Self-assessment of the outcome of early medical abortion versus clinic follow-up in India : a randomised, controlled, non-inferiority trial

Background: The need for multiple clinical visits remains a barrier to women accessing safe legal medical abortion services. Alternatives to routine clinic follow-up visits have not been assessed in rural low-resource settings. We compared the effectiveness of standard clinic follow-up versus home assessment of outcome of medical abortion in a low-resource setting. Methods: This randomised, controlled, non-inferiority trial was done in six health centres (three rural, three urban) in Rajasthan, India. Women seeking early medical abortion up to 9 weeks of gestation were randomly assigned (1:1) to either routine clinic follow-up or self-assessment at home. Randomisation was done with a computer-generated randomisation sequence, with a block size of six. The study was not blinded. Women in the home-assessment group were advised to use a pictorial instruction sheet and take a low-sensitivity urine pregnancy test at home, 10-14 days after intake of mifepristone, and were contacted by a home visit or telephone call to record the outcome of the abortion. The primary (non-inferiority) outcome was complete abortion without continuing pregnancy or need for surgical evacuation or additional mifepristone and misoprostol. The non-inferiority margin for the risk difference was 5%. All participants with a reported primary outcome and who followed the clinical protocol were included in the analysis. This study is registered with ClinicalTrials.gov, number NCT01827995. Findings: Between April 23, 2013, and May 15, 2014, 731 women were recruited and assigned to clinic follow-up (n=366) or home assessment (n=365), of whom 700 were analysed for the main outcomes (n=336 and n=364, respectively). Complete abortion without continuing pregnancy, surgical intervention, or additional mifepristone and misoprostol was reported in 313 (93%) of 336 women in the clinic follow-up group and 347 (95%) of 364 women in the home-assessment group (difference -2.2%, 95% CI -5.9 to 1.6). One case of haemorrhage occurred in each group (rate of adverse events 0.3% in each group); no other adverse events were noted. Interpretation Home assessment of medical abortion outcome with a low-sensitivity urine pregnancy test is non-inferior to clinic follow-up, and could be introduced instead of a clinic follow-up visit in a low-resource setting.

The fall descriptions and health characteristics of older adults with hip fracture : a mixed methods study

Background: In light of the multifactorial etiology of fall-related hip fracture, knowledge of fall circumstances may be especially valuable when placed in the context of the health of the person who falls. We aimed to investigate the circumstances surrounding fall-related hip fractures and to describe fall circumstances in relation to participants' health and functional characteristics. Methods: The fall circumstances of 125 individuals (age >= 50 years) with hip fracture were investigated using semi-structured interviews. Data concerning participants' health (comorbidities and medications) and function (self-reported performance of mobility, balance, personal activities of daily living and physical activity, previous falls and hand grip strength) were collected via medical records, questionnaires and dynamometry. Using a mixed methods design, both data sets were analysed separately and then merged in order to provide a comprehensive description of fall events and identify eventual patterns in the data. Results: Fall circumstances were described as i) Activity at the time of the fall: Positional change (n = 24, 19%); Standing (n = 16, 13%); Walking (n = 71, 57%); Balance challenging (n = 14, 11%) and ii) Nature of the fall: Environmental (n = 32, 26%); Physiological (n = 35, 28%); Activity-related indoor (n = 8, 6%) and outdoor (n = 8, 6%); Trips and slips on snow (n = 20, 16%) and in snow-free conditions (n = 12, 10%) and Unknown (n = 10, 8%). We observed the following patterns regarding fall circumstances and participants' health: those who fell i) during positional change had the poorest functional status; ii) due to environmental reasons (indoors) had moderate physical function, but high levels of comorbidity and fall risk increasing medications; iii) in snow-free environments (outdoors) appeared to have a poorer health and functional status than other outdoor groups. Conclusions: Our findings indicate that patterns exist in relation to the falls circumstances and health characteristics of people with hip fracture which build upon that previously reported. These patterns, when verified, can provide useful information as to the ways in which fall prevention strategies can be tailored to individuals of varying levels of health and function who are at risk for falls and hip fracture.

Violence and reproductive health preceding flight from war : accounts from Somali born women in Sweden

Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden. Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied. Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war. Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and

What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register

OBJECTIVES: There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes. DESIGN: Semistructured qualitative interviews analysed using content analysis. SETTING: Hospital-based outpatient clinics and primary healthcare clinics in Sweden. PARTICIPANTS: 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14). INCLUSION CRITERIA: Swedish adults (≥18 years) living with type 1 DM or type 2 DM (duration ≥5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics. RESULTS: To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional support from diabetes care. Diabetes care was a crucial resource to nurture the individual's ability and knowledge to manage diabetes, and to facilitate life with diabetes by supplying support, guidance, medical treatment and technical devices tailored to individual needs. The analysis resulted in the overarching theme 'To live a good life with diabetes' constituting the two main categories 'How I feel and how things are going with my diabetes' and 'Support from diabetes care in managing diabetes' including five different categories. CONCLUSIONS: Common aspects were identified including the experience of living with diabetes and support from diabetes care. These will be used to establish a basis for a tailored PROM for the NDR.

Women's experiences of two different self-assessment methods for monitoring fetal movements in full-term pregnancy : a crossover trial

Background: Low maternal awareness of fetal movements is associated with negative birth outcomes. Knowledge regarding pregnant women's compliance with programs of systematic self-assessment of fetal movements is needed. The aim of this study was to investigate women's experiences using two different self-assessment methods for monitoring fetal movements and to determine if the women had a preference for one or the other method. Methods: Data were collected by a crossover trial; 40 healthy women with an uncomplicated full-term pregnancy counted the fetal movements according to a Count-to-ten method and assessed the character of the movements according to the Mindfetalness method. Each self-assessment was observed by a midwife and followed by a questionnaire. A total of 80 self-assessments was performed; 40 with each method. Results: Of the 40 women, only one did not find at least one method suitable. Twenty of the total of 39 reported a preference, 15 for the Mindfetalness method and five for the Count-to-ten method. All 39 said they felt calm, relaxed, mentally present and focused during the observations. Furthermore, the women described the observation of the movements as safe and reassuring and a moment for communication with their unborn baby. Conclusions: In the 80 assessments all but one of the women found one or both methods suitable for self-assessment of fetal movements and they felt comfortable during the assessments. More women preferred the Mindfetalness method compared to the count-to-ten method, than vice versa.

Towards Presidential Rule in Ukraine : Hybrid Regime Dynamics under Semi-Presidentialism

This article sets out to analyse recent regime developments in Ukraine in relation to semi-presidentialism. The article asks: to what extent and in what ways theoretical arguments against semi-presidentialism (premier-presidential and president-parliamentary systems) are relevant for understanding the changing directions of the Ukrainian regime since the 1990s? The article also reviews the by now overwhelming evidence suggesting that President Yanukovych is turning Ukraine into a more authoritarian hybrid regime and raises the question to what extent the president-parliamentary system might serve this end. The article argues that both kinds of semi-presidentialism have, in different ways, exacerbated rather than mitigated institutional conflict and political stalemate. The return to the president-parliamentary system in 2010 – the constitutional arrangement with the most dismal record of democratisation – was a step in the wrong direction. The premier-presidential regime was by no means ideal, but it had at least two advantages. It weakened the presidential dominance and it explicitly anchored the survival of the government in parliament. The return to the 1996 constitution ties in well with the notion that President Viktor Yanukovych has embarked on an outright authoritarian path.

The village that vanished : The roots of erosion in a Tanzanian village

In the village'of Citing in the northern highlands of Tanzania, the factors: social stratification, land tenure, production strategies, investment patterns and the economic uncertainties of society are studied and their relationship to land degradation is examined. The main assumption of the study is that the causes of land degradation are so complex that a methodology that emphasises contextualisation has to be used. A methodological framework that considers inter-linkages between all these factors is developed and tested. The result of the test shows that contextualisation gives a more in-depth and complex explanation than conventional, positivist research. The study gives a detailed account of the relationship that various wealth groups have to land and land degradation in the village. It is found that all wealth groups are destructive to the land but in varying ways. The rich farmers are over-cultivating land marginal to agriculture, the middle peasants have too many cattle in the village while the poor peasants are so marginalised socially that they hardly influence land management. Those identified as having economic as well as social incentives to maintain soil fertility are the middle peasants, while the rich farmers are shown to be consciously soil-mining the former grazing areas.

A graded subring of an inverse limit of polynomial rings

We study the power series ring R= K[[x1,x2,x3,...]]on countably infinitely many variables, over a field K, and two particular K-subalgebras of it: the ring S, which is isomorphic to an inverse limit of the polynomial rings in finitely many variables over K, and the ring R', which is the largest graded subalgebra of R. Of particular interest are the homogeneous, finitely generated ideals in R', among them the generic ideals. The definition of S as an inverse limit yields a set of truncation homomorphisms from S to K[x1,...,xn] which restrict to R'. We have that the truncation of a generic I in R' is a generic ideal in K[x1,...,xn]. It is shown in Initial ideals of Truncated Homogeneous Ideals that the initial ideal of such an ideal converge to the initial ideal of the corresponding ideal in R'. This initial ideal need no longer be finitely generated, but it is always locally finitely generated: this is proved in Gröbner Bases in R'. We show in Reverse lexicographic initial ideals of generic ideals are finitely generated that the initial ideal of a generic ideal in R' is finitely generated. This contrast to the lexicographic term order. If I in R' is a homogeneous, locally finitely generated ideal, and if we write the Hilbert series of the truncated algebras K[x1,...,xn] module the truncation of I as qn(t)/(1-t)n, then we show in Generalized Hilbert Numerators that the qn's converge to a power series in t which we call the generalized Hilbert numerator of the algebra R'/I. In Gröbner bases for non-homogeneous ideals in R' we show that the calculations of Gröbner bases and initial ideals in R' can be done also for some non-homogeneous ideals, namely those which have an associated homogeneous ideal which is locally finitely generated. The fact that S is an inverse limit of polynomial rings, which are naturally endowed with the discrete topology, provides S with a topology which makes it into a complete Hausdorff topological ring. The ring R', with the subspace topology, is dense in R, and the latter ring is the Cauchy completion of the former. In Topological properties of R' we show that with respect to this topology, locally finitely generated ideals in R'are closed.

Tradition, Change and Variation : Past and Present Trends in Public Old-age Care

The general aim of this dissertation is to describe and analyse how public old-age care in Sweden has developed and changed during the last century. The study applies a provider perspective on how care has been planned and professionally carried out. A broader social policy perspective, studying old-age care at central/national as well as local/municipal level, is also developed. A special focus is directed at the large local variation in care and services for the elderly. The empirical base is comprised of official documents and other public sources, survey data from interviews with elderly recipients of public old-age care, and official statistics on publicly financed and controlled old-age care and services. Study I addresses the development of old-age care in Sweden during the twentieth century by studying an important occupation in this field – the supervisors and their professional roles, tasks and working conditions. Throughout, the roles of supervisors have followed the prevailing official policy on the proper way to provide care for elderly people in Sweden; from poor relief at the beginning of the 1900s, via a generous level of services in the 1960s and 1970s, to today’s restricted and economy-controlled mode of operation. Study II describes and compares two main forms of public old-age care in Sweden today, home help services and institutional care. The care-load found in home-based care was comparable to and sometimes even larger than in service-homes and other institutions, indicating that large care needs among elderly people in Sweden today can be met in their homes as well as in institutional settings. Studies III and IV analyse the local variation in public old-age care in Sweden. During the last decades there has been an overall decline in home help services. The coverage of home help for elderly people shows large differences between municipalities throughout this period, and the relative variation has increased. The local disparity seems to depend more on historical factors, e.g., previous coverage rates, than on the present municipal situation in levels of need or local economy and politics. In an introductory part the four papers are linked together by an outline of the demographic situation and the social policy model for old-age care in Sweden. Trends that have been apparent over time, e.g. professionalisation and market orientation, are traced and discussed. Conflicts between prevailing ideologies are analysed, in regards to for instance home-based and institution-based care, social and medical culture, and local and central levels of decision-making. ’Welfare municipality’, ‘path dependency’, and ‘decentralisation’ are suggested as a conceptual framework for describing the large and increasing local variations in old-age care. Finally, implications of the four studies with regard to old-age care policy and further research are discussed.

The Social City : Middle-way approaches to housing and sub-urban golvernmentality in southern Stockholm, 1900-1945

This dissertation deals with the period bridging the era of extreme housing shortages in Stockholm on the eve of industrialisation and the much admired programmes of housing provision that followed after the second world war, when Stockholm district Vällingby became an example for underground railway-serviced ”new towns”. It is argued that important changes were made in the housing and town planning policy in Stockholm in this period that paved the way for the successful ensuing period. Foremost among these changes was the uniquely developed practice of municipal leaseholding with the help of site leasehold rights (Erbbaurecht). The study is informed by recent developments in Foucauldian social research, which go under the heading ’governmentality’. Developments within urban planning are understood as different solutions to the problem of urban order. To a large extent, urban and housing policies changed during the period from direct interventions into the lives of inhabitants connected to a liberal understanding of housing provision, to the building of a disciplinary city, and the conduct of ’governmental’ power, building on increased activity on behalf of the local state to provide housing and the integration and co-operation of large collectives. Municipal leaseholding was a fundamental means for the implementation of this policy. When the new policies were introduced, they were limited to the outer parts of the city and administered by special administrative bodies. This administrative and spatial separation was largely upheld throughout the period, and represented as the parallel building of a ’social’ outer city, while things in the inner ’mercantile’ city proceeded more or less as before. This separation was founded in a radical difference in land holding policy: while sites in the inner city were privatised and sold at market values, land in the outer city was mostly leasehold land, distributed according to administrative – and thus politically decided – priorities. These differences were also understood and acknowledged by the inhabitants. Thorough studies of the local press and the organisational life of the southern parts of the outer city reveals that the local identity was tightly connected with the representations connected to the different land holding systems. Inhabitants in the south-western parts of the city, which in this period was still largely built on private sites, displayed a spatial understanding built on the contradictions between centre and periphery. The inhabitants living on leaseholding sites, however, showed a clear understanding of their position as members of model communities, tightly connected to the policy of the municipal administration. The organisations on leaseholding sites also displayed a deep co-operation with the administration. As the analyses of election results show, the inhabitants also seemed to have felt a greater degree of integration with the society at large, than people living in other parts of the city. The leaseholding system in Stockholm has persisted until today and has been one of the strongest in the world, although the local neo-liberal politicians are currently disposing it off.

Resonant States in Negative Ions

Resonant states are multiply excited states in atoms and ions that have enough energy to decay by emitting an electron. The ability to emit an electron and the strong electron correlation (which is extra strong in negative ions) makes these states both interesting and challenging from a theoretical point of view. The main contribution in this thesis is a method, which combines the use of B splines and complex rotation, to solve the three-electron Schrödinger equation treating all three electrons equally. It is used to calculate doubly excited and triply excited states of 4S symmetry with even parity in He-. For the doubly excited states there are experimental and theoretical data to compare with. For the triply excited states there is only theoretical data available and only for one of the resonances. The agreement is in general good. For the triply excited state there is a significant and interesting difference in the width between our calculation and another method. A cause for this deviation is suggested. The method is also used to find a resonant state of 4S symmetry with odd parity in H2-. This state, in this extremely negative system, has been predicted by two earlier calculations but is highly controversial. Several other studies presented here focus on two-electron systems. In one, the effect of the splitting of the degenerate H(n=2) thresholds in H-, on the resonant states converging to this threshold, is studied. If a completely degenerate threshold is assumed an infinite series of states is expected to converge to the threshold. Here states of 1P symmetry and odd parity are examined, and it is found that the relativistic and radiative splitting of the threshold causes the series to end after only three resonant states. Since the independent particle model completely fails for doubly excited states, several schemes of alternative quantum numbers have been suggested. We investigate the so called DESB (Doubly Excited Symmetry Basis) quantum numbers in several calculations. For the doubly excited states of He- mentioned above we investigate one resonance and find that it cannot be assigned DESB quantum numbers unambiguously. We also investigate these quantum numbers for states of 1S even parity in He. We find two types of mixing of DESB states in the doubly excited states calculated. We also show that the amount of mixing of DESB quantum numbers can be inferred from the value of the cosine of the inter-electronic angle. In a study on Li- the calculated cosine values are used to identify doubly excited states measured in a photodetachment experiment. In particular a resonant state that violates a propensity rule is found.

Innate Immunity in Insects, Function and Regulation of Hemolin from Hyalophora cecropia

Insects are useful models for the study of innate immune reactions and development. The distinction between recognition mechanisms preceding the breakdown of apoptotic cells during metamorphosis, and the breakdown of cells in response to infections, is unclear. Hemolin, a Lepidopteran member of the immunoglobulin superfamily, is a candidate molecule in self/nonself recognition. This thesis investigates hemolin function and hemolin gene regulation at a molecular level. We investigated the binding and cell adhesion properties of hemolin from H. cecropia and demonstrated that the proteins could homodimerize in presence of calcium. Moreover, a higher molecular weight membrane form of hemolin was present on hemocytes. These results, taken together with an earlier finding that soluble hemolin inhibits hemocyte adhesion, indicated that the secreted hemolin could modulate hemocyte aggregation in a competitive manner in the blood. In addition, hemolin was expressed in different tissues and at different developmental stages. Since hemolin is expressed both during development and during the immune response, its different regulatory factors must act in concert. We found that the third intron contains an enhancer, through which Dif, C/EBP and HMGI synergistically activate a reporter construct in vitro. We concluded that the enhancer is used during infection, since the κB-site is crucial for an immune response. Interestingly, we also found that the active form of the steroid hormone, ecdysone, induces the hemolin gene transcription in vivo, and in addition, acts synergistically during bacterial infection. Preliminary in vivo results indicate a secondary effect of ecdysone and the importance of hormone receptor elements in the upstream promoter region of hemolin. To explore the use of Drosophila as a genetic tool for understanding hemolin function and regulation, we sought to isolate the functional homologue in this species. A fly cDNA library in yeast was screened using H. cecropia hemolin as bait. The screen was not successful. However, it did lead to the discovery of a Drosophila protein with true binding specificity for hemolin. Subsequent characterization revealed a new, highly conserved gene, which we named yippee. Yippee is distantly related to zinc finger proteins and represents a novel family of proteins present in numerous eukaryotes, including fungi, plants and humans. Notably, when the Drosophila genome sequence was revealed, no hemolin orthologue could be detected. Finally, an extensive Drosophila genome chip analysis was initiated. The goal was to investigate the Drosophila immune response, and, in contrast to earlier studies of artificially injected flies, to examine a set of natural microbes, orally and externally applied. In parallel experiments viruses, bacteria, fungi and parasites were compared to unchallenged controls. We obtained a unique set of genes that were up-regulated in the response to the parasite Octosporea muscadomesticae and to the fungus Beauveria bassiana. We expect both down-regulated and up-regulated genes to serve as a source for the discovery of new effector molecules, in particular those that are active against parasites and fungi.

Experimental Investigation of Three-Dimensional Single and Double optical Lattices

A complete laser cooling setup was built, with focus on threedimensional near-resonant optical lattices for cesium. These consist of regularly ordered micropotentials, created by the interference of four laser beams. One key feature of optical lattices is an inherent ”Sisyphus cooling” process. It efficiently extracts kinetic energy from the atoms, leading to equilibrium temperatures of a few µK. The corresponding kinetic energy is lower than the depth of the potential wells, so that atoms can be trapped. We performed detailed studies of the cooling processes in optical lattices by using the time-of-flight and absorption-imaging techniques. We investigated the dependence of the equilibrium temperature on the optical lattice parameters, such as detuning, optical potential and lattice geometry. The presence of neighbouring transitions in the cesium hyperfine level structure was used to break symmetries in order to identify, which role “red” and “blue” transitions play in the cooling. We also examined the limits for the cooling process in optical lattices, and the possible difference in steady-state velocity distributions for different directions. Moreover, in collaboration with ´Ecole Normale Sup´erieure in Paris, numerical simulations were performed in order to get more insight in the cooling dynamics of optical lattices. Optical lattices can keep atoms almost perfectly isolated from the environment and have therefore been suggested as a platform for a host of possible experiments aimed at coherent quantum manipulations, such as spin-squeezing and the implementation of quantum logic-gates. We developed a novel way to trap two different cesium ground states in two distinct, interpenetrating optical lattices, and to change the distance between sites of one lattice relative to sites of the other lattice. This is a first step towards the implementation of quantum simulation schemes in optical lattices.

Den flygande maran : En studie om åtta narkotikabrukande kvinnor i Stockholm

Between April 1997 and November 1999, I followed eight socially excluded female drug users in an attempt to describe their lives and living conditions. The study employs an ethnographic approach with the focus being directed at the specific woman and her life in relation to the social context where this life is lived. The study’s objective has been to describe the lives and living conditions of the eight drug-using women, as well as the extent of the opportunities available to them, as being determined by mechanisms of social exclusion. Their lives are understood on the basis of a feminist and social constructionist perspective where perceptions of ‘the drug-abusing woman’ are regarded as the result of constructions of gender and deviance. The theoretical perspectives proceeds from the idea that one is not born a woman but rather becomes one. The fundamental idea is that women become women by means of processes of femininisation, in the context of which certain ways of interpreting and presenting oneself as a woman are regarded as good and others as bad. Our images of ‘the female drug addict’ are based on how we define and interpret deviance and on the cultural and social thought and behaviour patterns we ascribe to people on the basis of bodily differences. It is images of ‘the good woman’ that defines what we regard as characteristic of ‘the bad woman’ and vice versa. The findings are organised into three main topics: femininity, living conditions and social control. The main findings are: The women described themselves as women by relating to normative messages about how women “are and should be”, and their drug use constituted a means of coping with life from their social position. Their life revolved to a large extent around money via a constant struggle to find enough to cover the rent, food and other basic necessities. And finally, how the women’s relations to societal institutions were formed by their social position as ‘female drug addicts’ and how the asymmetry of these relations produced certain fixed patterns of action for the parties involved.

Norm and difference : Stone Age dietary practice in the Baltic region

Stone Age research on Northern Europe frequently makes gross generalizations about the Mesolithic and Neolithic, although we still lack much basic knowledge on how the people lived. The transition from the Mesolithic to the Neolithic in Europe has been described as a radical shift from an economy dominated by marine resources to one solely dependent on farming. Both the occurrence and the geographical extent of such a drastic shift can be questioned, however. It is therefore important to start out at a more detailed level of evidence in order to present the overall picture, and to account for the variability even in such regional or chronological overviews. Fifteen Stone Age sites were included in this study, ranging chronologically from the Early Mesolithic to the Middle or Late Neolithic, c. 8300–2500 BC, and stretching geographically from the westernmost coast of Sweden to the easternmost part of Latvia within the confines of latitudes 55–59° N. The most prominent sites in terms of the number of human and faunal samples analysed are Zvejnieki, Västerbjers and Skateholm I–II. Human and faunal skeletal remains were subjected to stable carbon and nitrogen isotope analysis to study diet and ecology at the sites. Stable isotope analyses of human remains provide quantitative information on the relative importance of various food sources, an important addition to the qualitative data supplied by certain artefacts and structures or by faunal or botanical remains. A vast number of new radiocarbon dates were also obtained. In conclusion, a rich diversity in Stone Age dietary practice in the Baltic Region was demonstrated. Evidence ranging from the Early Mesolithic to the Late Neolithic show that neither chronology nor location alone can account for this variety, but that there are inevitably cultural factors as well. Food habits are culturally governed, and therefore we cannot automatically assume that people at similar sites will have the same diet. Stable isotope studies are very important here, since they tell us what people actually consumed, not only what was available, or what one single meal contained. We should not be deceived in inferring diet from ritually deposited remains, since things that were mentally important were not always important in daily life. Thus, although a ritual and symbolic norm may emphasize certain food categories, these may in fact contribute very little to the diet. By the progress of analysis of intra-individual variation, new data on life history changes have been produced, revealing mobility patterns, breastfeeding behaviour and certain dietary transitions. The inclusion of faunal data has proved invaluable for understanding the stable isotope ecology of a site, and thereby improve the precision of the interpretations of human stable isotope data. The special case of dogs, though, demonstrates that these animals are not useful for inferring human diet, since, due to the number of roles they possess in human society, dogs could deviate significantly from humans in their diet, and in several cases have been proved to do so. When evaluating radiocarbon data derived from human and animal remains from the Pitted-Ware site of Västerbjers on Gotland, the importance of establishing the stable isotope ecology of the site before making deductions on reservoir effects was further demonstrated. The main aim of this thesis has been to demonstrate the variation and diversity in human practices, challenging the view of a “monolithic” Stone Age. By looking at individuals and not only at populations, the whole range of human behaviour has been accounted for, also revealing discrepancies between norm and practice, which are frequently visible both in the archaeological record and in present-day human behaviour.