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Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78%) and interviews (n=15). Results: The questionnaire showed that the majority of the respondents (52%) occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41%) were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet.

The aim of the study was to compare clients' and named home care (HC) workers' perceptions of clients' functional ability (FA) and need for help and to analyse which clientand municipality-related factors are associated with perceptions of client's FA. The total of 686 Finnish HC clients was interviewed in 2001. Further, the questionnaire was sent to 686 HC workers. FA was assessed by activities of daily living (ADL), which included both basic/physical (PADL) and instrumental (IADL) activities. The association between client's FA and municipality-related variables was analysed by using hierarchical logistic regression models. The findings indicated that clients' and HC-workers' perceptions about what the clients were able to do were similar in the PADL functions, but perceptions differed when it comes to the IADL functions for mobility and in climbing stairs. A smaller proportion of clients compared with HC workers assessed themselves to be in need of help in all ADL functions. Use of home help and bathing services increased the probability of belonging to the 'poor' FA class while living alone and small size of municipality decreased the probability. The study indicates that although clients and workers assessed client's FA fairly similarly, there were major differences in perceptions concerning clients' needs for help in ADL functions. Clients' and workers' shared view of need for help forms a basis for high-quality care. Therefore, the perception of both the clients and workers must be taken into account when planning care and services. There was also variation in clients' FA between municipalities, although only the size of municipality had some association with the variation. The probability that clients with a lower FA are cared for in HC is higher if the clients live in large- rather than small-sized municipalities. This may reflect a better mix of services and resources in large-sized municipalities. [ABSTRACT FROM AUTHOR]

The remediation of Lake Jarnsjon in Eman was carried out during the period 1993-1994. PCB-contaminated sediments were dredged, dewatered and disposed of in a landfill. In order to reduce the spreading of suspended solids and PCB to the watercourse, a suction dredger constructed specially for dredging with minimal spread of suspended solids was used. In addition, dredging of the most contaminated part of the lake was carried out within a protective geotextile screen. An extensive environmental monitoring program, running throughout the operation, showed that the spread of suspended solids and PCB during dredging was limited. Monitoring of PCB also showed that the use of geotextile screens considerably reduced the exposure of the river water to PCB. Dewatering was carried out with filter presses and the surplus water was returned to Jarnsjon after cleaning by flocculation, flotation and sedimentation. The landfill was covered with 1.2 m sand and gravel from the site. No external hydraulic barriers were constructed. Instead, the relatively low permeability of the fine-grained and low-contaminated sediments in the topmost meter of the disposedsediments was considered sufficient, also taking into account the low mobility of PCB from the deposited sediments, as measured in the pilot study. Thus, the calculated leakage from the landfill is small compared to the remaining transport of PCB in the river. During the first years of monitoring after construction, only minor leakage has been detected from the landfill. [ABSTRACT FROM AUTHOR]

Remediation of Lake Jarnsjon in Eman (a river in southeastern Sweden) is a part of the Swedish National Site Remediation Action Plan. Jarnsjon contained approx. 400 kg PCB that were slowly leaching out fromthe sediments into Eman. Without remedial action the sediments would have caused problems for many decades. Several investigationsand studies were carried out to determine how and under what limitations cleanup could be performed. An alternative for theremediation was selected that included vacuum dredging within a protective barrier of geotextile screens. Dredged material was to be dewatered and disposed of in a landfill. Remedial activities in Jarnsjon could, however, lead to an additional burden on Eman. Restrictions on and protective measures against such releases during remediation of Jarnsjon were therefore important issues. Dredging was carried out in 1993 and 1994. When dredging was completed, an amount of about 150 000 m3 had been dredged.According to the follow-up, 394 kg of PCB were removed, which constitutes about 97% of the estimated total amount of PCB in the lake. In the areas included in the remediation operation, about 2.9 kg of PCB were left. The major part of the remaining PCB (7.4 kg) is nowlocated at or near the lakeside, an area which was not included in the remediation operation. In the landfill, heavily contaminated sediments are separated from slightly contaminated sedimentsby a geotextile screen. The reason was to make it possible to localize the heavily contaminated sediments in the future, when remedial techniques have evolved and it may be feasible to carry out more definitive action. This far, the follow-up indicates that thelandfill is behaving satisfactorily. No increase in PCB concentration has been found in groundwater under the landfill, compared to reference levels. After remediation the concentration of PCBs in the l [ABSTRACT FROM AUTHOR]

Remediation of 150 000 m(3) of sediment containing 400 kg PCB was performed by suction dredging in a small lake in Sweden in the summers of 1993 and 1994. Upon project completion calculations indicated that97% of the PCB was deposited in a landfill with subsequent low transport to the surroundings, and that 2.9 kg was left in the lake sediment. Concentrations of PCB that were measured weekly in the water leaving the lake were 12 ng/L (geometric mean) during dredging, not exceeding 30 ng/L and not significantly higher than in investigations preceeding the remedial action. The concentration of PCB was negatively correlated to water discharge and positively correlated to water temperature. PCB transport in the river was correlated to water discharge but not to the dredging activity. During dredging of the most contaminated part of the lake, the dredging area was screened off by a geotextile silt curtain that reduced leakage of PCB to the river downstream. [ABSTRACT FROM AUTHOR]

While Electronic Prescription Systems (EPS) adoption varies across EU Member States, there's a lack of comprehensive comparative analysis. Existing studies focus on single EPSs, employ diverse methodologies, and lack up-to-date data. This study fills this gap by providing a comprehensive overview of EPS development, functionalities, and usage statistics in each EU Member State. Most EU Member States widely adopted EPS by 2022, with exceptions including Germany, France, and Luxembourg, where pilot projects or just plans existed at that time. Out of the 27 EPSs, 25 employ a similar design featuring a central server and end-user software or web-based applications. Among these, 22 are structured as single national systems. The fundamental technical solution is remarkably similar across the EU. Despite these similarities, functionalities, authentication methods, prescription validity, and medication coverage differ significantly among EPSs. A multinational team, including co-authors from each EU Member State, collected data using a structured questionnaire. The study underscores the need for standardized methodologies in EPS research and emphasizes the importance of comprehensive comparative analysis to inform healthcare policies and digitalization efforts.

Telemedicine in primary health care is expected to address many of the issues currently challenging service delivery. However, the impact and effect will depend on who will use the new technology., Objective: The objective of the study was to investigate differences between users and non-users of telemedicine integrated into traditional office-based primary health care., Methods: Quantitative registry-based population study in two regions in the southeast part of Sweden ( n  = 73,486), comparing users with non-users of telemedicine across the variables sex, age, socioeconomic status (SES), morbidity and health care seeking behaviour (HSB). Two study periods of six months were used (September 2019-February 2020 for Region Östergötland, and September 2021-February 2022 for Region Kalmar County) to collect user data. A reference period of 36 months (September 2016-August 2019) was used, to collect data on HSB., Results: Users were more often women under the age of 60 and had higher morbidity (measured as resource utilisation) than non-users ( p  < .001). In contrast, no statistically significant differences were seen between the two groups regarding SES, measured as Care Need Index (CNI). Regarding HSB, a proxy measure (health record entries) showed more entries for users than non-users., Conclusions: Our findings suggest that users are more likely to be women and below the age of 60. Likewise, users also tend to have a greater need for health care services compared to non-users, and they seek health care more often compared to non-users. No differences regarding SES were found.

Background: Deprescribing (i.e., the process of discontinuing an inappropriate medication) requires time, knowledge, and care, but there is a lack of education, support, and guidelines for this important clinical task. A clinical decision support system (CDSS) aims to influence the quality of care by combining structured medical knowledge with patient-specific information to generate recommendations., Objective: The objective was to examine the need to develop a CDSS for drug deprescribing. Furthermore, this study aimed to examine the obstacles to deprescribing and potential users' requirements for a CDSS for deprescribing., Methods: The qualitative design consisted of semistructured interviews with physicians ( n  = 10) in Sweden from different disciplines, including geriatrics, primary care and internal medicine. The interviews were conducted using a predefined guide containing multiple questions about any challenges related to deprescribing and the perceived need for a CDSS. A qualitative content analysis was performed to analyse the empirical data., Results: The interviews provided several aspects of the difficulty of deprescribing medicines. The structure and usability of the CDSS knowledge database in clinical practice needs to be ensured from the outset. Physicians needs fast, simple and up-to-date information filtered, summarized and synthesized from reliable sources. The information should preferably be integrated into pre-existing electronic health record., Conclusion: There is a need to develop a CDSS for deprescribing . There is little, if any, guidelines or support for deprescribing, which is regarded as a large obstacle. The current findings contribute to further knowledge regarding the perspective of physicians when deprescribing medication., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 The Authors.)

Adverse drug events (ADEs) occur frequently and are a common cause of suffering, hospitalizations, or death, and can be caused by harmful combinations of medications. One method used to prevent ADEs is by using clinical decision support systems (CDSSs). Janusmed Risk Profile is a CDSS evaluating the risk for nine common or serious ADEs resulting from combined pharmacodynamic effects. The aim of this study was to examine the prevalence of potential ADEs identified using CDSS algorithms from Janusmed Risk Profile. This retrospective, cross-sectional study covered the population of a Swedish region ( n = 246,010 inhabitants in year 2020) using data on all medications dispensed and administered. More than 20% of patients had an increased risk of bleeding, constipation, orthostatism, or renal toxicity based on their medications. The proportion of patients with an increased risk varied from 3.5% to almost 30% across the nine categories of ADEs. A higher age was associated with an increased risk of potential ADEs and there were gender differences. A cluster analysis identified groups of patients with an increased risk for several categories of ADEs. This study shows that combinations of medications that could increase the risk of ADEs are common. Future studies should examine how this correlates with observed ADEs.

In response to global challenges in resource supply, many industries are adopting the principles of the Circular Economy (CE) to improve their resource acquisition strategies. This paper introduces an innovative approach to address the environmental impact of waste Glass Fiber Reinforced-Polymer (GFRP) pipes and panels by repurposing them to manufacture structural components for new bicycle and pedestrian bridges. The study covers the entire process, including conceptualization, analysis, design, and testing of a deck system, with a focus on the manufacturing process for a 7-m-long prototype bridge. The study shows promising results in the concept of a sandwich structure utilizing discarded GFRP pipes and panels, which has the flexibility to account for variabilities in dimensions of incoming products while still meeting mechanical requirements. The LCA analysis shows that the transportation of materials is the governing contributing factor. It was concluded that further development of this concept should be accompanied by a business model that considers the importance of the contributions from the whole value chain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This paper provides an overview of shared medication lists (SMLs) in four Nordic countries (Denmark, Finland, Norway and Sweden) with a focus on the type of information the list is based on. This is a structured comparison conducted in stages using an expert group, grey papers, unpublished materials, web pages, as well as scientific papers. Denmark and Finland have implemented their solutions for an SML and Norway and Sweden are working on the implementation of their solution. Denmark and Norway have or are aiming at a list based on medication orders, while Finland and Sweden have lists based on prescriptions.