Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Cow?s milk and chronic constipation in children ? A systematic reviewAuthor: Sara Palm & Anna SvenssonSupervisor: Frode SlindeExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 27, 2014Background: Chronic functional constipation is common among children. Up to a third of all who seek a paediatrician suffer from constipation and it is a widespread problem for children in many countries. Lately it has been discussed if cow?s milk can be a cause of the constipation and if it should be considered a delayed hypersensitivity.Objective: The aim of this systematic review is to examine whether there is scientific evidence to recommend a cow?s milk-free diet as a potential treatment in chronically constipated children.Search strategy: The literature searches were performed in the databases Pubmed, Scopus and the Cochrane library, using the search terms cow?s milk, constipation, milk proteins, dairy products, milk hypersensitivity, cow milk and cows milk between March 17th and April 4th 2014.Selection criteria: Randomized controlled trials measuring stool frequency in chronically constipated children on a cow?s milk-free diet were included.

The purpose of the thesis is to examine why women face greater difficulties than men in the management consulting industry when advancing as well as to identify potential success factors that enable women to overcome the existing difficulties. In order to fulfil the purpose, a theoretical framework including gender and organisational theory has been applied to a qualitative case study of two Swedish management consulting firms. A number of difficulties have been identified related to women's career advancement, which are the following: the male leader and the stereotypical male leadership, firms having higher expectations on women's performance, women's reluctance to self-promotion and to play "the organizational game", women's preference of social networks, men's tendency to promote other men, and the choice and conflict between a career and family life. The identified success factors that enable women to overcome these difficulties are: adapting the male leadership style, having an extrovert behaviour, becoming more active in professional networks, promoting one self, actively seeking to gain more attention, and prioritising one's career. These success factors can be summarised as women adapting a more male-like behaviour.

Vaccinology is an ever expanding field. As a member of the veterinary staff it is important to stay up to date with the continuous new scientific data and recommendations that affect the care that our companion animals receive at the veterinary clinic. This paper presents adverse vaccination reactions, their cause, risk factors and suggestions how we can minimize the risk of adverse vaccine events in dogs. Dog owners in Sweden were allowed to answer a questionnaire about adverse events following vaccination. Lethargy, edema and pruritus were among the most frequently seen adverse effects.

Bakgrund: Sepsis ?r ett livshotande tillst?nd som i ca 20% av fallen resulterar i en d?dlig utg?ng. Eftersom sjukdomsf?rloppet ofta ?r akut ?r tidig identifiering och omedelbara ?tg?rder avg?rande f?r att f?rb?ttra patientens prognos. F?r att underl?tta detta anv?nds olika screeninginstrument som st?d i bed?mningen.

The purpose of this essay was to examine six high school welfare officers' experiences and work with students suffering from social phobia and discuss the welfare officers' view on social phobia from a psychiatric, cognitive and a knowledge theory. The study consists of qualitative interviews with welfare officers from several different high schools and attempts to answer the following questions: What previous experiences do welfare officers have of students with social phobia? How do welfare officers become aware of students with symptoms of social phobia and bring forth their problems? How do welfare officers describe their social work with students suffering from social phobia?The welfare officers' experiences of students with social phobia varied but turned out to be less salient than the amount of research in the area would suggest. The theoretical knowledge also varied, as did the acquiring and use of theory. These findings were then analysed on the basis of Rosmari Eliassons thoughts on knowledge, leading to the conclusion that the interviewed welfare officers do not construct their work on praxis-knowledge.

Background:  Heart failure is a multidimensional phenomenon with high mortality. Heart failure is treated with angiotensin converting enzyme (ACE) - inhibitors or angiotensin receptor blockers (ARBs) that counteract neurohormonal stimuli that occur in heart failure, as well as providing vessel dilatation, which reduces symptoms and the need for hospitalization and increases survival. Despite this, only about 50% of heart failure patients survive 6 years after diagnosis with drug therapy, and as heart failure is increasing globally, due to improved care and treatment and increasing life expectancy of the population, there is a great need for new drugs such as LCZ696 that acts by dual inhibition of the renin - angiotensin - aldosterone system and neprilysin inhibition.Objective: The aim of this literature study was to evaluate the efficacy of current treatment and possible future treatments on mortality and morbidity in heart failure patients.Results: The examined articles show that treatment with ACE inhibitors in patients with symptomatic heart failure reduces the risk of total mortality by 16% over 3.5 years, reduces all-cause mortality or hospitalization due to heart failure with NNT (number needed to treat) = 10.4 over 3.5 years and increases median survival by 9.2 months over 12.1 years in patients with asymptomatic heart failure. Treatments with high-dose ACE inhibitors reduce mortality and hospitalization because of cardiovascular causes and hospitalizations from any cause by NNT = 30 over 3 years. Beta-blockers reduce sudden death and total mortality and cardiac death or non - fatal myocardial infarction with NNT = 38 and NNT = 23, respectively, over 12 months.

- To be trapped in a roller-coaster That ?s how some of the patients are describing the situa- tion of living with heart failure. To be stuck in their home not knowing if they will have to seek care today and not knowing if they will have the energy to attend that birth- day party later this week.Each year 2-3% of the Swedish population are diagnosed with heart failure, which results in 30,000 new individu- als with the disorder. Cardiovascular disease is rapidly in- creasing in the world and before 2030, people with heart failure will increased by 100%. Our improved living condi- tions and better health have allowed us to grow older and made us more dependent on other types of care, care at home.Today the patients are only looking for changes in weight and if they have excessive water in their body.

Bakgrund: Sjuksko?terskestudenter kommer i kontakt med palliativa och cancerpatienter flertalet ga?nger under sin kliniska utbildning. Detta pa?verkar studenterna olika ka?nsloma?ssigt. Fo?r att hantera dessa nya upplevelser tilldelas studenter en handledare som skall ge sto?d, undervisa och guida dem under den kliniska utbildningen.Syfte: Syftet med studien var att underso?ka sjuksko?terskestudenter uppfattning av mo?tet med palliativa patienter samt erha?llen handledning i samband med dessa mo?ten.Metod: Metoden till denna kvalitativa studie var tva? semistrukturerade fokusgruppsintervjuer med ett bekva?mlighetsurval av studenter som haft klinisk utbildning pa? hematolog, onkolog eller palliativ avdelning.Resultat:Va?rd av palliativa patienter eller patienter med cancer uppfattades som en sorglig, sva?r, obekva?m men la?rorik upplevelse.

Powdery mildew is a serious problem in both field and greenhouse cucumber production and can cause serious infection and radically reduced yields. Today, powdery mildew is the main disease in greenhouse produced cucumber. Disease control should preferably be both efficient and environmentally friendly, which is not easy to achieve at all times. Alternatives to chemical control of powdery mildews are biological control, physical control, non-fungicide control and cultivation of resistant or tolerant varieties. Biological control can be described as the suppression of damaging activities inflicted of a harmful organism by one or more other organisms, which are called antagonists or natural enemies. In Sweden, there are currently no registered biological control products available to control cucumber powdery mildew. The aim of this study was to investigate the effect of two biological control products in order to evaluate their ability to prevent or reduce powdery mildew infection to an acceptable level in greenhouse produced cucumber. In the experiments, different application regimes were also studied.

AimThe purpose of this study was to examine the relationship between physical strain and recovery in dancers at The Ballet Academy in Stockholm, Sweden. Research questions used to guide the study were: How great is the dancers experience of physical strain? Do any of the dancers show mental or physical signs of overtraining syndrome?MethodPhysical strain was studied by letting the dancers fill out a booklet catloging their intensity during practice. Utilizing a questionnaire, data was gathered regarding preceding year. To give more nuance to the data gathered, The Profile of Mood States was used to detect possible mood disturbance.

Canine dilated cardiomyopathy (DCM) is a disease with high morbidity and mortality and with a high prevalence in certain breeds. Predominatly large breeds are affected, such as Great danes, Newfoundlands, Deerhounds and Dobermanns. One exception is Cocker spaniels, where both American and English Cocker spaniels are affected in a quite high frequency. Cardiomyopathy is characterised as a disease that affects the myocardium and gives an impaired heart function. To diagnose DCM following criteria have to be observed: 1. Dilation of the left ventricle. 2. Reduced systolic heart function. 3. Increased sphericity of the left ventricle. To be certain of the diagnosis, alternative reasons for the symptoms such as lung- and heart diseases with other etiologies have to be excluded Two different types of DCM have been found upon histological examination.

Listeriosis, which is caused by Listeria monocytogenes, is a rare food borne disease that primarily affects people whose immune system is weakened. These may be elderly people, pregnant women, new-born infants and individuals on immunosuppressive medication. The most common symptoms are meningitis, septikemia and abortion. The mortality is high, on average 20-30 %. In recent years the number of cases in Sweden has increased.

ECG-Screening for young elite athletesAbstractBackgroundSudden cardiac death (SCD) during physical activity is a frightening and emotional tragedy that draws huge media attentions when it occurs. Fortunately it is a relatively uncommon occurrence but happens nonetheless to young athletes who often seems to be in perfect health. SCD is used as a term for sudden unexpected complications on the cardiovascular system that leads to a deadly outcome normally within the first hour of onset of symptoms and the cause is some sort of underlying cardiovascular disease that gets triggered by physical activity.Normally athletes gets divided into two groups dependent on age, over and under 35 years, and this studies focus is on the younger group since it is often during this period athletes are at the elite level. It is also in this category the most unexpected sudden deaths occur that is not due to coronary atherosclerosis, which is the dominant cause of death, and drastically increases, for people over 35 years old.AimThe aim of this study was to scientific and unbiased analyze peer-reviewed clinical articles todescribe the pros, cons and cost to implement an ECG-screening as a standard before physicalactivities for specifically defined elite athletes.MethodA systematic review was performed and after all data collection 21 articles was chosen to beused as a base for both background and analyze. At the end 10 articles was fulfilling the criteria to be used at the analyze and later the results.ResultsThe implementation of ECG-screening has reduced SCD in Italy by 89 % between the years 1979-2004.

Amyotrophic lateral sclerosis is one of the major neurodegenerative diseases, causing an ascending paralysis that usually kills the patient within a few years from disease onset. The motor neurons show aggregates of proteins which in approximately 20 % of cases of the familial form contain mutated SOD1 protein. Trehalose is a disaccharide which has been shown to reduce protein aggregation and increase viability in cell models and alleviate symptoms in animal models of several neurodegenerative diseases associated with protein aggregation. When given orally to the SOD1G93A mouse model of ALS, trehalose failed to slow down the disease progression, which has led to questions about the uptake and distribution of the molecule in this mouse strain. The aim of this study was to investigate whether significant levels of trehalose reach the central nervous system of the SOD1G93A mouse after oral administration. This was performed by a trehalose assay of the brain of trehalose treated animals. A glucose assay was optimised for use in small samples of brain lysate after the digestion of trehalose into glucose by trehalase, and the difference in glucose concentration before and after digestion represented the trehalose level.

Bakgrund: Sjukdomen schizofreni innefattas av symtom såsom vanföreställningar, vrede och apati samt har en hög självmordsprevalens. Närstående får ofta en minskad livskvalitet pga. de stora påfrestningar de utsätts för. De behöver stöd från vården för att orka vara delaktiga i den sjukes liv. Syfte: Att beskriva upplevelser av att vara närstående till en person som har schizofreni och på så vis öka sjuksköterskans förståelse för denna individgrupp.