BakgrundTraditionell och komplementär eller alternativ medicin, vilket benämns Complementary and Alternative medicine (CAM), är enligt WHO en viktig, men ofta underskattad del i nationella hälso- och sjukvårdssystem. Användandet av CAM har ökat signifikant senaste åren för gravida kvinnor. Inom CAM ryms begreppet ?mind-body interventioner? eller ?mind-body therapies? och innefattar behandling så som mindfulness, yoga, akupunktur, massage. Yoga och mindfulness har enligt tidigare studier positiv inverkan på graviditet och graviditetsutfall.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Is pricing a way to affect share of fruits and vegetables in a diet?Author: Maria PopovSupervisor: Heléne Bertéus ForslundExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 23, 2013Background: Fruits and vegetables (FV) are important for health, including occurrence of diabetes, obesity and cardiovascular diseases. Said diseases cause most cases of illness and death in high-income countries. Only a small part of the population achieves the FV-intake goal, so a higher FV-intake is desirable. Besides general information campaigns there is another method of influencing what people might buy.Objective: To examine whether different pricing is connected to FV-intake or ?purchase.Search strategy: Databases PubMed, Scopus and Summon were searched with ?vegetable consumption", "price/pricing policy" and "food choice? in different combinations.Selection criteria: Studies performed after year 2000 on at least 18 years old persons from North America, Europe or Australia, examining changes in FV-price and -purchase.

Veterinary medicine is not merely an area of occupation but also an area of business. In a business the customer service is its identity and brand and more importantly what makes the client choose and recommend the clinic to other potential customers. The licensed veterinary nurse is habitually the one who first meets the clients at the clinic. Therefore it is particularly important for the licensed veterinary nurse at the clinic to offer high-quality customer service. The object of this study was to understand and elucidate how the pet owners experience the encounter with the licensed veterinary nurse at different stages in their contact with the clinic.

Sahlgrenska Academy at University of Gothenburg Department of Internal Medicine and Clinical NutritionAbstractTitle: Can probiotics prevent atopic dermatitis in children with high risk?Author: Laura Pienihäkkinen and Max OlinSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background Allergic disease is today common, this including atopic dermatitis, which is the most common inflammatory skin disease in the world. Heredity has been shown to play a major role in the development of this disease. It is therefore of high interest for both the individual and society to find effective methods for preventing atopic dermatitis in individuals with high risk profile. Probiotics are beneficial for the bacterial profile in the intestine and it is therefore of interest to study if they through their anti-inflammatory effect could prevent atopic dermatitis.Objective The aim was to study whether administration of probiotics to the mother and the child (directly or via breast milk) could prevent atopic dermatitis in children with high risk profile (at least one first degree relative with a diagnosed allergic disease).Search strategy A systematic literature search was done in databases PubMed and Scopus with search terms maternal, prenatal, probiotics, allergy, atopic dermatitis, prevention, and children.Selection criteria Randomized, controlled human studies and original articles in English were included.

Introduktion: Läkemedelsverkets generella rekommendation är att naturläkemedel ska sättasut inför anestesi. Litteratur tyder på att läkare sällan frågar om naturläkemedelsanvändning iden preoperativa bedömningen, samtidigt som patienten sällan uppger sådant användande. Attha väsentlig information om patienten inför anestesi är en förutsättning förhandlingsberedskap för anestesisjuksköterskan, vilket gör säker och tydlig kommunikation tillen viktig del i patientsäkerheten.Syfte: Syftet med denna studie var att kartlägga huruvida anestesiologer beaktar patientersanvändning av naturläkemedel inom anestesi.Metod: För denna kartläggning genomfördes en kvantitativ enkätundersökning riktad motanestesiologer inom Sahlgrenska Universitetssjukhuset. Enkäten bestod av nio slutna och tvåöppna frågor. Kvantitativ data analyserades i SPSS och redovisades med frekvenstabeller,medan samtliga kvalitativa data redovisades med citat.Resultat: Inom ramen för denna pilotstudie delades tretton enkäter ut, varav elva besvarades.Könsfördelningen av respondenterna var 64 % (n=7) män och 36 % (n=4) kvinnor ochrespondenternas läkartjänster inom anestesi var ST-läkare 36 % (n=4), överläkare 36 % (n=4)samt specialistläkare 27 % (n=3).

Wounds on horses are common and sometimes difficult to treat. The wounds are often big and could be discovered too late for primary sutures, which have to be applied within 8 hours from time of accident, before bacteria has been able to infiltrate the surrounding tissue. The healing is often complicated by delayed healing and wound infection with consequences like phlegmone, fistulation and proud flesh formation.To avoid these consequences, the traditional practice has been to administer systemic antibiotics alone, systemic antibiotics in combination with topical antibiotics or topical antibiotics alone. Because few antibiotics can be used in horses, is it important to household with the few substances that are available. In veterinary medicine today, the increasing resistance amongst pathogenic microbes such as MRSA presents a growing problem.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionTitle: The effect of the glycemic index of breakfasts in energy intake inchildren and adolescentsAuthor: Charlotte Olofsson, Cornelia Johansson and Maria NordbeckSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 16, 2013Background: The glycemic index (GI) and it´s effect on energy intake is a debated subject.Research has been done whether food with lower GI decreases hunger and lowers energyintake, which could be an effective tool to prevent overweight in children and adolescents.Breakfast eating is successful for maintaining a healthy weight and it´s therefore interesting tosee if the quality of the carbohydrates matters.Objective: To evaluate the scientific evidence regarding the effect of GI of breakfasts inchildren?s and adolescents energy intake.Search strategy: To find relevant articles, a systematic literature search was made in thedatabases PubMed, Scopus and Cochrane. Search terms that were used were: breakfast,breakfast quality, children, glycemic index, energy intake, obesity.Selection criteria: Randomized controlled trials and cohort trials, breakfast eatingindividuals, children and adolescents under 18 years old, reported glycemic index. Outcomemeasurements: Energy intake.Data collection and analysis: Six original articles met the inclusion criteria and werereviewed by the SBU audit template for randomized and controlled studies. There after onearticle was excluded because of very low quality of the study.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Effects of isoflavone supplementation from soybeans on LDL-cholesterol levels in adultAuthors: Malin Blomgren Alegria and Ruut ReivaaraSupervisor: Lena HulthénExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-08Background: One of the most common causes of death in Sweden is due to cardiovascular diseases such as heart attack and stroke. Hypercholesterolemia is one of the risk factors for cardiovascular disease. In Asia, hypercholesterolemia is less common than in the Western countries. In Asian countries, soy products are consumed in larger quantities than in the Western world, which has led to implemented research with the intention of examining soy's potential effect on cholesterol levels.Objective: To investigate whether there is scientific evidence that isoflavone supplementation from soy bean may have a lowering effect on LDL-cholesterol.Search strategy: The databases used for the systematic literature search were PubMed, Scopus and Cochrane. Keywords used were cholesterol and 9 versions of this, and isoflavones and 11 versions of that.Selection criteria: RCT articles, on humans, written in English, published from 2011 onwards, that focused on interventions with isoflavones from soybeans and its effect on blood cholesterol, the participants were over 18 years old and the study time was at least 24 weeks.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Whole fat versus low-fat dairy products for primary prevention of cardiovascular disease. A systematic review.Author: Josefine Lindqvist, Robin Järnmark, Mathilde OhlinSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2014-04-09BackgroundResearch indicates that dairy products seems to have a protective impact on the incidence of cardiovascular disease regardless fat content. Paradoxically the Nordic nutrition recommendations recommend an exchange of full fat dairy product to low-fat dairy products.ObjectiveThe aim of this review is to investigate whether the variation in fat content of dairy products have any bearing on the onset of cardiovascular disease. With regard to common risk markers for cardiovascular disease the outcome measures hypertension, hyperlipidemia and weight gain is examined.Search strategyThe searches were made in the databases Medline (23/1-14) and Scopus (6/2-14).Selection criteriaRestrictions: Human Studies, Adults, Randomized Controlled Trials, English.Data collection and analysisTwo RCTs were included. Validation of the separate studies was performed with SBU's review template for individual studies and GRADE was used for summarizing the evidence of outcome measuresMain resultsThe two included studies examined the outcome measures blood pressure, weight and blood lipids.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionABSTRACTTitle: The connection between IBS and FODMAPsAuthor: Helena Hautamäki and Rebecka BertilssonSupervisor: Sofia KlingbergExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 2013-04-10Background: IBS (Irritable Bowel Syndrome) is a functional gastrointestinal disorder, and is acommon disorder in the western population. The predominant symptoms are diarrhoea,abdominal pain, bloating, constipation, and excessive flatus. Today there are no evidence basedrecommendations concerning dietary factors for patients diagnosed with IBS, but recently certainfactors in the diet that seems to trigger the symptoms have been identified. These factors areshort-chain carbohydrates, Fermentable Oligosaccharides, Disaccharides, Monosaccharides, andPolyols (FODMAPS), which are not completely absorbed in the lumen.Objective: The purpose of this systematic review article is to examine whether there are anyevidence that a diet low in FODMAPs may induce improvement of symptoms in patientsdiagnosed with IBS.Search strategy: The literature search was performed in the databases PubMed, Scopus,Summon and Google Scholar. The keywords were ?Irritable bowel syndrome + FODMAPs?,?Irritable bowel syndrome + diet? and ?FODMAP and diet?.Selection criteria: The inclusion criteria were patients diagnosed with IBS between the ages 18and 69.

This paper has two parts. In the first part we analyse the Swedish translation of KIMS and we compare it with the American version that Baer and colleagues developed(Baer et al, 2004). Our focus is the factor structure, internal consistency, scale correlations and validity in relation to the already validated translation of the MAAS. The second part has three issues: Does a group of relatives to persons with borderline personality disorder differ from a group of university employees with respect to different aspects of mindfulness? What are the correlations between KIMS and the symptom measure BSI-GSI for the group of relatives? Has the Family Connections program had any effect on the degree of mindfulness for the group of relatives? 123 university employees answered the KIMS questionnaire.

Sahlgrenska Academy at University of GothenburgDepartment of Internal medicine and Clinical nutritionAbstractTitel: Can omega-3 prevent the emergence of allergy?? A systematic reviewAuthor: Karin Andersson and Cecilia BjörertzSupervisor: Henriette PhilipsonExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 hpType of paper: Examination paper, 15 hpDate: 2012-05-23Background Today allergy is a major public health issue and one of our most common chronic diseases. It would be most profitable if there was a way to prevent the emergence of allergies, both regarding the community and the individual. The antiinflammatory property of omega-3 influences the immune system and is thought to have a preventive effect on allergic symptoms. To investigate whether the mothers intake of omega-3 during pregnancy and lactation affects the child?s future development of allergy is therefore of high interest.Objective To examine if omega-3 supplement given to mothers during pregnancy, or pregnancy and lactation, is shown to be beneficial in children with heredity to develop allergy.Search strategy Articles were collected from the data bases PubMed, Cochrane and Scopus.

During a long period of time, rental doctors have created a vast debate in Sweden. Currently, there is a shortage of doctors working in Sweden and to guarantee the lawful right to healthcare of high quality the counties must hire doctors through employment agencies. There are different opinions about rental doctors, some thinks the temporary employment results in a negative work environment and furthermore puts the patients at risk. Other people consider the Swedish healthcare to not function without rental doctors.  The purpose of this essay is to investigate rental doctors through a legal perspective and how temporary employment actually affects the patients? security and the work environment in Sweden?s healthcare.

Purpose- The purpose of this project is to contribute to the knowledge of creating customer value through streamlining and coordination of patient flows for children and youth with frequent need of care on child and youth medical clinics.Method- One of the methods used for achieving the project's purpose is a case study on the Child and Youth Medicine Clinic at Länssjukhuset Ryhov in Jönköping. The case study has been used for collecting the empirical data that has been generated through interviews, observations and documents from the Child and Youth Health Clinic. Except the case study the authors also made studies in literature, which the collected empirical data has been anchored and related to. Together this led to the project's analysis and results.Results- When investigating the questions found in chapter one, it was determined standardized work is of great importance to create structure and implement procedures for the patient flows. A weak link in the patient flow has been identified, which is the sub-process coordination and planning.

60 million years ago the horse was the size of a small dog, and walked on four toes. Today it can weigh up to 500-1000 kg and has evolved to walking on only one phalanx. The anatomy of the horses? legs and hooves allow them to run at high speeds, and at the same time enables them to bear the extremely high concussions applied to the foot at high speeds or jumps. Every horse owner has his or her own opinion on how to manage their horses? hooves, and whether the horse should be shod or unshod. The knowledge, commitment and attention of the owner determine the quality of the hoof care, but also the time between the arising of symptoms of abnormalities of the hoof until care is sought with a farrier or veterinarian. New laws will be applied at the beginning of 2015 which bring on changes in authorization for farriers.