Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: A vegetarian diet, a possible treatment complement for relief of symptoms ofrheumatoid arthritis? A systematic review.Author: Alexandra Ahlsén and Caroline ForsbergSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background: Rheumatoid arthritis (RA) is a chronic remitting polyarthritis that is relapsing.Symptoms are inflammation of the joints with pain, stiffness and degradation of joint tissue.In some cases, also other parts of the body are involved. The treatment consists ofmedications to reduce pain, inflammation and degradation of joint tissue. Today, the offerednutritional treatment is primarily focused on meeting energy requirements and nutrient needs.The diet has also been discussed as symptomatic treatment, and one of the factors believed toinfluence the symptoms is meat.Objective: To assess the evidence as to whether a vegetarian diet affects the symptoms ofrheumatoid arthritis, and if so, to suggest how it can be implemented in practical dieteticswork.Search strategy The databases used in the literature search was PubMed, Scopus, and AMED.The search words used were: "rheumatiod arthritis", "vegetarian", "vegan", "diet", "meat" and"animal protein".Selection criteria: Studies investigating a vegetarian diet on the symptoms of RA wereincluded. Only RCT, clinical trial, controlled clinical trial, human studies and original articlesin English or Swedish were included.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Does the number of chews affect satiation and satiety?Author: Madeleine Johansson och Helena AnderssonSupervisor: Heléne Bertéus ForslundExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 27, 2014Background: Overweight and obesity is a growing problem worldwide. In 2008, 35% of theworld's population were overweight and 11% obese , which is almost doubling since 1980,according to WHO. Recommendations on overweight and obesity is not just about what weeat but how we eat. A generally accepted recommendation is to eat slowly and chew yourfood properly in order to increase fullness and reduce energy intake.

Thid thesis concerns pre-Roman religion in Gaul, taking as its starting point Caesar's De bello Gallico. Caesar's account of the Gauls and their religious customs is compared with the accounts of Lucan, Pliny the elder and Ammianus Marcellinus. These are also compared to, and contrasted to, the archaeological evidence. There is some discussion of the nature of the common interpretations of this evidence. The concept of 'the Celts' is touched upon, since much of the relevant evidence has, in our time, been thought of as Celtic.

The aim with this master?s thesis is to examine the information practices and information literacies among social workers in the field of the social services and in the work with child welfare investigations. This is in this study related to their ambition to fulfill the requirements of an evidence-based practice. On a theoretical level, the study is based on three theories grounded in the idea of situated learning and of human activities based in a social context. These are the sociocultural theory, the theory of communities of practices and the theory of information practices.

AimThe purpose of this study is to investigate whether there is scientific evidence that exercise and/or manual therapy can improve function, in terms of increased mobility and strength on shoulder impingement-like symptoms among athletes. Another aim is to investigate whether these interventions can reduce shoulder pain.MethodA systematic review was conducted in the databases PubMed, CINAHL, PEDro and Amed. A total of thirteen articles were selected for further review and compilation. They were then graded for level of evidence according to the PEDro scale and the Swedish Council on Technology Assessment (SBU).ResultsThe systematic review shows that there is strong scientific evidence that acupuncture and heat can reduce pain in athletes diagnosed with supraspinatus-tendiopathy. There is limited scientific evidence that exercise increases strength, limited scientific evidence that stretching increases mobility and insufficient scientific evidence that a combination of treatments, with both exercise and stretching, reduces pain and increases function in overhead athletes.ConclusionsExercise and manual therapy can reduce pain and/or improve function in terms of increased mobility and strength in athletes with shoulder impingement-like symptoms.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Artificial sweeteners in beverage and their effecton hunger and energy intakeAuthor: Sofia Andersson and Sofia JakobssonSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 11, 2012BackgroundIn 2010 the total consumption of soft drinks in Sweden was estimated to 69 litres per person and17 % of the domestic production was estimated to consist of soft drinks sweetened with artificialsweeteners. The effects of artificial sweeteners on hunger is not yet fully understood. It isspeculated that they might increase hunger and hence increase energy intake.ObjectiveThe aim was to compile the evidence regarding the effects of an intake of a beverage sweetenedwith artificial sweeteners compared to sucrose on subsequent hunger and energy intake.Search strategyA systematic search for literature was performed in the databases PubMed and Scopus.Selection criteriaThe inclusion criteria were RCT, human studies, articles published in Swedish or English, studieson healthy adults and studies measuring hunger with a subjective scale or energy intake. Theexclusion criteria were studies who measured energy intake under other forms than standardisedor controlled, studies without a standardised dose of the beverage and articles needed to beordered against payment.Data collection and analysisFour articles were selected and examined according to a template developed by SBU. Theevidence for each outcome was weighed together and graded according to GRADE based on asummarised evidence form developed by the Sahlgrenska Academy.Main resultsAll four articles measured subjectively rated hunger.

Aim: The aim of this study was to determine whether or not there is evidence for the usage of ginger as an antiemetic in patients experiencing chemotherapy related nausea, based on available scientific literature.Methods: The original articles were found by using search engines PubMed and CINAHL. The selected articles were then analyzed based on their content, quality and results. Based on the results from the content analysis the articles were placed in four different themes.Results: In the first theme two of the articles found that ginger had significant effect on chemotherapy related nausea, when used in combination with regular antiemetic treatment. Two other articles said that it does not. In the second theme four studies found that different forms of ginger lessens nausea, in contrast two other articles found that it does not have any increased effect on said nausea.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Breakfast and cognition from a youth perspectiveAuthor: Linn Kruse and Anneli HulldinSupervisor: Anna WinkvistExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 26, 2014Background: Breakfast as an influencing factor on cognition and is often on the table for discussion in society. A lot of research has been done about how omitting breakfast affects adolescents and their short time cognition. Cognition is complex as a concept and is measured in different ways and the existing research in the area often compares different types of breakfasts instead of the difference between eating and omitting breakfast.Objective: To evaluate the scientific evidence for an association between adolescents? breakfast eating and short time effects on cognition in adolescents.Search strategy: To find relevant articles a systematic literature search was made in the databases PubMed, Scopus and Cochrane. Search terms that were used were: children, young adults, adolescents, cognition, and breakfastSelection criteria: Ages 12-20 years, measures cognition, RCT, studies comparing breakfast eating with omitting breakfast, human studies, language English or Swedish, no sick adolescents or adolescents with diagnosis.Data collection and analysis: Two original articles met the inclusion criteria and were reviewed by the SBU audit template for RCT studies.

The purpose of this study was to examine people's experiences of self-medication with cannabis in relation to post-traumatic stress disorder and professions? opinions of cannabis for medical use. The study focuses on norms and values as well as its impact on individuals. A qualitative approach was used with thematically open interview questions, in order to gain an insight into the interviewees? reality and their experiences.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Alcohol consumption after training and its effects on muscle gain and recovery adult menAuthor: Frida Carlstedt, Puck JanssonSupervisor: Frode SlindeExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 09, 2014Background: Today, the Swedish population exceeds the recommendations for alcohol intake while advised to move at least thirty minutes a day. It is well established what happens if you drink alcohol before a workout or if you workout the day after an alcohol intake, but it is less well established how muscle gain and recovery are affected by an intake of alcohol in the phase of recovery.Objective: The objective of this review is to investigate if there is a relation between alcohol intake after a workout and effected recovery and muscle gain. This was performed by measuring the outcomes cortisol, testosterone, creatine kinase as well as different measures of muscle strength. The issue was ?Does an intake of alcohol after training affect recovery and muscle gain??Search strategy: A systematic review in the databases PubMed and Scopus with the MeSH-terms: exercise, muscles, recovery of function, training, athletic performance, performance, sport, alcohol drinking, alcohols, alcohol and ethanol.Selection criteria: Criteria for articles to be included in this review were that they would be RCT- and human studies in healthy subjects as well as containing an ethanol intake after a physical activity that consisted of weight training in the form of resistance training or other forms of activity that promotes strength.Data collection and analysis: A systematic search for literature as mentioned above (search strategy) was performed as well as an analysis with the SBU quality review template for randomized studies, and a quality review for each measure of outcome according to Gothenburg University summarized evidence template for measures of outcome.4Main results: Many studies are authored by the same group of researchers and/or are of a lower quality.

Att arbeta evidensbaserat innefattar både ett förhållningssätt och en process, vilket ställer krav på den enskilde arbetsterapeuten att kontinuerligt ompröva olika arbetsmetoder. Syftet med denna uppsats var att belysa arbetsterapeuters kunskap om och attityd till evidensbaserad praxis. Vidare att undersöka vilka hinder som angavs och förslag till lösning av eventuella hinder för att arbeta evidensbaserat. Metoden litteraturstudie användes och artiklarna valdes utifrån systematisk litteratursökning. Tio artiklar, publicerade 2000-2005, från fyra olika länder granskades avseende olika aspekter av evidensbaserad praxis.

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.

This report is the documentation of a project in the education Master of Science in Mechanical Engineering. The project was carried out at Alfakonsult AB. The purpose of the project was to map out the transference of information between the different operators in the supply chain of medicine in Sweden and to analyse this in order to reduce lead-time and the total throughputtime. The supply chain of medicine in Sweden consists of producers, distributors, one wholesaler, prescribers and patients. The mapping of the transference of information showed that most operators in the supply chain have done well introducing technical aids to facilitate the transference of information.

What happens when historical theories are used as evidence in a trial? Is it possible for historians to use their own scientific tools when acting as participants in a juridical process? And how do judges deal with historical evidence? The aim of this study is to answer these questions by analyzing a specific trial, known as ?Härjedalsmålet?. Härjedalsmålet was a court case about the Sami people?s right to let their reindeer graze on private property grounds in Härjedalen during the winter season. Their claim to this right was based on prescription of time immemorial.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Vitamin D supplementation and its effect on body composition in the overweightand obese ? a systematic reviewAuthor: Johanna Blum and Emma Sellin FrimodigSupervisor: Sofia KlingbergExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 10, 2013Background: There is an increasing burden of overweight and obesity worldwide. Theconditions lead to morbidity and lowered quality of life. Since there is research showing aconnection between obesity and low levels of serum 25(OH)D, this raises the question ifsupplementation of vitamin D may have positive effects on body weight, waist circumference andbody composition in the overweight and obese.Objective: To investigate if there is enough scientific evidence to recommend vitamin Dsupplementation combined with nutrition therapy to overweight and obese patients.Search strategy: The systematic collection of data was performed in the databases PubMed andScopus. Search terms included were ?vitamin D supplementation?, ?obesity? ?cohort?, ?vitamin D?,?vitamin D3 supplementation? and ?overweight?.Selection criteria: Human studies with RCT, CCT or cohort design written in English orSwedish were included.