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  • 237851.
    Åhlén, Julia
    et al.
    Högskolan i Gävle.
    Seipel, Stefan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    TIME-SPACE VISUALISATION OF AMUR RIVER CHANNEL CHANGES DUE TO FLOODING DISASTER2014In: Proceedings of International Multidisciplinary Scientific GeoScience Conference (SGEM), 2014, 2014Conference paper (Refereed)
    Abstract [en]

    The analysis of flooding levels is a highly complex temporal and spatial assessment task that involves estimation of distances between references in geographical space as well as estimations of instances along the time-line that coincide with given spatial locations. This work has an aim to interactively explore changes of Amur River boundaries caused by the severe flooding in September 2013. In our analysis of river bank changes we use satellite imagery (Landsat 7) to extract parts belonging to Amur River. We use imagery from that covers time interval July 2003 until February 2014. Image data is pre-processed using low level image processing techniques prior to visualization. Pre-processing has a purpose to extract information about the boundaries of the river, and to transform it into a vectorized format, suitable as inputs subsequent visualization. We develop visualization tools to explore the spatial and temporal relationship in the change of river banks. In particular the visualization shall allow for exploring specific geographic locations and their proximity to the river/floods at arbitrary times. We propose a time space visualization that emanates from edge detection, morphological operations and boundary statistics on Landsat 2D imagery in order to extract the borders of Amur River. For the visualization we use the time-spacecube metaphor. It is based on a 3D rectilinear context, where the 2D geographical coordinate system is extended with a time-axis pointing along the 3rd Cartesian axis. Such visualization facilitates analysis of the channel shape of Amur River and thus enabling for a conclusion regarding the defined problem. As a result we demonstrate our time-space visualization for river Amur and using some amount of geographical point data as a reference we suggest an adequate method of interpolation or imputation that can be employed to estimate value at a given location and time.

  • 237852.
    Åhlén, Julia
    et al.
    Högskolan i Gävle.
    Seipel, Stefan
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Liu, Fei
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Evaluation of the Automatic methods for Building Extraction2014In: International Journal of Computers and Communications, ISSN 2074-1294, Vol. 8, p. 171-176Article in journal (Refereed)
  • 237853.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    Bottom Reflectance Influence on a Color Correction Algorithm for Underwater Images2003In: Lecture Notes in Computer Science. Proceedings of the 13th Scandinavian Conference on Image Analysis (SCIA), ISSN 0302-9743, Vol. 2749, p. 922-926Article in journal (Refereed)
  • 237854.
    Åhlén Julia, Sundgren David
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Bottom Reflectance Influence on a Color Correction Algorithm for Underwater Images2003In: 13th Scandinavian Conference, SCIA 2003 Göteborg, Sweden, June 29-July 2, 2003, 2003, p. 922-926Conference paper (Refereed)
  • 237855.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    Improvement of a Color Correction Algorithm for Underwater Images Through Compensating for Digital Camera Behaviour2004In: Proceedings of the Swedish Symposium on Image Analysis, p. 142-145Article in journal (Refereed)
  • 237856.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis.
    Sundgren, David
    Bengtsson, Ewert
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis.
    Application of underwater hyperspectral data for color correction purposes2007In: Pattern Recognition and Image Analysis, ISSN 1054-6618 (Print) 1555-6212 (Online), Vol. 17, no 1, p. 170-173Article in journal (Refereed)
    Abstract [en]

    Color correction of underwater images has been considered a difficult task for a number of reasons. Those include severe absorption of the water column, the unpredictable behavior of light under the water surface, limited access to reliable data for correction purposes, and the fact that we are only able to process three spectral channels, which is insufficient for most color correction applications. Here, the authors present a method to estimate a hyperspectral image from an RGB image and pointwise hyperspectral data. This is then used to color correct the hyperspectral underwater image and transform it back into RGB color space.

  • 237857.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    Bengtsson, Ewert
    Application of Underwater Spectral Data for Colour Correction PurposesArticle in journal (Refereed)
  • 237858.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    Bengtsson, Ewert
    Pre-Processing of Underwater Images Taken in Shallow Water for Color Reconstruction Purposes2005In: Proceedings of the 7th IASTED International Conference on Signal and Image ProcessingArticle in journal (Refereed)
  • 237859.
    Åhlén, Julia
    et al.
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    KTH.
    Bengtsson, Ewert
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Pre-Processing of Underwater Images Taken in shallow Water for Color Reconstruction Purposes2005In: IASTED Proceeding (479): IASTED 7th Conference on Signal and Image Processing - 2005, 2005Conference paper (Refereed)
    Abstract [en]

    Coral reefs are monitored with different techniques in or der to examine their health. Digital cameras, which pro vide an economically defendable tool for marine scientists to collect underwater data, tend to produce bluish images due to severe absorption of light at longer wavelengths. In this paper we study the possibilities of correcting for this color distortion through image processing. The decrease of red light by depth can be predicted by Beer’s Law. An other parameter that has been taken into account is the image enhancement functions built into the camera. We use a spectrometer and a reflectance standard to obtain the data needed to approximate the joint effect of these func tions. This model is used to pre-process the underwater images taken by digital cameras so that the red, green and blue channels show correct values before the images are subjected to correction for the effects of the water column through application of Beer’s Law. This process is fully automatic and the amount of processed images is limited only by the speed of computer system. Experimental re sults show that the proposed method works well for cor recting images taken at different depths with two different cameras.

  • 237860.
    Åhlén, Julia
    et al.
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    KTH.
    Lindell, Tommy
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Bengtsson, Ewert
    Uppsala University, Interfaculty Units, Centre for Image Analysis. Teknisk-naturvetenskapliga vetenskapsområdet, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Dissolved Organic Matters Impact on Colour2005In: Image Analysis: 14th Scandinavian Conference, SCIA 2005, 2005, p. 1148-1156Conference paper (Refereed)
    Abstract [en]

    The natural properties of water column usually affect under-water

    imagery by suppressing high-energy light. In application such as

    color correction of underwater images estimation of water column parameters is crucial. Diffuse attenuation coefficients are estimated and used for further processing of underwater taken data. The coefficients will give information on how fast light of different wavelengths decreases with increasing depth. Based on the exact depth measurements and data from a spectrometer the calculation of downwelling irradiance will be done. Chlorophyll concentration and a yellow substance factor contribute to a great variety of values of attenuation coefficients at different depth. By taking advantage of variations in depth, a method is presented to

    estimate the in uence of dissolved organic matters and chlorophyll on color correction. Attenuation coefficients that depends on concentration of dissolved organic matters in water gives an indication on how well any spectral band is suited for color correction algorithm.

  • 237861.
    Åhlén, Julia
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Centre for Image Analysis. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis.
    Sundgren, David
    Lindell, Tommy
    Bengtsson, Ewert
    Dissolved Organic Matters Impact on Colour Reconstruction in Underwater Images2005In: Lecture Notes in Computer Science. Proceedings of the 14th Scandinavian Conference on Image Analysis, ISSN 3-540-26320-9, Vol. 3540, p. 1148-1156Article in journal (Refereed)
  • 237862.
    Åhlén, Karina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Collagen-binding integrin α2β1 activity in vivo and in vitro: Effects of platelet-derived growth factor-BB1998Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The expression of integrins by two cell clones from a rat colon carcinoma was investigated. Cloned cells that gave rise to regressive tumors, but not cells that gave rise to progressive, lethal, tumors, adhered to interstitial collagens through the integrin α2β1, although both cell types expressed it. These data suggest that the apparent activity of α2β1 is important for tumorinvasiveness.

    Inhibition of the α2β1 integrin in rat paw skin lead to a lowering of the interstitial fluid pressure (PIF). an effect that could be overcome by platelet-derived growth factor-BB (PDGF-BB).

    PDGF-BB could stimulate the synthesis of the α2, but not α1, α3 or β1 integrin chains in human AG1518 fibroblasts.

    PDGF-BB also stimulated cell spreading and induced a rapid and transientrelocalization of α2β1 in AG1518 fibroblasts. The relocalization was dependent on phosphatidylinositol 3-kinase (PI3-K) and protein kinase C (PKC), and involved disassembly of focal adhesions as seen in interference reflection microscopy (IRM). The mobility of β1-integrins in the cell membrane was increased in cells stimulated with PDGF-BB.

    PDGF-BB-stimulated collagen gel contraction, as well as the induction of a rise in cytoplasmic free calcium [Ca2+]i were shown to depend on PI3-K. The experimental anti-inflamatory drug α-trinositol induced an increase in [Ca2+]i and could restore PI3-K-dependent chemotaxis towards PDGF-BB as well as the lowering of PIF induced bv inhibitors of PI3K.

    In conclusion: α2β1 is implicated in invasiveness of tumor cells in vivo, and in the maintenance of interstitial fluid pressure (PIF). PDGF-BB is shown to regulate PIF, to stimulate synthesis of the integrin α2 chain, and to modulate cytoskeletal interactions of α1- integrins. The maintenance of PIF, as well as PDGF-BB-stimulation of collagen gel contraction, induction of integrin reorganization from focal adhesions, and induction of a calcium response, was dependent on an activation of PI3-K. PI3-K is hypothesized to mediate these effects at least in part through induction of a rise in [Ca2+]i.

  • 237863.
    Åhlén, Madeléne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Forsberg Isacsson, Niccole
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Screeninginstrument för nutritionsstatus och ät- och måltidsobservationer: En litteraturstudie i syfte att identifiera vilka faktorer som observeras i samband med måltid hos multisjuka äldre2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Malnutrition is a common condition in health care. Malnutrition is associated with increased morbidity and mortality. It leads to increased charges imposed on society when the length at hospital becomes longer. Patients becomes vulnerable to increased suffering. According to the nutrition care process, malnutrition can be detected when a nutritional status screening is performed. Then, to investigate the causes of malnutrition eating and meal instruments can be utilized. Aim: The aim of the present study was to identify the factors that are observed in connection with the nutritional status screening and eat -and meal observations. Which instruments are developed to identify these factors in multi-ill elderly. Methods: The review was based on scientific papers on the basis of the study's purpose. The data were available at Uppsala University's electronic subscriptions. The analysis was done by examination and processing of the collected material. Result: The result showed that the weight loss, body mass index, diagnosis, appetite and functional capacity were factors that most nutritional screening instruments observed. Factors that were observed to the greatest extent in eat observation instrument was chewing and swallowing difficulties, transportation of food to the mouth, sit position and energy intake. There was no instrument that observed only meal environment. Most of the instruments examined proved to have reliability and validity. There are also other factors shown to influence the nutritional status that is not observed in any instrument. These factors were of the psychosocial and economic character. Conclusion:There are nutritional status screening instruments of good quality, however, there are not as extensive eat -and meal instruments.

  • 237864.
    Åhlén, Marit
    Uppsala University, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Faculty of Languages, Department of Scandinavian Languages.
    Runristaren Öpir: En monografi1997Doctoral thesis, monograph (Other academic)
  • 237865.
    Åhlén, Michelle
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Nanoparticle loaded hydrogels as a pathway for enzyme controlled drug release in ophthalmic applications2017Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to develop nanoparticle loaded hydrogel based contact lenses that could be used for ocular drug delivery. Two potential contact lens platforms for controlled ophthalmic drug delivery was thus developed by incorporating chitosan-poly(acrylic acid) nanoparticles into polyvinyl alcohol (PVA) hydrogels and nanoparticles together with cellulose nanocrystals (CNC) in PVA. The nanoparticles were shown to disintegrate in a physiological 2.7 mg/ml concentration of lysozyme resulting from the hydrolysis of the chitosan chains by the enzyme. An extended release over a 28-hour period was demonstrated once the nanoparticles had been integrated into the composite lenses, with nanoparticle-CNC PVA lenses showing even greater potential for extended release. Further experiments using a suitable drug molecule incorporated into the nanoparticles during the synthesis, and released from the lenses in simulated tear fluid would be needed in order to validate the hydrogels as a potential drug delivery platform.

    The full text will be freely available from 2020-06-29 15:20
  • 237866.
    Åhlén, Michelle
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Cheung, Ocean
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Strömme, Maria
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Amorphous Mesoporous Magnesium Carbonate as a Functional Support for UV-Blocking Semiconductor Nanoparticles for Cosmetic Applications2019In: ACS Omega, ISSN 2470-1343, Vol. 4, no 2, p. 4429-4436Article in journal (Refereed)
    Abstract [en]

    Highly porous amorphous mesoporous magnesium carbonate (MMC) with a Brunauer–Emmett–Teller (BET) surface area over 600 m2·g–1 was evaluated as a micrometer-sized support for TiO2 and ZnO semiconductor nanoparticles. The resulting MMC-TiO2-ZnO contained 25 wt % TiO2 and 25 wt % ZnO incorporated into an MMC structure without blocking the pores as revealed by nitrogen sorption isotherms, scanning electron microscopy, and transmission electron microscopy. In vitro ultraviolet (UV) light-blocking experiments showed that the MMC-TiO2-ZnO had comparable UV-blocking ability as a TiO2 and ZnO nanoparticle mixture containing the same amount of semiconductor particles without a support. Amaranth dye degradation studies revealed that MMC was able to diminish the catalytic activity of TiO2 and ZnO nanoparticles, possibly due to the presence of free carbonate ions in MMC as well as in the dye solution. In summary, this paper demonstrated for the first time that micrometer-sized particles of the recently emerged MMC materials can be used as a support for sun-blocking semiconductor nanoparticles without compromising their UV blocking ability and with significantly lowered photocatalytic activity. When used in a formulation as a support for semiconductor nanoparticles, MMC may also reduce the risk of nanoparticle exposure, and the high porosity of MMC-TiO2-ZnO may be utilized for the delivery of therapeutic agents to the skin.

  • 237867.
    Åhlén, Michelle
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Tikhomirov, Evgenii
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    Lindh, Jonas
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Nanotechnology and Functional Materials.
    The role of additive manufacturing in the creation of personalized medicine.2019In: Uppsala Biomaterials and Bioengineering Meeting 2019, 2019Conference paper (Other academic)
  • 237868.
    Åhlén, Mikaela
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Signals and Systems Group.
    A framework for traffic management and collision avoidance in underground mines2014Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Mining is an ancient occupation and the purpose is to access and extract minerals in the ground, which after being brought to the surface can be processed and sold at a profit. A mine, especially when active, is a dangerous place; mine collapse and other accidents have over the years claimed many lives. To improve the safety of personnel and equipment, there is an increased market for automating the vehicles operating in the mines. With no drivers in the vehicles, it is necessary to make sure the vehicles get to their goals without colliding with each other or perhaps with vulnerable personnel working in the mine. This can be done by performing traffic management. The traffic management is also important from a scheduling point of view; by planning where and when a vehicle should go to a certain part of the mine, the material flow can be optimized and so also the profit.

    This project has been carried out with the purpose of creating a framework to be used for simulating autonomous vehicles in underground mines. The framework is dynamic and supports e.g. fast map generation, and has an anticollision algorithm to prevent collisions when the simulated vehicles all try to go to different destinations in the map. With a total runtime of 100 hours using this framework, 2 total shutdowns have occurred (a state where all vehicles are stopped as a result from a pair of vehicles getting too close to each other) and 1 dead lock (a case where no collision has occurred, yet none of the vehicles could continue to their goal). Hence, due to the rarity of these, the conclusion that the overall concept of the collision avoidance algorithm seems to work has been made.

  • 237869.
    Åhlén, Victor
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Population PK Modeling of Plasma Derived Coagulation Factor IX2011Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aims of this project were to first develop a population pharmacokinetic

    model of plasma derived coagulation factor IX and secondly to investigate if

    coagulation factor IX has 3-compartment pharmacokinetics rather than

    2-compartment pharmacokinetics. A total of 999 plasma samples along with

    the patient characteristics bodyweight, age and factor IX preparation from 26

    patients served as data for the project. Population pharmacokinetic curve

    fitting was performed by means of NONMEM 6. Clotting factor IX had

    3-compartment pharmacokinetics rather than 2-compartment pharmacokinetics.

    This allowed for the computation of the three half-lives. The typical value

    terminal half-life for coagulation factor IX was shorter than published mean

    values of 29-43 hours, while the terminal half-lives for individual patients were

    well within the interval of reported terminal half-lives. The new model shows

    that inter-occasion variance is lower than inter-individual variance, which is a

    requirement for pharmacokinetic based dosing. Model performance was evaluated

    using tools for model diagnostics. Goodness of fit plots along with calculations

    of epsilon and eta shrinkage showed good fit with low shrinkage. Visual

    predictive check indicated excellent performance of the 3-compartment model

    of clotting factor IX. The development of the first population pharmacokinetic

    model of plasma derived coagulation factor IX and the estimations of variance

    and pharmacokinetic parameters allows for treatment optimization through

    multiple-dose simulations, optimization of sampling for determination of

    individual pharmacokinetics and statistical support for pharmacokinetic based

    dosing.

  • 237870.
    Åhman, Alexander
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology.
    Making Love: En socialkonstruktivistisk analys av relationen mellan kärlek och sex2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the thesis is to analyze how the modern west society looks upon and talks about sex and love. I am looking at how they are combined in the so called romantic ideology. The object of my analyzes is the movie Crazy, stupid love from 2011. I will observe certain cultural aspects of western society considering love and sex by using examples from the movie. My theoretical platform for the thesis will be the social constructive perspective (Barlebo Wenneberg 2001) an modern film theory (Andersson och Hedling 1995).

     

    The result show amongst other things that works of fiction, like the movie I use in the thesis, can in fact take a position in the cultural discourse. The movie keeps its legitimacy by harmoniesing with many of the beliefs and hopes that we in the west have about relationships and romance. The romantic ideology keeps being dominant today even though there are conflicts between the romantic ideology’s more traditional construction and the post modern society’s other norms. 

  • 237871.
    Åhman, Angelica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Söderström, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vårdhund: Ett icke-farmakologiskt behandlingsalternativ för personer med demenssjukdom2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:Animal-assisted interventions (AAI) first came about in the US in the 1960s and was primarily used in child psychiatry. Since then it has evolved and spread to other countries and to other disciplines in health care. In Sweden AAI is used in some institutions for people living with dementia and is a popular feature among the residents. The purpose of the study is to examine if there are reasons for the use of AAI as a non-pharmacological treatment to promote the quality of life of people living with dementia. Methods: The study is a systematic literature review. 13 articles were used to answer the purpose. Results: The compilation of the studies shows that several positive effects appear when using AAI of people with dementia. This applies to several elements of the concept of quality of life which are improved. However, the number of people participating in the studies are small, and many of the results are not statistically significant. Conclusion: AAI appears to be a very popular feature in the care of people with dementia and for those who enjoy being in the company of animals, it may be a way to raise the perceived quality of life. More research with larger groups of participants are needed to obtain more reliable results.

  • 237872.
    Åhman, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Pregnancy Ultrasound Detecting Soft Markers – the Challenge of Communicating Risk Figures2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis focuses on expectant parents’ experiences and needs when soft makers are detected at mid-trimester ultrasound, resulting in an unexpected assessment of risk for fetal anomalies. The thesis also describes the prevalence of ultrasonographic fetal soft markers and the incidence of Down syndrome in a low-risk population of 10,535 pregnant women with a total of 10,710 fetuses, as well as the risk of invasive prenatal diagnostics in conjunction with the detection of soft markers. Finally, the thesis aims to explore the value of a web-based patient decision aid (DA) in facilitating informed decision making regarding routine fetal screening for anomalies and the fathers’ role in decision making regarding prenatal screening.

    A prospective observational study was conducted between 2008–2011 to investigate the prevalence of ultrasonographic fetal soft markers at second trimester screening. During this time period, 12 women and 17 men were interviewed about their experience when soft markers were detected. Based on the results of these interviews, a web-based decision aid (DA) to enhance expectant parents’ decision-making concerning fetal screening was developed and a trial initiated to test its utility. Interviews were conducted with 17 women who received access to the DA, 11 who had chosen to use the DA and six who had not used it. All interview studies were analysed using systematic text condensation (STC) developed by Malterud.

    Soft markers were detected in 5.9% of the fetuses at mid-trimester ultrasound, whereof 5.1% were isolated. All soft markers showed a positive likelihood ratio (LR+) for DS; however, the association was only statistically significant for the collapsed category ‘any marker’ (isolated, multiple or combined with anomaly), not for isolated markers. An almost 24-fold increase of invasive diagnostic testing was shown in all women, including those with a low estimated risk for aneuploidy, i.e. < 1/200 (paper III).

    The results from interviews showed that the finding of soft markers created much anxiety and indicated that both women and men lacked awareness of the potential of the ultrasound examination (papers I and II). The results also showed that the men were actively engaged in decision making not only by supporting their partners, but also considered their own values and needs regarding these issues (paper II). It was also evident that women wanted their partners to be engaged in decisions regarding fetal diagnostics (papers I and IV).

    The web-based patient DA was able to initiate a process of conscious decision making in pregnant women, as a result of their interaction with the tool. The DA allowed for clarification of women’s thoughts and priorities and helped them to understand the significance of the screening result and providing a basis for making informed decisions regarding fetal screening (paper IV).

    List of papers
    1. Did I really want to know this?: Pregnant women's reaction to detection of a soft marker during ultrasound screening
    Open this publication in new window or tab >>Did I really want to know this?: Pregnant women's reaction to detection of a soft marker during ultrasound screening
    2010 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 81, no 1, p. 87-93Article in journal (Refereed) Published
    Abstract [en]

    Objective: To investigate women's expectations of routine ultrasound and experiences when soft markers were discovered: what the disclosure meant, how it affected them, how they experienced the information given and why they did or did not choose amniocentesis. Design: Semi-structured, in-depth interviews were conducted with 11 women 25-30 weeks into the pregnancy, 7-13 weeks after the discovery of a soft marker. Findings: Women lacked knowledge about the potential of the scan and detection of soft markers created strong emotional reactions that women thought could have been alleviated by prior information about potential findings. Information in connection with the scan was perceived as insufficient. Decision about amniocentesis was affected by attitudes to disability, anxiety about fetal loss due to the procedure, need for certainty by a diagnostic test, and partner's opinion. Conclusions: Women were shocked by the unexpected and sometimes unwanted information on elevated risk for a chromosomal aberration for which they lacked any preparation. Because this event often has long-lasting effects on the pregnancy, models of information that are efficient in promoting informed decisions are imperative. Practice implications: Both women and their partners need relevant information before and in connection with ultrasound scan to be able to make informed choices.

    Keywords
    Fetal ultrasonography, Ultrasonographic soft markers, Chromosomal aberrations, Ethical dilemmas, Psychological aspects
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-134822 (URN)10.1016/j.pec.2009.12.011 (DOI)000282070900015 ()
    Available from: 2010-12-02 Created: 2010-12-01 Last updated: 2017-12-12Bibliographically approved
    2. Facts first, then reaction: expectant fathers' experiences of an ultrasound screening identifying soft markers
    Open this publication in new window or tab >>Facts first, then reaction: expectant fathers' experiences of an ultrasound screening identifying soft markers
    2012 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, p. 60-61Article in journal, Meeting abstract (Other academic) Published
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-177434 (URN)000304987600093 ()
    Available from: 2012-12-13 Created: 2012-07-13 Last updated: 2017-12-06Bibliographically approved
    3. Ultrasonographic fetal soft markers in a low-risk population: prevalence, association with trisomies and invasive tests
    Open this publication in new window or tab >>Ultrasonographic fetal soft markers in a low-risk population: prevalence, association with trisomies and invasive tests
    Show others...
    2014 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, no 4, p. 367-373Article in journal (Refereed) Published
    Abstract [en]

    Objective

    To investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and the association of these markers with trisomies and invasive testing.

    Design

    Prospective observational study.

    Setting

    Swedish University Hospital.

    Population

    All women with fetuses examined by ultrasound at 15+0–22+0 weeks gestation between July 2008 and March 2011.

    Methods

    Cases with soft markers were compared with non-cases with regard to trisomies and invasive testing.

    Main outcome measures

    Prevalence of soft markers, likelihood ratio for trisomies and risk ratio for invasive tests after detection of soft markers.

    Results

    Second trimester ultrasound was performed on 10 710 fetuses. Markers were detected in 5.9% of fetuses. 5.1% were isolated, 0.7% were multiple and 0.1% were combined with an anomaly. Presence of markers showed a positive likelihood ratio for Down syndrome, but the association (likelihood ratio = 7.1) was only statistically significant for the combined category of any marker (isolated, multiple or combined with anomaly). The risk ratio for invasive testing after the second trimester ultrasound was 24.0 in pregnancies with isolated soft markers compared with those without markers.

    Conclusion

    In a low-risk population, soft markers were found in 5.9% of fetuses at second trimester ultrasound. The likelihood ratio for Down syndrome was significant only for any marker (isolated, multiple or combined with anomaly). The presence of soft markers increased the incidence of invasive procedures substantially. Soft markers should be noted when information on second trimester ultrasound is formulated, and all units performing fetal ultrasound examinations should have established routines concerning information management when soft markers are identified.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-219104 (URN)10.1111/aogs.12334 (DOI)000333150700007 ()24433283 (PubMedID)
    Available from: 2014-02-21 Created: 2014-02-21 Last updated: 2017-12-05Bibliographically approved
    4. ‘It made you think about your opinion’ -Women's perception of a web-based decision aid concerning screening for fetal anomalies
    Open this publication in new window or tab >>‘It made you think about your opinion’ -Women's perception of a web-based decision aid concerning screening for fetal anomalies
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Background:All pregnant women in Sweden are offered amid-trimester ultrasound examination as part of antenatal care. It is free ofcharge and very few women decline. Despite efforts to provide information,research shows that women’s choice of prenatal screening is often not based oninformed decisions. Objectives:To investigate the potential of a web-baseddecision aid (DA) concerning screening for fetal anomalies to initiate aprocess of reflection and conscious decision-making in pregnant women. Methods: Theweb-based DA consisted of four modules: ‘Facts about fetal diagnostics’,‘Likelihood of anomalies’, ‘Expectant parents’ stories’, and the interactive‘Worksheets’. Seventeen women with access to the DA were interviewed, eleven who opted to usethe DA and six who did not. Data were analysed by systematic text condensation. Results: Women appreciated the decisional aid for being easilyaccessible and emphasised the importance of a reliable source. The DA helpedthem to clarify their own standpoints and engaged their partner in the decision-makingprocess. Reading the expectant parents’ stories seemed especially instrumentalin making women more aware of their own standpoint. Women described that the DAenhanced their awareness that participating in prenatal screening anddiagnostics was a conscious choice. Women who chose not to use the web-based DAwhen offered believed they already had sufficient knowledge to make a decisionabout the different tests. Conclusions: TheDA was able to initiate a process of conscious decision-making in pregnantwomen as a result of their interaction with the tool. Practical Implications: A web-based DA has low costs, is convenientlyavailable to a population with Internet access and can be used on one’s ownterms. The DAs ability to improve awareness of the need to make a consciouschoice showed that this might be a feasible tool for sharing information duringpregnancy.

    Keywords
    Decision aid, genetic screening, informed choice, pregnancy ultrasound
    National Category
    Other Clinical Medicine
    Research subject
    Obstetrics and Gynaecology
    Identifiers
    urn:nbn:se:uu:diva-221140 (URN)
    Available from: 2014-03-25 Created: 2014-03-25 Last updated: 2014-04-29
  • 237873.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Axelsson, Ove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Maras, Gordan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ultrasonographic fetal soft markers in a low-risk population: prevalence, association with trisomies and invasive tests2014In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, no 4, p. 367-373Article in journal (Refereed)
    Abstract [en]

    Objective

    To investigate the prevalence of soft markers identified at second trimester ultrasound in a low-risk population and the association of these markers with trisomies and invasive testing.

    Design

    Prospective observational study.

    Setting

    Swedish University Hospital.

    Population

    All women with fetuses examined by ultrasound at 15+0–22+0 weeks gestation between July 2008 and March 2011.

    Methods

    Cases with soft markers were compared with non-cases with regard to trisomies and invasive testing.

    Main outcome measures

    Prevalence of soft markers, likelihood ratio for trisomies and risk ratio for invasive tests after detection of soft markers.

    Results

    Second trimester ultrasound was performed on 10 710 fetuses. Markers were detected in 5.9% of fetuses. 5.1% were isolated, 0.7% were multiple and 0.1% were combined with an anomaly. Presence of markers showed a positive likelihood ratio for Down syndrome, but the association (likelihood ratio = 7.1) was only statistically significant for the combined category of any marker (isolated, multiple or combined with anomaly). The risk ratio for invasive testing after the second trimester ultrasound was 24.0 in pregnancies with isolated soft markers compared with those without markers.

    Conclusion

    In a low-risk population, soft markers were found in 5.9% of fetuses at second trimester ultrasound. The likelihood ratio for Down syndrome was significant only for any marker (isolated, multiple or combined with anomaly). The presence of soft markers increased the incidence of invasive procedures substantially. Soft markers should be noted when information on second trimester ultrasound is formulated, and all units performing fetal ultrasound examinations should have established routines concerning information management when soft markers are identified.

  • 237874.
    Åhman, Annika
    et al.
    Umea Univ, Dept Clin Sci Obstet & Gynecol, S-90187 Umea, Sweden.
    Edvardsson, Kristina
    Umea Univ, Dept Clin Sci Obstet & Gynecol, S-90187 Umea, Sweden;La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia.
    Fagerli, Tove Anita
    Trondheim Reg & Univ Hosp, Natl Ctr Fetal Med, St Olavs Hosp, Trondheim, Norway.
    Darj, Elisabeth
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). St Olavs Hosp, Dept Obstet & Gynecol, Trondheim, Norway;Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, NTNU, Trondheim, Norway.
    Holmlund, Sophia
    Umea Univ, Dept Clin Sci Obstet & Gynecol, S-90187 Umea, Sweden.
    Small, Rhonda
    La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia;Karolinska Inst, Reprod Hlth Womens & Childrens Hlth, Stockholm, Sweden.
    Mogren, Ingrid
    Umea Univ, Dept Clin Sci Obstet & Gynecol, S-90187 Umea, Sweden;La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia.
    A much valued tool that also brings ethical dilemmas - a qualitative study of Norwegian midwives' experiences and views on the role of obstetric ultrasound2019In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, article id 33Article in journal (Refereed)
    Abstract [en]

    Background: Midwives are the main providers of routine antenatal care services including the routine ultrasound examination in Norway. The ultrasound examination can be perceived by expectant parents not only as a medical examination but also as a social event facilitating attachment to their fetus. This study explores Norwegian midwives' experiences and views on the role of ultrasound in clinical management of pregnancy.

    Methods: A qualitative study design was applied. Twenty-four midwives who all performed obstetric ultrasound examinations were recruited for focus group discussions and individual interviews. Data collection took place in 2015 in five hospitals in two different regions of Norway. Data were analyzed using qualitative content analysis.

    Results: Midwives described obstetric ultrasound examinations as very valuable although doing ultrasounds placed high demands on their operational and counselling skills. Increasing requests for ultrasound from pregnant women were mentioned. Advancements in ultrasound diagnosis were considered to have put the fetus in the position of a patient, and that pregnant women declining ultrasound could be viewed as irresponsible by some health professionals. Ethical concerns were raised regarding the possibility of pregnancy termination when fetal anomalies were detected. Fears were also expressed that prenatal diagnoses including those following ultrasound, might create a society where only perfect' children are valued. However, participants stressed that their intention in performing ultrasound was to optimize pregnancy outcome and thereby assist expectant couples and their unborn children.

    Conclusions: Midwives in Norwegian maternity care services describe obstetric ultrasound as very valuable, playing a central role in pregnancy management by optimizing pregnancy outcomes. Although high demands are placed on operators' technical skills and counseling, midwives described performing obstetric ultrasound as very satisfying work. However, midwives believed that expectant parents' approach to the ultrasound examination, both its medical value and the precious images obtained of the fetus, could put extra strain on the midwives performing ultrasounds. The potential of ultrasound to detect fetal anomalies and the possibility that this may lead to termination of pregnancy, seemed to create some ambivalent feelings in midwives towards its use.

  • 237875.
    Åhman, Annika
    et al.
    Umea Univ, Dept Clin Sci Obstet & Gynaecol, SE-90187 Umea, Sweden..
    Edvardsson, Kristina
    Umea Univ, Dept Clin Sci Obstet & Gynaecol, SE-90187 Umea, Sweden.;La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia..
    Kidanto, Hussein L.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). Minist Hlth Social Welf Gender Children & Elderly, Reproduct Maternal & Child Hlth, Dar Es Salaam, Tanzania.
    Ngarina, Matilda
    Muhimbili Natl Hosp, Dept Obstet & Gynaecol, Dar Es Salaam, Tanzania..
    Small, Rhonda
    La Trobe Univ, Judith Lumley Ctr, Melbourne, Vic, Australia..
    Mogren, Ingrid
    Umea Univ, Dept Clin Sci Obstet & Gynaecol, SE-90187 Umea, Sweden..
    'Without ultrasound you can't reach the best decision': Midwives' experiences and views of the role of ultrasound in maternity care in Dar Es Salaam, Tanzania2018In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 15, p. 28-34Article in journal (Refereed)
    Abstract [en]

    Objective: To explore Tanzanian midwives' experiences and views of the role of obstetric ultrasound in relation to clinical management of pregnancy, and in situations where maternal and fetal health interests conflict.

    Method: In 2015, five focus group discussions were conducted with midwives (N = 31) at three public referral hospitals in the Dar es Salaam region as part of the CROss Country Ultrasound Study (CROCUS).

    Results: Ultrasound was described as decisive for proper management of pregnancy complications. Midwives noted an increasing interest in ultrasound among pregnant women. However, concerns were expressed about the lack of ultrasound equipment and staff capable of skilful operation. Further, counselling regarding medical management was perceived as difficult due to low levels of education among pregnant women.

    Conclusion: Ultrasound has an important role in management of pregnancy complications. However, lack of equipment and shortage of skilled healthcare professionals seem to hamper use of obstetric ultrasound in this particular low-resource setting. Increased availability of obstetric ultrasound seems warranted, but further investments need to be balanced with advanced clinical skills' training as barriers, including power outages and lack of functioning equipment, are likely to continue to limit the provision of pregnancy ultrasound in this setting.

  • 237876.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Facts first, then reaction: expectant fathers' experiences of an ultrasound screening identifying soft markers2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, p. 60-61Article in journal (Other academic)
  • 237877.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Facts first, then reaction: Expectant fathers' experiences of an ultrasound screening identifying soft markers2012In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 5, p. E667-E675Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    expectant fathers often attend pregnancy ultrasound but their needs are poorly examined, especially in connection with adverse findings.

    OBJECTIVE:

    to explore men's expectations of routine ultrasound and experiences when soft markers were discovered.

    DESIGN/SETTING:

    a qualitative study at Uppsala University Hospital in Sweden where semi-structured, in-depth interviews were conducted with 17 expectant fathers 6-12 weeks after the discovery of a soft marker at the routine ultrasound scan.

    FINDINGS:

    five major themes emerged: (1) 'immediate reaction: frustration and thoughts about consequences', (2) 'need for facts to gain control', (3) 'concern about the partner', (4) 'in retrospect: almost okay but routines need changing' and (5) 'amniocenteses or not: a joint decision with several considerations'.

    CONCLUSIONS AND IMPLICATIONS FOR PRACTISE:

    these findings contribute important knowledge about men's needs related to pregnancy ultrasound with unexpected findings, and their role in decision-making concerning fetal diagnostics. Our results show that men enter a role of a kind of fact manager and have both a psychological need as well as the capacity to perceive important information during the process following the detection of a soft marker in the fetus. Practitioners conducting pregnancy ultrasound should therefore have relevant knowledge to be able to provide immediate information about soft markers, including risk assessment for chromosomal defects. In addition to this, written information about soft markers should be available to expecting parents in this situation.

  • 237878.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Maras, Gordan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Axelsson, Ove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Prevalence of ultrasonographic fetal soft markers during the second trimester ultrasound screening and its correlation to Down Syndrome2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, p. 60-60Article in journal (Other academic)
  • 237879. Åhman, Annika
    et al.
    Runestam, Karin
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Did I really want to know this?: Pregnant women's reaction to detection of a soft marker during ultrasound screening2010In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 81, no 1, p. 87-93Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate women's expectations of routine ultrasound and experiences when soft markers were discovered: what the disclosure meant, how it affected them, how they experienced the information given and why they did or did not choose amniocentesis. Design: Semi-structured, in-depth interviews were conducted with 11 women 25-30 weeks into the pregnancy, 7-13 weeks after the discovery of a soft marker. Findings: Women lacked knowledge about the potential of the scan and detection of soft markers created strong emotional reactions that women thought could have been alleviated by prior information about potential findings. Information in connection with the scan was perceived as insufficient. Decision about amniocentesis was affected by attitudes to disability, anxiety about fetal loss due to the procedure, need for certainty by a diagnostic test, and partner's opinion. Conclusions: Women were shocked by the unexpected and sometimes unwanted information on elevated risk for a chromosomal aberration for which they lacked any preparation. Because this event often has long-lasting effects on the pregnancy, models of information that are efficient in promoting informed decisions are imperative. Practice implications: Both women and their partners need relevant information before and in connection with ultrasound scan to be able to make informed choices.

  • 237880.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    ‘It made you think about your opinion’ -Women's perception of a web-based decision aid concerning screening for fetal anomaliesManuscript (preprint) (Other academic)
    Abstract [en]

    Background:All pregnant women in Sweden are offered amid-trimester ultrasound examination as part of antenatal care. It is free ofcharge and very few women decline. Despite efforts to provide information,research shows that women’s choice of prenatal screening is often not based oninformed decisions. Objectives:To investigate the potential of a web-baseddecision aid (DA) concerning screening for fetal anomalies to initiate aprocess of reflection and conscious decision-making in pregnant women. Methods: Theweb-based DA consisted of four modules: ‘Facts about fetal diagnostics’,‘Likelihood of anomalies’, ‘Expectant parents’ stories’, and the interactive‘Worksheets’. Seventeen women with access to the DA were interviewed, eleven who opted to usethe DA and six who did not. Data were analysed by systematic text condensation. Results: Women appreciated the decisional aid for being easilyaccessible and emphasised the importance of a reliable source. The DA helpedthem to clarify their own standpoints and engaged their partner in the decision-makingprocess. Reading the expectant parents’ stories seemed especially instrumentalin making women more aware of their own standpoint. Women described that the DAenhanced their awareness that participating in prenatal screening anddiagnostics was a conscious choice. Women who chose not to use the web-based DAwhen offered believed they already had sufficient knowledge to make a decisionabout the different tests. Conclusions: TheDA was able to initiate a process of conscious decision-making in pregnantwomen as a result of their interaction with the tool. Practical Implications: A web-based DA has low costs, is convenientlyavailable to a population with Internet access and can be used on one’s ownterms. The DAs ability to improve awareness of the need to make a consciouschoice showed that this might be a feasible tool for sharing information duringpregnancy.

  • 237881.
    Åhman, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Lindgren, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Rubertsson, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    'It made you think twice': an interview study of women's perception of a web-based decision aid concerning screening and diagnostic testing for fetal anomalies2016In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, article id 267Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Enabling women to make informed decisions is a key objective in the guidelines governing prenatal screening and diagnostics. Despite efforts to provide information, research shows that women's choice of prenatal screening is often not based on informed decisions. The aim of this study was to investigate pregnant women's perceptions of the use of an interactive web-based DA, developed to initiate a process of reflection and deliberate decision-making concerning screening and testing for fetal anomalies.

    METHODS:

    A qualitative study was applied and individual interviews were conducted. Seventeen pregnant women attending antenatal healthcare in Uppsala County, Sweden, who had access to the decision aid were interviewed. Eleven opted to use the decision aid and six did not. Data were analysed by systematic text condensation.

    RESULTS:

    Women appreciated the decision aid, as it was easily accessible; moreover, they emphasised the importance of a reliable source. It helped them to clarify their own standpoints and engaged their partner in the decision-making process. Women described the decision aid as enhancing their awareness that participating in prenatal screening and diagnostics was a conscious choice. Those who chose not to use the web-based decision aid when offered reported that they already had sufficient knowledge.

    CONCLUSIONS:

    The decision aid was able to initiate a process of deliberate decision-making in pregnant women as a result of their interaction with the tool. Access to a web-based decision aid tool can be valuable to expectant parents in making quality decisions regarding screening for fetal anomalies.

  • 237882.
    Åhman, Bertil
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Swedish Institute of Mission Research. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, Church and Mission studies, Science of Mission.
    Daniel Ndoundou: Väckelseledare i den Evangeliska Kyrkan i Kongo2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Daniel Ndoundou (1911 – 1986) was born in the southern part of French Equatorial Africa, close to the border of the Belgian Congo. At an early age he joined the Swe-dish protestant mission. As a young man he began to work as an evangelist and in 1946 he was ordained pastor. The following year a spiritual revival started and soon Daniel Ndou¬ndou became its leader, a position he held for the rest of his life.

    The aim of this thesis was to describe and analyse how Daniel Ndoundou carried out his ministry as a revival leader in the intersection between traditional beliefs and the new religion introduced by the protestant missionaries. He experienced the pro-cess of his country gaining its independence and the founding of the autonomous Evangelical Church of Congo. As a well-known counsellor and healer he received many pilgrims at his home. During revival meetings he sometimes preached to thou-sands of people. He had to take a stand on different movements of political and religious character that emerged especially during the colonial era.

    The thesis shows that the doctrines adopted by Daniel Ndoundou were close to those of the missionaries. However, he sometimes accepted and applied practices that were seen as controversial by his Church leaders. This was particularly evident when he invited people to the “Pool of Siloam” where he organized ritual baths for healing. The thesis also describes the legacy left by Daniel Ndoundou namely how the Evangelical Church of Congo manages the revival almost 30 years after his death. Many charismatic Christians play an important role and for the local pastor they are sometimes difficult to handle. The void left by Daniel Ndoundou is strongly felt by many church members since he was seen as the authority in matters relating to spiritual gifts.

  • 237883.
    Åhman, Bertil
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Theology, Department of Theology, Church and Mission studies, Science of Mission.
    Åhman, Birgitta (Translator)
    Pasteur Daniel Ndoundou: Dirigeant de réveil dans l’Église Évangélique du Congo2016Book (Other academic)
    Abstract [fr]

    Le pasteur Daniel Ndoundou (1911-1986), de nationalité congolaise, a d’abord servi dans la Mission Évangélique Suédoise, ensuite dans l’Église Évangélique du Congo. Quand un réveil spirituel éclate en 1947, pasteur Ndoundou devient son dirigeant et son encadreur, un engagement qui fut le sien jusqu’à sa mort.

    Dans cet ouvrage, qui est la traduction d’une thèse de doctorat présentée à l’Université d’Uppsala, Suède, l’auteur décrit le rôle de ce dirigeant du Réveil, un réveil qui avait plusieurs aspects caractéristiques. La culture traditionnelle a marqué en grande partie ce Réveil, comme on pouvait le voir dans la liturgie, notamment dans les cantiques et l’utilisation des instruments de musique. Pour le dirigeant du Réveil, il fut toujours important de déterminer ce qui, dans les traditions et croyances traditionnelles, pouvait être accepté dans le Réveil et dans la vie de l’Église.

    L’auteur de cette thèse, de nationalité suédoise, a vécu plusieurs années dans les deux républiques Congo, et veut, à travers cette biographie, donner sa contribution à la documentation d’une époque passionnante de l’histoire de l’Église.

  • 237884.
    Åhman, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    Lundberg, Fredrik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    The effect of firm characteristics on disclosures: A Swedish context2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The aim of this thesis is to examine the quality of the disclosure IAS 1 Presentation of Financial Statements, paragraphs 122 and 125 in the annual reports of Swedish publicly listed firms. These paragraphs state that firms are required to disclose judgments made by management in preparing financial statements that may have significant impact on the recognized carrying amount. These paragraphs should also include information about major sources of estimation uncertainty.

    A quantitative research approach is used and the sample consists of 1,519 annual reports over a 7-year period. We construct a disclosure index to assess the quality of the disclosures in Critical judgements and key sources of estimation uncertainty (IAS 1:122 and 1:125) note and categorize the annual reports into four index groups. Additionally, the number of headlines in the note are counted and sorted into three other groups, creating a headline index. Lastly, we multiply the disclosure index with the headline index to get a score, which then enable us to distinguish and rank the quality of disclosure between firms. Further, we count the number of words in each individual disclosure in each annual report. This additional quantitative data enable regression analyses, further ensuring objectivity in assessing the disclosure quality.

    Agency theory and political cost theory are used as base for determining which firm characteristics may affect disclosure quality. We examine the firm characteristics firm visibility, ownership concentration and leverage to investigate any relationship with disclosure quality. We use the ordinary least squares (OLS) regression method to analyse this data. The analysis shows that firm visibility and leverage have positive relationships with disclosure quality. This supports the political cost theory and suggests that firms that are more visible have stronger incentives to attain a high disclosure quality. Our findings also support debt-associated agency problems and are also in line with prior studies that found a positive relationship between disclosure quality and the degree of leverage, which indicates that disclosures reduces the information gap. 

  • 237885.
    Åhman, Emmy
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Nilsson, Ida
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Samtal med vårdpersonal gällande barns övervikt: -Ett föräldraperspektiv2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight among children in Sweden increases, this trend needs to change. Health care professionals find it difficult to talk about the subject with parents.

    Aim: Increase the understanding of parents’ perspective on conversations with health care professionals regarding their child’s overweight and identify barriers in communication.

    Methods: General literature review.

    Result: Four categories and 11 subcategories have emerged. Parents consider the relationship with health care professionals to be important. Certain choices of words should be avoided and parents should be treated with respect and not guilt. Family-centered care is preferred. Parents may have another approach to what’s most motivating to make a change in their lifestyle. One area that divides the group of parents’ is whether or not the child should be present during the meeting about overweight. The cause of this is fear that the child should be harmed. Counseling given today is generally criticized. Parents concearns about the childs overweight should be taken seriously. Barriers such as ignorance, lack of time, overweight in parents, unawareness of parents and cultural differences have been identified.

    Conclusion: Overweight should be treated as any other health condition. Family-centered care is preffered where the whole family is involved. The family should be treated with respect and not be subject to guilt. Knowledge and motivation for change can be improved by health care professionals. Do not neglect concerns about overweight. Barriers in this area require consideration from the health care professionals.

  • 237886.
    Åhman, Frida
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    Kans, Maria
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    Stockholms Stadsmissions förtroendekrisfrån: medias kelgris till svin2007Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Problem: Stockholms Stadsmission anklagades av Uppdrag granskning i december, 2003 för att ge extravaganta förmåner till organisationens direktor (VD) och oegentligheter med lägenheter. Den ideella organisationen fick utstå hård kritik i media och av allmänheten då de inte lyckades leva upp till de förväntningar som ställts på organisationen.

    Syfte: Uppsatsen syftar till att beskriva den förtroendekris som drabbade Stockholms Stadsmissionens 2003 utifrån de olika aktörernas subjektiva bild av krisförloppet. Vi har avgränsat oss till att endast fokusera på den förtroendekris som drabbade Stadsmissionen 2003 och då specifikt Stockholms Stadsmission.

    Teori och modell: Vi har använt oss av teori som behandlar förtroendekriser, krishantering och kriskommunikation.

    Metod: Uppsatsen är baserad på en kvalitativ studie. Vår empiri består av 4 personliga intervjuer och 2 telefonintervjuer.

    Resultat: Våra resultat visar att Stockholms Stadsmission hanterade krisen på ett felaktigt sätt. De borde ha varit mer öppna och tagit mer initiativ. Organisationen visar ingen ödmjukhet för det inträffade och förringar sin skuld. Samtidigt beskyller de Uppdrag granskning för att ha vinklat programmet. Stockholms Stadsmission gjorde inte kopplingen mellan sig själv som ideell organisation och de förmåner som chefen hade.

  • 237887.
    Åhman, Hanna Bozkurt
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Giedraitis, Vilmantas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Cedervall, Ylva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Lennhed, Bjorn
    Falu Lasarett, Dept Geriatr & Rehabil Med, Falun, Sweden.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    McKee, Kevin
    Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Kilander, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Uppsala Univ, Dept Publ Hlth & Caring Sci, Box 564, SE-75122 Uppsala, Sweden.
    Rosendahl, Erik
    Umea Univ, Dept Community Med & Rehabil, Umea, Sweden.
    Ingelsson, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Uppsala Univ, Dept Publ Hlth & Caring Sci, Box 564, SE-75122 Uppsala, Sweden.
    Åberg, Anna Cristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden.
    Dual-Task Performance and Neurodegeneration: Correlations Between Timed Up-and-Go Dual-Task Test Outcomes and Alzheimer's Disease Cerebrospinal Fluid Biomarkers2019In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, p. S75-S83Article in journal (Refereed)
    Abstract [en]

    Background: Tools to identify individuals at preclinical stages of dementia disorders are needed to enable early interventions. Alterations in dual-task performance have been detected early in progressive neurodegenerative disorders. Hence, dual-task testing may have the potential to screen for cognitive impairment caused by neurodegeneration. Exploring correlations between dual-task performance and biomarkers of neurodegeneration is therefore of interest. Objective: To investigate correlations between Timed Up-and-Go dual-task (TUGdt) outcomes and Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-beta 42 (A beta(42)), total tau (t-tau), and phosphorylated tau (p-tau). Methods: This cross-sectional cohort study included 90 participants (age range 49-84 years) undergoing memory assessment, who were subsequently diagnosed with AD, other dementia disorders, mild cognitive impairment, or subjective cognitive impairment. TUG combined with "Naming Animals" (TUGdt NA) and "Months Backwards" (TUGdt MB), respectively, were used to assess dual-task performance. The number of correct words and time taken to complete the tests were measured. The CSF biomarkers were analysed by ELISA. Spearman's rank correlation was used for analyses between TUGdt outcomes (TUGdt NA and TUGdt MB), and CSF biomarkers, adjusted for age, gender, and educational level. Results: The number of correct words, as well as the number of correct words/10 s during TUGdt NA correlated negatively to CSF t-tau and p-tau. No correlations were found between any time scores and CSF biomarkers. Conclusion: The correlations between TUGdt NA and t-tau and p-tau may indicate that neurodegeneration affects dual-task performance. Longitudinal studies are needed to further explore dual-task testing in screening for cognitive impairment due to neurodegeneration.

  • 237888.
    Åhman, Hannah Bartonek
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Languages, Department of Linguistics and Philology.
    The Hero and the Law: A Study of Silius Italicus' Punica2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This study of Silius Italicus’ Punica is executed by means of the analytical tools provided in Hegel’s Aesthetics together with the Weberian concept of the Idealtypus. The Punica and in particular a group of its protagonists are examined in relation to the “Hegelian Idealtypus of epic”, in order to identify the driving forces in the narrative and the pivotal conflict of the poem.

    I argue that although the Punica displays numerous traditional epic features regarding formal criteria and subject matter, its historical situation must be taken into consideration as well as its text-internal qualities. Accordingly, the Punica must be considered a Kunstepos.

    Furthermore, in the frequent occurrences of conflict and disintegration within the epicizing narrative, the poetic principle of drama emerges. This quality is shared by Livy’s reflective and pragmatical history. The dramatic principle, however, is not allowed its full realization. The narrating subject of the Punica appropriates the space of the objective narrator of the ideal-typical epic, but is substantially the counterpart to historiography’s ideological epitomator. The narrating subject’s point of view is closely connected to the notions of Roman fides, ius and mos, which are construed as opposites to Carthaginian unpredictability and primitivism. However, several of the central Roman protagonists also have problematic relationships to these notions and fail to comply with the expectations imposed on them as state officials. Above all, this becomes obvious through their defeat and death.

    Hence, the pivotal conflict of the Punica is the struggle to yoke together epic heroism and historically oriented rationality. The parties of the conflict can be expressed as “the law”, as a metonym for the ideological demands of the Roman state, and “the hero” embodied by the generals that fight and die, but without recognition.

    In four close readings, the characters Gracchus, Flaminius, Paulus and Marcellus are studied. They express in different ways the incompatibility between the heroic inner driving forces and the demands of usefulness and rationality associated with the Roman state.

  • 237889.
    Åhman, Henrik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Informatics and Media.
    Conceptualizing the self: A critical analysis of the self as a discursive trend in Human-Computer Interaction research2017In: Human Technology, ISSN 1795-6889, E-ISSN 1795-6889, Vol. 13, no 2, p. 149-179Article in journal (Refereed)
    Abstract [en]

    In Human–Computer Interaction (HCI), the human often has been conceptualized as a user. Although this notion has illuminated one aspect of the human–technology relationship, some researchers have argued for the need to explore alternative notions. One such notion becoming increasingly frequent in HCI is the self. In this paper, a study of how the self is described in 88 HCI research publications is presented. Four main aspects of the self are identified: instrumental, communicative, emotional, and playful. These four aspects differ, yet they present the self as stable, coherent, and individual. However, these characteristics have been criticized by several contemporary philosophers. This paper presents arguments from poststructuralist writers as a foundation for advocating the need to develop further these positions within HCI. The theories of Mark C. Taylor, who combines poststructuralism with complexity theory, provide a framework for viewing the self as relational to the extent that interaction becomes an existential process and thus interactive technology constitutes an existential arena.

  • 237890.
    Åhman, Henrik
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Informatics and Media, Human-Computer Interaction.
    Hedman, Anders
    KTH Royal Institute of Technology.
    Frameworks for studying social media interaction: A discussion on phenomenology and poststructuralism2019In: Human-Computer Interaction – INTERACT 2019 / [ed] David Lamas, Fernando Loizides, Lennart Nacke, Helen Petrie, Marco Winckler, Panayiotis Zaphiris, Cham, Switzerland, 2019, Vol. 3, p. 701-718Conference paper (Refereed)
    Abstract [en]

    During the past decade or so, much HCI research has, according to many researchers, become increasingly phenomenologically oriented. Some have gone so far as to argue that HCI is now in a phenomenological paradigm. But how does such a paradigmatic view work for understanding interaction in the ever growing sphere of social media? Prima facie it may look as it would work only well since social media has become increasingly richer in terms of the sheer range of phenomenologically possible user experiences provided by new and emerging interaction technologies. However, through a critical reading of three major phenomenological works in HCI, we argue that phenomenology as traditionally applied in HCI points indirectly to alternative approaches for engaging in much of contemporary social media research due to its associated semiotic and relationally oriented contents. One possible family of approaches for analyzing such content can be found, as we will argue, in poststructuralist theory. We propose an increased engagement with poststructuralist semiotics grounded in Jacques Derrida’s philosophy and exemplify how this could contribute to the study of social media in the context of HCI.

  • 237891.
    Åhman, Ingrid
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Law, Department of Law.
    Ne bis in idem i konkurrensrätten: Överensstämmer EU-domstolens tolkning av idem-begreppet i konkurrenssituationer med Europakonventionen och EU:s stadga?2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 237892.
    Åhman, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Läkemedelsgenomgångar av apotekare vid vårdcentral - förbättras kvaliteten på de äldres läkemedelsbehandling?2014Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Polyfarmaci tillsammans med åldersrelaterade fysiologiska förändringar ger en ökad risk för läkemedelsrelaterade problem hos äldre. Under hösten 2012 startades i landstinget i Uppsala län ett projekt med apotekare baserad på vårdcentral för att i nära samarbete med läkarna genomföra fördjupade läkemedelsgenomgångar (LMG) för äldre.

    Syfte: Att utvärdera effekten av apotekare vid vårdcentral genom att undersöka och jämföra kvaliteten på patienternas läkemedelsbehandling före och efter de fördjupade LMG.

    Metoder och material: Antalet ”Potentially Inappropriate Medications” (PIMs) identifierade av STOPP, ”Potential Prescription Omissions” (PPOs) identifierade av START, olämpliga, antipsykotiska och antiinflammatoriska läkemedel enligt 2013 års indikatorer av regeringen och Sveriges Kommuner och Landsting (SKL) samt D-interaktioner undersöktes före och efter LMG. Antalet läkemedel, som efter förslag av apotekare, sattes ut p.g.a. avsaknad av indikation eller behov undersöktes också.

    Resultat: Totalt 83 patienter med en medelålder på 81 år och i genomsnitt 10,4 läkemedel inkluderades. Statistiskt signifikanta reduceringar, per patient, kunde ses för PIMs (0,72 vs. 0,43, p<0,001), ”olämpliga läkemedel” (0,26 vs. 0,16, p<0,01), ”antiinflammatoriska läkemedel” (0,10 vs. 0,06, p<0,05) samt D-interaktioner (0,07 vs. 0,02, p<0,05). Reduceringar, men ej statistiskt signifikanta, kunde ses för PPOs (0,47 vs. 0,42, p>0,05) och ”antipsykotiska läkemedel” (0,23 vs. 0,18, p>0,05). 0,4 läkemedel per patient sattes ut p.g.a. avsaknad av indikation eller behov.

    Konklusion: Kvaliteten på patienternas läkemedelsbehandling förbättrades efter LMG av apotekare. Signifikanta förbättringar sågs vid mätning med STOPP, regeringens och SKL:s indikatorer ”olämpliga läkemedel” och ”antiinflammatoriska läkemedel” samt D-interaktioner.