No consensus on gestational diabetes mellitus screening regimes in Sweden : pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

Background: Although associated adverse pregnancy outcomes, no international or Swedish consensus exists that identifies a cut-off value or what screening method to use for definition of gestational diabetes mellitus. This study investigates the following: i) guidelines for screening of GDM; ii) background and risk factors for GDM and selection to OGTT; and iii) pregnancy outcomes in relation to GDM, screening regimes and levels of OGTT 2 hour glucose values. Methods: This cross-sectional and population-based study uses data from the Swedish Maternal Health Care Register (MHCR) (2011 and 2012) combined with guidelines for GDM screening (2011-2012) from each Maternal Health Care Area (MHCA) in Sweden. The sample consisted of 184, 183 women: 88, 140 in 2011 and 96,043 in 2012. Chi-square and two independent samples t-tests were used. Univariate and multivariate logistic regression analyses were performed. Results: Four screening regimes of oral glucose tolerance test (OGTT) (75 g of glucose) were used: A) universal screening with a 2-hour cut-off value of 10.0 mmol/L; B) selective screening with a 2-hour cut-off value of 8.9 mmol/L; C) selective screening with a 2-hour cut-off value of 10.0 mmol/L; and D) selective screening with a 2-hour cut-off value of 12.2 mmol/L. The highest prevalence of GDM (2.9%) was found with a 2-hour cut-off value of 8.9 mmol/L when selective screening was applied. Unemployment and low educational level were associated with an increased risk of GDM. The OR was 4.14 (CI 95%: 3.81-4.50) for GDM in obese women compared to women with BMI <30 kg/m(2). Women with non-Nordic origin presented a more than doubled risk for GDM compared to women with Nordic origin (OR = 2.24; CI 95%: 2.06-2.43). Increasing OGTT values were associated with increasing risks of adverse pregnancy outcomes. Conclusions: There was no consensus regarding screening regimes for GDM from 2011 through 2012 when four different regimes were applied in Sweden. Increasing levels of OGTT 2-hour glucose values were strongly associated with adverse pregnancy outcomes. Based on these findings, we suggest that Sweden adopts the recent recommendations of the International Association of Diabetes and Pregnancy Study Group (IADPSG) concerning the performance of OGTT and the diagnostic criteria for GDM.

Violence and reproductive health preceding flight from war : accounts from Somali born women in Sweden

Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden. Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied. Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war. Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and

High female mortality resulting in herd collapse in free-ranging domesticated reindeer (Rangifer tarandus tarandus) in Sweden

Reindeer herding in Sweden is a form of pastoralism practised by the indigenous Sami population. The economy is mainly based on meat production. Herd size is generally regulated by harvest in order not to overuse grazing ranges and keep a productive herd. Nonetheless, herd growth and room for harvest is currently small in many areas. Negative herd growth and low harvest rate were observed in one of two herds in a reindeer herding community in Central Sweden. The herds (A and B) used the same ranges from April until the autumn gathering in October-December, but were separated on different ranges over winter. Analyses of capture-recapture for 723 adult female reindeer over five years (2007-2012) revealed high annual losses (7.1% and 18.4%, for herd A and B respectively). A continuing decline in the total reindeer number in herd B demonstrated an inability to maintain the herd size in spite of a very small harvest. An estimated breakpoint for when herd size cannot be kept stable confirmed that the observed female mortality rate in herd B represented a state of herd collapse. Lower calving success in herd B compared to A indicated differences in winter foraging conditions. However, we found only minor differences in animal body condition between the herds in autumn. We found no evidence that a lower autumn body mass generally increased the risk for a female of dying from one autumn to the next. We conclude that the prime driver of the on-going collapse of herd B is not high animal density or poor body condition. Accidents or disease seem unlikely as major causes of mortality. Predation, primarily by lynx and wolverine, appears to be the most plausible reason for the high female mortality and state of collapse in the studied reindeer herding community.

Perceptions of Sustainability and Functional Aspects on Liquid Carton Board Packaging Materials versus Competing Materials for Juice Applications in Sweden

This research explores the downstream perceptions of liquid carton board versus competing materials in packaging applications for juice. The methodology used is focus groups. The context is sustainability and functional performance, and related potential implications for the beverage industry value chain. The purpose is to get a deeper insight and understanding of functionality in relation to juice beverage packaging. The results confirm that there is no optimal packaging for every juice product, but a multitude, depending on the distribution channel, retail outlet, customer preferences, and context of consumption. There are some general packaging preferences, but the main deciding criteria for purchase seem to be the product characteristics in terms of quality, taste, brand, price and shelf life. For marketing reasons, packaging has to be adopted to the product and its positioning, liquid carton board packaging seem to have some functional advantages in distribution and is considered as sustainable and functional among many consumers. Major drawbacks seem to be shape limitations, lack of transparency, and lack of a “premium look”. To improve packaging performance and avoid sub-optimization, actors in the beverage industry value chain need to be integrated in development processes.

Geoprocessing journey-to-work data : delineating commuting regions in Dalarna, Sweden

Delineation of commuting regions has always been based on statistical units, often municipalities or wards. However, using these units has certain disadvantages as their land areas differ considerably. Much information is lost in the larger spatial base units and distortions in self-containment values, the main criterion in rule-based delineation procedures, occur. Alternatively, one can start from relatively small standard size units such as hexagons. In this way, much greater detail in spatial patterns is obtained. In this paper, regions are built by means of intrazonal maximization (Intramax) on the basis of hexagons. The use of geoprocessing tools, specifically developed for the processing ofcommuting data, speeds up processing time considerably. The results of the Intramax analysis are evaluated with travel-to-work area constraints, and comparisons are made with commuting fields, accessibility to employment, commuting flow density and network commuting flow size. From selected steps in the regionalization process, a hierarchy of nested commuting regions emerges, revealing the complexity of commuting patterns.

Pharmaceutical benefits in Australia and Sweden: welfare policy and the cost of prescription drugs

Pharmaceutical benefits provide a stable framework within which consumers, prescribers, suppliers, pharmacists and other actors undertake transactions. The state in effect delivers a good that enhances individual autonomy. A major reason for the legitimacy enjoyed by pharmaceutical benefits in both Australia and Sweden is that these programs have strong attributes of universalism (rather than targeting). Sweden's predominantly public health system allows greater scope for pharmaceutical policy innovation. Australia's Pharmaceutical Benefits Scheme (PBS), while historically resilient and effective, is now wedged precariously between traditional considerations of equity and public health on the one hand, and constant pressure for increased marketisation on the other.

Biotechnology and governance in Australia and Sweden: path dependency or instutional convergence?

The development of new generic technologies occurs within traditional structures of industry-government interaction, but also unleashes a process of 'creative destruction' generating new institutional patterns. This article, focusing on biotechnology, describes and compares policy processes and institutional arrangements in Australia and Sweden. The Swedish biotechnology sector displays a pattern of fragmentation and relatively weak state steering. Australia, by contrast, has implemented a set of comparatively coordinated regulatory and other measures to foster the growth of biotechnology. This observation contradicts the characterisation of Sweden as a 'strong state' economy, and challenges the depiction of Australia as lacking in state steering capacity. The relative open-endedness of the search in these countries for a mode of regulation of biotechnology suggests that the role of the state in economic restructuring today is fundamentally distinct from that of earlier periods.

Social-movement unionism in theory and in Sweden

Many union leaders and observers of unionism in industrially advanced countries have recently argued for stronger links between unions and social movements but their arguments leave the nature of social movements underspecified. This article reviews the literature on social movements and argues in favour of a minimalist theory of the social actor rather than choose between American and European approaches to studying social movements. Both Melucci's European approach and McAdam, Tarrow, and Tilly's American approach to integrating the European and American schools of thought on social movements are inadequate to the task of specifying social-movement unionism. Hindess's minimalist theory of the social actor and articulated arenas of conflict offers a stronger approach to understanding social-movement unionism and appreciating its strategic pertinence in particular times and places. Two episodes of contention in Sweden illustrate the advantages of a minimalist theory of articulated social-movement unionism.

The commitment of public sector Sweden to codes of ethics

This article examines the results of a study conducted of the top 100 public sector units in Sweden. These units are comprised of entities of government, municipalities, and county councils. The aim of the study was to examine and describe the commitment to codes of ethics in these Swedish public sector units. This article reports on the responses of those public sector units that possessed a code of ethics. The construct of commitment was measured by a consideration of the inputs, objectives and outputs of the code across six areas. The commitment to codes of ethics has an interest for those involved in the public sector in Sweden and society in general. Most public sector units are in the early stages of development and assimilation into overall ethics policies in code artefacts. On a specific level there are customized codes of ethics that are not always documented in a generic artefact. Theoretical and managerial implications are provided. Furthermore, suggestions for further research are proposed.

A comparative study of the contents of corporate codes of ethics in Australia, Canada and Sweden

This paper reports on and analyzes the contents of 197 corporate codes of ethics (78 Australian, 80 Canadian and 39 Swedish). Among other things, it was found that the contents of the Australian and Canadian codes were similar, reflecting the similar histories and cultures (as measured by Hofstede's dimensions) of these two countries. Further, the contents of the Swedish codes were found to be very different from the Australian and Canadian codes in some areas, reflecting the cultural differences between Sweden and the other two countries.

Investigating codes of ethics within the largest private sector organizations in Sweden and Turkey

The aim of the study was to examine the ways that private sector organizations in Sweden and Turkey communicated the intent of their codes of ethics to their employees. Primary data was obtained via a self-administered mail questionnaire distributed to a census of the top 500 private sector organizations in each country based on revenue. The study identified some interesting results that showed that the small group of companies in Turkey that have a code may be more advanced in ethics artefacts usage than Sweden. Such a conclusion is counterintuitive as one would have expected a developed nation like Sweden to be more advanced in these measures than a developing nation such as Turkey. The culture of one's country may playa large role in the implementation of ethics artefacts in corporations and could be a major reason for this difference.