The aim: was to describe and compare a group of experts and critical care nurses' agreement in detecting delirium in intubated, ventilator treated patients with sedation / analgesia, before and after an in house training intervention with the instrument Confusion Assessment Method for the Intensive Care Unit (CAM-ICU).Method: A quasi-experimental study, one group pretest - posttest design. A convenience sample of 17 critical care nurses in a general intensive care unit included. To detect delirium the instrument CAM-ICU was used, 21 paired tests before and 22 after an educational intervention.Main Results: The results showed that after an in house training intervention sensitivity and kappa coefficient improved of the characteristic 1 "acute onset and fluctuating course," an improvement that was significant. In other features, and overall values were signs of numerical improvement and deterioration in sensitivity, specificity and kappa coefficient but no significant change.Conclusion: Implementing a new instrument for detecting delirium in clinical practice requires education and follow-up. A small sample of critical care nurses with varying ability to use the new instrument and the fact that patients' status may change rapidly making it difficult to draw any conclusions from this study.

Sahlgrenska AcademyAt University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: The obesity paradox, myth or truth in adults with cardiovascular disease.Author: Louise Svensson och Amanda NilssonSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 30, 2013Background: It has long been generally accepted that obesity is a risk factor for many diseases. Despite this, new research indicates that a higher BMI could be a protective factor for those with a chronic cardiovascular disease. This discovery is called the obesity paradox and could change the perception of patients' BMI in both public health and clinical work.Objective: The objective of this systematic review article is to examine the scientific evidence for the existence of the obesity paradox in chronic cardiovascular disease, i.e. if a BMI >25 kg/m2 is associated with lower mortality among adults with chronic cardiovascular disease.Search strategy: The databases used in the literature study were PubMed, Summon, Scopus and Cochrane. The keywords were: obesity paradox, cardiovascular, heart, male, BMI, intentional weight loss, cardiovascular mortality and mortality heart failure.Selection criteria: Studies, which had an adult population classified after BMI that suffered from chronic cardiovascular disease and had all-cause mortality and cardiovascular mortality as endpoints, were included.Data collection and analysis: Ten studies were included.

Scrapie is an infectious neurologic disease in sheep caused by prions, corresponding to transmissible spongiform encephalopathies (TSEs) in other species. The prion is presumably constituted of PrPSc, the misfolded form of the normal endogenous prion protein, PrPC, which is found in practically all cells in the body. PrPSc can induce a conformational change in PrPC and misfold it as an imprint of itself; this is how prions amplify and spread. The process of conformational change is poorly understood and there might exist intermediate forms between PrPC and PrPSc. Bioassay using mice has traditionally been the golden standard in prion studies but is limited by cost and time.

Laminitis has crippled horses through times and many cures have been used to treat it. Since the mechanism of the disease is yet not fully understood, treatments are only ways to alleviate the pain and at best, slow down the pathological process enough to make time for improvement. This paper is a retrospective study of 71 horses treated by a protocol at Hästsjukhuset Strömsholm. The protocol implies three visits at zero, five and fifteen weeks. At each the horse is evaluated and treated by a veterinarian.

The aim for the study was to examine a harwarder´s (combined harvester-forwarder) productivity when harvesting forest fuel in first thinning stands that contains Lodgepole pine and calculate the economy of the harvesting work and estimate the quality of the thinning . The field study area where located near Arvån, about 15 kilometres south ?east from the city of Lycksele. The field studies were taken place in three different stands. All tree stands had the same tree age, but the tree species combination and the density varied.

Varje år drabbas cirka 1100 personer av någon form av hjärntumör i Sverige. Patienterna drabbas av fysiska, psykiska och kognitiva inskränkningar som förändrar individen. Förändringarna påverkar inte enbart patienterna utan även de närstående. Därför är det viktigt att sjuksköterskan uppmärksammar vilka behov patienter och närstående har samt hur sjuksköterskan kan underlätta för familjerna under sjukdomstiden. Syftet med litteraturstudien var att beskriva hur patienter med diagnosen hjärntumör och deras närstående upplever sjukdomen och dess konsekvenser samt utvärdera vilken funktion sjuksköterskan hade för dem.

SammanfattningBakgrund: Diabetes förekommer hos 3-4 procent av Sveriges befolkning. Uppkomsten av diabetes är ofta relaterad till livsstil. Hur människor upplever att få diagnosen påverkar synen på sjukdom och framtid. Människor som får sjukdomen är i behov av stöd från vårdpersonal. Syfte: Beskriva vuxnas upplevelser av stöd efter att ha fått diagnosen diabetes mellitus.

Background Anesthesia-related deaths are common in dogs, especially in the postoperative period, in compare to humans. This study aims to describe and elucidate the qualities of the postoperative care for dogs in Sweden. Method To investigate the postoperative care, a qualitative study was made by interviewing personnel in the animal health care sector. The primary information from the interviews was analyzed in a qualitative manor and a few distinguished qualities came forth. Results These qualities describe the postoperative care and include preventive activities, postoperative activities, monitoring and communication. A variation in regards to the results was seen between the interviewed.

This thesis gives suggestions as to how to design a wooden-based wave-power buoy. The thesiswas carried out at Uppsala University in collaboration with the Division of Electricity and AppliedMechanical Engineering. The product was conceived and developed taking into consideration anumber of requirements put forward by the supervisor, Magnus Rahm. The most importantdemands were that the material used should be able to withstand pressure from the sea withoutbeing damaged and that the production costs should be low.Department of Engineering Sciences, Division of Electricity at Uppsala University was visitedseveral times to discuss issues including the various ideas with the supervisor Magnus Rahm, andwith several people in the department.The work started by studying available literature in order to get background information aboutsuitable methods available for the project and to see how similar projects were carried out. Thereason for this was to get a better understanding of this particular problem and how to solve it.After consulting the supervisor, the group decided to construct four different buoys using fourdifferent materials.

This thesis gives suggestions as to how to design a wooden-based wave-power buoy. The thesiswas carried out at Uppsala University in collaboration with the Division of Electricity and AppliedMechanical Engineering. The product was conceived and developed taking into consideration anumber of requirements put forward by the supervisor, Magnus Rahm. The most importantdemands were that the material used should be able to withstand pressure from the sea withoutbeing damaged and that the production costs should be low.Department of Engineering Sciences, Division of Electricity at Uppsala University was visitedseveral times to discuss issues including the various ideas with the supervisor Magnus Rahm, andwith several people in the department.The work started by studying available literature in order to get background information aboutsuitable methods available for the project and to see how similar projects were carried out. Thereason for this was to get a better understanding of this particular problem and how to solve it.After consulting the supervisor, the group decided to construct four different buoys using fourdifferent materials.

During the 8th and 9th of January 2005 a devastating storm named Gudrun entered the south of Sweden and a big part of the forest owners got their forests damaged. The study objective was to investigate on which basis and how the affected forest owners made their managment decisions immediately after the storm and if there are any differences between different categories of forest owners. - Members ? non members in a forest owner association (FOA) - Resident owners ? non resident owners - Female and male forest owner The study is based on a questionnaire survey with the purpose to examine the most important counsellor and information channels of the forest owners. A total of 450 forest owners participated in the survey. Results show that all categories of forest owners prefer professional counselling rather than personal counselling.

A common perception is that fungicide treatments increases yield, but that the nitrogen of the particular grain is diluted so that the overall removal of grain nitrogen from the field remains unchanged. The aim of this paper is to demonstrate that a healthy crop reduces the risk of nutrient loss from agricultural land. The results from genotype and plant protection trials often show constant nitrogen content in the grain, although the yield has been increased. Results from such experiments are therefore processed in order to confirm this and show that it is no statistically significant difference between the protein content (and also nitrogen content) in crops which have undergone fungicide treatment compared to crops which remained untreated. The trials processed have been carried out in the southernmost part of Sweden and are distinguished to concern winter wheat production.The explanation to the results is that a healthy crop is able to maintain the biological functions of the plant in a more efficient way than a crop damaged by a fungal infection.

The present study discusses the metabolism of ethanol in the human body from the ingestion of ethanol to the excretion of its break down products water and carbon dioxide. Ethanol is a small molecule, soluble in water as well as in organic solutions. It is quickly distributed to every section in the body, where it exerts a direct toxic effect on the cells. Ethanol cannot directly leave the body efficiently so it needs other metabolic pathways. The molecule is metabolized by oxidation, predominately in the liver.

Nowadays the majority of the thinnings made in Swedish forests are done by machines, harvesters and forwarders. The most common model in thinning with a harvester is strip-road operated thinning and stand-operated thinning with one intermediate passage between the strip-roads. This study is a time study with some quality follow ups on a strip-road operated thinning model, a stand-operated thinning model with one intermediate passage between the strip-roads and a stand-operated thinning model with two intermediate passages between the strip-roads. The machines in the study were a small harvester (Forestline MPM C90) and a medium sized forwarder (Timberjack 1110). The study was made in Litsnäset outside the city of Östersund in Sweden and was made during the autumn 2007. In a lodgepole pine stand six study units (0,6 ha) were thinned with the three different models, two study units per model.

Background: The speech- and language deficit aphasia affects 12 000 persons annually in Sweden. Aphasia is caused by injury in the brain and the most common etiology is stroke. According to the tool for describing and assessing aphasia, A-FROM (Kagan et al., 2008), the four following aspects of aphasia need to be considered: severity of aphasia, participation in life situations, communication and language environment and personal factors. Several different interventions and treatments can be performed in every domain. There is scientific evidence for interventions performed by speech and language pathologists; however, the question is yet being discussed since results are unambiguous.Purpose: The main purpose of this study is to investigate which aphasia interventions performed by speech and language pathologists that are supported by evidence.