1177, 24/7? User perceptions of human elements in the chatbot "1177 direkt" in Region Uppsala

In the realm of healthcare, the significance of chatbots cannot be overstated. These systems play multifaceted roles, from distributing medical information to making appointments, checking symptoms, and managing medications. At the same time, there is a surge in the development and adoption of human-like conversational agents, such as Apple’s Siri, Amazon’s Alexa and Microsoft’s Cortana. Previous research is divided about whether human-likeness in chatbots is favourable. This study therefore seeks to explore how users in Region Uppsala perceive human elements in relation to 1177 direkt, using the following research questions: 1) What are the advantages and disadvantages of 1177 direkt, a non-human-like chatbot? 2) How does the presence/absence of human elements affect user perceptions of the chatbot’s a) reliability, b) functionality, and c) effectiveness? 3) What changes do users suggest in regards to the human element of 1177 direkt? Ten users were interviewed and qualitative content analysis was done on the material to generate four themes. The Uses and Gratifications model and a unique triad of reliability, functionality and effectiveness was applied on the themes. Results show that 1177 direkt offers significant media appeal in providing medical assistance in an easy and timely manner. However, the chatbot needs to become more adaptable to different user needs and contexts. With the addition of human elements such as greetings, acknowledge words, emoticons and natural language processing, 1177 direkt can offer users a more reliable, effective and functional eHealth experience. Concrete recommendations are presented to help policy-makers and developers in Region Uppsala improve 1177 direkt, which can benefit both healthcare receivers and healthcare workers in Sweden. The present study focuses on 20-29 year old students and recent graduates, seeing as this is the age group most commonly found amongst 1177 direkt users. It is important to include other demographics in eHealth development. Future research can therefore explore how the digital divide influences user experiences of healthcare chatbots

Unveiling the heterogeneous utilisation of the same digital patient management platform : case studies in primary healthcare in Sweden

Background: The utilisation of digital technology in primary healthcare, particularly digital patient management platforms, has gained prominence, notably due to the global pandemic. These platforms are positioned as substitutes for face-to-face consultations and telephone triage. They are seen as a potential solution to the escalating costs associated with an aging population, increasing chronic conditions, and a shrinking healthcare workforce. However, a significant knowledge gap exists concerning the practical aspects of their implementation and their effect on the utilisation of digital patient management in primary healthcare. Methods: This study addresses this gap by conducting a comprehensive analysis of three case studies involving the implementation of a specific digital patient management platform. Over a period of three years, we examine how the practicalities of implementation shape the adoption and utilisation of a digital patient management platform in three different clinics. Results: Our findings revealed that differences in implementation strategies directly influenced variations in utilisation. The successful utilisation of the platform was achieved through a bottom-up decision-making process that involved the employees of the primary healthcare clinics. Onsite training, close collaboration with the eHealth provider, and a structured patient onboarding process played crucial roles in this utilisation. In contrast, a top-down approach at two of the primary healthcare clinics led to limited utilisation of the platform into daily workflows. Furthermore, making the platform a part of everyday work meant putting accessibility, by working as a team of physicians, at the forefront of continuity of care, with patients being managed by their designated physician. Additionally, it was observed that digital patient management proved most effective for addressing simple patient issues such as skin rashes, rather than complex cases, and did not reduce the demand for phone triage. Conclusion: Only one of the three clinics studied effectively integrated digital patient management into its daily operations, and did so by aligning objectives among management and all categories of healthcare professionals, employing a bottom-up decision-making process, collaborating with the eHealth service provider for regular platform adjustments to clinic needs, and implementing active patient onboarding. This sociotechnical integration resulted in high platform utilisation. In contrast, the other two clinics faced challenges due to incoherent objectives among diverse healthcare professional employees and top management, a top-down decision-making approach during implementation, limited collaboration with the eHealth service provider, and passive patient onboarding. The findings indicate that these factors negatively affected utilisation and led to low platform adoption as well as disrupted the sociotechnical balance

"I've literally Googles that on TikTok before" : A qualitative study of the link between interface design and young adults increased usage of social media as search engines over traditional search engines

This study aims to explore the link between user interface design and the increased usage of social media as a search engine over traditional search engines by young adults. We conducted semi-structured interviews and user testing with 9 participants who have previously used both TikTok and Google for searching. The results showed a link between design attributes, user interaction patterns, and the evolving demands of information retrieval. We conducted a thematic analysis which created seven different themes which provided us with an overview of how participants' opinions related to different theories. Key themes included TikTok being used instead of Google for casual browsing and visual content, and Google being preferred for goal-oriented searches due to its efficiency. Participants liked TikTok's simplicity in interface design, and Google for its practical design and functions. Additionally, users perceived TikTok as more genuine and authentic for casual topics, while Google was seen as reliable for factual information. Users often combined the strengths of both platforms for a full search experience. The findings of this study could provide insights into optimizing digital experiences and information seeking for this demographic. We suggest broadening the sample group and exploring the impact of content, including sponsored content, on user search behavior across different social media platforms in future research

A collaborative development initiative to strengthen Midwifery Education in Somalia

Galkayo University, in an ongoing partnership with Benadir University and the Karolinska Institutet, reports on the co-creation of a mentorship program for midwifery educators at Galkayo University. This program was initiated in Spring 2023 with the aim of sharing experiences on midwifery education between educators from Sweden and Somalia—both countries with long traditions of midwifery care. By leveraging the expertise of Swedish and Somali midwifery educators, the mentorship program seeks to bridge gaps in knowledge and skills, ultimately contributing to better midwifery education and care in both Somalia and Sweden. This commentary describes the significance of the program and its potential for impact if scaled up after contextualization

Utformning av ett bildbehandlingsprotokoll för Arthro-CT

Arthro-CT is an imaging method where a contrast agent is injected into a patient before a standard CT scan is performed, ensuring that the cartilage is visible in the images produced. Episurf Medical AB typically utilise MRI to scan patients’ knees when creating personalised implants. For those patients who cannot be scanned with MRI, Episurf would like to use arthro-CT. The project aimed to create an arthro-CT imaging protocol. Episurf provided twelve cases where arthro-CT had been used to scan patients’ knees and ankles. The cases were judged on their image quality, and the parameters used on the CT scanners were investigated. To create the imaging protocol, the parameters were compared to find the optimal ones. The resulting protocol identified optimal settings: slice thickness of 0.6 - 1 millimetre, a slice increment smaller than slice thickness, bone convolution kernel, 120 - 140 kV tube voltage, helical acquisition mode and a field of view covering the distal femur and cartilage.Arthro-CT är en bildgivande metod där ett kontrastmedel injiceras i en patient innan en standard CT-scan utförs. Detta säkerställer att brosket blir synligt i bilderna som produceras. Episurf Medical AB använder vanligtvis MR för att skanna patienters knän när de skapar personliga implantat. För de patienter som MR är olämpligt för, skulle Episurf vilja använda arthro-CT. Målet med detta projekt var att skapa ett bildbehandlingsprotokoll för arthro-CT.Tolv fall där arthro-CT hade använts för att scanna patienters knän och fotleder förseddes av Episurf. Fallen blev bedömda på dess bildkvalitet, och CT-scannernas använda parametrar undersöktes. För att skapa bildbehandlingsprotokollet, jämfördes parametrarna för att hitta de optimala. Det resulterade protokollet identifierade optimala värden: skivtjocklek 0.6 - 1 millimeter, avståndet mellan skivorna mindre än skivtjockleken, en benalgoritm, 120 - 140 kV röntgenrörsspänning, helical skanläge och ett scanyta som täcker distala femur och brosket

Electrocortical activity associated with movement-related fear: a methodological exploration of a threat-conditioning paradigm involving destabilising perturbations during quiet standing

Musculoskeletal trauma often leads to lasting psychological impacts stemming from concerns of future injuries. Often referred to as kinesiophobia or re-injury anxiety, such concerns have been shown to hinder return to physical activity and are believed to increase the risk for secondary injuries. Screening for re-injury anxiety is currently restricted to subjective questionnaires, which are prone to self-report bias. We introduce a novel approach to objectively identify electrocortical activity associated with the threat of destabilising perturbations. We aimed to explore its feasibility among non-injured persons, with potential future implementation for screening of re-injury anxiety. Twenty-three participants stood blindfolded on a translational balance perturbation platform. Consecutive auditory stimuli were provided as low (neutral stimulus [CS–]) or high (conditioned stimulus [CS+]) tones. For the main experimental protocol (Protocol I), half of the high tones were followed by a perturbation in one of eight unpredictable directions. A separate validation protocol (Protocol II) requiring voluntary squatting without perturbations was performed with 12 participants. Event-related potentials (ERP) were computed from electroencephalography recordings and significant time-domain components were detected using an interval-wise testing procedure. High-amplitude early contingent negative variation (CNV) waves were significantly greater for CS+ compared with CS– trials in all channels for Protocol I (> 521-800ms), most prominently over frontal and central midline locations (P ≤ 0.001). For Protocol II, shorter frontal ERP components were observed (541-609ms). Our test paradigm revealed electrocortical activation possibly associated with movement-related fear. Exploring the discriminative validity of the paradigm among individuals with and without self-reported re-injury anxiety is warranted

Selektion av multivalenta DNA-baserade bindare till norovirus

Aptamerer är nukleinsyra-baserade molekyler som binder specifikt till en målstruktur. Aptamerer har flera fördelar över antikroppar, så som snabb och billig framtagning och produktion. Multimera aptamer-baserade strukturer har visats ge bättre resultat än monomera aptamerer, men framtagningen av sådana strukturer är tidskrävande och icke-skalbar. Denna studie utforskar generering och selektion av multimera aptamer-baserade strukturer genom slumpmässig ligering och in vitro-evolution, med virusliknande partiklar av norovirus GII.2 och GII.4 som målstruktur. Optimering av ligeringsförhållanden visade att en större andel aptamerer, flerarmade fragment, och linjära fragment resulterade i störst diversitet i den ursprungliga strukturblandingen. Selektionsexperiment uppvisade kraftig positiv selektion för strukturer innehållande aptameren Buf-2, vilket indikerar att den har hög affinitet för båda genotyper. Aptameren SMV21 uppvisade också positiv selektion för båda genotyper. Studien finner också positiv selektion av multimera aptamer-baserade strukturer, vilket bekräftar att de binder starkare till sin målstruktur. Potentiella sekvenser med hög affinitet togs fram genom att generera konsensus-sekvenser från sekvenseringsdatan av de selekterade strukturerna. SPR användes för att mäta affiniteten av de selekterade strukturerna till norovirus, men på grund av ospecifik binding kunde inga slutsatser dras.Aptamers are nucleic acid-based targeted binders that hold advantages over antibodies, such as cheap and fast development and production. Multimeric aptamer-based structures have shown improved performance compared to monomeric aptamers, but the development of such structures is time-consuming and unscalable. This study explores the generation and selection of multimeric aptamer-based structures through random ligation and in vitro evolution, targeting norovirus GII.2 and GII.4. Optimization of ligation conditions was performed, revealing that a bigger proportion of aptamers, multi-armed fragments, and linear fragments ensures a diverse initial structure pool. Selection experiments demonstrated a strong positive selection for structures containing the Buf-2 aptamer, indicating its high affinity for both norovirus genotypes. The SMV21 aptamer also showed positive selection for both genotypes. The study further found that multimeric aptamer-based structures experience positive selection, confirming their stronger binding to the desired target. Potential strong-binding sequences were obtained by generating consensus sequences from sequencing data of the selected strong binders. SPR was employed to determine the affinity of the selected binders to the norovirus, but the results were inconclusive due to unspecific binding

Att planera för en tillgänglig och trygg stadsdel : Ett gestaltningsförslag av Hattholmen

Trygghet är en viktig faktor för människors rörelsefrihet. Människor behöver känna sig trygga i sin omgivning samt vid förflyttning, annars riskerar dem att bli begränsad i sin vardag. För att främja människors rörelsefrihet krävs det att omgivningen är tillgänglig. Det är därmed viktigt att planera för både tillgänglighet och trygghet för att kunna uppnå dem båda. Det är däremot svårt att planera för trygghet då trygghet är en känsla som beror på den tillfrågades erfarenheter och preferenser. Arbetets syfte var att genom kunskapsöversikt sammanställa de faktorer som behövs för att planera ur ett trygghetsperspektiv där människans tillgänglighet är god. Viktiga faktorer som sammanställdes var stadsstrukturer, överblickbarhet, orienterbarhet, möjligheten för möten, val av belysning, förvaltning samt att motverka barriärer. Med hjälp av platsanalyser klargjordes även planområdets nuvarande läge samt dess förutsättningar. Planområdet för gestaltningsarbetet är stadsdelen Hattholmen i Karlskrona som idag är outnyttjat med stor potential med dess läge nära centrala Karlskrona