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  • 251.
    Johansson, Angelica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Behovet av en strategisk behörighetsstyrning för att skydda patientens integritet: En kvalitativ beskrivande innehållsanalys av regionernas styrande dokument för elektronisk åtkomst till patientuppgifter2021Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Vid upprepade tillfällen har Integritetsskyddsmyndighetens tillsyn funnit brister i vårdgivares efterlevnad av juridiska krav som avser dokumenterad behörighets-styrning och behörighetsgrundande behovs- och riskanalys. Dessutom har tillsyn identifierat fall där hälso- och sjukvårdspersonal haft mer behörigheter än vad arbetsuppgiften kräver, vilket medför att patienter saknar det integritetsskydd de har rätt till. Bristerna kan tyda på en osäkerhet hos vårdgivare avseende hur dessa juridiska krav bör tillämpas i praktiken. Därför är studiens syfte att sammanfatta hur regionerna beskriver tillåten åtkomst till patientuppgifter och behörighetsgrundande behovs- och riskanalys i sina styrande dokument. Studien ska dessutom lyfta fram förslag på hur en behörighetsgrundande behovs- och riskanalys kan genomföras och dokumenteras.

    Arbetet har bedrivits som en deskriptiv kvalitativ studie med en induktiv ansats, vilken utifrån empiririska data ska besvara studiens frågeställningar. De empiriska data som insamlats avser textuella data i form av styrande dokument som erhållit från 17 av de 21 regionerna genom begäran om allmän handling. För dataanalys av dessa styrande dokument har en konventionell innehållsanalys valt som metod, som på manifest nivå sammanställt innehållet i dessa styrande dokument. Resultatet diskuteras därefter utifrån Integritetsskyddsmyndighetens vägledning samt Da Veiga och Eloffs ramverk för styrning av informationssäkerhet.

    Resultatet visar både likheter och skillnader i regionernas styrande dokument, exempelvis återfinns beskrivning om tillåten och otillåten åtkomst till patient-uppgifter hos samtliga regioner. Den största likheten avser dock beskrivning av verksamhetschefens ansvar för medarbetarnas behörigheter samt behovs- och riskanalys, där det sista skiljer sig markant från Integritetsskyddsmyndighetens vägledning vilken anger att behovs- och riskanalys ska ske på en strategisk nivå. Resultatet visar dessutom att det inte finns någon generell metod hos regionerna som kan rekommenderas för genomförande och dokumentation av den behörighets-grundande behovs- och riskanalysen. Däremot kan Integritetsskyddsmyndighetens vägledning utgöra ett stöd vid genomförandet av en strategisk behovs- och riskanalys.

    Slutsatsen är att en behörighetspolicy, tillsammans med en strategisk behovs- och riskanalys, skulle kunna ge stöd vid utformning av en ändamålsenlig och enhetlig behörighetsstruktur. Dessutom kan behörighetspolicyn, tillsammans med resultatet av den strategiska behovs- och riskanalysen, kunna utgöra underlag för krav vid upphandling, utveckling och anpassning av vårdinformationssystem. Genom att kombinera behörighetspolicy och en strategisk analys skulle vårdgivaren kunna uppnå en behovs- och riskbaserad behörighetsstyrning som i slutänden leder till trygghet för patienten utifrån både ett patientsäkerhets- och integritetsperspektiv. 

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  • 252.
    Johansson Hultman, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sjuksköterskors upplevelser av vårdinformationssystem och vårddokumentation: En kvalitativ intervjustudie om utmaningar och möjligheter2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Currently in Sweden, there are a number of ongoing extensive projects aiming towards development and adoption of futures’ health information technology (HIT). These systems are formed to make the processes and IT environment of health care more effective. Electronic health records are the most used type of health information technology. Other examples are systems for laboratory testing, patient administration and prescription of medications. Even though HIT has proven to contribute to effectiveness and quality of care, the implementations of such systems has a history of failing. According to the Technology, People, Organizations and Macroenvironmental factors framework (TPOM), a number of dimensions has an impact to determine the success of HIT implementation. 

    Nurses are the largest group of registered health care practitioners in Sweden. Nursing care include caring for the individual in whole, which leads to nurses extensive, and frequent use of HIT. To contribute to successful development, implementation and continuous management of HIT, nurses’ experiences of challenges and possibilities in HIT and documentation must be described further. 

    Aim: This study aims to describe nurses’ experiences of challenges and possibilities in Health information technology and documentation in the perspective of Technology, People, Organizations and Macroenvironmental factors. 

    Method: Qualitative, semistructured interviews was conducted with ten registered nurses coming from different types of care. Data was analyzed based on deductive approached qualitative content analysis, using the TPOM framework. 

    Results: Challenges and possibilites within technology, people, organizations and macroenvironmental domains were identified and described. A total of ten subcategories were identified. The respondendts experienced similar challenges and possibilites, regardless of workplace and health information technology. This implicates that the result of this study might be considered in development, implementation and management of HIT. 

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  • 253.
    Johansson, Linus
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Kontaktlinsbärandets effekt och inverkan på tårosmolariteten2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka hur kontaktlinsanvändande påverkar tårosmolariteten. Men även se om det skiljer sig mellan höger- och vänster öga samt mellan män och kvinnor.

    Metod: Innan mätningarna genomfördes en urvalsprocess där de som uppfyllde ålders-kraven fick svara på TERTC-DEQ, symptomenkät för ögontorrhet. Totalt deltog 30 personer i studien (8 män och 22 kvinnor i åldrarna 19-34 år, med en snittålder på 22,9 +/-3). Sammanlagt genomfördes fyra stycken mätningar vid två olika tillfällen, två på höger och två på vänster öga. Proven på tårfilmen gjordes lateralt i tårmenisken ovanför den nedre ögonlockskanten.

    Resultat: Ett t-test gjordes för att utvärdera huruvida osmolaritetsvärdet förändrades med och utan kontaktlinser för både höger- (OD) och vänster öga (OS). Det fanns ingen signifikant statistisk skillnad mellan värdena för varken OD (P=0,2) eller OS (P=0,12). Ingen korrelationen åt vilken riktning osmolariteten förändrades kunde inte heller ses. OD och OS jämfördes och ingen statistisk skillnad fanns, ytterligare jämfördes könen och inte heller här kunde någon signifikant statistisk skillnad ses, varken med (P=0,66) eller utan kontaktlinser (P=0,33).

    Slutsats: Det Finns inget statistisk signifikant samband mellan ett förändrat osmolaritetsvärde och normalt kontaktlinsbärande, dvs. kontaktlinser påverkar inte osmolariteten i tårfilmen. Inte heller ses det någon skillnad mellan höger- och vänster öga. Vidare framkommer det i studien att det inte finns någon skillnad mellan män och kvinnor.

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  • 254.
    Johansson, Maja
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Komfortskillnad mellan sfäriska och asfäriska stabila linser vid initial tillpassning2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att jämföra den initiala komforten mellan sfäriska och asfäriska stabila linser då uppfattningen har varit att asfäriska linser (med sin mer följsamma passform) borde vara bekvämare.

    Metoder: Studien omfattade 30 deltagare med en medelålder på 26 år. Med hjälp av topografens (Topcon CA-100) kontaktlinstillpassningsprogramvara valdes en sfärisk A- design lins (från Nordiska Lins) och en asfärisk A90 lins (från Expert Optik, Sverige) ut med passande parametrar. Linserna sattes i vardera öga utan att försökspersonen visste vilken lins som var vilken. Efter 5 respektive 15 minuter fick patienten, med hjälp av en modifierad VAS-skala, avgöra hur linserna kändes både i höger och vänster öga.

    Resultat: Ingen signifikant skillnad i komforten mellan de asfäriska och sfäriska linserna varken observerades efter 5 (p=0,78) eller 15 (p=0,84) minuter. Överlag ökade komforten både för de asfäriska och för de sfäriska linserna efter att de suttit i en stund; komforten ökade med 0,9 enheter för de asfäriska respektive 1,1 enheter för de sfäriska linserna mellan 5 och 15 minuters bärtid. Det fanns en signifikant skillnad i komfort för den enskilda asfäriska linsen mellan första och andra graderingstillfället (p=0,015) och samma gällde de sfäriska (p=0,0001).

    Slutsats: Resultatet visar ingen markant skillnad i initial komfort på stabila linser med dessa olika typer av designer; en multikurvig asfärisk samt en trekurvig sfärisk lins. Med detta i åtanke behöver man inte, ur ett komfortmässigt perspektiv, ta hänsyn till den specifika designen vid tillpassning med moderna stabila linser. 

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    Komfortskillnad mellan sfäriska och asfäriska stabila linser vid initial tillpassning
  • 255.
    Johansson, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Svedlund, Angelica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    En longitudinell studie med OCTA på strukturella och funktionella förändringar i centrala retina hos barn2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 256.
    Johansson, Oskar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalence and explanatory factors of digital eye strain in Sweden2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 257.
    Johansson, Oskar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Gierow, Peter
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Morgan, Philip
    University of Manchester, UK.
    Trends in Swedish Contact Lens Prescribing 20172019Conference paper (Other academic)
    Abstract [en]

    Poster display 2: TRENDS IN SWEDISH CONTACT LENS PRESCRIBING 2017

    Presenter: Oskar Johansson

    Authors: OSKAR JOHANSSON1 , PHILP MORGAN2 , PETER GIEROW1

    Affiliation:1) Linnaeus University 2) University of Manchester

    Key words: Contact lens, fitting, lens type

    Purpose: The purpose was to evaluate the trends of contact lens prescribing among Swedish optometrists in 2017.

    Methods: A standardized survey form developed by Morgan er al. was distributed to Swedish optometrists usingtheir professional organizations, optometry chains, direct email, and by hand directly. They were asked to fill out theform for the next ten contact lens patients after receiving the survey. Information was collected regarding the dayof fitting, age, sex, lens material, design, frequency of replacement, wear frequency, modality and type of caresystem. A weighting system is employed to account for the volume of activity undertaken by the respondents,calculated by the time period required to achieve 10 fits. All the forms and data were analyzed at the University of Manchester.

    Results: 57 forms were returned, including 562 fits. The mean age of the patients was 37 yrs, and 65 % were female.83 % were fitted for full-time wear and 27 % were managed as new fits. Soft contact lenses is the most fitted modalityand represents 97.8 % of all new fits and 93.6 % of all refits. Rigid contact lens fits represents therefore in grand total5.3 % with 2.2 % of the new fits and 6.4 % of the refits. About two-thirds of soft lenses prescribed were siliconehydrogels. Of the different designs, spherical lenses were most widely fitted, with toric lenses on at least one eyecoming right after. Extended wear accounts for 10.6 % of the fittings. Multi-purpose solutions were the most popularregimen prescribed at 99.4 %.

    Conclusions: When compared with data from Norway and Denmark, it is evident that daily disposables are morepopular in these countries (74 %), whereas in Sweden it is monthly replacements (58 %). Otherwise, the results aresimilar to what has been reported from other parts of the world.

  • 258.
    Johansson, Oskar
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Morgan, Philip
    University of Manchester, UK.
    Gierow, Peter
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Trends in Swedish Contact Lens Prescribing 20172019In: Scandinavian Journal of Optometry and Visual Science, ISSN 1891-0882, E-ISSN 1891-0890, Vol. 12, no 1, p. 5-7Article in journal (Other academic)
    Abstract [en]

    Background: The purpose was to evaluate the trends of contact lens prescribing among Swedish optometrists in 2017.

    Materials and Methods: A standardized survey form was distributed to Swedish optometrists using their professional organisations, optometry chains, direct email, and by hand directly. They were asked to fill out the form for the ten contact lens fits performed after receipt of the survey form. Information was collected regarding age and sex of patient, fit/refit, lens design and material, modality and solution prescribed.

    Results: 57 forms were returned detailing 562 fits. The mean age of the patients was 37 yrs, and 65 % were female. 83 % were fitted for full-time wear and 27 % were managed as new fits. 94.7 % were soft contact lens fits and silicone hydrogel was the dominating material.

    Conclusions: When compared with data from Norway and Denmark, it is evident that daily disposables are more popular in these countries (74 %), whereas in Sweden it is monthly replacements (58 %). Otherwise, the results are similar to what has been reported from other parts of the world.

  • 259.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Nationellt kompetenscentrum anhöriga.
    Brolin, Rosita
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Magnusson, Lennart
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Nationellt kompetenscentrum anhöriga.
    Hanson, Elizabeth
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Nationellt kompetenscentrum anhöriga.
    Barn som anhöriga och unga omsorgsgivare2023In: Stora anhörigboken / [ed] Gunilla Klingberg, Ulrika Hallberg, Lund: Studentlitteratur AB, 2023, p. 67-105Chapter in book (Other (popular science, discussion, etc.))
  • 260.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Nursing students' experience of using a personal digital assistant (PDA) in clinical practice: an intervention study2013In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 33, no 10, p. 1246-1251Article in journal (Refereed)
    Abstract [en]

    Background

    A personal digital assistant (PDA) is a multifunctional information and communication tool allowing nursing students to keep up to date with expanding health related knowledge.

    Objectives

    This study was aimed at exploring nursing students' experience of using a PDA in clinical practice.

    Method

    In this intervention study, nursing students (n=67) used PDAs during a period of 15weeks, replied to questionnaires, and participated in focus group interviews.

    Results

    The PDA was found to support nursing students in clinical practice and to have the potential to be a useful tool with benefits for both the patients and for the students. The PDA was regarded as useful, and was presumed to imply increased confidence and time savings, and contribute to improved patient safety and quality of care.

    Conclusions

    With available mobile technology, nursing students would be able to access necessary information, independent of time and place. Therefore, it is important that stakeholders and educators facilitate the use of PDAs to support nursing students during their clinical practice, in order to prepare them for their future work, and to continuously improve the safety and quality of healthcare.

  • 261.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Saveman, Britt-Inger
    Umeå universitet.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Using advanced mobile devices in nursing practice - the views of nurses and nursing students2014In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 20, no 3, p. 220-231Article in journal (Refereed)
    Abstract [en]

    Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses’ and nursing students’ views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.

  • 262.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Swedish Family Care Competence Centre, Sweden.
    Sennemark, Eva
    Swedish Family Care Competence Centre, Sweden.
    Magnusson, Lennart
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Swedish Family Care Competence Centre, Sweden.
    Hanson, Elizabeth
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Swedish Family Care Competence Centre, Sweden.
    Konsekvenser av Covid-19-pandemin för barn som anhöriga och unga omsorgsgivare2021Report (Other academic)
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  • 263.
    Johansson, Pauline
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Wilde Björling, Camilla
    Kalmar County Council, Sweden.
    Axelsson, Clara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Östlund, Martin
    Linnaeus University, Faculty of Technology, Department of computer science and media technology (CM), Department of Media Technology.
    Widell, Ingela
    Kalmar County Council, Sweden.
    Jonsson, Stefan
    Kalmar County Council, Sweden.
    Tablet computers as a mean to strengthen patients undergoing radiotherapy2015In: Presented at the 6th International Carers Conference - Care and caring: future proofing the new demographics, Gothenburg, Sweden, September 3-6, 2015, 2015Conference paper (Refereed)
  • 264.
    Johansson Östbring, Malin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar County, Sweden.
    Pharmaceutical care in coronary heart disease2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: In coronary heart disease (CHD), pharmaceutical care implies that health care professionals cooperate with the patient to optimize drug therapy primarily for secondary prevention. Low adherence and discontinuation of drugs are common among patients with CHD, and this is associated with increased morbidity and mortality. The achievement of guidelines-recommended treatment goals for risk factors is disappointingly low in secondary prevention.

    Aim: To study clinical and patient related aspects of pharmaceutical care for secondary prevention in patients with CHD.

    Method: A pharmacist used medication review and motivational interviewing to impact patients’ beliefs about medicines and adherence in a pilot study. This intervention was further developed and tested in a randomized controlled trial (RCT) in 316 patients with verified CHD who were planned for follow-up at the cardiology clinic in Kalmar. The primary study outcome was the proportion ofpatients who reached the treatment goal for low-density lipoprotein (LDL)cholesterol. Patients’ adherence to cholesterol-lowering drugs according to a combination of refilled prescriptions and self-report was the key secondary outcome. In the RCT, pharmacists individualized both the dose and the content of thesupport based on the patient’s need. A process evaluation was planned alongside the trial to investigate implementation and mechanisms of impact such as pharmacists’ actions and effects on patients’ medication beliefs. In a separate qualitative study, we interviewed patients with CHD who had used their medicines for at least 12 months.

    Results: At 15 months follow-up of the RCT, the primary outcome measure did not differ between groups. The intervention improved patient adherence to cholesterol-lowering medicines; 88% vs 77% of the patients were adherent, possibly because the intervention lowered patients’ concerns about medicines. In 84% of the intervention patients at least one actual drug-related problem (DRP) was identified, and for 90% of those DRPs actions were taken to resolve the problems. Analyses of the interviews with patients revealed that patients´ experiences with medicines varied greatly - from trivial to troublesome – and these were classified into one of seven categories: a sense of security, unproblematic, learning to live with it, taking responsibility for it, somewhat uncertain, troublesome, or distressing.

    Conclusion: Pharmaceutical care improved the patients’ use of medicines in CHD but did not increase treatment goal achievement for LDL-cholesterol. Overall, the findings of this thesis emphasize that when support in managing medications is offered to patients, it should encompass various aspects of medicine-taking: safety, knowledge, beliefs, practical handling, impact on day-to-day life, and the patient’s medication experience.

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    Doctoral Dissertation (Comprehensive summary)
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    Errata
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    Front page
  • 265.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Eriksson, T.
    Lund Univ.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Patient-centered medication review in coronary heart disease: impact on beliefs about medicines2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, p. S15-S15Article in journal (Other academic)
  • 266.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar County, Sweden.
    Eriksson, Tommy
    Malmö University, Sweden.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kalmar County, Sweden.
    Effects of a pharmaceutical care intervention on clinical outcomes and patient adherence in coronary heart disease - the MIMeRiC randomized controlled trial2021In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 21, no 1, article id 367Article in journal (Refereed)
    Abstract [en]

    Background: In the treatment of coronary heart disease, secondary prevention goals are still often unmet and pooradherence to prescribed drugs has been suggested as one of the reasons. We aimed to investigate whether pharmaceutical care by a pharmacist at the cardiology clinic trained in motivational interviewing improves clinical outcomesand patient adherence.

    Methods: This was a prospective, randomized, controlled, outcomes-blinded trial designed to compare pharmaceutical care follow-up with standard care. After standard follow-up at the cardiology clinic, patients in the interventiongroup were seen by a clinical pharmacist two to fve times as required over seven months. Pharmacists were trainedto use motivational interviewing in the consultations and they tailored their support to each patient’s clinical needsand beliefs about medicines. The primary study end-point was the proportion of patients who reached the treatmentgoal for low-density lipoprotein cholesterol by 12 months after discharge. The key secondary outcome was patientadherence to lipid-lowering therapy at 15 months after discharge, and other secondary outcomes were the efectson patient adherence to other preventive drugs, systolic blood pressure, disease-specifc quality of life, and healthcareuse.

    Results: 316 patients were included. The proportion of patients who reached the target for low-density lipoproteincholesterol were 37.0% in the intervention group and 44.2% in the control group (P=.263). More intervention thancontrol patients were adherent to cholesterol-lowering drugs (88 vs 77%; P=.033) and aspirin (97 vs 91%; P=.036)but not to beta-blocking agents or renin–angiotensin–aldosterone system inhibitors.

    Conclusions: Our intervention had no positive efects on risk factors for CHD, but it increased patient adherence.Further investigation of the intervention process is needed to explore the diference in results between patient adherence and medication efects. Longer follow-up of healthcare use and mortality will determine if the increased adherence per se eventually will have a meaningful efect on patient health

  • 267.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Eriksson, Tommy
    Lund University.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Medication beliefs and self-reported adherence - results of a pharmacist’s consultation: A pilot study2014In: European Journal of Hospital Pharmacy: Science and Practice, ISSN 2047-9956, Vol. 21, no 2, p. 102-107Article in journal (Refereed)
    Abstract [en]

    ObjectivesClinical outcomes in the secondary prevention of cardiovascular disease depend on the patients’ adherence to prescribed medicines. Motivational interviewing (MI) is a patient-centered approach used to change different health behaviors. The objective of this pilot study was to explore the impact of a clinical pharmacist’s consultation on beliefs about medicines and self-reported medication adherence among patients with coronary heart disease (CHD).

    MethodsCHD-patients participating in a prevention program at the Kalmar County Hospital were randomized to control or intervention. The intervention consisted of a medication review focused on cardiovascular drugs, and a semi-structured interview based on MI-approach, with a follow-up phone call two weeks later. The intervention was conducted by a clinical pharmacist at the cardiology unit three months post-discharge.

    Primary outcome measures were the results from the Beliefs about medicines-Specific (BMQ-S) and the 8-Item Morisky Medication Adherence Scale (MMAS-8) two weeks after intervention.

    Results21 enrolled patients (11 intervention) all completed to follow-up. MMAS-8 was very similar in the intervention and control groups. In BMQ-S the intervention group had a mean (SD) necessity score of 21 (4) and a concern score of 12 (6), corresponding results in the control group were 21 (3) and 10 (5). However, since there was a difference in BMQ-S at baseline, seven intervention patients shifted towards more positive beliefs compared to two control patients.

    ConclusionNo difference was found in adherence and beliefs at follow-up. However, after consultation a larger proportion of patients changed towards more positive beliefs compared to control.

  • 268.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Council, Sweden.
    Eriksson, Tommy
    Malmö University, Sweden;Norwegian University of Sciences and Technology, Norway.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Kalmar County Council, Sweden.
    Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Intervention Development and Protocol for the Process Evaluation2018In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 7, no 1, p. 1-12, article id e21Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation.

    OBJECTIVE: This paper aims to describe how the intervention was designed and developed. The aim of the process evaluation is to better understand how and why the intervention in the MIMeRiC trial was effective or not effective.

    METHODS: The research questions for evaluating the process are based on the conceptual model of change processes assumed in the intervention and will be analyzed by qualitative and quantitative methods. Quantitative data are used to evaluate the medication review in terms of drug-related problems, to describe how patients' beliefs about medicines are affected by the intervention, and to evaluate the quality of motivational interviewing. Qualitative data will be used to analyze whether patients experienced the intervention as intended, how cardiologists experienced the collaboration and intervention, and how the intervention affected patients' overall experience of care after coronary heart disease.

    RESULTS: The development and piloting of the intervention are described in relation to the theoretical framework. Data for the process evaluation will be collected until March 2018. Some process evaluation questions will be analyzed before, and others will be analyzed after the outcomes of the MIMeRiC RCT are known.

    CONCLUSIONS: This paper describes the framework for the design of the intervention tested in the MIMeRiC trial, development of the intervention from the pilot stage to the complete trial intervention, and the framework and methods for the process evaluation. Providing the protocol of the process evaluation allows prespecification of the processes that will be evaluated, because we hypothesize that they will determine the outcomes of the MIMeRiC trial. This protocol also constitutes a contribution to the new field of process evaluations as made explicit in health services research and clinical trials of complex interventions.

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  • 269.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Council, Sweden.
    Eriksson, Tommy
    Malmö University, Sweden;Norweigan University of Sciences and Technology, Norway.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Kalmar County Council, Sweden.
    Motivational Interviewing and Medication Review in Coronary Heart Disease (MIMeRiC): Protocol for a Randomized Controlled Trial Investigating Effects on Clinical Outcomes, Adherence, and Quality of Life2018In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 7, no 2, p. 1-15, article id e57Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes.

    OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease. A protocol for the prespecified process evaluation of the trial is published separately.

    METHODS: The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a prospective, randomized, outcomes-blinded trial designed to compare individualized follow-up by a clinical pharmacist using motivational interviewing (MI) and medication review with standard follow-up. Patients were randomized to 2 groups after stratification according to their beliefs about medicines. After standard follow-up at the cardiology clinic, patients in the intervention group are seen individually by a clinical pharmacist 2 to 5 times as required over 7 months, at the clinic. The pharmacist reviews each patient's medication and uses MI to manage any problems with prescribing and adherence. The primary study outcome is the proportion of patients who have reached the treatment goal for low-density lipoprotein cholesterol by 12 months after discharge. Secondary outcomes are the effects on patient adherence, systolic blood pressure, disease-specific quality of life, and health care use.

    RESULTS: The protocol for this study was approved by the Regional Ethics Committee, Linköping, in 2013. Enrollment started in October 2013 and ended in December 2016 when 417 patients had been included. Follow-up data collection will conclude in March 2018. Publication of the primary and secondary outcome results from the MIMeRiC trial is anticipated in 2019.

    CONCLUSIONS: The MIMeRiC trial will assess the effectiveness of an intervention involving medication reviews and individualized support. The results will inform the continued development of support for this large group of patients who use preventive medicines for lifelong treatment. The design of this adherence intervention is based on a theoretical framework and is the first trial of an intervention that uses beliefs about medicines to individualize the intervention protocol.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT02102503; https://clinicaltrials.gov/ct2/show/NCT02102503 (Archived by WebCite at http://www.webcitation.org/6x7iUDohy).

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  • 270.
    Johansson Östbring, Malin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Region Kalmar county, Sweden.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Region Kalmar county, Sweden.
    Mårtensson, Jan
    Jönköping University, Sweden.
    Trivial or Troublesome: Experience with Coronary Heart Disease Medication from the Patient's Perspective2020In: Patient Preference and Adherence, E-ISSN 1177-889X, Vol. 14, p. 411-424Article in journal (Refereed)
    Abstract [en]

    Background: Living with coronary heart disease (CHD) usually means being prescribed several medications to help prevent new cardiac events. Using medicines for long-term conditions impacts on day-to-day life, and coping with medicines can be burdensome and can affect the quality of life. To enable better support of these patients, we need to understand their collective medicine-related experience. Purpose: The purpose of this study was to describe patients' medicine-related experience 1 year after the diagnosis of CHD. Patients and Methods: A qualitative, descriptive study using semi-structured interviews was conducted in 19 patients in their homes or at Linnaeus University, Sweden. Interviews were recorded and transcribed verbatim. Qualitative content analysis with an inductive approach was used. Results: Patients' experiences with using their medicines after diagnosis of CHD differed considerably. Some patients found handling the medicines and administering their treatment very easy, natural and straightforward, while others found that it was distressing or trouble-some, and influenced their lives extensively. There was a varied sense of personal responsibility about the treatment and use of medicines. The patients' experiences were classified into one of seven categories: a sense of security, unproblematic, learning to live with it, taking responsibility for it, somewhat uncertain, troublesome, or distressing. Participants in the study who expressed an unproblematic view of medicine taking also often revealed that they had dilemmas or uncertainties. Conclusion: Patients' medicine-related experiences after CHD vary greatly. The findings of this study highlight a need for more individualized support for patients using medicines for secondary prevention. The patients often needed better dialogue with healthcare providers to optimally manage their medicines. Medicine-related support for these patients should encompass various aspects of medicine-taking.

  • 271.
    Jokela, Päivi
    et al.
    Linnaeus University, Faculty of Technology, Department of Informatics.
    Nilsson, Anna-Lena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Rahman Jabin, MD Shafiqur
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Testbäddar inom hälso och sjukvård2022Report (Other academic)
    Abstract [sv]

    Rapporten sammanställer resultatet från två delstudier om digitala testbäddar inom hälso- och sjukvården i Sverige. Den första var en explorativ studie som omfattade 15 digitala testbäddar inom hälso- och sjukvården i Sverige. Den andra var en studie som fokuserade på företag som utvecklar produkter och tjänster inom hälsa, vård och omsorg, för att erhålla företagens perspektiv på testbäddar.

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  • 272.
    Jungo, Katharina Tabea
    et al.
    Univ Bern, Switzerland.
    Mantelli, Sophie
    Univ Bern, Switzerland.
    Rozsnyai, Zsofia
    Univ Bern, Switzerland.
    Missiou, Aristea
    Univ Ioannina, Greece.
    Kitanovska, Biljana Gerasimovska
    Univ St Cyril & Metodius Skopje, North Macedonia.
    Weltermann, Birgitta
    Univ Duisburg Essen, Germany;Univ Bonn, Germany.
    Mallen, Christian
    Keele Univ, UK.
    Collins, Claire
    Irish Coll Gen Practitioners, Ireland.
    Bonfim, Daiana
    Hosp Israelita Albert Einstein, Brazil.
    Kurpas, Donata
    Wroclaw Med Univ, Poland.
    Petrazzuoli, Ferdinando
    Lund University, Sweden.
    Dumitra, Gindrovel
    Romanian Soc Family Med, Romania.
    Thulesius, Hans
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Lund University, Sweden.
    Lingner, Heidrun
    Hannover Med Sch, Germany.
    Johansen, Kasper Lorenz
    Danish Coll Gen Practitioners, Denmark.
    Wallis, Katharine
    Univ Queensland, Australia.
    Hoffmann, Kathryn
    Med Univ Vienna, Austria.
    Peremans, Lieve
    Univ Antwerp, Belgium.
    Pilv, Liina
    Univ Tartu, Estonia.
    Ster, Marija Petek
    Univ Ljubljana, Slovenia.
    Bleckwenn, Markus
    Univ Leipzig, Germany.
    Sattler, Martin
    Soc Sci Luxembourgois Med Gen, Luxembourg.
    van der Ploeg, Milly
    Leiden Univ, Netherlands.
    Torzsa, Peter
    Semmelwe Univ, Hungary.
    Kanska, Petra Bomberova
    Charles Univ Prague, Czech Republic.
    Vinker, Shlomo
    Tel Aviv Univ, Israel.
    Assenova, Radost
    Med Univ Plovdiv, Bulgaria.
    Bravo, Raquel Gomez
    Univ Luxembourg, Luxembourg.
    Viegas, Rita P. A.
    NOVA Med Sch, Portugal.
    Tsopra, Rosy
    Univ Paris, France;Hop Europeen Georges Pompidou, France.
    Pestic, Sanda Kreitmayer
    Univ Tuzla, Bosnia and Herzegovina.
    Gintere, Sandra
    Riga Stradins Univ, Latvia.
    Koskela, Tuomas H.
    Tampere Univ, Finland.
    Lazic, Vanja
    Dom Zdravlja Zagreb Ctr, Croatia.
    Tkachenko, Victoria
    Shupyk Natl Med Acad Postgrad Educ, Ukraine.
    Reeve, Emily
    Univ South Australia, Australia;Dalhousie Univ, Canada;Nova Scotia Hlth Author, Canada.
    Luymes, Clare
    Leiden Univ, Netherlands;UWV Employee Insurance Agcy, Netherlands.
    Poortvliet, Rosalinde K. E.
    Leiden Univ, Netherlands.
    Rodondi, Nicolas
    Univ Bern, Switzerland.
    Gussekloo, Jacobijn
    Leiden Univ, Netherlands.
    Streit, Sven
    Univ Bern, Switzerland.
    General practitioners' deprescribing decisions in older adults with polypharmacy: a case vignette study in 31 countries2021In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, no 1, p. 1-12, article id 19Article in journal (Refereed)
    Abstract [en]

    Background General practitioners (GPs) should regularly review patients' medications and, if necessary, deprescribe, as inappropriate polypharmacy may harm patients' health. However, deprescribing can be challenging for physicians. This study investigates GPs' deprescribing decisions in 31 countries. Methods In this case vignette study, GPs were invited to participate in an online survey containing three clinical cases of oldest-old multimorbid patients with potentially inappropriate polypharmacy. Patients differed in terms of dependency in activities of daily living (ADL) and were presented with and without history of cardiovascular disease (CVD). For each case, we asked GPs if they would deprescribe in their usual practice. We calculated proportions of GPs who reported they would deprescribe and performed a multilevel logistic regression to examine the association between history of CVD and level of dependency on GPs' deprescribing decisions. Results Of 3,175 invited GPs, 54% responded (N = 1,706). The mean age was 50 years and 60% of respondents were female. Despite differences across GP characteristics, such as age (with older GPs being more likely to take deprescribing decisions), and across countries, overall more than 80% of GPs reported they would deprescribe the dosage of at least one medication in oldest-old patients (> 80 years) with polypharmacy irrespective of history of CVD. The odds of deprescribing was higher in patients with a higher level of dependency in ADL (OR =1.5, 95%CI 1.25 to 1.80) and absence of CVD (OR =3.04, 95%CI 2.58 to 3.57). Interpretation The majority of GPs in this study were willing to deprescribe one or more medications in oldest-old multimorbid patients with polypharmacy. Willingness was higher in patients with increased dependency in ADL and lower in patients with CVD.

  • 273.
    Justad, Hanna
    et al.
    Region Stockholm, Sweden.
    Askfors, Ylva
    Region Stockholm, Sweden.
    Shemeikka, Tero
    Region Stockholm, Sweden.
    Andersson, Marine
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Hammar, Tora
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Patients’ Use and Perceptions of a Drug-Drug Interaction Database: A Survey of Janusmed Interactions2021In: Pharmacy, E-ISSN 2226-4787, Vol. 9, no 1, p. 1-13, article id 23Article in journal (Refereed)
    Abstract [en]

    Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register for a personal account. The aim of this study was to investigate why and how patients use the database Janusmed interactions, how they perceive content and usability, and how they would react if they found an interaction. A web-based questionnaire was sent by email to all users who had registered for Janusmed interactions as a “patient” (n = 3219). A total of 406 patients completed the survey (response rate 12.6%). The study shows that there is an interest among patients to use a DDI database to check their own or a relative’s medication. The respondents found the database easy to use and perceive they understand the information aimed at HCP. Most patients stated they would talk to their HCP if they found an interaction and not adjust their treatment by themselves. However, the respondents in this study are actively searching for information and seem to have high health literacy. Thus, the findings are not generalizable for the general population.

  • 274.
    Järhult, Bengt
    et al.
    Vårdcentralen Ryd.
    Andersson, Christer
    Inst. för allmänmedicin, Umeå universitet.
    Cizinsky, Stella
    Specialist i kardiologi, Örebro.
    Ekerstad, Niklas
    Med dr, spec kardiologi Trollhättan.
    Elisasson, Mats
    Professor, spec internmedicin, Umeå.
    Ervander, Cecilia
    Spec allmänmedicin Lund.
    Flordal, Per Anders
    Spec kirurgi, Stockholm.
    Hagström, Bertil
    Spec allmänmedicin, Horred.
    Halldin, Jan
    Specialist i psykiatri och socialmedicin, Stockholm.
    Järhult, Johannes
    Professor em. Jönköping.
    Löfmark, Rurik
    Med dr Gävle.
    Petersson, Christer
    Allmänmedicinare, Växjö.
    Sandberg, CG
    Spec psykiatri och företagshälsovård, Stockholm.
    Schmitt, Christian
    Spec allmänmedicin, Sätila.
    Svenberg, Torgny
    Specialist i kirurgi, Stockholm.
    Tjärnström, Johan
    Specialist i kirurgi, Trollhättan.
    Wingstrand, Hans
    Professor i ortopedi, Lund.
    Zur-Mühlen B, Bengt
    Med dr, öl neurologi, Uppsala.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Läkarförbundet bör ta strid mot PaRIS – för kompetens och läkaretik.2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, article id 170223Article in journal (Other (popular science, discussion, etc.))
  • 275.
    Järhult, Bengt
    et al.
    Vårdcentralen Ryd.
    Andersson, Christer
    Inst. för allmänmedicin, Umeå universitet.
    Cizinsky, Stella
    Specialist i kardiologi, Örebro.
    Ekerstad, Niklas
    Med dr, spec kardiologi Trollhättan.
    Elisasson, Mats
    Professor, spec internmedicin, Umeå.
    Hagström, Bertil
    Spec allmänmedicin, Horred.
    Halldin, Jan
    Specialist i psykiatri och socialmedicin, Stockholm.
    Järhult, Johannes
    Professor em. Jönköping.
    Löfmark, Rurik
    Med dr Gävle.
    Petersson, Christer
    Allmänmedicinare, Växjö.
    Sandberg, CG
    Spec psykiatri och företagshälsovård, Stockholm.
    Schmitt, Christian
    Spec allmänmedicin, Sätila.
    Svenberg, Torgny
    Specialist i kirurgi, Stockholm.
    Tjärnström, Johan
    Specialist i kirurgi, Trollhättan.
    Wingstrand, Hans
    Professor i ortopedi, Lund.
    Zur-Mühlen B, Bengt
    Med dr, öl neurologi, Uppsala.
    Akner, Gunnar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ska värdebaserad vård införas av konsulter utan vetenskaplig evidens?2017In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 114, article id 170116Article in journal (Other (popular science, discussion, etc.))
  • 276.
    Jönsson, Annica
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ojämn addition och ackommodationsamplitud hos presbyoper2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att se om presbyopin, det vill säga minskningen av ackommodationsamplitud, utvecklas likadant i båda ögonen. Syftet var även att se om en ojämn addition i vissa fall gav bättre subjektiv respons än en binokulär jämn addition.

    Metod: Studien innefattade 33 deltagare där samtliga var mellan 43-57 år. Med hjälp av en RAF-stav mättes den monokulära ackommodationsamplituden för höger och vänster öga med push-up/push-down metoden. Utöver detta gjordes en binokulär och en monokulär additionsbestämning. Skilde sig resultaten åt från dessa additionsbestämningar fick deltagaren bestämma vilken styrka som subjektivt gav bäst upplevda synskärpa.

    Resultat: Resultaten visade att 11 deltagare hade en skillnad >0,25 D i ackommodationsamplitud mellan ögonen. 8 av de 11 hade en skillnad >0,50 D mellan ögonen. Mätresultaten visade att 24 av de 33 medverkande fick en skillnad i addition mellan ögonen vid den monokulära additionsbestämningen. Som slutgiltig addition föredrog 14 personer en monokulär ojämn addition och 19 personer en binokulär jämn addition. Det fanns en god korrelation (r = 0,71) mellan en skillnad i ackommodationsamplitud och en skillnad i addition mellan ögonen (p<0,001). Det vill säga att det fanns ett samband mellan en lägre ackommodationsamplitud monokulärt och en högre vald addition i det ögat samt vice versa.

    Slutsats: Denna studie fann skillnader i både monokulär ackommodationsamplitud och addition hos presbyoper. Genom att uteslutande bestämma additionen binokulärt tar undersökaren ej hänsyn till dessa skillnader. För att tillgodose de personer som föredrar en ojämn addition som optimal närkorrektion så rekommenderas en monokulär additionsbestämning.

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  • 277.
    Jönsson, Sanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Implementeringen av Nationella läkemedelslistan ur tre perspektiv - med hjälp av mjukt systemtänkande2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    On 1 May 2021, the Act (2018:1212) on the national medication list came into effect. The National Medication List (NLL) is supposed to provide a comprehensive and updated list of the patient's prescribed and dispensed medicines to the healthcare, pharmacies and the patient. The actors concerned experience various concerns linked to the implementation of NLL and there does not seem to be any common, concrete target image.

    The aim of the study is to explore experiences and perceptions of the implementation of the National Medication List using soft systems thinking. The study used techniques within Soft Systems Methodology. As a complement, qualitative content analysis was used. Three semi-structured group interviews with 2-5 participants, based on a strategic selection, from each perspective of authority, pharmacy and healthcare were carried out.

    From the three perspectives asked, there is a consensus that the idea of ​​NLL is good in essence, but there is no common picture of when NLL will be implemented or how it will work then. The different perspectives have different prerequisites for implementing NLL and have reached different stages of implementation. The biggest challenges seem to be for the healthcare perspective, where the technology described around NLL is far from the working processes that exist today, and it is unclear how different laws cooperate. 

    Regarding how it will work with NLL in December 2025, there is a consensus that changed working processes will be required in order for the benefits of NLL to be realized, but perceptions of how and when that will occur diverge. There are perceptions that the full implementation of NLL will not be carried out in December 2025. The future desires regarding NLL also differ between the different perspectives. 

    It is not possible to implement NLL with solely a technical focus. More focus is required on working processes and how they are affected. More research is needed into how perceived problems and obstacles can be solved and studies to evaluate the implementation and to measure results and effects of NLL are needed too.

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  • 278.
    Kaardal, Kamilla
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Wahlberg, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    A comparison of measuring peripheral refraction in children using COAS-HD VR aberrometer and Shin-Nippon NVision-K 5001 autorefractometer2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 279.
    Kalin Winkler, Sara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Centrering av kontaktlinsen MiSight®1days behandlingszoner vid konventionell linstillpassning2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 280.
    Karlsson, Jonna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Forsman, Maja
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jämförelse mellan gradient AK/A-kvot och beräknad AK/A-kvot mellan tre forimätningsmetoder2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Vergences are different directions the eyes can move in relation to each other. The relationship between convergence and accommodation is called the AC/A ratio. The ratio can be produced with either a calculated method or with the gradient method. The calculated method is based on the distance and near phorias. The gradient method is only based on the near phorias and the change in the accommodative stimulus. The methods that can be used for measuring the AC/A ratio are for example von Graefe, Modified Thorington and Maddox Rod. 

    Purpose: Compare the difference in AC/A ratio between gradient and calculated method for three phoria measuring methods: von Graefe, Modified Thorington and Maddox Rod. 

    Method: The inclusion criterias in this quantitative study were people between 18-35 years of age, monocular visual acuity of at least 1,0, functioning binocular vision and absence of tropia. A total of 30 people participated in this study and were between the ages of 21-29 years. Examination including test of binocular vision, covertest and best refraction were made. Thereafter phorias at distance and near were measured for each person with von Graefe, Modified Thorington and Maddox Rod in a randomized order. One measurement for each method was taken, between each measurement there was a 10 minute break. All examinations were made by the same examiner.   

    Results: A Friedman two way analysis gave (𝜒2(5) = 105.9, p<0.001). The difference in averaged value between gradient and calculated AC/A with von Graefe was 2.0∆ in prism diopters, with Modified Thorington 3.4∆ in prism diopters and with Maddox Rod 2.2∆ in prism diopters. All phoria measurements showed significant difference between gradient AC/A and calculated AC/A (p<0.001). There was a significant difference between von Graefe- and Modified Thorington calculated AC/A ratio (p<0.05), Modified Thorington- and Maddox Rod calculated AC/A ratio (p<0.05) and Maddox Rod- and von Graefe gradient AC/A ratio (p<0.05)    

    Conclusion: The difference between the gradient and calculated AC/A is not the same for the three methods used for measuring phorias. 

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  • 281.
    Karlsson, Linda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Demens och dess påverkan av kontrastseendet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte

    Studiens syfte var att undersöka ifall det fanns en skillnad av kontrastseendet mellan icke-dementa människor över 65 år jämförelsevis med människor som var diagnostiserade med demens. Även denna grupp hade nått en ålder över 65 år.

    Metod

    Studien genomfördes på olika demensboenden eller hemma hos deltagarna. Först fick alla deltagare genomgå en kontroll av närvisus för att se om de kunde läsa 8 punkter eller bättre på en närvisustavla. Om det visade sig att de klarade detta fick de delta i studien. Därefter fick de, binokulärt, läsa så långt de kunde på Mars letter kontrast sensitivity test. Luminansen på tavla rekommenderades till 85 cd/m2 och samtliga deltagande låg runt detta värde.

    Resultat

    Resultatet visade att de personer som var diagnostiserade med demens i olika former presterade sämre på Mars letter contrast sensitivity test än de som inte hade sjukdomen. Medelvärdet för de utan demens var 1.61±0.16 medan de med demens hamnade på ett medelvärde av 1.29±0.28. Detta visade att de utan demens kunde läsa nästan en rad bättre på Mars letter contrast sensitivity test jämfört med de med demens. Skillnaden som visades i resultatet var statistiskt signifikant (P<0.01).

    Slutsats

    Sammanfattningsvis visade resultatet på ett sämre kontrastseende hos de personer som led av demens. Därför är det viktigt att deras omgivning anpassas efter deras synproblem. Att till exempel inte ha en vit dörr mot en ljus vägg då det kan vara svårt för en person att hitta dörren. Att tänka på att ha starkare kontraster i en miljö där en dement vistas kan underlätta mycket för hur personen klarar sig i sin vardag.

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  • 282.
    Karlsson, Oscar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Validering och reliabilitetstest av ett digitalt självrapporterat 30 sekunders sitt-till-stå-test.2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Hälso- och sjukvården står inför stora utmaningar, och digitaliseringen anses vara ett av de viktigaste verktygen för att möta dessa. Telerehabilitering i form av egenmonitorering och distansbehandlingar är viktiga inslag i den digitala transformationen, inte minst vad gäller att hantera kroniska besvär. När vi nu övergår till mer digitala behandlingsupplägg används även utvärderingsinstrument i en mer digital kontext. För att bibehålla vårdens kvalitet är det väsentligt att kontrollera dessa med avseende på tillförlitlighet.  

    Syfte

    Syftet med denna studie var att undersöka det självrapporterade 30 sekunder Chair Stand Test (30s CST) som används i Joint Academys digitala behandling. Syftet var att kontrollera testets tillförlitlighet och om huruvida det självrapporterade testet är likvärdigt ett traditionellt 30s CST.  

    Material och metod

    Studien genomfördes i två delmoment, där samtidig validitet respektive stabilitet (test-retest reliabilitet) bedömdes. För att bedöma samtidig validitet studerades inter-rater reliabilitet och samstämmighet mellan det traditionella 30s CST och det självrapporterade testet. Det självrapporterade testets stabilitet bedömdes genom att studera test-retest reliabilitet och samstämmighet mellan upprepade mätningar. Data analyserades med Inter-Class Correlation Coefficient (ICC), Bland Almandiagram med tillhörande Limits of Agreement (LoA) och intervall för Minimal Clinically Important Difference (MCID). 

    Resultat 

    Inter-rater reliabilitet bedömdes god till utmärkt (ICC=0.930 95% CI 0.636 - 0.979). Undersökning av samstämmighet mellan traditionellt och självrapporterat test visade en medelskillnad på -1.5 uppresningar, vilken tillsammans med 95% konfidensintervall hamnade innanför intervallet för MCID. Test-retest reliabiliteten bedömdes god till utmärkt (ICC=0.923, 95% CI 0.828 - 0.962). Bland Altmandiagrammet för samstämmighet mellan upprepade mätningar visade en medelskillnad på -1.2 uppresningar vilken även den hamnade innanför MCID. Utöver detta observerades stora individuella skillnader. 

    Slutsats 

    Det självrapporterade funktionstestet kan anses likvärdigt ett traditionellt 30s CST vid mätning av fysisk funktion. Det digitala och självrapporterade 30s CST bör vid kliniska bedömningar, precis som det traditionella 30s CST, användas tillsammans med annan relevant information som exempelvis smärtskattning.

  • 283.
    Karlsson, Pernilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Vårdpersonalens upplevelse av utmaningar för delaktighet i utvecklingen av vårdinformationssystem2024Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Several Nordic countries are replacing their healthcare information systems when the life cycle of the systems has been exhausted. This leads to a generational shift among Nordic healthcare information systems. Within healthcare organizations, there is an expectation and a need for modern healthcare information systems that are suitable for healthcare work processes. The participation of healthcare professionals in the development of the healthcare information system of the future is crucial for whether expectations can be met.

    Aim: The main purpose of the study is to investigate health care professionals' experiences of participation in the development of health care information systems based on technical, social/human, organizational and societal areas.

    Method: Data was collected through a web-based questionnaire with open and closed questions. The collected data was analyzed with qualitative content analysis with a deductive approach based on the areas of the Technology, People, Organizations, and Macroenvironmental factors (TPOM) framework. Respondents in the study were record-keeping staff working in a Finnish health care organization. A total of 101 respondents participated in the study.

    Results: With the support of the TPOM framework, 2 areas and 6 subcategories were identified that demonstrate healthcare professionals' experiences of challenges for participation in the development of healthcare information systems. Healthcare professionals' experiences show that Workload, Commitment, Attitudes and expectations, Education and support, Communication and Vision affect participation.

    Conclusion: On an overall level, the study contributes to recalling that the participation of health care professionals plays a crucial role in developing health care information systems that are suitable for the health care system. Based on healthcare professionals' experiences regarding challenges for participation in the development of healthcare information systems, the study highlights circumstances that may affect how the healthcare information system of the future looks like and the level of usability of the information systems. Suggestions for future research include investigating what education would promote the participation of health care professionals in the development of health care information systems and whether that education can be incorporated into the core competencies of health care professionals.

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  • 284.
    Karlsson, Victor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Effektiviteten av synträning för konvergensinsufficiens: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To report the effectiveness of vision therapy for symptomatic convergence insufficiency (CI) by looking at studies and articles that have been written in this area.

    Method: This study has been done by using articles and their references, that have been found on Google Scholar and PubMed. The keywords used were Effectiveness, Efficacy, Vision Therapy and Convergence Insufficiency.

    Results: The result of this study shows that vision therapy is an effective treatment for children between the ages of 8-18 in improving the symptoms of Convergence Insufficiency. It also shows that out of the most common, Office-Based Vergence/Accommodative Therapy with Home Reinforcement is the most efficient method to deal with symptomatic Convergence Insufficiency.

    Conclusion: The conclusion of this study is that vision therapy for symptomatic Convergence Insufficiency is an effective and sustainable method for children between the ages of 8-18, since the improvments are sustained for 1 year after completed vison therapy.

  • 285.
    Khudaida, Hussein
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Brytningsfelfördelning och den ackommoderande funktioner i en grupp av 8-21 år Mellanösternpersoner i Sverige.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To investigate the occurrence of refractive errors in a sample of Middle East people aged 8-21 who live in Sweden and to evaluate the accommodating functions in this sample and compare it with the normative data.

    Method: The study was carried out from 1 April  to 30 April  in Norrköping / Sweden. A subjective binocular refraction was performed on the patients where spherical equivalence was applied. Myopia was defined as a spherical equivalent break at least -0.50 D. Prevalence of hyperopia, defined as a spherical equivalent break of at least +0.75 D.When measuring visus, decimal point is used. Accommodative facility was measured using a (+2.00 / -2.00 D) flippers at 40 cm both monocular and binocular. Nott dynamic retinoscopy was used to measure accommodation respons. To measure the amplitude of accommodation in the eyes, the push-up technique was used. A cover-uncover test was performed to confirm the diagnosis if strabismus was detected.

    Results: As for the types of refractive error, the prevalence as such was: Simple myopia 7 persons (22.58%), compound myopic astigmatism 7 persons (22.58%), simple myopic astigmatism 1 person (3.22%), simple hypermetropic 2 persons (6.45%), compound hypermetropic 1 person (3.221%), Emmetropi 13 people (41.93%). The myopia occurrence was highest in the age group 16-21 years. The refractive errors of the subjects ranged from -0.50 to -7.25 D with a mean refraction of -1.75 D. Minimum amplitude 11.5 D, mean amplitude 14.3 D and maximum amplitude was 19.4 D. The average amplitude of accommodation: OD 11.7 D, OS 11.6 D and OU 12.8 ± 1.33 D. The normal average of  NOTT OD 0.66 D and OS 0.70 D. Distance cover test 19 people were subj. orto and 12 people were subj. exotropy. Near cover test 15 people were subj. orto and 16 people were subj exotropy. When examining obj. distance cover test and obj. near cover tes, 3 persons were exotropic and 28 persons were ortho. The average of accommodative of  facility for OD 10.4 cpm, OS 10.5 cpm and OU were 10.6 cpm.

    Conclusion: The results of the study showed a higher incidence of myopia than hyperopia in the population between 8-21 years from the Middle East. The most common visual impairment in all occupational groups was myopia. The results of the study also showed that the prevalence of myopia in the Middle East is lower than in Sweden. One reason for this may be less close work. The people in the Middle East do not devote as much time to near work as in Sweden, and it has been shown that much near work and uncorrected refractive errors affect near-sightedness development. Heredity also affects the near-sightedness when myopia is to some extent hereditary. The binocular and monocular amplitude of accommodation was consistent with the formula proposed by Hofstetter. Ack.amplitud and NOTT was consistent with normative data. Den binocular and monocular accommodative of facility was significantly higher compared to studies in Sweden but agree with the recommended data.

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  • 286.
    Kinsey, Elisa
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Wickenberg, Rut
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Longitudinal changes in peripheral refraction in children2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 287.
    Klinthage, Jakob
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Koffeins påverkan på osmolariteten i tårfilmen2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to investigate if there was a difference in the tear film’s osmolarity before and after drinking coffee. '

    Method: All subjects in this study were asked to fill in a questionnaire to diagnose factors in their subjective symptoms, the questionnaire TERTC-DEQ. The subjects with a total graduated points of over 17 were not allowed to participate in the further measurements. In the study there was a total amount of 38 subjects, were 5 participated twice for both measurements, coffee and water. The measurements were done by TearLab to bring the the osmolarity values, of coffee and water, the before and after measurements, to be compared with each column. Each subject was measured before the drinks was served, 200 milliliters of water or 200 milliliters of coffee. 45 minutes after the first measurement, after the intake of one of the liquids, then the second measurement was occured with TearLab.  All of these values and measurements was later compared to each columns of coffee or water.

    Results: There was no significant difference between neither the coffee or water results (p>0,05). Though there was a little quotable difference between the before and after measurement values of coffee, but not significant.

    Conclusion: There was no significant difference related to coffe drinking and tear osmolarity. There is no contribution to the tear film’s osmolarity and it will not work as a factor into the dry eyes diagnosis. 

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    Koffeins påverkan på osmolariteten i tårfilmen
  • 288.
    Klompstra, L. Verheijden
    et al.
    Linköping University.
    Ostbring, M. J.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jaarsma, T.
    Linköping University.
    Martensson, J.
    Jönköping Univ.
    Stromberg, A.
    Linköping University.
    Thylen, I.
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Evaluation of cardiovascular educational websites in Sweden2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, p. S61-S61Article in journal (Other academic)
  • 289.
    Klompstra, Leonie
    et al.
    Linköping University, Sweden.
    Johansson Östbring, Malin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jaarsma, Tiny
    Linköping University, Sweden.
    Ågren, Susanna
    Linköping University, Sweden.
    Fridlund, Bengt
    Jönköping University, Sweden.
    Hjelm, Carina
    Linköping University, Sweden.
    Hjelmfors, Lisa
    Linköping University, Sweden.
    Ingadottir, Brynja
    University of Iceland, Iceland.
    Liljeroos, Maria
    Linköping University, Sweden;Sörmland County Council, Sweden.
    Lundgren, Johan
    Linköping University, Sweden.
    Mårtensson, Jan
    Jönköping University, Sweden.
    Mourad, Ghassan
    Linköping University, Sweden.
    Thylen, Ingela
    Linköping University, Sweden.
    Walfridsson, Ulla
    Linköping University, Sweden.
    Strömberg, Anna
    Linköping University, Sweden.
    The Appropriateness and Presentation of Commonly Available Cardiovascular Web Pages Providing Information About Cardiovascular Diseases2019In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 37, no 10, p. 493-497Article in journal (Refereed)
  • 290.
    Krasniqi, Dafina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Repeterbarheten hos I-Pen®2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 291.
    Kristiansen, Eva
    et al.
    Region Kalmar County, Sweden;Region Västra Götaland County, Sweden.
    Wanby, Pär
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Region Kalmar County, Sweden.
    Åkesson, Karin
    Futurum Academy for Health and Care, Sweden;Region Jönköping County, Sweden.
    Blomstrand, Peter
    Jönköping University, Sweden;Region Jönköping County, Sweden.
    Brudin, Lars
    Region Kalmar County, Sweden.
    Thegerström, Johanna
    Region Kalmar County, Sweden.
    Assessing heart rate variability in type 1 diabetes mellitus - Psychosocial stress a possible confounder2020In: Annals of Noninvasive Electrocardiology, ISSN 1082-720X, E-ISSN 1542-474X, Vol. 25, no 5, p. 1-12, article id e12760Article in journal (Refereed)
    Abstract [en]

    Background Autonomic neuropathy (AN) commonly arises as a long-term complication in diabetes mellitus and can be diagnosed from heart rate variability (HRV), calculated from electrocardiogram recordings. Psychosocial stress also affects HRV and could be one of several confounders for cardiac AN. The present work investigated the impact of psychosocial stress on HRV in individuals with type 1 diabetes mellitus (T1DM) and assessed the use of salivary cortisol as a biomarker for psychosocial stress in this context. Methods A total of 167 individuals 6-60 years old (113 with T1DM and 54 healthy controls) underwent 24-hr ECG recordings with HRV analysis. Salivary cortisol was sampled thrice during the registration day. Perceived psychosocial stress along with other factors of possible importance for the interpretation of HRV was documented in a diary. Results Heart rate variability (high-frequency power during sleep) was reduced (p < .05) with older age, longer diabetes duration, higher mean glucose levels, physical inactivity, and perceived psychosocial stress. Salivary cortisol levels in the evening were increased (p < .05) in women in ovulation phase, in individuals with preceding hypoglycemia or with hyperglycemia. The amplitude of salivary cortisol was reduced (p < .05) with the presence of perceived psychosocial stress, but only in adult healthy controls, not in individuals with diabetes. Conclusion Psychosocial stress might be a confounder for reduced HRV when diagnosing cardiac AN in T1DM. Salivary cortisol is, however, not a useful biomarker for psychosocial stress in diabetes since the physiological stress of both hypoglycemia and hyperglycemia seems to overrule the effect of psychosocial stress on cortisol.

  • 292.
    Könönen, Magdalena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Arbetsavståndets påverkan på mätningar av dissocierad fori och fixationsdisparitet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 293.
    Laaksonen, Iris
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Edgarsson, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sambandet mellan ljus-och levnadsförhållanden och barns refraktionsfel: En tvärsnittsstudie2022Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 294.
    Lagrosen, Stefan
    et al.
    Linnaeus University, School of Business and Economics, Department of Organisation and Entrepreneurship.
    Nilsson, Anna-Lena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nilsson, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Creating a market for ehealth entrepreneurs2019In: Proceedings of the 14th European Conference on Innovation and Entrepreneurship, University of Peloponnese, Kalamata, Greece, 19-20 September 2019 / [ed] Panagiotis Liargovas & Alexandros Kakouris, ECIE , 2019, p. 566-571Conference paper (Refereed)
    Abstract [en]

    Digitalisation is rapidly changing the conditions for providing healthcare. New digital products and services are continuously integrated into the operations although not without frequent hurdles and difficulties. In addition, the ehealth market for public healthcare is dominated by fairly large companies while smaller, entrepreneurial companies have difficulties accessing the public health market. The purpose for the project reported in this paper is to examine how the competitiveness of ehealth entrepreneurs can be increased by gaining access to public healthcare. The aim is to develop a model describing the necessary conditions for a common development-process involving organisations in healthcare and small and medium size companies (SMEs), which can serve as a support in iterative improvement activities. The main methodology used in the project has been interactive workshops led by a professional moderator. Ten workshops involving representatives from healthcare, elderly care, SMEs and academia as well as politicians have been carried out. The findings are summarised in the model which gradually has emerged. The model has four vital cornerstones: understanding of needs, technical openness, procurement process and collaboration forum. Understanding of needs is a crucial aspect both from the perspective of healthcare and from SMEs. Currently, dialogue is lacking and SMEs do not in enough detail understand the processes taking place in healthcare and thus which the problems are. On the other hand, the healthcare representatives often do not have any overview of which suppliers and products exist and in what way they can aid in their operations. This leads to the procurement process often being ad hoc at the same time as it is limited by public procurement rules which frequently are too rigidly followed. Consequently, competence development of both healthcare organisations and SMEs is key to success. This development process will be highly facilitated by a collaboration forum – an arena in which healthcare representatives and SMEs can meet and learn from each other. The model, with its cornerstones, constitutes the main finding of the project.

  • 295.
    Laitamaa, Peder
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sdogos, Dimitra
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Kontrastseende vid myopibehandling: En experimentell jämförande pilotstudie mellan MiSight 1 day och Biofinity Multifocal2023Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this study was to investigate whether there is a difference in contrast sensitivity between different multifocal contact lenses used in myopia treatment, with a focus on MiSight 1 day and Biofinity multifocal lenses, and determine whether the difference is due to lens design or addition.

    Method: In this study, 11 participants aged between 19-29 years were included. Three different types of contact lenses were tested, including MiSight and Biofinity multifocal lenses with an addition of +2.00 D and +2.50 D. Monocular measurements were conducted using Metropsis to determine the contrast threshold value.

    Results: There was no statistically significant difference in contrast sensitivity observed between the three different contact lenses. 

    Conclusion: Although no statistically significant difference in contrast sensitivity between the lenses could be measured, the contrast curves appeared as expected. This indicates either that the difference between the contact lenses is small or not significant. However, a larger study would be needed to determine which.

  • 296.
    Lammers, My
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Väring, My
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förekomsten av vergens- och ackommodationsrelaterad problematik hos barn med Dyslexi2024Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Introduction: Sufficient binocular vision is a fundamental basis for proficient reading.Individuals with binocular vision problems such as convergence insufficiency and accommodativeinsufficiency often find it difficult to read and interpret text, and these are some of the mostcommon vision problems among children. Individuals with dyslexia may face complications inreading and comprehending text, which are symptoms also observed in children with binocularvision issues. If a significant prevalence of reduced vergences or poor accommodative ability isseen in individuals with dyslexia, it allows for further aid through vision therapy or correctivemeasures.Purpose: The purpose of this study was to examine the current prevalence of vergence andaccommodation issues in children diagnosed with dyslexia. The goal of this study was to providea summary of the findings that can be useful for making informed decisions about themanagement of patients who are suspected of having dyslexia.Method: The selection of studies was based on their relevance to the investigation of vergenceand accommodation-related issues in children with dyslexia, with the exclusion of those thatexclusively addressed binocular dysfunctions such as saccades and pursuits. Criterias were limitedto clinical studies not older than 6 years. Thorough searches conducted in various databases, usingBoolean operators and search terms resulted in a focused collection of five studies.Results: Study 1 and 3 to 5 reported that the children with dyslexia had reduced accommodationor accommodation insufficiency, while study 3 to 5 found signs of vergence impairments incomparison to children without dyslexia. Nevertheless, a common factor across all studies was thepresence of affected vergences or impaired accommodation ability in some form among childrenwith dyslexia.Conclusion: The results showed that children with dyslexia face somewhat more binocular visionanomalies than children without dyslexia. Thus, it is necessary to conduct a more comprehensiveeye examination before diagnosing dyslexia in a patient.

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  • 297.
    Larsson, Albin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Effekten av kvällsanvändning av blåljusblockerande glasögon på sömn: En litteraturstudie av blåljusfilters effekt på sömn2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med den här litteraturstudien är att undersöka om det finns anledning att bära blåljusblockerande glasögon innan sänggående i syfte att förbättra sömnkvalitet relaterat till ljus, melatonin och skärmarbete kvällstid.  

    Metod: Det här arbetet är en litteraturstudie som baseras på vetenskapliga publikationer inom området optometri. Publikationerna som valdes hittas via sökning i databasen PubMed och Medline. 

    Resultat: Av fem artiklar kunde alla visa diverse parametrar med indikation på förbättrad sömn, vilket inkluderade färre uppvaknande och kortare tid att somna, en visade på högre andel djupsömn med blåljusblockerande glasögon jämfört med utan, däremot noterades inga andra positiva mätvärden. Slutligen ökade melatoninhalten signifikant och en ökad total sömn i den sista studien. Studieuppläggen skiljde sig åt i de olika vetenskapliga artiklarna.

    Slutsats: Sammanfattningsvis visar resultatet av studierna att effekten av blåljusblockerande filter på kvällen är inkonsekventa och det kan inte med säkerhet konstateras att det hjälper sömnkvaliteten, även om mindre förbättringar kan ses. Däremot finns det tydligare evidens för en ökad melatoninhalt vilket kan ha en positiv innebörd för sömnen. Framtida studier behöver inkludera fler deltagare, längre studier och fler objektiva parametrar.

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  • 298.
    Larsson, Clara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Binokulär balansering: Jämförelse mellan monokulär refraktion och två balanseringsmetoder2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med den här studien var att jämföra två olika binokulära balanseringsmetoder, samt att jämföra metodernas resultat med resultatet från en monokulär refraktion.

    Metod: I studien medverkade 30 personer med en medelålder på 23 år (±3år). Det gjordes en monokulär refraktion och två olika binokulära balanseringsmetoder på alla medverkande. De balanseringsmetoder som användes var polariserande röd/grönt-test och modifierad Humphriss. Skillnaden mellan ögonen räknades ut och jämfördes mellan de olika metoderna.

    Resultat: Det fanns inte någon statistiskt signifikant skillnad (p>0,05) mellan metoderna. Inte heller när balanseringsmetoderna jämfördes med en monokulär refraktion fanns det någon statistisk signifikant skillnad i resultaten (p>0,05).

    Slutsats: Det fanns ingen skillnad på de olika balanseringsmetoderna. Inte heller någon skillnad mellan balanseringsmetoderna och en helt monokulär refraktion. Så länge patienten har ett fungerande binokulärseende så kan metod väljas ut efter vilken undersökaren finner mest praktisk och känner sig mest säker på.

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  • 299.
    Larsson, Marie C.
    et al.
    Linköping Univ Hosp.
    Lerm, Maria
    Linköping Univ.
    Angeby, Kristian
    Karolinska Univ Hosp ; Univ W Indies, Jamaica.
    Nordvall, Michaela
    Linköping Univ Hosp.
    Jureen, Pontus
    Publ Hlth Agcy Sweden.
    Schön, Thomas
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linköping Univ ; Kalmar County Hospital.
    A luciferase-based assay for rapid assessment of drug activity against Mycobacterium tuberculosis including monitoring of macrophage viability2014In: Journal of Microbiological Methods, ISSN 0167-7012, E-ISSN 1872-8359, Vol. 106, p. 146-150Article in journal (Refereed)
    Abstract [en]

    The intracellular (IC) effect of drugs against Mycobacterium tuberculosis (Mtb) is not well established but increasingly important to consider when combining current and future multidrug regimens into the best possible treatment strategies. For this purpose, we developed an IC model based on a genetically modified Mtb H37Rv strain, expressing the Vibrio harvei luciferase (H37Rv-lux) infecting the human macrophage like cell line THP-1. Cells were infected at a low multiplicity of infection (1:1) and subsequently exposed to isoniazid (INH), ethambutol (EMB), amikacin (AMI) or levofloxacin (LEV) for 5 days in a 96-well format. Cell viability was evaluated by Calcein AM and was maintained throughout the experiment. The number of viable H37Rv-lux was determined by luminescence and verified by a colony forming unit analysis. The results were compared to the effects of the same drugs in broth cultures. AMI, EMB and LEV were significantly less effective intracellularly (MIC90: >4 mg/L, 8 mg/L and 2 mg/L, respectively) compared to extracellularly (MIC90: 0.5 mg/L for AMI and EMB; 0.25 mg/L for LEV). The reverse was the case for INH (IC: 0.064 mg/L vs EC: 0.25 mg/L). In conclusion, this luciferase based method, in which monitoring of cell viability is included, has the potential to become a useful tool while evaluating the intracellular effects of anti-mycobacterial drugs. (C) 2014 Elsevier B.V. All rights reserved.

  • 300.
    Latteur, Jack
    et al.
    Karolinska Institutet, Sweden.
    Ernstsson, Olivia
    Karolinska Institutet, Sweden.
    Nilsson, Evalill
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Karolinska Institutet, Sweden.
    Jäghult, Susanna
    Karolinska Institutet, Sweden;Danderyd Hospital, Sweden;Södersjukhuset, Sweden.
    Heintz, Emelie
    Karolinska Institutet, Sweden;Stockholm Healthcare Services, Sweden.
    Construct validity of EQ-5D-5L among patients with inflammatory bowel disease — a study based on real-world data from the Swedish Inflammatory Bowel Disease Registry2024In: Journal of Patient-Reported Outcomes, E-ISSN 2509-8020, Vol. 8, article id 39Article in journal (Refereed)
    Abstract [en]

    Objectives

    The Swedish Inflammatory Bowel Disease Registry (SWIBREG) includes approximately 84% of all patients with inflammatory bowel disease (IBD) treated with immunomodulators, biologics or surgery in Sweden. Data on health-related quality of life (HRQoL) have been collected using EQ-5D-5L in the registry since 2012. Nevertheless, there are few studies assessing the validity of EQ-5D-5L in this patient population. Thus, the aim of this study was to assess the construct validity of EQ-5D-5L amongst patients with IBD (ulcerative colitis and Crohn’s disease).

    Methods

    Individual-level data on EQ-5D-5L and other disease-specific measures were extracted from SWIBREG. Known-groups validity was assessed by analysing whether the EQ-5D-5L captured expected differences between patient groups with different activity levels of the disease. Convergent validity was assessed by analysing whether the reported problems in the dimensions of EQ-5D-5L, EQ VAS, and the EQ-5D-5L index value correlated, as hypothesized, with the four dimensions in the Short Health Scale, a symptom index question, and the Physician Global Assessment (PGA) score.

    Results

    In total, 9769 patients with IBD were included in the study. Patients with active IBD reported more health problems in the EQ-5D-5L descriptive system than patients being in remission. The effect sizes for the differences in reported problems between patients with active and inactive disease were at least small (≥0.1) or medium (≥0.3) in all dimensions except self-care. Differences in the mean EQ-5D-5L index and EQ-VAS score between patients with active and inactive disease were statistically significant (p < 0.001) and larger than pre-defined cut-offs for minimally important differences (>0.08 for the index and >11.0 for EQ-VAS). The analysis of convergent validity showed that EQ-5D-5L results correlated as expected with the disease-specific measures in 16 of the 21 analyses. In total, 22 (79%) of the 28 hypotheses were supported.

    Conclusion

    The findings support the construct validity of EQ-5D-5L amongst patients with IBD and contribute to the scarce literature on the validity of the five-level version of EQ-5D in this patient population. These findings have important implications for the choice of HRQoL measure in routine health care registries like SWIBREG as well as for future clinical or health economic studies considering using EQ-5D-5L as a measure of HRQoL.

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