March 11-12, 2014. Gothenburg, Sweden.
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Conference paper (peer-reviewed)abstract
- Bio-molecules, due to their structure and size, have vibrational and rotational resonances at THz frequencies (0.1 to 10 THz) [1]. This unique interaction promises a multitude of applications in life sciences, wherein the latest development of THz sources and detectors has enabled this field of research to grow. Although being at an early and mostly exploratory stage of development, this field is riddled with many challenges that should be overcome; measurements of inhomogeneous media, short interaction lengths with few molecules, strong water absorption, and also the cultural gap between medical and engineering communities. In this work we present our preliminary results for three experiments within this field.
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