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Background: A closed-loop medication system is planned to be implemented at Uppsala University Hospital. Thus, an advanced pharmaceutical validation system called System-Assisted Pharmaceutical VALidation (SAPVAL) is being developed, which aims to identify and manage risk prescriptions, hence reducing potential adverse drug events (ADEs). The system is based on clinical rules that generate an alert due to a "risk score”. As part of SAPVAL, this study focuses on alerts related to an increased risk of bleeding. Aim: This study aims to investigate, gain an enhanced understanding, and determine the clinical significance of alerts generated by one of the clinical rules (rule 2- risk of bleeding) that was developed within SAPVAL. Methods: A cross-sectional retrospective study where alerts 100 from randomly selected patients, with a previously identified risk of bleeding, were investigated in regard to the risk period for potential/true ADEs, undertaken mitigation measures and clinical significance. This was done by accessing the patients’ electronic health records. Results: The risk period for potential ADEs was 29 days. In total, 35 ADEs were identified, with anemia as the most common symptom. Mitigation measures were undertaken for 55 patients, of which the most common were prescription of a proton pump inhibitor and blood transfusions. The clinical evaluation showed that 66% of the 103 included alerts were deemed clinically insignificant. Conclusion: Most alerts were deemed clinically insignificant. This in turn, emphasizes the importance of a system like SAPVAL, where insignificant alerts are filtered away by pharmacists before reaching the physicians, thus reducing problems related to alert fatigue.

BAKGRUND: Bröstcancer är allmänt känt i samhället, men få känner till den ärftliga aspekten av bröstcancer. Genom ett blodprov kan vårdpersonal påvisa om kvinnor har en genmutation, som ger ökad risk för bröstcancer, eller inte. SYFTE: Syftet med studien är att beskriva kvinnors upplevelser av att leva med ärftligt ökad risk för bröstcancer. METOD: En kvalitativ litteraturstudie där 14 vetenskapliga artiklar har analyserats. RESULTAT: Kvinnorna som lever med ärftligt ökad risk för bröstcancer lever med en ständig oro och osäkerhet. Varje kvinna är unik och hennes erfarenheter är därav individuella. Trots denna individualitet kan vissa mönster identifieras. De mest framstående ämnesområdena är oro och osäkerhet samt svårighet att hantera hotet. DISKUSSION: Kvinnorna med ärftligt ökad risk för bröstcancer ser till familjens bröstcancererfarenheter vid hantering av den egna situationen. Detta är relevant för all vårdpersonal då det är av vikt att förstå patienten och hennes unika situation. / BACKGROUND: Breast cancer is commonly known through out the society, but few people are aware about the hereditary aspect of breast cancer. Through a blood test the healthcare professionals can determine if women have a genetic mutation, that increase the risk of getting breast cancer, or not. PURPOSE: The purpose of this study is to describe women's experience of living with an increased hereditary risk of breast cancer. METHOD: A qualitative literature study where 14 scientific articles were analysed. RESULT: Women who live with an increased hereditary risk of breast cancer live under constant worry and uncertainty. Each woman is unique and her experience is therefore very individual. Despite this individuality certain key point can be identified. The most distinguished subject areas are anxiety and uncertainty together with difficulty to handle the threat. DISCUSSION: Women with increased hereditary risk of breast cancer see to their family's breast cancer history when dealing with their own situation. This is important for all medical staff due to the importance of understanding the patient and her unique situation.

<p><strong>BAKGRUND</strong>: Bröstcancer är allmänt känt i samhället, men få känner till den ärftliga aspekten av bröstcancer. Genom ett blodprov kan vårdpersonal påvisa om kvinnor har en genmutation, som ger ökad risk för bröstcancer, eller inte.</p><p><strong>SYFTE</strong>: Syftet med studien är att beskriva kvinnors upplevelser av att leva med ärftligt ökad risk för bröstcancer.</p><p><strong>METOD</strong>: En kvalitativ litteraturstudie där 14 vetenskapliga artiklar har analyserats.</p><p><strong>RESULTAT</strong>: Kvinnorna som lever med ärftligt ökad risk för bröstcancer lever med en ständig oro och osäkerhet. Varje kvinna är unik och hennes erfarenheter är därav individuella. Trots denna individualitet kan vissa mönster identifieras. De mest framstående ämnesområdena är oro och osäkerhet samt svårighet att hantera hotet.</p><p><strong>DISKUSSION</strong>: Kvinnorna med ärftligt ökad risk för bröstcancer ser till familjens bröstcancererfarenheter vid hantering av den egna situationen. Detta är relevant för all vårdpersonal då det är av vikt att förstå patienten och hennes unika situation.</p> / <p><strong>BACKGROUND</strong>: Breast cancer is commonly known through out the society, but few people are aware about the hereditary aspect of breast cancer. Through a blood test the healthcare professionals can determine if women have a genetic mutation, that increase the risk of getting breast cancer, or not.</p><p><strong>PURPOSE</strong>: The purpose of this study is to describe women's experience of living with an increased hereditary risk of breast cancer.</p><p><strong>METHOD</strong>: A qualitative literature study where 14 scientific articles were analysed.</p><p><strong>RESULT</strong>: Women who live with an increased hereditary risk of breast cancer live under constant worry and uncertainty. Each woman is unique and her experience is therefore very individual. Despite this individuality certain key point can be identified. The most distinguished subject areas are anxiety and uncertainty together with difficulty to handle the threat.</p><p><strong>DISCUSSION</strong>: Women with increased hereditary risk of breast cancer see to their family's breast cancer history when dealing with their own situation. This is important for all medical staff due to the importance of understanding the patient and her unique situation.</p>

La santé est un risque. La raison d’être de l’assurance est de couvrir les individus contre les aléas de la vie. Pourtant, la nature économique de cette opération a conduit les assureurs à écarter de leur mutualité, de manière croissante, les plus hauts risques de survenance d’un sinistre. Cette pratique appelée la segmentation est parfaitement autorisée. L’assureur peut, au moment de la discussion précontractuelle, procéder à une évaluation du risque par des investigations sur la situation personnelle et intime du candidat à l’assurance. Plusieurs constats sont faits. Le fait justificatif de discrimination n’est plus précis. Les techniques de collecte de l’information s’émancipent d’un encadrement légal sécurisé. L’existence d’un risque aggravé a des conséquences déraisonnables sur le contrat d’assurance. En France, plus de 2,7 millions de personnes présentent, au sens des assureurs, un risque aggravé du fait de leur état de santé. Il s’agit aussi bien de personnes diabétiques, atteintes de la maladie de parkinson ou ayant développé une pathologie cancéreuse. Pour eux l’accès à l’assurance rime avec le refus, les exclusions ou les surprimes. Ce phénomène concourt à une véritable injustice sociale, particulièrement lorsque le contrat d’assurance conditionne l’octroi d’un crédit immobilier. Pour cette raison, et sous les pressions associatives, des mesures ont été prises visant à limiter l’intrusion de l’assureur dans la vie privée du preneur d’assurance et parallèlement à renforcer les obligations d’information, de conseil ou de mise en garde du professionnel préalablement à la souscription du contrat / Health is a risk. The main purpose of insurance is to cover individuals against life’s uncertainties. However, because of the economic nature of this activity, insurers discard more and more the highest risks from their mutuality. This practice, named segmentation, is perfectly allowed. The insurer may, at the time of precontractual discussions, carry out a risk assessment by investigating the personal and intimate situation of the applicant. Several observations can be made. Evidence of discrimination is no longer precise. The techniques for information gathering emancipate themselves from a secure legal framework. The existence of an increased risk has unreasonable consequences on the insurance contract. In France, more than 2.7 million people are, in the sense of insurers, increased risks profiles due to their health status. Those are people living with diabetes, Parkinson's disease or other cancerous pathologies. For them, access to insurance rhymes with refusal, exclusion or additional premia. This phenomenon contributes to a real social injustice, especially when the insurance contract is necessary to be granted a mortgage. For this reason, and under pressures from associations, some measures have been implemented to limit the intrusion of the insurer into the policyholder’s privacy; and in parallel, to strengthen the obligations lying on the professionals to provide information, advice and warning, prior to any contract subscription