Background: It is well known that patients' adherence to chronic drug treatment is low and in developed countries it is estimated to be 50 percent. In other European countries, pharmaceutical services are already offered but this is not done in Sweden yet. The pharmaceutical services are aimed at specific patient groups to improve drug utilization and adherence in patients with chronic drug treatment.  Aim: The aim of this study was to investigate whether it was feasible to develop and conduct pharmaceutical counselling through a videoconference call since pharmaceutical services have not been offered through videoconference calls before.Method: Material for the intervention was developed by the researcher. The study was conducted during October and November 2021, customers were recruited from two pharmacies in Uppsala. The intervention was evaluated based on how the pharmacist and customers used the material developed for the pharmaceutical service. Additionally, semi-structured interviews were conducted to evaluate customers experience of the pharmaceutical service  Results: The five customers who participated in the study were satisfied with the experience of the pharmaceutical service and thought the technology worked well. However, customers had different experiences of how useful the material developed for the service was. Conclusion: It was feasible to offer pharmaceutical counselling as a videoconference call. However, the study population was small and had little diversity. Further studies are needed to evaluate the effectiveness of the pharmaceutical service in terms of improved adherence and drug utilization.

Background: Pharmaceuticals are a big part of healthcare expenditures. Advancements such as the sequencing of the human genome and technical methods has led to the development of more advanced drugs. Aim: The aim of this study was to explore the trends in new drug development areas and the costs of drugs in different therapy areas. Method: To do this, data from the Swedish Medical Products Agency, e-Hälsomyndigheten and the 20 biggest pharmaceutical companies regarding new approved drugs during a 20-year period, costs and new chemical entities in late development stage has been analyzed. Results: Each year, between 20 and 60 new drugs are approved. New chemical entities are most prevalent in the ATC-group L, which includes oncology and immunomodulating drugs. Innovation is also seen in group J, antiinfectives. The cost of drugs has increased during the study period, especially for oncology drugs. In the coming years, we can expect the introduction of even more oncology drugs, as mostdrugs in later development phases are expected to be classified in this group. Conclusion: Over the studied period, the most innovative therapeutic group has not changed but rather grown. The cost of drugs has also grown, possibly because of more new drugs introduced but also due to expanded indications and larger patient groups. It is hard to see a future where oncology drugs are not the biggest cost since in the coming years, many of the expected new drugs will fall into the same category.

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Both vertebrates and invertebrates use an innate system to recognise and fight pathogens such as bacteria. In this study, I focus on the methods the freshwater crayfish Pacifastacus leniusculus possess to inhibit the Gram-negative bacteria via LPS-recognition. Previous research has shown that this crayfish has certain proteins that can bind LPS, and that its bloodcells, the haemocytes, have an important role in this. However, scientists have yet to find evidence that LPS can bind the outside of these cells, similar to LPS-binding in humans. By bleeding crayfish and treating the cells with a primary and secondary antibody I could observe LPS-binding to the outside of granular haemocytes. This suggests there might be a protein positioned in or on the membrane of these types of cells that can bind LPS, which initiates the defence mechanisms.

Di(isononyl)cyclohexane – 1,2 dicarboxylate (DINCH) and Diisononyl phthalate (DINP) are high molecular weight compounds used as plasticizers. DINCH and DINP use on the market have been increasing recently to replace previously used phthalate plasticizers in polymeric products. Exposure to the compounds DINCH and DINP has been shown to be targeting the adipose tissue and potentially inducing lipid metabolism. However, few studies have reported the potential toxicity of these plasticizers and in this study, their effect on the 3T3-L1 cell line was investigated. The preadipocytes 3T3-L1 cell lines were exposed to 1 μM, 10 μM, and 100 μM DINCH and DINP for 10 days and assessed by lipid accumulation, gene expression, and protein analysis. The result of the lipid accumulation showed that higher concentrations of DINCH and DINP can induce adipogenesis. The proliferator-activated receptor gamma (Pparγ) agonist Rosiglitazone (Rosi) was used as a positive control. Further, the result of DINCH and DINP on gene expression showed that these compounds can both upregulate and downregulate genes involved in adipogenesis. The plasticizers DINCH and DINP upregulated proliferator-activated receptor-gamma and alpha (Pparγ, Pparα), CCAAT/enhancer-binding protein alpha (C/EBPα) and the fatty acid-binding protein 4 and 5 (Fabp4, Fabp5) and downregulated Fatty acid synthase (Fasn) and Gata binding factor 2 (Gata2) transcript levels. Protein analysis using Western blot showed that both DINCH and DINP can downregulate FASN protein expression. From this study, it can be concluded that DINCH and DINP influence the metabolic pathways and this can be a serious threat to animals and humans as the use and their levels in the environment are increasing.

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Creating noise-pollution and other disturbances, marine traffic poses a great threat to marine mammals all over the world which may demonstrate through short- and long-term changes in behavior and distribution. The Covid-19 lockdown in 2020 provided a setting to study the effects of marine traffic on cetacean presence and interactive behavior. We investigated the effects of fluctuations in both general marine traffic and whale-watching vessels that resulted from lockdown. Observational data in the North Atlantic Ocean off the coast of southern Tenerife was used, which have been collected during whale-watching tours between 2017-2021. The analysis showed that the decrease in general marine traffic in 2020 was mirrored in a lower number of whale-watching vessels present during cetacean observations. This reduction in boat traffic had a significant effect on how often the animals would approach the boat or stay indifferent to the presence of the boat among the resident species, with a significant increase in boat approaches and a significant decrease in indifference to boats after lockdown. We did not find a difference in presence for either resident or non-resident species as a group after lockdown, however, there was a significant increase of one individual species - the Atlantic spotted dolphin - after lockdown. Even though the resident species are living in a protected area, our results suggest that they are still affected by a high frequency of boats and boat interactions. To enhance the wellbeing of both resident and visiting populations, further management should be implemented, such as spatial or temporal boat-free zones as well as improvements on how whale-watching is performed. / Sjöfarten utgör ett stort hot mot marina däggdjur över hela världen då den skapar buller och andra störningar som kan orsaka både korta och långsiktiga förändringar i djurens beteende och distribution. Covid-19 nedstängningen under 2020 skapade unika förhållanden för att undersöka vilka eventuella effekter valskådning och sjöfart har på valars förekomst och beteende. Vi undersökte effekter av fluktuationerna i sjöfart och valskådning som resulterade av nedstängningen. I vår studie använde vi oss av observationsdata som samlats in under valskådningsturer mellan 2017 och 2021 i Nordatlanten utanför Teneriffas södra kust. Våra analyser visade att minskningen av den allmänna sjöfarten 2020 återspeglades i ett färre antal valskådningsfartyg som var närvarande vid observationer av valar. Den minskade båttrafiken hade en signifikant effekt på hur ofta de residenta delfinerna närmade sig observationsbåten och hur ofta dom var likgiltiga till dess närvaro. Vi fann en signifikant ökning av närmanden till båten och en signifikant minskning av likgiltighet till båten efter nedstängningen. Vi fann ingen skillnad i förekomst av vare sig residenta eller migrerande arter som grupp efter Covid-19 nedstängningen, men däremot en signifikant ökning av en enskild art - tygeldelfiner - efter nedstängningen. Trots att de residenta arterna lever i ett skyddat område tyder våra resultat på att de påverkas av den höga frekvensen av båtar och båtinteraktioner.  Vår slutsats är att ytterligare förvaltning behöver implementeras för att förbättra välbefinnandet för både residenta och migrerande arter. Dessa åtgärder omfattar rumsliga eller tidsmässiga båtfria zoner samt förbättringar i utförandet av valskådningar.

development.3KLIMATSMART MAT OCH HÄLSA I SKOLANEN INTERVJUSTUDIE OM SKOLMAT FRÅN HÅLLBARHETS- SAMT MILJÖMÄSSIGA OCH HÄLSOMÄSSIGA PERSPEKTIV MED EXEMPEL FRÅN MALMÖ STADGALINA PREMOVSKAPremovska, G. Klimatsmart mat och hälsa i skolan. En intervjustudie om skolmat. Examensarbete i folkhälsovetenskap 15 poäng. Malmö Högskola: Hälsa och samhälle, Utbildningsområde folkhälsovetenskap, 2011.SAMMANFATTNINGSyftet med denna empiriska intervjustudie är att undersöka personalens kunskaper om och användandet av Ät S.M.A.R.T.-modellen i Malmö skolrestauranger. Studien syftar till att identifiera vilka hinder och möjligheter finns det med implementeringen av modellen politiskt, ekonomiskt, ekologiskt och kulturellt. Undersökningarna i denna studie baseras på matsedelsförändringar enligt Ät S.M.A.R.T.-modellen, utgiven av Samhällsmedicin vid Stockholms läns landsting 2001. I den modellen finns ett konkret förslag på hur matvanorna i skolorna bör förändras för att på sikt bli mer klimatsmarta med tanke på miljö och hälsa. Studien bygger på intervjuer som gjordes med fyra kökspersonal och två pedagoger vid fyra skolor i Malmö. Med intervjuerna avses att få en bättre förståelse för hur personalen försöker nå den aktuella förändringen av skolmaten. Jag använder en hermeneutisk ansats där jag lyfter fram intressanta synpunkter som uppkommer under intervjuerna. Som teoretiskt perspektiv jag utgått från är det salutogena perspektivet med fokus på KASAM (Känsla för Sammanhang). Resultatet visar att ekologiska livsmedel har ökat med ca 20 procent trots en snäv ekonomi. En förutsättning för att Malmö skolrestauranger ska tjäna på förslaget är att klimatsmart mat ska ersätta så kallade ”tomma kalorier”, glass, chips, godis, läsk, etc. Ät S.M.A.R.T.-modellen innebär dessutom att andelen kött ska minska och andelen vegetabilier ska öka, utan att öka den totala kostnaden. Slutsatsen är att central styrning och tydliga beslut främjar övergång till klimatsmart mat och ekologisk livsmedel. Det finns dock en del hinder, t.ex. försvåras upphandling av närproducerade livsmedel av lagen om offentlig upphandling.Nyckelord: ekologiska livsmedel, hållbar utveckling, hälsa, klimatsmart mat, skolmåltider. / 2CLIMATE FRIENDLY FOOD AND HEALTH IN SCHOOLAN INTERVIEW ON SCHOOL MEALS FROM THE SUSTAINABILITY AND ENVIRONMENTAL AND HEALTH PERSPECTIVES WITH EXEMPLES FROM MALMÖGALINA PREMOVSKAPremovska, G. Climate friendly food and Health in School. An interview on school meals. Degree Project, 15 Credit Points. Public Health Programme, Malmö University: Health and Society, Department of Public Health, 2011.ABSTRACTThe purpose of this qualitative study is to examine the staff’ s knowledge of the Eat S.M.A.R.T.- model in Malmoe school restaurants. My aim is to identify what obstacles and possibilities there are with the implementation of the model politically, economically, ecologically and culturally. The investigations in this study are based on the bill of fare changes under Eat SMART model, published by Community Medicine at Stockholm County Council 2001. This model is a concrete proposal on how eating habits in the school can be changed in order to become more climate-friendly in view of environment and the health. The study was based on interviews which were made with four kitchen staff and two educators at four schools in Malmö, Sweden. The interviews were made to indicate how school staffs work in order to change school meals in accordance with the Eat S.M.A.R.T model. In analysing the material the hermeneutic approach was used to highlight what was relevant for this study. As theoretical perspective I assumed the salutogenic perspective, with focus on the SOC (Sense of Coherence). The results show that organic food has increased by approximately 20 percent despite a tight economy. In order to make a profit, Malmo school restaurants should be able to replace the so called "empty" calories, ice cream, potato chips, candy, soft drinks, etc. The Eat SMART.-model also means to reduce the proportion of meat and increase the proportion of plants, without increasing the total cost. Accordingly, central governing and clear decision making are significant for the transition to climate friendly and sustainable eating and organic food. However, there are some obstacles with regard to the purchasing of locally produced food and the law for the Public Purchasing Act.Keywords: climate friendly food, health, organic food, school meals, sustainable development.