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.

The aim ofthis study was to examine how economic growth affects the level of democracy inauthoritarian states. Some of these states have experienced high economicgrowth. However, one can discuss how it affects the country?s democratization-process.For that reason this study was needed to contribute to a clarification of howeconomic growth can affect authoritarian rule and democratization. This wasdone through an examination of the development in China.

Ledarskap finns på flera platser i samhället och kan se ut på olika sätt. Det är något som alla känner till eller har kommit i kontakt med på ett eller annat sätt. Likt ord som lycka eller kärlek är ledarskap subjektivt och öppet för tolkning. Vissa hävdar att ledarskap är en medfödd förmåga medan andra menar att det är en förmåga som kan tränas upp. Ledarskapets speciella karaktär med sin skiftande betydelse och utseende fick oss att skriva det här arbetet.

Background: Knatteskutt is one of the largest organizations in children's sports. Operations are located in approximately 150 cities / areas and have both sports and dance focus. The children are aged 3-7 years and may try several sports activities or dance styles during the semester, focusing on play and motor skills. All who are leaders at Knatteskutt has undergone Swedish Sports Promotion of Child Leaders Training. There are also regional managers around Sweden is as a sounding board for leaders and as an extended arm between the office and the leaders.

The most recent couple of years the boundaries of the world have been erased and we have come to live in a more global environment. It has been even more evident since the European Union has got a more prominent role in the society. It appears as obvious for most of us that we live in a changeable time and that a new, global perspective has been developed. Companies have to focus on the effect globalization and differences in culture have, to be competitive in the market today. Because of that business managers more often can come to work in other countries than their country of origin, it becomes interesting whether these managers adapt their management style or if they continue to work the same way as they did in their native country.This thesis aims to investigate if business managers with a foreign background bring along their national culture when managing a company in Sweden.

The purpose with our study is to investigate in which way a public field of action has succeeded to make the economic management more effective and also find out which factors/activities that have contributed to get the result of the budget in balance. We also want to find out in which degree the balanced scorecard (BSC) has contributed to the positive result of the budget. Method: We had started out from the qualitative method theory which is based on the hermeneutic theory, because we will interpret and understand. With this starting point we have chosen to use a case study with semi-standardised interviews supplemented with information from different documents, and to get the theoretic connection we have studied literature in the subject field. The analyse and even the theoretic connection have then started from, for this study, a special analyse model.

Renal dysplasi (RD) is a congenital chronic renal disease affecting young dogs. It is a rather common disease that occurs in a large number of dogs and in some breeds there is a familiar incidence or suspected hereditary background. Both the etiology and pathogenesis are still unknown, but a theory about the cause of RD is that the two components that form the kidney, the uretheric bud and the metanephrogenic blastema, don´t interact normally in the embryo. Kidneys affected by RD contain fetal (immature) structures that are inappropriate for the state of development/age of the dog and abnormal structures caused by an abnormal differentiation. Affected dogs usually are under .

When we started this study we quickly saw that almost all the previous research that we find was focused and concentrated on the fact that the employees should be motivated. The research also presents a top-down perspective which means from the head to the employee. A Swedish newspaper wrote in an article that 1/3 of all Swedish heads can?t motivate their employers. A Swedish internet platform discusses this and says that heads need to be motivated to be able to motivate people around himself.

Every year 300 children in Sweden are diagnosed with cancer, but through research and successful clinical work 70 % of the children survive their cancer. Aim: To illuminate nursing care of children with cancer. Method: The study was carried out as a general literature study through systematic review and analyse of 18 scientific articles. Result: The analysis resulted in five themes: Support, play as a psychological assistance, alternatives to alleviation of pain, nutrition and relieving symptoms of fatigue.Conclusion: It is important that the nurse has knowledge about the children and their family?s experiences when dealing with a cancer illness to provide the children with adequate care.

ABSTRACTChlamydia and Chlamydophila are species of a family of bacteria (Chlamydiaceae) that cause a range of diseases, including conjunctivitis, in a variety of animals including pigs and humans. Some species cause zoonotic disease. This study examined the occurrence of Chlamydiaceae in samples taken from the lower eyelid conjunctiva in pigs with and without conjunctivitis. The study was initiated based on a herd investigation aimed to examine the experienced increase of conjunctivitis in some finisher herds. This study was conducted as a case-control study, by collecting samples from 62 case pigs (16-26 weeks old) and an equal number of controls, from three herds in Uppland, Sweden.

Canine parvovirus is associated with two disorders: enteritis, which is common, and myocarditis, which is rare. Prominent clinical signs of parvovirus enteritis are vomiting, diarrhea and rapid dehydration. Canine parvovirus type 2 (CPV-2) is very contagious. When CPV-2 first emerged it had high rates of mortality, but later studies have shown that most infections are self-limiting and do not require veterinary care. Mortality rates vary greatly, and therefore it is important to determine risk factors for developing severe canine parvovirus enteritis.

Back problems are well noticed in horses, especially in horses used for riding. Kissing spines (impingement of the dorsal spinous processes) are often found at radiographic examinations of the thoracic spine. Kissing spines is a radiological diagnosis, indicating that parts of at least two adjacent dorsal spinous processes are in contact with each other. It is not uncommon that horses without clinical signs of back problems have some degree of kissing spines. It is therefore not sufficient with a radiographic examination to say that the cause of pain is kissing spines.

Syftet med denna tvärsnittsstudie var att undersöka, det som i studien benämns, själslig intelligens, hos chefer och ledare i näringslivet samt att validera instrument för vad som i studien benämns ledarintelligens med fokus på själslig intelligens. Studien utvärderade den själsliga intelligensen hos chefer och ledare samt om det var någon nivåskillnad på den själsliga intelligensen hos kvinnor och män. I studien användes en enkät där deltagarna fick svara på påståenden kring själslig, emotionell och rationell intelligens. Studien validerade två skalor för själslig intelligens utifrån ett kanadensiskt instrument, SISRI (The Spiritual Intelligence Self-Report Inventory), en skala för själslig intelligens, (SQ), som ingick i ett svenskt instrument, LIQ (Leadership Intelligence Questionnaire), samt en ny skala för själslig intelligens, NySQ. Det var 90 chefer och ledare i Västra Götalands näringsliv, 37 kvinnor och 53 män som besvarade enkäten, medelåldern var 47 år.

Background: It is required that health care professionals continuously work with patient safety and quality improvements, and the skills of registered nurses are significant in this work. However, quality improvement also requires commitment and knowledge about how to improve health care and ensure patient safety. There is a lack of studies that highlights the importance of supportive functions for this work. Nurses in clinical settings can be utilized as facilitators that make things easier for other health care professionals who are engaged in quality improvement and patient safety. In order to gain understanding about the significance and needs of nurses with a role of facilitator, it is urgent to learn from their experiences of facilitating quality improvement in health care.Aim: The aim was to study nurses? experiences of facilitating quality improvement of nursing care, patient safety and multi-professional collaboration in health care.Method: Semi-structured qualitative interviews were performed with ten registered nurses who had experience of being in the role of facilitators.