Blomsterlupin, Lupinus polyphyllus, är en invasiv art som introducerades i Europa som trädgårdsväxt på 1800-talet. Arten har sedan spridits och finns idag vild i stora delar av Europa. Mänskliga aktiviteter antas ha en betydande påverkan på växtens spridning. Trädgårdslupin visar en stor variation i blomfärger; där blått är den genetiskt dominerande och vanligaste färgen. I denna studie ville jag testa om avståndet till bebyggelse påverkar mångfalden i olika blomfärger och om den blå färgen blir mer dominerande, desto längre bort från bebyggelsen växtplatsen är lokaliserad. Jag undersökte också om det fanns något samband mellan mångfalden av olika blomfärger och breddgraden för växtplatsen. Det fanns inga signifikanta samband mellan de olika variablerna för vilka jag utförde regressionsanalys, men det fanns vissa trender med p-värde <0,06. Det fanns en tendens till samband mellan den ökade variationen i effektivt antal huvudfärger med latitud, vilket skulle stödja min initiala hypotes. Det fanns också en tendens att det effektiva antalet blomfärger ökade när man minskade avståndet till närmaste hus, vilket ger ett visst stöd till uppfattningen att mänskliga aktiviteter påverkar förekomsten av olika blomfärger genom multipla introduktioner. / Garden lupine, Lupinus polyphyllus, is an invasive species introduced in Europe as a garden plant in the 19th century. The species has since then spread and is today distributed over large parts of Europe. Human activities played a significant role in the spread of the plant. Garden lupine shows a large variety of flower colours, with blue being the genetically dominant and most common colour. In this study, I test whether the distance to the next settlement affects the diversity of different flower colours and if the blue colour becomes more dominant with distance from human settlements. I also investigated whether there was a relationship between the diversity of different colours and latitude. There were no significant relationships between the different variables for which I performed regression analysis, although there were some trends with p-values <0.06. There was a tendency for variation in overall flower colours to be positively correlated with latitude, which supports my initial hypothesis. There was also a tendency for effective flower colour to be inversely correlated with distance to the nearest settlement, which supports the notion that human activities affect the frequency of different flower colours through multiple introductions.

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Still one of the most important animals on the planet, Honeybees are responsible for pollinating several species of plants that are vital to the ecosystem. They also produce honey, which is one of the few natural edible products of animal origin and has many beneficial properties for humans. Using 16S barcoding (SQK-16S024, Oxford Nanopore Technology) together with third generation sequencing MinION Mk1B and Flongle Flow Cell (Oxford Nanopore Technology) it was possible to acquire thousands of reads across the samples. The reads generated by the sequencer were analyzed using the Epi2Me software (Oxford Nanopore Technology) that identifies each sequence to species level. The initial results showed that the samples contained very small amounts of bacterial DNA. To increase the number of reads generated on each sample the number of cycles during PCR was increased. By Principal component analysis of the most common bacteria present across the samples, it was seen that in the microbiota of Swedish raw honey and processed honey there was no significant difference between them. When the Italian sample was considered in the analysis it was possible to see a significant difference between Swedish honey and Italian honey. The results suggest that different processes involved in preparing the honey to sell can cause differences in the microbiome of honey.

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Background and objective: An adequate communication of medicine information to the patient along with a correct medication list form the basis for a safe use of medicines. The aim was to study patients’ experiences of the information and communication about newly initiated drug treatment along with if and how the information was given during discharge.  Study design: A qualitative observational and semistructured interview. Observational data were collected using an observational form. Interview data was recorded with tape recorder and transcribed in verbatim in Microsoft Word. Analysis was performed using content analysis.  Setting: The cardiac ward at Länssjukhuset hospital in Kalmar and telephone interviews within one week after discharge. Six patientes were included. Main outcome measures: Primarily patient experiences of the drug information and communication about newly initiated drug treatment and secondarily which kind of information is given to the patient at discharge.  Results: Six patientes were included. Analysis of patient observations and interviews showed a great variation in experiences of the given information about newly introduced drugs. Eight main categories; clear drug information, sufficient drug information, insufficient drug information, positive experience of communication, obstacles for good communication, feeling of participation, barriers for participation and independently searching for information. All patients recieved a printed medication list at discharge but none recieved a written medication report.  Conclusion: Patients describe varying experiences of the drug information at discharge. Patients are prone to seek information about their medication in different sources following discharge. The information provided should be more individualized so that the patient is given the opportunity to feel involved in the drug treatment.

Idag sker stora populationsminskningar för många arter på grund av avsaknaden av livsmiljöer. Utifrån detta är det av stor vikt att stärka grön infrastruktur i hela landskapet och speciellt i sådana områden där det idag finns brist på livsmiljöer för olika djur- och växtarter. Värdekärna är den primära indikatorn för att beskriva kvalitéer i landskapet och kan till exempel utgöras av en nyckelbiotop i skogen. Den tretåiga hackspetten (Picoides tridactylus) anses i allmänt vara en specialist på barrskog och även svartmesen (Periparus ater) betraktas som en utpräglad barrskogsart. Syftet med studien är att undersöka om det finns områden i Götene, Karlsborg och Skövde kommun som kan utöka/förbättra barrskogsområden med värdekärnor. Detta genom att utföra en landskapsanalys och jämföra levnadsförutsättningarna mellan de två barrskogsarterna, tretåig hackspett (Picoides tridactylus) och svartmes (Periparus ater). Målet är att på lång sikt försöka förbättra områden med värdekärnor i berörda kommuner för att öka arternas förekomst och sannolikheten att överleva. Data för värdekärnor, avverkningsanmälningar och medelhöjd av träd har analyserats i ArcMap för eventuella hot mot arternas livsmiljö och lokalisering av potentiella framtida livsmiljö områden. Karlsborg kommun har stört areal av värdekärnor och minst avverkningsanmälning. Skövde kommun har mindre areal av värdekärnor och mer avverkningsanmälningar jämfört med Karlsborg. Götene kommun har minst areal av värdekärnor och mest avverkningsanmälningar. Skövde kommun har störts areal av potentiella framtida områden med värdekärnor för båda arterna. Karlsborg kommun har något mindre än Skövde och Götene kommun har mints areal av potentiella framtida områden med värdekärnor för båda arterna. Resultaten framtagna i denna studie kan inte betraktas som mer än ett första steg i arbetet med att försöka lokalisera framtida områden med värdekärnor för den tretåiga hackspetten och svartmesen. För framtida arbeten skulle det vara av intresse att i fält inventera de ”potentiellt framtida områdena” och på så vis avgöra om denna arbetsmetod är något som går att tillämpa i fler kommuner och eventuellt andra fågelarter för att finna potentiella framtida områden med värdekärnor för arter. / Today, large population reductions occur for many species due to the lack of habitats. Based on this, it is of great importance to strengthen green infrastructure throughout the landscape and especially in such areas where there is currently a shortage of habitats for various animal and plant species. Value core is the primary indicator for describing qualities in the landscape and can, for example, consist of a key biotope in the forest. The three-toed woodpecker (Picoides tridactylus) is generally considered a specialist in coniferous forest and the black tit (Periparus ater) is also considered a distinct coniferous forest species. The purpose of the study is to investigate whether there are areas in Götene, Karlsborg and Skövde municipalities that can expand / improve coniferous forest areas with core values. This is done by performing a landscape analysis and comparing the living conditions between the two coniferous forest species, the threetoed woodpecker (Picoides tridactylus) and the black tit (Periparus ater). The goal is to try to improve areas with core values in the municipalities concerned in the long term in order to increase the occurrence of the species and the probability of survival. Data for core values, deforestation reports and average height of trees have been analyzed in ArcMap for possible threats to the species' habitat and location of potential future habitat areas. Karlsborg municipality has disturbed the area of value cores and at least felling reports. Skövde municipality has a smaller area of value cores and more felling reports compared to Karlsborg. Götene municipality has the least area of value cores and the most felling reports. Skövde municipality has disturbed area of potential future areas with core values for both species. Karlsborg municipality has slightly less than Skövde and Götene municipality has mined area of potential future areas with value cores for both species. The results of this study cannot be considered as more than a first step in the work of trying to locate future areas with value cores for the threetoed woodpecker and the black tit. For future work, it would be of interest to inventory the "potentially future areas" in the field and thus determine whether this working method is something that can be applied in more municipalities and possibly other bird species to find potential future areas with value cores for species.

Lenvatinib är en läkemedelssubstans som ingår i läkemedlen Lenvima och Kisplyx. Lenvatinib är ett cytostatikum och tillhör gruppen proteinkinashämmare. Indikationerna som läkemedelssubstansen lenvatinib har är: Differentierad sköldkörtelcancer, hepatocellulär cancer och endometriecancer. Dosering bör övervakas och initieras av sjukvård- och hälsopersonal med erfarenhet av cancerläkemedel. Hypertoni och proteinuri är två av de vanligaste biverkningarna som uppkommer under behandling med lenvatinib. Incidensen för sköldkörtelcancer i Sverige var för 10 år sedan konstant runt 350–400 fall varje år, men under det senaste decenniet har denna siffra ökat och är nu 550–600 fall. Årligen diagnostiseras ungefär 500 fall hepatocellulär cancer. Den vanligaste gynekologiska tumörformen i Sverige är endometriecancer och drabbar framför allt äldre kvinnor.    Syftet med detta examensarbete som är en litteraturstudie, var att undersöka läkemedlet Lenvima samt dess toxicitet och biverkningar. Denna substans har ett flertal indikationer för cancer, men har också en brist då läkemedlet bidrar till biverkningar och toxicitet. I detta arbete användes fem vetenskapliga artiklar vilka valdes med hjälp av databasen PubMed. Sökorden som användes var ”lenvatinib”, ”lenvatinib thyroid cancer”, ”lenvatinib hepatocellular carcinoma”, ”lenvatinib molecular” och ”lenvatinib endometrial cancer”. Alla de vetenskapliga artiklarna som har studerats under detta examensarbete påvisar resultat som bevisar att lenvatinib är en potentiell läkemedelssubstans vid indikationerna differentierad sköldkörtelcancer, hepatocellulär cancer och endometriecancer trots biverkningar och toxicitet. En av studierna påvisar att en lägre startdos bör rekommenderas för att minska toxiciteten. Lenvatinib har påvisats sig ha terapeutiska effekter för olika solida tumörer. Lenvatinib i kombination med pembrolizumab gav resultat i studier som gjorde att läkemedelssubstanserna godkändes för behandling vid avancerat endometriecancer.  Om en tidig identifiering av behandlingsrelaterade biverkningar tillämpas under studier leder det till att dosavbrott samt dosminskning och biverkningar kan minska. Food and Drug Administration godkände lenvatinib som förstahandsbehandling för patienter med icke-operabelt hepatocellulär cancer och lenvatinib i kombination med pembrolizumab är en godkänd indikation för avancerad endometriecancer. I samtliga fall skall behandlingen fortsätta så länge det observeras en klinisk nytta eller tills en oacceptabel toxicitet uppstår. / Lenvatinib is the active medical substance in the pharmaceutical drugs Lenvima and Kisplyx. Lenvatinib is an anti-cancer drug belonging to the protein kinase inhibitor group. Indications for the usage of Lenvatinib include differentiated thyroid cancer, hepatic cell carcinoma, and endometrial cancer. Dosage should be monitored and initiated by health care and health professionals with experience in cancer treatment. Hypertension and proteinuria are the most common adverse events from the treatment with lenvatinib. The goal is that >90% of the patients with thyroid cancer should be treated, investigated, and followed up according to the recommendations of the healthcare program. The incidence of thyroid cancer in Sweden was constant at around 350-400 cases each year ten years ago, but the disease has increased to 550-600 cases/year during the last decade. Each year about 500 patients are diagnosed with hepatic cellular carcinoma. In Sweden, the most common form of gynecological tumor is endometrial cancer, which primarily affects older women.   This literature study aimed to investigate the pharmaceutical drug Lenvima, containing the active drug substance lenvantinib. This substance has several indications for cancer treatment but can also contribute to adverse events and toxicity. In this study, five scientific articles from the database PubMed were selected. The keywords used for the search were “Lenvatinib,” “lenvatinib thyroid cancer,” “lenvatinib hepatocellular carcinoma,” “lenvatinib molecular,” and “lenvatinib endometrial cancer.”  All the scientific articles used for this thesis prove that lenvatinib is a potential substance as cytostatic for several indications, despite adverse effects and toxicity. One of the studies shows that a lower starting dose should be recommended to lower the toxicity. Lenvatinib has been shown to have therapeutic effects on different solid tumors. Lenvatinib, in combination with pembrolizumab, showed results in studies that approved them for treatment for advanced endometrial carcinoma.   If an early identification of treatment-related adverse events is applied during the studies, this leads to an interruption and decreased dosage in time to reduce the serious adverse events. Food and Drug Administration approved Lenvatinib as the firsthand treatment for patients with non-operable hepatocellular carcinoma, and lenvatinib, in combination with pembrolizumab, is an approved indication for advanced endometrial cancer. The treatment should continue as long as there is a clinical benefit or until non-acceptable toxicity occurs.

Risks with drug labels used in preparation of medicines in pediatric hospitals Background: Dosing and preparation of medicines can be challenging and risky. Therefore, drug labels are often used by healthcare personnel when preparing medicines for hospitalized patients. There is a lack of information on how the labels should be designed and how much information they should contain. However, the National Board of Health and Welfare has required that all labels need to contain seven attributes. Aim: The purpose of this study was to analyse risks associated with labels used in pediatric care, and to investigate which attributes a standardized drug label should contain to increase patient safety. Methods: A survey was answered by pharmacist from different hospitals in Sweden. In addition, the pharmacists were asked to send pictures of labels. A risk analysis was performed to calculate the risk-level of identified label attributes.  Results: Different systems are in use for labeling when preparing medicines in Swedish hospitals, including commercial and self-developed systems. The study showed that none of the 54 collected labels complied with the National requirements. However, many labels contained additional attributes. This study identified 18 different label attributes that had different impact on patient safety as valued by pharmacists working in pediatric wards, for example barcodes to quickly look up important information. Conclusion: It is important to optimize labels used in hospitals when preparing medicines, particularly in pediatric care where the usage of off-label drugs and medication errors are common. Further studies are needed to understand the best design of labels and to increase patient safety in pediatric care.