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.

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.

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.

The purpose of this litterature review is to illustrate the nursing care to patient with chronic pain. As a theoretic frame for this study we choose Aron Antonowsky. The results of this study are based on 8 scientific articles. The findings are presented in main categories and ideas. The findings show that chronic pain is a multidimensional phenomenon that influences peoples quality of life in a physical, psychological as well as social way.

Bakgrund: Robot-assisterad kirurgi har blivit alltmer popul?rt och effektivt som en alternativ teknik till traditionell ?ppen kirurgi. Detta tillv?gag?ngss?tt som anv?nder ett avancerat system f?r att genomf?ra kirurgiska ingrepp har utvecklats ?ver tid och inneb?r flera f?rdelar som ?kad precision och kontroll samt minskad risk f?r komplikationer. Trots framstegen st?r kirurgiska team inf?r utmaningar med anpassning till den nya tekniken och behovet av att utveckla strategier f?r att uppn? optimalt resultat.

This is a study of the importance of culture for persons who are in their terminal stage of life. The purpose of my study is to find out if culture, particularly literature, can be a comfort for persons who are about to die. The study is based on interviews with people who are working in the palliative team at Norra Älvsborgs Länssjukhus (NÄL) in Trollhättan. It is also based on study of literature. It is literature about hospital library, culture in hospital treatment, palliative care, bibliotherapy and ?own stories? from dying persons.

Amalie Skram (1846-1905) was born in Norway but lived in Denmark. She published several books about gender relations and built up a reputation as a naturalistic writer. In 1894, a nervous breakdown made her seek help from the famous psychiatrist Knud Pontoppidan. He sent her to an asylum, but she returned home after spending two months in psychiatric care. In 1895, Skram published two novels about the painter Else Kant, based on her own experiences but not written as autobiographies.

This report addresses the growing need to adapt the medical healthcare to the new possibilities that can be accomplished by incorporating a web aspect to the personal treatment plans of patients. It describes what implementations that need to be considered in order to successfully convert to a partially web-based treatment.The report also reflects the potential economical gain that can be made by keeping the communication between the patient and the doctor frequent. It also takes into account the personal gain to the patient by increased feedback and easier ways to communicate with their attending physician and thereby increasing the quality of their healthcare and service.The construction of a prototype of the system required is also included in the report as a description of construction and functionality of the prototype along with results and estimated outcome..

Syftet med litteraturstudien var att undersöka hur buller påverkar sjukhusmiljön med hänseende på vårdpersonal och patienter. Studiens avsikt omfattar även en undersökning av vårdpersonalens och patienters eventuella olika uppfattningar angående buller. Effekterna av buller och dess omfattning inom vårdavdelningsmiljön har också undersökts. Resultatet av studien visar på att bullermiljön på sjukhus överskrider de riktlinjer för buller som WHO fastslagit. Vidare visar studien på indikationer på att brittiska sjuksköterskors kunskap angående fenomenet buller är bristfällig.

AbstractBackground: Plantar fasciitis is the most common heel injury and is a long-term pain syndrom in the attachment of the plantar fascia to the calcaneus bone. The condition is treated mainly in primary care, but there is currently no treatment guideline for the treatment of plantar fasciitis in Sweden. The purpose of this study was to investigate which treatment that occurred in primary care in Dalarna, Gävleborg and Västmanland counties, which treatments that were most common alone and in combination with each other. The aim was also to investigate if the four most commonly used treatment methods as physical therapists said they had used were supported in the literature, and if there was any difference between county employees and private physical therapists in the choice of treatment method.Method: 100 physiotherapists in primary care in Dalarna, Gävleborg and Västmanland counties, received a questionnaire by mail. 80 of the 100 physiotherapists were county employees and 20 were private employees.