International trade in services has increased over the past 30 years as a result of progress in information and communication technology, increased focus on services from the manufacturing sector and the establishment of trade associations.The international market for healthcare services, also referred to as medical tourism, is growing more and more. Patients increasingly seeking treatment at other countries healthcare systems because of long queues within their own country or because it exists better prices for the same care abroad. However, this type of service exports occurs at a limited extent in Sweden.The purpose of this study is to highlight and analyze the conditions for Swedish service companies to export healthcare services. This, includes the challenges and opportunities that exist to expand the exports of these services.The approach for this study has been in the form of interviews with two market actors and written responses, from the same interview guide, with three market actors. These market participants are the so-called Care companies which export healthcare services in various counties, and the membership organization Swecare who work with export promotion activities for its members in the Swedish healthcare sector.

The so called ?ByggaF-method? is a relatively new Swedish method to stop moisture from being built into a building. The method should prevent damages on buildings as a result of mould growth and moisture. The purpose of the method is to include moisture control in the entire constructionprocess, from the projecting phase and all the way to the management phase. Up until now, there is no proof if the method is profitable or not and no studies have been made on the topic.

Denna studie unders?ker vilka regler som finns vid m?ltidssituationen p? olika f?rskolor, vad de grundar sig i samt pedagogers uppfattningar kring dessa och hur makt anv?nds f?r att uppr?tth?lla eller f?r?ndra reglerna kring m?ltidssituationen. I styrdokument som ?L?roplan f?r f?rskolan? (Lpf?18, 2018) saknas riktlinjer f?r m?ltidssituationer vilket kan leda till os?kerhet kring hur de kan se ut. ?r reglerna outtalade och grundade i f?rskoll?rarens egna uppfattningar och normer eller gemensamt best?mda i f?rskolan? Genom en kvalitativ unders?kning med fr?gelista som metod visar resultatet att reglerna varierar fr?n f?rskola till f?rskola och att de innefattar b?de hur barnen f?r bete sig, vad som ska ligga p? tallriken, att det m?ste smakas och att barnen m?ste v?nta p? varandra innan de f?r g? fr?n matbordet.

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.

Laminitis has crippled horses through times and many cures have been used to treat it. Since the mechanism of the disease is yet not fully understood, treatments are only ways to alleviate the pain and at best, slow down the pathological process enough to make time for improvement. This paper is a retrospective study of 71 horses treated by a protocol at Hästsjukhuset Strömsholm. The protocol implies three visits at zero, five and fifteen weeks. At each the horse is evaluated and treated by a veterinarian.

SammanfattningBakgrund: Diabetes förekommer hos 3-4 procent av Sveriges befolkning. Uppkomsten av diabetes är ofta relaterad till livsstil. Hur människor upplever att få diagnosen påverkar synen på sjukdom och framtid. Människor som får sjukdomen är i behov av stöd från vårdpersonal. Syfte: Beskriva vuxnas upplevelser av stöd efter att ha fått diagnosen diabetes mellitus.

Background Anesthesia-related deaths are common in dogs, especially in the postoperative period, in compare to humans. This study aims to describe and elucidate the qualities of the postoperative care for dogs in Sweden. Method To investigate the postoperative care, a qualitative study was made by interviewing personnel in the animal health care sector. The primary information from the interviews was analyzed in a qualitative manor and a few distinguished qualities came forth. Results These qualities describe the postoperative care and include preventive activities, postoperative activities, monitoring and communication. A variation in regards to the results was seen between the interviewed.

Bakgrund: Att leva med bipola?r sjukdom inneba?r att drabbas av va?xlande maniska och depressiva skov. Begra?nsningar uppsta?r na?r sjukdomen pa?verkar det dagliga livet. Bipola?r sjukdom a?r kronisk och kra?ver farmakologisk och icke-farmakologisk behandling.Syfte: Syftet med studien var att belysa upplevelsen av att leva med bipola?r sjukdom.Metod: Litteraturstudien baserades pa? fem sja?lvbiografier och Lundman & Ha?llgren Graneheims (2008) kvalitativa inneha?llsanalys med ett manifest tillva?gaga?ngssa?tt anva?ndes som analysmetod.Resultat: I resultatet framkom fem kategorier som beskrev upplevelsen av att leva med bipola?r sjukdom.

Enligt Myndigheten för samhällsskydd och beredskap så är information ?mycket värdefull, ibland till och med livsviktig? (1). Informationssäkerhetsarbete syftar i korthet till att skydda information och för att möjliggöra det krävs det att utifrån de förutsättningar som finns att anpassade skydds- och säkerhetsåtgärder införs för att informationen ska få ett välavvägt, anpassat och kostnadseffektivt skydd i förhållande till dess värde för en organisation eller individ (1).I detta examensarbete har Försvarsmaktens metod för applikationsgranskning utvärderats i syfte att utifrån ett informationssäkerhetsperspektiv se om den är tillämpbar som en säkerhetsåtgärd för andra svenska myndigheter samt ta fram en uppdaterad version av metodiken.Kvantitativa och kvalitativa data har samlats in via enkätundersökning, litteraturstudie samt intervjuer och resultatet visar att applikationsgranskning passar väl in i det övriga informationssäkerhetsarbetet.Denna studie visar att svenska myndigheter har brister i sitt informationssäkerhetsarbete och efterlyser konkreta exempel och metodstöd för att det ska bli bättre. I den här studien visar sig Försvarsmaktens metod för applikationsgranskning vara en lämplig och flexibel grund som kan bidra med detta då den är anpassningsbar utifrån miljö och förutsättningar och en billig säkerhetsåtgärd som går fort att genomföra och klarar sig med små resurser. Metoden ger en god grund till ett fortsatt informationssäkerhetsarbete genom att den metodiskt steg för steg går igenom och granskar en applikation.

Närstående bör erbjudas närvaro vid hjärt- lungräddning enligt nationella och internationella riktlinjer. Tidigare var intensivvårdssjuksjuksköterskor inte vana vid närståen-des närvaro men en attitydförändring har enligt flera studier påbörjats. Syfte: Att beskriva intensivvårdssjuksköterskans tankar om att ha närstående närvarande vid hjärt- lungräddning.Metod: Data insamlades genom intervjuer som bearbetades och analyserades enligt den kvalitativa innehållsanalysen. Två intensivvårdssjuksköterskor, som arbetar på en intensivvårdsavdelning på ett länssjukhus i Sverige, intervjuades till pilotstudien. Resultat: Intensivvårdssjuksköterskornas tankar som framkom i pilotstudien speglar en osä-kerhet och olust inför att ha med närstående vid hjärt- lungräddning.

The purpose of this study was to find knowledge about ostomy patients experience with a focus on overall life situation and the care they receive from the nurse. The method used was a systematic literature review according to Polit, Beck & Hungler. Six scientific research reports have been used as foundation of the result in this study. The articles have been reviewed according to Antonovsky's Sense of Coherence (SOC).The result shows that experiences of having ostomy are individual. Adapting to their new life situation varies depending on the reason for having an ostomy.

AbstractBackground: After a while the usage of urinary catheters leads to UTI which for the patient means inconvenience, suffering and pain. Aim: The aim of this study was to illuminate how to prevent UTI from patients with indwelling catheter. Method: This study was a literature review in which the articles have been searched for in PubMed, Cinahl and ELIN@Kristianstad. Results: It is important for the nurse to clean the periutheral area before inserting the catheter, and has the knowledge of different cathetermaterials. Silver alloy-coated catheters reduces the rate of UTI.

Bakgrund: Att leva med bipola?r sjukdom inneba?r att drabbas av va?xlande maniska och depressiva skov. Begra?nsningar uppsta?r na?r sjukdomen pa?verkar det dagliga livet. Bipola?r sjukdom a?r kronisk och kra?ver farmakologisk och icke-farmakologisk behandling.Syfte: Syftet med studien var att belysa upplevelsen av att leva med bipola?r sjukdom.Metod: Litteraturstudien baserades pa? fem sja?lvbiografier och Lundman & Ha?llgren Graneheims (2008) kvalitativa inneha?llsanalys med ett manifest tillva?gaga?ngssa?tt anva?ndes som analysmetod.Resultat: I resultatet framkom fem kategorier som beskrev upplevelsen av att leva med bipola?r sjukdom.

Ambulatory surgery is common and develops alongside surgery and anesthetic methods. Time admitted is short and aftercare takes place in the home environment.Objective: The aim of the study was to investigate which symptoms patients experience after ambulatory surgery related to anesthesia. Furthermore how strongly symptoms affect the patient. Symptoms appear as a result of anesthesia and surgery and can therefore be interpreted as nursing induced suffering.Method: Participants were recruited at ambulatory clinics at a Swedish university hospital spring, 2015.  Prior to the study permission was granted from the clinic managers. The study is a quantitative descriptive longitudinal study.  Data collection forms were administered and data collection was performed by phone.