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.

This study is based on a qualitative internet research about people with Asperger syndrome and their thoughts and opinions about the difficulties that occurs in the environment outside the home and their experiences of Internet. We have analyzed Internets social influences for those with Asperger syndrome, as a consequence of the difficulties that they meet in other environments. The constructed communities in the environment outside the home and the social interaction that occurs there is not adjusted for those with the diagnosis. This leads to difficulties to be there for those with Asperger syndrome. By doing a content analysis of the assembled data from a community site on the Internet, we found out that the environment on Internet is more comfortable for those with the diagnosis in several ways.

The number of elderly in society is increasing and therefore the number of people with dementia. They continue to live in their homes longer, which also increases the responsibility of district nurses. The purpose of this study was to describe the experiences of district nurses to care for and have responsibility for the care of people with dementia in home care. The method chosen was a qualitative interview study. The method chosen was a qualitative interview study and content analysis was used for data processing.

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.

Background:In Sweden and Northern Europe, cardiovascular disease mortality rates are high. The clinical picture in the Western world is dominated by lifestyle diseases in which individual behavior and attitudes have a significant impact on the health effect. In the society cardiovascular disease is seen as an illness factor and contribution to disability. Conditions for a good life are not only good health also factors such as intimate relationships and meaningful work which affect the person's quality of life.Aim:Lifestyle changes and quality of life for patients, regarding cardiovascular disease.Method:A literature review was made. Eight articles, quantitative and qualitative were analyzed.

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 purpose of this essay is to look at the Swedbank Stadion, which is a modern stadium in the south of Sweden. Swedbank Stadion is the home ground of Malmö FF, one of the largest football team in Sweden, and the goal is to create value for the team. The stadium owners have to get companies to hire premises inside of the stadium so they can pay for the home ground of Malmö FF. Therefore we have focused on the servicescape in the stadium and how it can create value for the companies that act on Swedbank Stadion on a daily basis.This study of the Swedbank Stadion is based on a qualitative approach. The qualitative approach is chosen because we wanted to establish deeper understanding for the case itself.

The purpose of this study was to examine psychosomaticsymptomsissuesamongst children and adolescents between the ages of 0-18 years and to clarify the underlying factors.Method: Literature study based on 10 scientific articles.Results: Psychosomatic issues amongst children and adolescents, due to stress, were common in Europe and Scandinavia. The symptoms varied between gender and age. The underlying factors were mainly school environmental issues, home conditions, socio-economic situations and disputes with teachers and peers. The symptoms varied from headache, gastro intestinal problems and insomnia to eating disorders, depression and pounding heart.               Conclusion: The future of children?s psychosomatic health depends on interventions on all levels of society since they are affected by everything from school environment and home conditions to unemployment and recession..

As a patient you can find a lot of information concerning health and diseaseson the Internet. Purpose: The purpose of my study is to gain a betterunderstanding of how physicians relate to well-informed patientsfrom the point of doctor's changing role in meeting the patient related to theweb-based patient information. Today's patients are turning increasingly tothe Internet before they visit their doctor, this is due to the electronic healthinformation is available 24 hours a day, 7 days a week while the regulardoctor usually have several weeks of waiting. Problems that can arise with theWeb-based information is that the patient does not have a medical educationto know whether the information is appropriate or not. Method: To explorethese questions, I decided to use both qualitative semi-structured postalquestionnaires and telephone interviews in which the physicians preferreddifferently.

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.

The effectiveness of communication in the Swedish healthcare system context has long been the subject of debate. Issues stemming from usability, accessability and interpretation affect the lives of patients, and yet the vocal groups in the healthcare communication debate are patients and administrators, not healthcare professionals. With the advent of eHealth services and new demands being put forth on the ability of healthcare professionals' to handle increasingly numerous and innovative systems, it is of more importance than ever to understand the healthcare professionals' work context. This article is based on interviews with five healthcare professionals concerning their views on electronic health records (EHR), eHealth services, trends in healthcare services development in Sweden, as well as their views on the future of eHealth solutions and health information technology (HIT). Analysis of collected information shows an apprehension among healthcare professionals towards electronic communication, as well as a dissatisfaction with the usability of modern healthcare systems.

Background:There are approximately 45 000 people in the ages over 65 years dies outside the health facilities of the hospitals in Sweden in every year. Previous research has shown lacking knowledge in taking care of the next of kin during and after a sudden death. However, conducted research has emphasized that ambulance nurses often are the next of kin?s first contact with the health care system during sudden death at home. Research has also shown that the mourning of the next of kin is affected by the ambulance nurses? way of announcing the next of kin when someone close dies.

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.