Open sand habitats in Sweden has been declining for the past century and this is mirrored by the increasing fragmentation and attenuation of species bound to these habitats. Many threatened species coexist in the same habitats as sand lizards, habitats best described as warm sites with a long continuity. Often with a sand-based substrate and a mosaic landscape of heather Calluna vulgaris, herbs, and patches of grass. Generally, areas with open sand are one of the keys for species bound to these habitats considering many of the species use south-facing sand slopes as nesting sites since it holds a warmer microhabitat that is beneficial for incubation of eggs and thus is essential for the whole lifecycle. This study investigates four current sand lizard (Lacerta agilis) localities in the county of Skåne and compares them to four empty localities in Southern Halland with similar character. The data collected from the study sites were analyzed to see if there were any significant differences between the populated and empty localities and thus could give information if key structures in the habitat are missing. The result from the analysis clearly shows that both the study sites Vapnö and Långenäsudden have the key structures that are essential for the sand lizard and could be considered as suitable habitats for potential new sand lizard populations. Information about both recreational pressure and predator abundance in these study sites would be an essential step in the final evaluation of the adequacy of the habitat as a whole.

Bakgrund: Generiska läkemedel är läkemedel som är medicinskt utbytbara och har samma funktion, kvalitet och säkerhet som originalläkemedel. Generika har samma aktiva substans och effekt men har ett annat namn och produceras av en annan tillverkare. Skillnaden mellan generika och originalläkemedel är att de kan ha olika produktnamn, hjälpämnen, bipacksedel, utseende och en annan leverantör. Kriterier för att generika och originalläkemedel ska vara utbytbara är att de båda ska vara godkända som läkemedel, ha samma beredningsform samt vara bioekvivalenta. Lag om läkemedelsförmåner och generiskutbyte trädde i kraft den 1. oktober 2002. I denna lag finns bestämmelser om läkemedelsförmåner, prisreglering av läkemedel som ingår i förmånen och andra sammanhängande frågor. Apoteken är skyldiga att byta det förskrivna läkemedlet mot det billigaste likvärdiga läkemedel som finns tillgängligt. Detta gäller endast läkemedel som omfattas av läkemedelsförmån. Syfte: Syftet med studien var att undersöka hur kunder på apoteket upplever generiskt utbyte och identifiera vilka eventuella problem som kan förekomma samt att undersöka om kundernas modersmål påverkar deras syn på generiskt utbyte. Metod: Enkätstudie med semikvantitativ och systematisk ansats. Kunder 18 år och äldre och som hämtade läkemedel på recept där generiskt utbyte var möjligt tillfrågades av expedierande farmaceuten om deltagandet i studie. I undersökningen besvarades 502 enkäter varav 40 deltagare hade ett annat modersmål än svenska. Resultat: Majoriteten, 87% av deltagarna angav att de hade fått generiskt utbyte. 42% av respondenterna hade fått information om generiskt utbyte av sin läkare medan 98% fick informationen på apoteket. Största andelen av deltagarna 36% var i åldern 45–64 år. 24% av deltagarna upplevde generiskt utbyte som ett problem. Skillnad mellan deltagare som hade svenska som sitt modersmål och de som hade ett annat språk var inte så stor när det gällde hur de upplevde generiskt utbyte. De mest förekommande svar när det gällde problem med generiskt utbyte var att kunder inte kände igen förpackning, tablett och/eller namn. De som hade ett annat språk som sitt modersmål svarade att största problemet med utbytet var att de kände skillnad i effekt, nya biverkningar och inte kände igen namnet på generikan. Slutsats: Studien visar att majoriteten (87%) var nöjda med generiskt utbyte. Det var på apoteket som de flesta fick information om det generiska utbytet. De som svarade att de upplevde generiskt utbyte som ett problem angav att de inte kände igen förpackningen, tabletten eller namn på generikan.

Introduction: Paracetamol is the most common medicine used as painkiller in the world. Since it has been on the market for a very long time it has been thought to be one of the safest medicines to use during pregnancy. Many women use this medicine for different indications during pregnancy thinking it is safe for the fetus. However, the mechanism of action for paracetamol is still unknown and therefore there is no information about how it could affect the fetus. Objective: To study paracetamol safety during pregnancy and its effect on the fetus and behaviour in childhood. Method: The information search for this literature study has been done through searching for different articles in the database pubmed. In these articles, pregnant women who used paracetamol during pregnancy have been analysed to see the effect on their children. Result: Different articles used in this literature study have shown an association between prenatal paracetamol exposure and behavioural problems in children. One study shows that if paracetamol is used during pregnancy the risk increases to get a Hyperkinetic disorder, HKD diagnosis (Hazard ratio (HR)= 1,37; 95% confidence interval (CI), 1,19-1,59), similarly the risk to get an ADHD-diagnosis increases (HR=1,29: 95% CI, 1,15-1,44). Discussion: The association between prenatal paracetamol exposure and behavioural problems has been shown in different studies made om pregnant women even though the exact mechanism is still unknown. Changes in children’s epigenetics seem to be associated with prenatal paracetamol exposure. Changes in DNA-methylation of genes previously linked to ADHD have been detected.   Conclusion: Prenatal paracetamol exposure seems to be associated with child behavioural problems. Therefore, paracetamol may not be a completely safe medicine in pregnancy and all pregnant women should have this information available to avoid unnecessary use especially during the second and third trimester. / Introduktion: Under graviditeten kan kvinnan få olika besvär och tillstånd som leder till att hon behöver behandlas. Paracetamol är det läkemedlet som används mest och är oftast lättast att få tag på då det säljs receptfritt. Läkemedel bör användas med största möjliga försiktighet då de flesta läkemedlen kan nå fostret via placentan. Eftersom paracetamols verkningsmekanism har varit okänd har inte några risker kunnat förutses hos foster. Syftet: Denna litteraturstudie har gjorts för att samla tillräckligt med information för att kunna besvara frågeställningen som är om paracetamolanvändning under graviditeten kan påverka fostret och barnets utveckling senare i livet. Metod: I denna litteraturstudie har information sökts genom att identifiera studier som har gjorts på gravida kvinnor och deras barn. Sökningarna har gjorts via pubmed och 6 originalartiklar har valts för att studera paracetamols effekt på fostret och senare effekt på barnet. Resultat: Flera studier på gravida och barn har visat association mellan paracetamolanvändning och barnens beteendeproblem. Hos kvinnor som använde paracetamol under graviditeten höjs risken för barnet att få en HKD (Hyperkinetic Disorder) diagnos (hazard ratio (HR)= 1,37; 95% konfidensintervall (CI), 1,19–1,59) och ADHD-diagnos (HR= 1,29; 95% CI, 1,15-1,44). Diskussion: Studierna påpekar associationen mellan paracetamolanvändning prenatalt och förhöjd risk för beteendeproblem hos barnen. Varje studie har tagit med olika confounders som kan bidra till ökad risk för beteendeproblem hos barnen. Att paracetamol kan associeras med beteendeproblem hos barnet kan inte uteslutas. Paracetamol borde användas under en kort period och enligt läkares ordinationer för att undvika komplikationer. Slutsats: Associationer mellan paracetamolanvändning under graviditeten och barns beteendeproblem senare i livet verkar existera även om de inte kan bekräftas helt säkert. Försiktighet borde iakttas när det gäller paracetamolanvändning under graviditet. Kvinnor borde få information för att undvika onödig användning av paracetamol under graviditet.

Mantle cell lymphoma (MCL) is a subtype of B-cell lymphoma characterized by chromosomal translocation t(11;14)(q13;q32), enhancing the expression of cyclin D1, resulting in alteration in cell cycle progression. The translocation is the key event for initiation of mantle cell lymphoma however is not sufficient for the development of the disease. Changes in the expression of the G-protein coupled receptors in different cancer types due to mutations and other regulating mechanisms can lead to changes in expression of proteins, resulting in defects in signalling pathways, favouring tumor dissemination. Growing evidences suggests that the disease progression in various B cell malignancies is due to the interactions between neoplastic B cells and stromal cells in tissue microenvironment. ONC201 is an imipridone, which is an antagonist to a type of G-protein coupled receptor: dopamine receptor D2. ONC201 has the property for inhibiting proliferation and inducing apoptosis. The objective of the project was to investigate the migration of MCL cells towards fetal bovine serum and by this, study the impact of ONC201 on the migration of mantle cell lymphoma cells using chemotaxis assay. The apoptotic effect of the drug was examined by detection of active caspase-3 and cleaved PARP proteins using western blotting. The chemotaxis assay and western blot demonstrated that ONC201 inhibited migration of the mantle cell lymphoma cell lines at the concentration-dependent manner without inducing apoptosis in the cells at the investigated time point. The expression of cyclin D1 in the cells treated with ONC201 was also investigated after incubation period of 24 hours and it was observed that ONC201 plays a role in reducing cyclin D1 expression in mantle cell lymphoma cells.

Forest fires are an important part of the boreal forest ecosystem but have become very reduced in Sweden over the past 100 years. To recreate this feature in nature, prescribed forest fire has become a management method used to promote biodiversity. The purpose of this study was to investigate the effects of prescribed forest fire on the ground and field layer vegetation in terms of vegetation structure, species composition, coverage ratio, biomass and soil pH. The study was conducted in the Brännan Nature Reserve where prescribed forest fires have been implemented on several occasions during the past 21 years, which also made it possible to compare several areas and investigate effects over time. Four sub-areas were studied, three previously fire-affected areas and one control area. The result shows that prescribed forest fires influence the ground and field layer vegetation, and there were significant differences between the areas. The vegetation structure changed, and new conditions were created for subsequent successional processes. The effective number of species decreased after the fire but subsequently increased over time. The percentage of vegetation cover showed the same result with a rapid re-establishment rate, especially during the 6 following years. Biomass production reached the highest value 21 years after the fire, but showed a declining trend compared to the control area. There was no significant difference regarding soil pH, which was expected. There are many factors that may affect the short- and long-term effects of prescribed forest fires, such as fire intensity and the soil depth reached by the fire, but despite variations among the areas, some trends were found.

No description available.

Aim: The aims of the study were to compare the effects on depressive symptoms and insomnia between agomelatine and SSRIs/SNRIs in adult patients with major depression disorder. Method: Materials were collected from the database Pubmed and selected through the aims of the study and certain selection criterias. It was required that the studies fulfilled at least one of the study´s aims to be eligible for inclusion. Eight randomised clinical trials were included in the study. The results from the studies were compared according to statistical and clinical significance. Results: Depressive symtoms were reduced both with agomelatin and SSRIs/SNRIs. Generally the rates of respone and remission were similar of agomelatine and SSRIs/SNRIs. There were advantages for agomelatine in the individual studies concerning rates of respone and remission. Six of the included studies investigated the effect on insomnia. In a majority of these studies agomelatine caused a statistically significant improvement compared to SSRIs/SNRIs. Clinically, both agomelatine och SSRIs/SNRIs improved most of the variables related to insomnia that were examinated according to patient-reported outcome results. Conclusion: Statistically both SSRIs/SNRIs and agomelatine achieved similiar effects on depressive symptoms. In the majority of the included studies that examinated effect on insomnia agomelatine showed a statistically significant improvement compared to SSRIs/SNRIs. Clinically, agomelatine is viewed as a viable option for adult patients with major depressive disorder with unsuccessful response or remission from SSRIs/SNRIs. A similiar clinical relevance were shown for agomelatine and SSRIs/SNRIs concerning improvement of insomnia according to patient-reported outcome results.

Drugs are an essential part of health care today. They improve and extend the lives of many people. If drugs are wrongfully combined or given in inaccurate dose, it may lead to poorer quality of life, hospital admissions and even deaths. Drug-related problems cost society a large amount of money each year. To minimize these problems, there are now electronic decision supports that doctors and pharmacists can use. At all pharmacies in Sweden, the electronic expert support system available. The EES analyzes electronic prescriptions and doses prescribed and indicates if it detects any potential drug-related problems. Such risks may be that the customer has several drugs with the same effect, drug interactions or that the drug is inappropriate due to age. For children, there are special warnings that may be that the doctor on the prescription has prescribed a higher dose of the drug against what is commonly given to a child. The purpose of the study was to investigate pharmacy customers view of and knowledge about pharmacist use of EES. Data were collected via surveys for 100 hours at several different pharmacies in Sweden. The vast majority of pharmacy customers did not know of EES, only one fifth of the survey respondents knew what EES meant. Consent from the customer is required for the pharmacist to use EES when dispensing drugs and one third of the customers did not know if they agreed to this or not. Half of the customers did not know if the pharmacist used EES when the drugs were dispensed. Most of the customers also did not know whether their drug dispensing would be safer, if they would get better advice if the EES was used or if they wanted the pharmacist to use EES as a tool in the prescription expedition. The study shows that pharmacy customers' views and knowledge about the use of  EES by pharmacists are limited. The reason for this may be that it takes extra time for pharmacists to inform customers about what EES means and ask them for consent that the expert support should be used in the prescription expedition. Many times the pharmacist is experiencing a shortage of time to do this. The reason why EES is not used may be because the pharmacist does not feel adequately educated in how the decision support works and therefore chooses not to use it. It may also be due to communication difficulties such as language problems, hearing impairment or the customer's reduced cognitive ability. There is a need for communicative improvements between the customer and the pharmacist so that the pharmacists will increase the use of EES when dispensing drugs. There is also a need for pharmacists to get education in how EES works and how to use the decision support. If this is done, it will provide the customer with a better drug use with reduced risk of side effects and drug-related problems.

Abstract Pharmacists have for many years been an important part of health care. They have rescued many people from diseases and poisoning. It´s important that they ensure the right drug, dosage and administration in right time for each customer. Elderly people usually have more prescribes than younger which increases the risk of interactions. Poor compliance may result in increased morbidity or premature death. There are several reasons why treatment is not followed. Lack of information about the treatment of disease or information about the medications for both indication and side effects are some of them At all pharmacies in Sweden, EES, Electronic Expert Support, is available. The introduction of e-prescription in the 21st century has enabled an additional safety check for the pharmacist, using Electronic Expert Support (EES) for dispatching prescriptions. The current recipe is compared with other prescriptions where there are withdrawals and the prescriptions where there should be pharmaceuticals left to consume. If there is a risk of incorrect dose, double prescription, age warning, interactions, gender specific or if drug affecting disease, a signal is given at EES control showing strength and action that may, should be done. The purpose of the study was to investigate customers perception of advice at the pharmacy and if the use and knowledge of the EES (Elektroniskt Expertstöd) differed between different age groups. The survey was conducted using data collection from seven pharmacies located in five locations spread across Sweden. The collection was conducted for about 100 hours and generated in 277 participants. All participation was voluntary and anonymous. The participants were divided into three age groups: 40 years or younger, 41-60 and over 60 years. The collected data was analyzed by using IBM SPSS and a chi2 test was performed to see if there were any significant differences between the age-groups. The result was compiled and demonstrated in excel diagrams. There was no significant difference between the groups in terms of safety and information they received about their drugs. Most people received information about their medicines by the doctor, pharmacist or by reading the package leaflet. However, there was some difference regarding the use of the Internet in a search for information retrieval among those over 60 years. This may be due to lack of internet knowledge or physical impairment. There was also a significant difference when it came to the question of calling 1177 for information on medicines, where people 40 years or younger, called more often than other groups. This may be because they usually have younger children and may need advice regarding illness or injuries. There was a significant difference between the age-groups in consent to use EES were elderly people had consented more often. Elderly people usually have more drug prescribes than younger and therefore is it more useful for people over 60 years. The risk of interactions increases with the number of drugs.

Background: Pain is one of the most prominent and disturbing symptoms reported by cancer patients. Appropriate pain relief is obtainable in more than 75 % of the patients with optimized analgesic treatment. Opioids and non-opioids are being utilized in cancer pain treatment and analgesics are used to improve the effectiveness of opioids. Gabapentin is primarily used as an anti-epileptic drug that is also recommended as the first-choice drug in treatment of neuropathic pain. Research is being conducted to evaluate cannabinoids as adjuvans analgesics. Sativex is the extract of cannabis sativa plant and is used to treat and ease moderate to severe symptoms of spasticity caused by multiple sclerosis (MS) in Sweden. Several scientific studies have recently studied sativex with positive results and the drug is currently being used in some countries in treatment of resistant cancer-related neuropathic pain. Purpose: The purpose of this paper was to conduct a scientific study and examine whether sativex is as efficient and secure as gabapentin and thus an option as addendum in cancer-related neuropathic pain when the treatment with only opioids is not sufficient for pain relief. Method: This literature study is based on examination of six clinical scientific studies. The articles are searched in PubMed database, the articles are about examination of effectiveness and security of gabapentin and sativex compared to placebo or other equivalent drugs in cancer patients suffering from neuropathic pain. Results: Two of the studies that compared gabapentin with placebo and one that compared Gabapentin with Amitriptylin (an anti depressive drug) showed that gabapentin was an efficient adjuvans analgesic that led to statistically significant pain relief in patients suffering from cancer. The side effects were mild to moderate in all three studies, and overdose of the study-drug was tolerated well. One of three studies evaluating efficacy and safety of sativex showed that the change in daily average pain score during two weeks of treatment was statistically significant in patients in the sativex-group compared to the group of patients receiving THC-extract and placebo-group. In the second study, sativex was compared within three different dosage groups (low, middle and high) as well as placebo and the result showed that sativex had significant pain relief only in patients receiving low dose of sativex. The third study showed that sativex led to pain relief in patients receiving sativex compared to those receiving placebo however the effect was not statistically significant. Dizziness, nausea and vomiting were the most common side effects in all three studies. The side-effects were mild to moderate and no serious safety issues were observed in the first and third studies. In the second study on the other hand, the patients were encouraged to maintain a stable opioid-dose which resulted in more side-effects. Conclusion: All three studies that examined the effectivness of sativex showed improvement on sleeping quality as well as pain relief, where two of the studies showed statistically significant pain relief in patients suffering from neuropathic cancer-pain. Studies on cannabinoids are quite controversial and there are not many global studies available that have studied its safety and efficacy in the treatment of neuropathic cancer-related pain. It is however a growing and upcoming area that is also expected to grow multiply in turnover which should enable more studies being conducted. These results show that sativex has the potential of being a good alternative in the treatment of neuropathic cancer-related pain. Sativex is also effective in low doses without the need for increases over time, furthermore side effects are mild to moderate and possible overdose is well managed by patients. Gabapentin been used in pain management in neuropathic cancer-pain for a long time with minimal side effects. Sativex, on the other hand, is quite new and there are not many studies performed on the medicine. Furthermore, there are no studies comparing sativex and gabapentin which makes it very difficult to conclude whether it holds the same safety and may act as a good alternative to gabapentin. In future studies, sativex should be compared to medicines used today such as gabapentin in order to prove its ability of being an alternative.