Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionTitle: Can nutritional support contribute to the healing of pressure ulcers in elderly patients?Author: Anton Kinnander, Sandra SmidelikSupervisor: Elisabet RothenbergExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: 12-04-11Background The number of elderly patients with co-morbidity is increasing in the western world. It is therefore reasonable to predict increasing incidence and prevalence of pressure ulcers. One study, published 2009, found that as many as 59 % of geriatric patients within the Swedish health care system had developed pressure ulcers. Symptoms vary from mild erythema to severe deep tissue damage and development of pressure varies from hours to weeks.

ABSTRACTThe aim of this study was to describe various methods of treatment and effects of treatment of ADHD, and to investigate wheater there is an association between adults with ADHD and obesity. Method:  Literature review. Twelve quantitative scientific articles were found in the data bases PubMed, Cinahl and MedLine.  Result: ADHD is a cognitive impairment that can lead to serious complications such as obesity. Studies show that drug treatments of adults with ADHD have positive effects in terms of reduced symptoms, increased efficiency and improved quality of life, but drugs can also cause side effects in form of loss of appetite and insomnia. For adults with ADHD and obesity drugs that affect metabolism have a significant impact on patients ability to lose weight.

The share of human beings with overweight or obesity is increasing. This has become a problem for society since obesity often leads to illness. This illness affects life negatively and often leads to depression, absence from work and medical care. One treatment against obesity is to do bariatric surgery, or Gastric bypass. The purpose of the study was to illuminate the experiences of care encompassing Gastric bypass surgery.

Background:Existential and spiritual thoughts are a big part of pallative care. The terms existential and spiritual can be understood in many different ways. It may mean thoughts about faith or thoughts concerning life and death. The nurse in palliative care need to have good communication skills, be responsible and be present and supportive in meeting with the patient.Aim:To describe the nurse's experiences of meeting patients' existential and spiritual thoughts in palliative care.Methods:A literature review based on 10 scientific studies have been done. The studies have been downloaded from the following scientific databases; Academic Search preimer, CINAHL Plus with   Full Text, and PubMed.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: BCAA supplementation in patients undergoing resection for liver cancerAuthor: Mikael Semaan and Viktor SjölingSupervisor: Fredrik BertzExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 10, 2013BackgroundLiver cancer is the fifth most common cancer worldwide and the third largest to cause death. Protein-energy malnutrition is common in patients with liver disease and they often suffer from changes in the hepatic metabolism of nutrients and other substances. There is a basis for recommending BCAA supplementation in other certain liver diseases. Given the similar clinical picture of liver cancer surgery, it is possible that supplementation of BCAA can be beneficial for these patients as well.ObjectiveThe aim was to study the scientific basis for the effect of branched chain amino acid (BCAA) supplementation in liver cancer patients. Can it improve their recovery in terms of nutritional status and albumin levels, and does it changes the duration of hospital stay, after surgery?Search strategyFive extensive searches were performed on PubMed and Cochrane after appropriate study material.

The perioperative nurse's primary responsibility is to care for the patient during the operation?s three phases; before, during and after. The communication between colleagues in the surgical department is increasing opportunities for safe care for the patient and a good dialogue with the patient can alleviate the concerns facing the unknown environment such as an operating theater. The pilot study was to investigate the surgical nurses' perceptions of conversations with the patient one year after graduation. To answer the pilot study's aim a qualitative interview study was chosen with a phenomenographic approach.

Platelets are small fragments, but they are of crucial importance for the coagulation. The risk of spontaneous bleeding increases when the level of platelets falls below a thrombocyte particle concentration threshold value of 50 x 109/L. In those cases a platelet transfusion might be compulsory. Ongoing research tries to improve the quality of the platelets and to increase the safety of the method used. However, we still need to better understand which factors that affect how patients react upon platelet transfusion.

AbstractAim of the study: Aim of the study was to investigate whether there were any connections in time between different parts of care in patients with cardiac arrest and hypothermia treatment and cognitive and physical function six months after cardiac arrest and to investigate neurological outcome related to primary registered cardiac arrest rhythm after six months and if there were any changes in cognitive and physical functions as well as self-related health between discharge from hospital and six months after cardiac arrest.Method: The study included 39 patients admitted to three Swedish hospitals between 2008-2011. Cognitive and physical function was evaluated with Cerebral Performance Cathegory, CPC completed with Mini Mental State Examination, MMSE for cognitive function and Bartels Index, BI for physical function and Euroqol-VAS for evaluating the self-related health.Result:  A significant connection was shown between time to start hypothermia treatment and BI, patients with longer time showed improved physical function after six months.Majority of the participants (66,7 %) had Ventricular fibrillation/Ventricular tachycardia, VF /VT, as primary registered cardiac arrest rhythm and in this group CPC and BI was significant better compared with the asystole /Pulsless Electrical Aktivity, PEA group.CPC, MMSE, BI and Euroqol-VAS were all improved over time.Conclusion: Participants with VF /VT as primary registered cardias arrest rhythm had significant better cognitive and physical function 6 months after hypothermia-treated cardiac arrest compared with participants with asystole/PEA as primary registered rhythm. This shows the importance of access to defibrillators in public places in the society and in hospitals and optimal education of lay people and medical staff. Cognitive and physical function and self-rated health improves over time, which might be a very important reason to convey patients, relatives and medical staff to continue cognitive and physical rehabilitation. Keywords: Cardiac arrest, hypothermia, cognitive and physical function, wellbeeing.

The purpose of the study was to review the current veterinary literature regarding gastric dilatation and volvulus (GDV) considering pathophysiology and treatment, and to evaluate the operative technique (incisional gastropexy) used during the years 2005 and 2006 at the University Animal Hospital (Universitetsdjursjukhuset), SLU, Uppsala, Sweden. GDV has a complicated pathophysiology which foremost effects the circulatory system. Progress is often acute and it is not unusual that patients are affected with shock. The initial treatment targets to alleviate the shock by fluid therapy and decompression of the stomach. There is a high risk of recurrence in the long term perspective unless the stomach is surgically fixated by gastropexy. The study describes two different techniques for gastropexy; incisional gastropexy, and funduspexy. Long term complications were rare among the patients that were treated surgically, while about half out of the eighteen dogs that undergo surgery do experience complications of various severity in the short term..

The aim of this study was to describe the importance of diet and physical activity related to Diabetes Mellitus (diabetes). Method used was a descriptive literature study based on empirical studies. The study shows that diet, physical activity and lifestyle-changes are very important factors when it comes to preventing and treating of diabetes. By the right diet and physical activity the treatment with medications in some cases can be superfluous and people with the disease could live longer and be healthier during their lifetime. Nurses have the responsibility to educate, inform and make sure that the diabetic patient gets the best care as possible specially suited for this individual patient.

The health care formulation of the principle of autonomy can be expressed as follows; ?you shall not treat a patient without the informed consent of the patient, or his or her lawfulsurrogate, except in narrowly defined emergencies?. The principle of beneficence refers to a moral obligation to act for the benefit of others. In heath care, the good or benefit in question is the restoration of the health of the patient. In fulfilling this obligation of beneficence, the physician sometimes intentionally overrides the patient?s preferences or actions for the purpose of benefiting the patient.

SAMMANFATTNINGBakgrundVid ett cancerbesked ges mycket information som kan ge psykologiska reaktioner hos patienten.  Att ge individuellt stöd, information och ett bra bemötande är viktigt för att patienten ska känna sig trygga och delaktig i sin vård.SyfteAtt utvärdera bröstcancerpatientens upplevelse av information, stöd, bemötande och delaktighet i samband med sitt återbesök hos kontaktsjuksköterska efter operation på Bröstmottagning.MetodEn tvärsnittsstudie med kvantitativ ansats då huvudfokus var patientens upplevelse av information, stöd, bemötande och delaktighet. Patienterna fick svara på en elektronisk enkät direkt efter sitt återbesök på mottagningen. Totalt svarade 48 patienter på enkäten.Resultat Resultatet visade en mycket hög nöjdhetsgrad bland bröstcancerpatienter vad gäller information, stöd, bemötande och delaktighet i samband med återbesöket hos kontaktsjuksköterskan efter bröstkirurgi. Äldre kvinnor var mer nöjda med informationen jämfört med de yngre.

ABSTRACTThe aim of this study was to describe various methods of treatment and effects of treatment of ADHD, and to investigate wheater there is an association between adults with ADHD and obesity. Method:  Literature review. Twelve quantitative scientific articles were found in the data bases PubMed, Cinahl and MedLine.  Result: ADHD is a cognitive impairment that can lead to serious complications such as obesity. Studies show that drug treatments of adults with ADHD have positive effects in terms of reduced symptoms, increased efficiency and improved quality of life, but drugs can also cause side effects in form of loss of appetite and insomnia. For adults with ADHD and obesity drugs that affect metabolism have a significant impact on patients ability to lose weight.

Feelings the nurses and the students experience in their encounter with death and dying patients..

The prehospital management of patients with acute myocardial infarction (AMI)now includes 12-lead electrocardiogram transmission directly from the ambulance to hospital.If the ECG shows ST-elevated myocardial infarction the patient should be transported directlyto a hospital with capability for percutaneous coronary intervention (PCI).                                               Aim: The aim of this study was to describe how ambulance nurses experienced the prehospital management of patients with AMI who are transported by ambulance directly to hospital for PCI.                                                Method: Semi structured interviews were conducted with eight ambulance nurses. Data were analysed using qualitative content analysis. The categories that emerged were: Use ofcompetence, Responsibility and Insufficiency. Result: The result showed that the ambulance nurses felt secure when they cared for patients transported directly to PCI. The nurses assessed the patient and decided how he or she should be cared for.