With those utilities and possibilities we have today, 3D-models should be usted more than they are. The posibilities to work further with these models are enormous. The purpose with this report is to investigate why the BIM technology isn’t used to its fully potential in the construction industry. And also to investige the posibilities to implement the technique further by interconnecting the 3D-model to more information consisting of 4D-BIM and 5D-BIM. By a comparison between the real estate industry and the construction industry produce solutions that can be implied in the construction industry. The methods that have been used in this operation is a study of literature and interviews of experts in the industry. Based on these methods the author has concluded several reasons why 5D-modeling is so limited as it is. This area is rather undiscovered, few in the industry even thinks of this as a problem, or an area that needs improvement, so the investigation in the area is very limited. Besides, the time it takes for a person to learn a new working progress is time the person often doesn’t have. Plus that the new is frightening, the time it takes to learn the new way is unknown and the time it takes to imply it in the projekt is unknown. The way you’ve always worked is safe and you know approximitly how long it’s going to take. One thing that is notable in the construction industry is that the demands from the clients is starting to appear and the competens of the contractors doesn’t exist. And there is a fatal chans that the demands will increase much faster than the development of competens in the industry. For the industry to keep develop in the right pace, the industry must dare to invest in 5D-modeling. By giving priority to learn a more efficient way of working, by daring to invest economically in software and education of competens and to look at these costs as an investment in the future and not a cost for the ongoing projekts.

Denna studie syftar till att utvärdera möjligheterna med bygginformationsmodellering, BIM, inom anläggningsbranschen genom att skapa en fullständig 5D-modell som beskriver ett anläggningsprojekt. BIM är i praktiken definierat som en dynamisk modell där man använder sig av intelligenta objekt istället för linjer. För att den skapade modellen ska vara användbar vid kalkyl- och tidplanarbete ska de skapade objekten vara sammanlänkade med en mängdförteckning enligt AMA Anläggning 2013. Modellen representeras av en nybrytning av en väg med tillhörande schakt, bankfyll, vägöverbyggnader, krondikning, trumläggning samt en omkoppling av en befintlig åkerdränering. Dessa arbetsmoment medför att 23 stycken AMA Anläggning- kodsatta objekt modelleras i Auto Cad. Objekten har kontrollerats i Sketchup Pro innan import till Vico Office. I Vico Office visas de skapade objekten i en mängdlista samtidigt som en 3Dvy är tillgänglig. Objektens mängder tilldelas en mängdförteckning skapad enligt kodsystemet i AMA Anläggning. I denna process skapas en länk mellan objekten och mängförteckningen; sker någon ändring av objekten, uppdateras även mängdförteckningen. En kalkyl skapas sedan genom att mängdförteckningen tillsätts priser och resurser med kapaciteter genom manuell inmatning av data. Eftersom kalkylen innehåller resurser med kapaciteter för respektive mängd, skapas en tidplan löpande tillsammans med kalkylen. Den färdiga tidplanen möjliggör en 4D-simulering där aktiviteternas förlopp visas i en filmsekvens. Eftersom både kalkylen och tidplanen är länkad till objekten såväl som mängdförteckningen är modellen dynamisk. Ändras något i en vy, slår det igenom i alla led. Studien visar att en 5D-modellering av ett anläggningsprojekt är fullt möjlig. Problem uppstod dock vid import av modell med komplicerade geometrier från Auto Cad till Vico Office. Studien visar även att BIM-objekt bör skapas enligt en tydlig strukturell indelning. Vid modellering av anläggningsprojekt bör denna indelning följa AMA Anläggning då projektdokumenten som används under ett projekt är indelade och styrs av detta referensverk.

Low productivity and high costs have led to an increased interest for industrialized construction methods in Sweden. Several new construction systems have been developed to increase productivity and contribute to a more efficient construction process. Virtual Design and Construction is another term for efficient management of “design-construction projects, including the product (i.e., facilities), work processes and organization of the design - construction - operation team in order to support explicit and public business objectives” (CIFE, Stanford). By streamlining all these areas a cost-effective building process can be achieved. VeidekkeMAX, an open building system that has its roots in the Virtual Design and Construction, has been developed with a focus to increase productivity and be the most cost effective option while the keeping the flexibility in the design of various building components. This thesis has studied the repetitive construction process of the structural system of VeidekkeMax buildings. Vico Office have been used to automate the 5D planning of the construction process of the structural system. A reference project of a VeidekkeMAX building has been used as a basis for the development by comparisons and identifying similarities and differences with the project. The proposed method is based on the definition of a reference file in Vico Office that is supported by information and connecting structures from other software for the 5D design work process. In order to create a reliable procedure it must be designed with the knowledge of how the information is interpreted by different users. In addition the building parts need to be predefined and supplied with the correct specification id, a cost and activity recipe and be connected to a particular work process in the production schedule.

Abstract Building Information Model/Modeling/Management (BIM) is a tool that allows for efficient working methods. BIM saves time and money while providing the potential for visualization. This method of working is based on a 3D-model, and then a fourth and fifth dimension are connected. 5D modeling means that a spreadsheet creates cost estimates based on the 3D model. This provides opportunities to carry out calculations in the early stages of the projects.   Calculations are currently performed manually and do not contribute to the development that the construction industry requires. To examine the efficiency of 5D BIM, a comparison should be made with the traditional calculation method. The purpose of this study is to propose a more reliable quantity takeoff and to study the advantages and disadvantages of each method.   The research questions to be studied in this thesis read as follows:  How reliable is quantity takeoff with the help of Vico Office in contrast to traditional quantity takeoff? What is required of a BIM model to perform a quantity takeoff in Vico Office?   To create calculations manually, bills of quantities are performed with recipes for each building component and then price lists from recipe databases are used. With the 5D BIM, a spreadsheet is connected to the BIM model that generates price lists and calculations for each building component. Spreadsheet entries are created for the component that contain the right amount of information, that is then connected to the correct building component. Vico Office is a program that provides opportunities to import 3D models from CAD tools to then carry out timetables and calculations.   Vico Office offers many advantages in contrast to the manual spreadsheet work in, among other things, time and cost. It is easy to handle and contributes to the development of BIM. It also contributes to increased communication between participants that makes it easier to handle delays. At the same time, the program needs new knowledge. The manual spreadsheet work gives uncertain calculations and the risk of measurement errors exist.   To perform a complete quantity takeoff in Vico Office an architectural model and a construction model is required. It is also important to name the components in the model before it is imported to Vico Office. Vico Office gives more BIM, and it is easier to perform a quantity takeoff because all the tools are in one place. It is not possible to determine that it is actually more efficient with Vico Office because the building model was lacking in this study.    This thesis demonstrates the advantages of 5D BIM, but at the same time it requires an initiative of the companies to implement the system. This transition from manual spreadsheet work to 5D BIM can be complicated because it requires time and knowledge.   Keywords: 5D BIM, Vico Office, Cost, Quantity Takeoff

Psoriasis is a chronic, immunological and systemic disease with an estimated prevalence of about 2-3 percent. Psoriasis is associated with the joint disease psoriasis arthropathy. There are several treatments options available for psoriasis and patients with moderate to severe psoriasis generally need systemic agents. In 2004 biologics were introduced for patients with moderate to severe psoriasis in Sweden. The overall objective of this thesis was to assess the relationship between Health Related Quality of Life (HRQOL) and clinical outcome measures in psoriasis patients, to analyse the effectiveness of biologics in psoriasis in everyday clinical practice and to explore how costs of the psoriasis population changed after the introduction of biologics in Sweden. Methods: Research was based on national administrative registers and PsoReg, the Swedish registry for systemic treatment of psoriasis. In a cross-sectional study (paper I) the three outcome measures: the generic HRQOL measure EQ-5D, the dermatology specific HRQOL measure the Dermatology Life Quality Index (DLQI) and the clinical measure of skin involvement, Psoriasis Area and Severity Index (PASI), were analysed by demographic characteristics. The generic EQ-5D among psoriasis patients was compared to previously published values for the general population in Sweden. Relationships between measures were examined with correlation tests and regression analysis. A longitudinal study included patients registered in PsoReg who switched to a biologic agent for the first time during registration (paper II). The three outcomes EQ-5D, DLQI, and PASI were analysed before and after switch in the overall patient group and in subgroups. The relative effectiveness of continuing with the standard care of conventional treatment compared to switching from standard care to biologics was analysed in patients with moderate to severe psoriasis (paper III). Patients in PsoReg were matched with propensity scores and average treatment effects were estimated. The estimated outcomes were the change of EQ-5D, DLQI, and PASI. Patients were identified in national registers at the National Board of Health and Welfare when analysing costs; either by a registration of a psoriasis diagnosis in the national patients register and/or by a registration in the prescribed drugs register of a topical treatment with calcipotriol, a substance which has the indication psoriasis only (paper IV). Direct costs included patients’ visits in specialist health care and prescribed drugs used for psoriasis treatment, retrieved from the national patients register and the prescribed drugs register, respectively. Indirect costs included productivity loss in terms of sick leave and disability pension, which estimated as excess costs compared to controls. Controls were selected from the normal population and matched on sex, age and municipality. Productivity loss was estimated based on data from the Longitudinal integration database for health insurance and labour market studies at Statistics Sweden. Results: Patients with moderate to severe psoriasis had significantly lower HRQOL in EQ-5D than the general population (paper I). Women rated their HRQOL lower than men, even though men had more severe clinical skin involvement than women. (paper I). The generic measure EQ-5D and the dermatology-specific DLQI had moderate correlations whereas EQ-5D had low correlation with the clinical measure PASI (paper I). Patients who switched to a biologic agent during registration in PsoReg had significant improvements in all outcomes (paper II). Patients who fulfilled the criteria for moderate to severe psoriasis had the highest benefits of the biologic agents (paper II). The matched conventionally and biologically treated patients with moderate to severe psoriasis were essentially equal in important observable variables (paper III). The subgroup of patients not responding to conventional treatment had high potential benefits of biologic agents (paper III). Individuals with psoriasis had sick leave and disability pension to a larger extent than their matched controls (paper IV). Direct costs increased, whereas the indirect costs of productivity loss decreased between 2006 and 2009 (paper IV). Conclusion: Psoriasis is associated both with direct costs and indirect costs, and it has a negative impact on patients’ HRQOL. When evaluating psoriasis treatments and making decisions about treatment guidelines, both generic, dermatology-specific HRQOL measures, and clinical measures are necessary; as they answer to different needs. Although dependent on data quality, generalisability, and current pricing, results suggest that conventional treatments are suitable as first line and biologic agents as second line treatment. Results indicate that the different types of systemic treatments are not allocated optimally among patients with psoriasis in Swedish clinical practice.

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Syfte: Syftet med examensarbetet är att analysera i vilken utsträckning BIM används i kalkyleringsarbetet, och hur hindren kan övervinnas för att öka implementeringen av BIM i kalkyleringsarbetet. Metod: Vi har använt oss av en litteraturanalys och ett antal kvalitativa intervjuer. Resultat: Resultatet av examensarbetet är att det finns ett antal hinder som behöver övervinnas för att öka implementeringen av BIM i kalkyleringsarbetet. Ett av hindren är att i förfrågningsunderlaget från beställaren finns inte BIM-modeller med. Och om de finns med så håller de en bristande kvalité. Ytterligare hinder som är identifierade är de juridiska, tekniska och branschens motstånd mot ny teknik. Även utbildning i BIMverktygen, avsaknad av en gemensam branschstandard och att de inblandade aktörerna måste få en förståelse att BIM är ett verktyg som alla kan dra nytta av. Konsekvenser: BIM i kalkyleringsarbetet har en potential att ge en exaktare, mer tidsbesparande och säkrare kalkyler. Den analys som vi kan dra av vårt examensarbete är att vi upplever att Peab är på rätt väg. De väntar inte på att beställarna ska ge dem en användbar BIM-modell tillsammans med anbudunderlaget. De har istället tagit ett ledningsbeslut att själva börja modellera upp rätta geometriska modeller som är användbara för kalkylingenjören. De har insett vikten av att kalkylingenjören får de digitala verktygen och utbildning på dessa så att de kan dra nytta av de fördelar som BIM kan ge i kalkyleringsarbetet. För att driva implementeringen av BIM framåt så kan det behövas åtgärder i form av nationella regler gällande hur standardiseringar ska utformas. Dessa standardiseringar kan möjliggöra att processen att implementera BIM underlättas och att dessa standardiseringar kan övervinna hinder i informationsutbytet mellan aktörerna. För att öka användandet av BIM så rekommenderas att en BIM-samordnare utses, som tidigt i projekten ställer krav på de olika aktörerna på hur filer och handlingar ska utformas så att informationen går att använda, inte bara vid kalkyleringsskeendet utan också vidare i projektet. För att driva implementeringen av BIM framåt så behöver det juridiska hindret få en lösning. Därför att nu så saknas regler i standardavtalen för att kunna inkludera digital information i handlingarna. Dessa förändringar behöver åtgärdas för att kunna knyta leverantören och mottagarens ansvar och nyttjanderätt av innehållet i leveransen av digital information. Begränsningar: Vi har avgränsat oss till att endast analysera hur BIM används idag och hur det kan komma att användas i kalkyleringsarbetet i framtiden. / Purpose: The purpose with our thesis is to analyze to what extent BIM is used in the calculation work, and how to overcome the obstacles of implementing BIM in the calculation work. Method: We have used literature analysis and a number of qualitative interviews. Findings: The outcome of our thesis is that there are several obstacles to overcome in order to increase the implementation of BIM in the calculation work. One of the obstacles is that BIM structures are missing in the specifications from the clients and if they are included they do not live up to the standard necessary. Further obstacles are the juridical and technical problems alongside with the industry’s resistance towards new techniques. Insufficient education in BIM tools, and the lack of a common industrial standard are problems as well as there’s a need to help the involved operators acquire knowledge that BIM is a tool that everyone can benefit from. Implications: BIM has the potential to give more precise, more timesaving and more accurate calculations in the calculation work. When analyzing our work, we feel that Peab is on the right path. They don’t wait for the clients to give them a useful BIM structure together with the tender documentation. Instead, the management have decided to make geometrically correct structures themselves that are useful to the calculation engineer. They have realized the importance of providing the calculation engineer with the proper digital tools and education of these tools so that they can benefit from the advantages BIM can give in the calculation work. In order to drive the implementation of BIM forward, there might be a need for some workarounds in the form of national rules about standardizations are to be formed. These standardizations can make it possible to ease the process of implementing BIM and that these standardizations can overcome obstacles in the information exchange between the clients. To increase the use of BIM it’s recommended that a BIM coordinator is selected, who can make demands on the various clients about how files and documents should be designed in order to be able to use them, not just in the calculation stage but also further into the project. In order to drive the implementation of BIM forward, a solution to the juridical obstacle are needed. As it is now, rules to include digital information in the acts are missing in the standard documents. Changes need to be done in order to attach the contractor and the client`s responsibility and usufruct of content in the delivery of digital information. Limitations: We have limited ourselves to only analyze how BIM are used today and how it may be used in the calculation work in the future.

Utvecklingen inom byggindustrin går sakta men säkert framåt. Branschen har börjat förstå vilka framgångar och möjligheter det finns med att digitalisera sig, däremot är det är en lång resa som är under ständig förbättring. Inom byggbranschens digitalisering handlar det alltsomoftast om BIM, ett begrepp som har många olika betydelser. Enkelt förklarat handlar det om att en 3D-modell kopplas ihop med olika typer av information, vilket kan ge många möjligheter till att effektivisera byggets samt projektets gång. Främst talas det om möjligheten att genom en 3D-modell få fram både 4D (tid) och 5D (kostnad)-modeller. Många aktörer inom bostadsproduktion har påbörjat sin resa mot ett digitalt arbetssätt och JM AB är definitivt en utav dem. År 2018 började JM AB arbeta med sin ambition om att en dag vara branschledande inom digitalisering. En del av digitaliseringsarbetet sker inom kalkylavdelningen på JM, där avdelningen i detta nu gör mängdning samt kalkylering i mjukvaruprogrammet VO. Det är i sin tur kalkylavdelningen som tar fram produktionskalkylen inför byggstart och det görs också i VO. Tack vare utvecklingen inom digitaliseringen kan JM AB nu göra tydliga kopplingar mellan tid och kostnader med 3D-modeller som bas. En kalkyl som inte kopplas på detta sätt är arbetsomkostnadskalkylen. Här krävs en undersökning i hur kalkylen kan kopplas till en 5D-modell och på sikt kunna bidra till produktionskalkylens utveckling, vilket för oss till rapportens syfte. Examensarbetet fokuserar på att ta fram olika nyckeltal för arbetsplatsomkostnader som kan kopplas till 5D-kalkylering. I denna process har det krävts intervjuer med sakkunniga, för att få en tydlig bild gällande både, vem som upprättar kalkylerna och hur de tas fram. För att bekräfta och stärka det som har sagts i intervjuerna har litteratur i form av artiklar och böcker används. Resultatet redovisar vad som krävs vid 5D-kalkylering av produktionskalkylen i VO. Det visar även vilka nyckeltal för kontona Kran samt Bodar, kontor m.m. som har tagits fram baserat på data från de utvalda flerbostadshusprojekten. För att nyckeltalen på bästa sätt ska kunna visualiseras samt redovisas i VO, behöver dem kopplas till en tidsram, vilket i detta fall är tidsplanen. Målet med rapporten har varit att förbättra analysen av kalkylerade produktionskostnader med tillämpning av 5D-kalkylering. Sammanställningen av nyckeltal på arbetsplatsomkostnader, som visualiseras i VO, har som syfte att optimera projekten genom att ta fram tydligare kopplingar mellan kostnad och tid. Rapportens reliabilitet måste självklart valideras av företaget i fråga. Denna visualisering och nyckeltalsframställning är däremot ett exempel på hur ett möjligt tillvägagångsätt kan se ut. Tillvägagångsättet och 5D-visualiseringen är även det första i sitt slag inom företaget JM AB. / The development in the construction industry is slowly but surely moving forward. The industry has begun to understand the successes and opportunities of digitizing itself, but it is a long journey that is constantly improving. In the construction industry's digitization, it is mostly common that it talks about BIM, a concept that has many different meanings. Simply explained, it is about connecting a 3D model with different types of information, which can provide many opportunities for streamlining the construction of the building and the project. It is mainly talked about the possibility of obtaining a 4D (time) and 5D (cost) models through a 3D model. Many housing production companies have begun their journey towards a digital world and JM AB is definitely one of them. In 2018, JM AB began to work with its ambition to one day be the leading actor in the industry of digitization. Part of the digitization work takes place within the calculations department at JM, where the department in this now makes quantity and cost estimations in the Vico Office program. It is the calculations department that produces the production costing for the construction start and this is also done in VO. Thanks to the development in digitalization, they can now make clear connections between time schedule and costs with 3D models as a base. A calculation that is not linked in this way is the overhead cost calculation. This requires a study into how the calculation can be linked to a 5D model and in the long run be able to contribute to the development of the production costing, which for us is the purpose of the report. This study focuses on developing various key figures for overhead costs that can be linked to 5D calculation. In this process, interviews with experts have been required, in order to get a clear picture of both, who establishes the calculations and how they are produced. To confirm and strengthen what has been said in the interviews, literature in the form of articles and books has been used. The result in the report shows what is required in 5D calculation of the production costing in VO. It also shows which key figures have been produced based on data from the specified comparison projects. In order for the key figures to be best visualized and reported in VO, they need to be linked to a time frame, which in this case is the projects timetable. The aim of the report has been to improve the analysis of estimated production costs with the application of 5D calculation. The compilation of key figures on costs, which is visualized in VO, aims to optimize the projects by producing better connections between cost and time. The report's reliability must of course be validated on the basis of the company's, JM, response to the rapport. This visualization and key figures presentation are an example of how a possible approach might look. The procedure and the 5D visualization are also the first of its kind within the company JM AB.

Hirsutism is excessive hair growth in women. The prevalence is estimated at 5%. The aim of this thesis was to describe different aspects of how life is affected for women suffering from hirsutism. Both qualitative and quantitative methods were used. Study I showed that hirsutism deeply affects women’s experiences of their bodies in a negative way and was experienced as a life sorrow. In Study II the patient-physician relationship was described. The patient-physician relationship from the patient’s perspective was suboptimal, as most meetings included feelings of being rejected and even humiliation. In Study III the aim was to translate and psychometrically evaluate an instrument that measures perceived social support, “The Multidimensional Scale of Perceived Social Support” (MSPSS). The translation was performed according to WHO:s official process, and validation was performed in a sample that consisted of 281 participants, 127 women with hirsutism (main sample) and 154 nursing students. MSPSS had good psychometric properties with regard to factor structure, construct validity, internal consistency and reproducibility. Study IV described different aspects of HRQoL in the main sample, the correlation of anxiety, depression, level of hairiness, age and BMI. The F-G scores were dichotomized into minor (F-G ≤14) and major (F-G≥15) hair growth. Higher levels of hair growth were significantly correlated to a lower level of QoL measured by DLQI, EQ-5D and symptoms of both anxiety and depression measured by HADS. Study V investigated if social support was associated with quality of life and outcome of HRQoL compared to a reference group of women (n=1115). SF-36, the MSPSS and the F-G scale were used. Compared to the reference group, women with hirsutism reported lower quality of life in all dimensions of SF-36 (p<0.01) The dimension most affected was vitality (VT=41.2), which had a lower value than has been reported for patients with MS and myasthenia gravis. A Multiple Regression Analysis showed a significant relation between quality of life and social support, indicating its importance for the ability to adapt, in spite of low quality of life.

Bakgrund: Höftfrakturer håller på att bli ett stort hälso- och vårdproblem på grund av den snabbt växande åldrande befolkningen. Det är därför viktigt att undersöka hur höftfrakturer påverkar de äldres hälsorelaterade livskvalitet. Syfte: Syftet med denna studie var att undersöka hur höftfraktur hos äldre personer, över 60 år, påverkar deras uppfattade hälsorelaterade livskvalitet. Metod: Studien är en litteraturöversikt och består av 12 vetenskapliga originalartiklar med kvantitativ ansats. Resultat: Höftfrakturer har en negativ påverkan av individens hälsorelaterade livskvalitet. Framförallt försämras individens rörlighet och självständighet. Ålder utgör den främsta bidragande faktorn och störst återhämtning sker under det första halvåret. Efter ett år är den fortsatta återhämtningen måttlig eller obefintlig.  Slutsats: Höftfraktur har en direkt negativ påverkan hos den enskilda individens funktionella rörlighet och psykosociala omständigheter vilket negativt påverkar individens hälsorelaterade livskvalitet. För att möta kommande vårdbehov skulle investeringar i mer resurser behövas, för att aktivt arbeta med att utveckla rehabiliteringsprogram för individer som råkat ut för höftfraktur, för att minska bestående besvär och tidigt avvärja vidare komplikationer. Samt att sjukvården aktivt informerar om höftfrakturer, så att patienter har realistiska förväntningar på sin återhämtning. För fortsatt forskning bör fler mätinstrument än EQ-5D inkluderas för att skapa en bättre helhetssyn av individens hälsosituation.