Introduction: Each year 1200-1300 patients are diagnosed with head neck cancer. Treatment that involves radiotherapy can cause severe side effects for example trismus that affects quality of life.Purpose: To study health-related quality of life in patients who have undergone radiation treatment for head and neck cancer and participated in a intervention group who received training intended to prevent trismus or in a control group who received standard treatment.Method: This is a prospective study in which data is collected from 66 patients participating in a randomized study aiming to evaluate a training program to prevent trismus. Thirty three participated in the intervention group and thirty three in the control group. Both patient groups assessed health related quality of life (HRQOL) with EORTC QLQ C30 and QLQ-H&N35, at start and end of the radiation treatment, and at 3 and 6-months after completing radiation treatment.Results: There is no difference between the intervention and control groups regarding symptoms, functional status and global health, except for intake of nutritional supplements.  For both groups almost all scales measuring HRQOL deteriorated under the radiation treatment. However, 3 and 6 months after end of radiotherapy HRQOL had improved and had returned to the baseline values.

Bakgrund: Forskning- och utvecklingsarbete är något som bedrivs på många håll inom hälso- och sjukvården. Detta innebär att många patienter som söker vård och behandling kan komma att tillfrågas om att delta i forskning. En person som är sjuk, och i behov av vård, kan uppleva att man i patientrollen hamnar i en beroendeställning i förhållande till vårdpersonalen. Patienten är den hjälpsökande och vårdpersonalen är de som på grund av kunskap och förmåga att hjälpa patienten har en starkare ställning. Att vara patient och medverka i forskning kan innebära att patienten får ökad uppmärksamhet men patienten kan också uppleva att beroendeställningen gentemot vårdpersonalen förstärks.Syfte: Syftet var att beskriva patienters erfarenheter av att delta i forskning.Metod: En litteraturöversikt har gjorts där tio vetenskapliga, kvalitativa artiklar, med begränsning vuxna patienter, har utgjort grunden till resultatet.Resultat: Resultatet presenteras i fyra kategorier, vilka är; Överväganden inför beslut om att delta i forskning, Meningsfullhet av att delta i forskning, Upplevelse av hinder i samband med forskning samt Från känslan av stöd ? till känslan av övergivenhet.Diskussion: Resultatet har diskuterats i relation till livsvärldsperspektivet enligt Dahlberg och Segesten.

Every year many dogs in Sweden are bitten by the adder, a venomous snake (Vipera berus). Despite the fact that adder bites are so common in dogs there have been few investigations made that study the effects of treatment with glucocorticoids, a drug that is commonly used. We have carried out a literature study concerning adder bites in dogs and a prospective study where case history, clinical signs and treatment have been recorded in dogs that were presented at two veterinary hospitals after a confirmed or suspected adder bite. Fifty three dogs were included in the study out of which 22 were treated with glucocorticoids. In our study, the group of dogs treated with glucocorticoids was compared with the group of dogs that did not receive glucocorticoid treatment by the owner or on arrival at the clinic.

Sahlgrenska Academyat University of GothenburgDepartment Of Internal Medicine And Clinical NutritionAbstractTitle: The effect of CLA on body weight and body fat amongst overweight and obese.Author: Sierra De Goldsmith and Amanda EgebergSupervisor: Frode SlindeExaminer: Anna WinkvistProgram: Dietician study program 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 12, 2012Background: Overweight and obesity represents a global problem as it is accompanied by an accumulation of body fat which increases the risk of developing diseases such as diabetes type 2, insulin resistance, cardio vascular diseases and certain types of cancer. Moreover, the prevalence is increasing worldwide. Many consider it difficult to reach a normal weight using only methods such as changing dietary- and exercise habits, this creating a market for products that facilitate weight loss and loss of body fat. The supplement of conjugated linoleic acid (CLA) is such a product. In animal studies, CLA has demonstrated a reduction in both body fat and weight.

St. John?s wort extract is composed of a large number of components, about 150, but the most studied and interesting substance are hyperforin and hypericin. The herb is very popular and it is known for its pharmacological efficacy in numerous disorders. It is used for treatment of mild to moderated depression as an alternative to synthetic antidepressants.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

The aim of this study was to conduct an instrument test of the Canadian questionnaire Alberta Context Tool (ACT) version Long-Term care for Swedish conditions. ACT is designed in order to measure the context in the care environment and different behaviours related to the changes in clinical practice. In total, 159 Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) within municipality care of the elderly were included in the survey. The test included the instrument's reliability and face validity.The reliability test was implemented through calculation of Cronbach´s Alpha, and showed internal consistency for five of the scales of the ACT-instrument with Cronbach´s Alpha values ranging between 0,728 and 0,873. However, three dimensions got lower values (0,558 - 0,683).The analysis was carried out with content analysis and carried out for LPNs and RNs in separate groups.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

The purpose of this essay is to explain which factors influence the disciplinary effect of visible constant surveillance on the people under surveillance. In order to do this we have used recorded video from a tv-show called Big Brother, which is characterized by this kind of surveillance. In addition, an open-ended interview was performed with one of the participants from the show. We have, based on a number of theoretical assumptions, as well as reflections from the interview, precisely defined expected symptoms of the participants, that would indicate when the disciplinary effect was low respectively high. Our observations and analysis allows us to conclude that the disciplinary effect of surveillance in many situations is counteracted when surveillance is constant, leading to relatively low levels of disciplinary effect in Big Brother..

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.

It has been observed by both onion producers and a plant protection advisor on Öland (an island off the east coast of Sweden) that basal rot is the largest contributory factor to reduced onion quality and yield. Basal rot is mainly caused by species of Fusarium fungi. The aim of this study was to: a) investigate which species of Fusarium that can be found in onion produced on Öland, b) describe the symptoms caused by the different Fusarium fungi found and c) explore, through interviews with the onion producers on Öland, the mechanisms that may be involved in the observed increase in basal rot.Onion bulbs (Allium cepa) were sampled on two occasions. In total 181 onions from 11 different fields were analysed. In addition, eight onion producers were interviewed.

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 .

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.

Introduction: Approximately one in eight women suffer from postpartum depression, which can affect them for a period of weeks or even years. Postpartum depression does not only affect the mother, it also has a negative influence on the rest of the family. Postpartum depression can also lead to negative consequences for the development of the infant. It is an illness that is still considered a taboo, a fact that makes it hard to identify among women who are affected. Aim: The aim of the study was to examine cases where there is a connection between social economic status (SES) and the presence of postpartum depression.