Adherence to screening guidelines for gestational diabetes in pregnancy

Background/Objective: There are major controversies in screening and diagnostic criteria for gestational diabetes. In 2017, new national guidelines were implemented in Norway. The aim of this study is to evaluate change in size of risk population for GDM, adherence to screening guidelines and follow up before and after implementation of the new guidelines. Method: This study is a retrospective case-series study. Data from women giving birth at the University Hospital of North Norway and the local maternity wards in Troms during first half-years of 2013 and 2018 was collected from the electronic medical record PARTUS and the antenatal fact sheet. Included were women giving birth after 29 weeks’ gestation, with singleton fetus and no pre-pregnancy DM (N=1349). Categorical variables were age (17-24, 25-34, 35-39 and 40 through highest), pre-pregnancy BMI (lowest thru 24.99, 25.00-26.99, 27.00 thru highest), parity (nulliparous/parous), ethnicity (high risk/low risk), follow up (neglected/lifestyle intervention/metformin/insulin), obstetric risk assessment (yes/no). Primary outcomes were change in size of risk population across guidelines, adherence to screening guidelines and prevalence of GDM. Statistical analyses were done using IBM SPSS with Chi-square test. P-values < 0.05 were considered statistically significant. Results: After changing the screening guidelines in 2017, the population at risk for GDM increased from 46.4% to 67.6% (p<0.01). However, only 28.7% in 2013 and 49.2% in 2018 were actually exposed to OGTT (p<0.01). Of those correctly screened 16.7% (15/90) of the women were diagnosed with GDM in 2013, respectively 10.7% (24/224) in 2018. Overall 2.2% (15/676) of the cohort was diagnosed with GDM in 2013 and 3.6% (24/673) in 2018. In 2018 41.7% of the women were diagnosed with GDM based on the fasting plasma glucose test solely. Among the women diagnosed with GDM, follow up was neglected in 13.3% in 2013, and in 20.8% in 2018. Of the remaining women, all women eligible for obstetric risk assessment in week 36 were followed-up as scheduled in the guidelines. Conclusion: With the introduction of new, broader criteria far more women were screened, resulting in a slightly higher prevalence of GDM. Adherence to screening guidelines remained poor across study populations. The national authorities in charge of screening for GDM need to consolidate quality measures that increase focus on screening and follow-up of women diagnosed with GDM

Analysis of Creep in Paperboard Packages With Plastic Tops

Beverage packages made of paper and plastic materials that are stored for a long time, deform due to creep deformations. The phenomena is termed bulging and means that the package changes its shape. Bulging is a major issue for the producers of beverage packages. The purpose of this master’s dissertation, is to develop a Finite Element-model for simulation of bulging of beverage packages at varying loadings and time scales that is verified to experimentally determined data of creep. In order to formulate a suitable FE-model for simulation of creep, a profound knowledge of the material behavior of the various materials in a beverage package is required. Therefore, creep tests of paper, polymer, and aluminum foil were performed. The creep deformation of paper was found to be approximately four to six times larger in CD than in MD. The elastic + creep deformation of the laminate is approximately three times larger in CD in comparison to MD. A creep material model for each of the materials in the laminate was calibrated to experimental data. The creep behavior of the FE-model was compared to bulge tests, which described the deflection of the package. The FE-model was proven to produce accurate results for shorter time periods and acceptable results for longer time frames. As experimental creep tests require long time frames, it is important to anticipate the creep behavior with a mathematical model. The FE-method was shown to be an excellent tool in order to describe, understand, and predict the phenomena of creep

Identification of Data Representation Needs in Service Design

Organisations are looking for new service offers through innovative use of data, often through a Service Design approach. However, current Service Design tools conceal technological aspects of service development like data and datasets. Data can support the design of future services but is often not represented or rendered as a readily workable design material. This paper reports on an early qualitative study of the tools used to work with data and analytics in a medium-sized organisation. The findings identify the current representations of data and data analytics used in the case organisation. We discuss to which extend the available representations of data and data analytics support data-driven service innovation. A comparison of our findings and current Service Design representations show that Service Design lack to represent data as design material. We propose the notion of expansiveness as a criterion to evaluate future data representations for data-driven Service Design