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.

Construction of an autonomous wind station was a project with the goal of creating a product that could collect wind data from a sensor and then transfer this data to a server wirelessly over the GSM network. The device would be powered by batteries and solar cells and function fully without requiring external power supply. This required that a small computer was constructed and programmed to store and send data at predetermined cycle times and programming of a server that received the sent data. The project also required optimization of power consumption and dimensioning of solar cells and batteries based on this. The construction of this station demanded research both for the selection of hardware and programming software. The computer was based on a microcontroller and a GSM module that sent the data over the 2G network.

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.

This study aims at examining the prospects for a policy transfer of a Swedish municipal environmental policy (that of Växjö) to the French urban commune Blois, for which an ambition of becoming a leading eco-city in France, was declared by the mayor in 2008.In the analysis, emphasis is laid on mechanisms to institutionalize the main environmental policy principles, such as political and institutional structures and processes. Other prospects for an institutionalization of a new environmental policy that are to be investigated are economic structures as well as visions of the different decision-makers concerned. Research methods used in the study are qualitative interviews, document studies and a questionnaire.The findings of the analysis show that today?s prospects for an environmental policy in Blois close to that of Växjö, are clearly limited. The limitations can partly be found in economic structures but these seem to be rather related to a lack of priority amongst actors.

The creation of Region Skåne, and the transfer of the development responsibility from the national administrative country board (Länsstyrelsen) has given the state new challenges. New structures have grown between Region and State, and also between different municipalities. These can be characterized as Policy-networks, and the goal of this study is to analyze the planning process of the regional infrastructure with these theories.This is a qualitative study of the infrastructure process in Skåne, and the actors that acts within this process. It has been studied with the eyes of the theories of Governance and Policy-networks. The main method to collect material has been through interviews with different actors within the process, and very little written material has been used.

The focus of this project was to characterize the occurrence of ESBL-­?producing bacteria in two irrigation water ponds in Southern Sweden. Samples were taken from two ponds nearby each other, from which analyses were made based on levels of community and individual isolates. Community samples were used for attempts for characterization of resistance patterns in irrigation water using the Omnilog PM-­?plate system. The growth of community microbiota in the presence of the following antibiotic substances was assessed; amikacin, gentamicin, kanamycin, penicillin G, ampicillin, piperacillin, trimethoprim, potassium tellurite and ciprofloxacin. Isolates were pure cultured using semi-­?selective media: LB, Rainbow Agar, mEnterococcus, 0.1 TSA and VRBD. A total of 177 isolates were isolated randomly. Each isolate was identified using the Omnilog GENIII-­?system of biochemical characterization. Further, the isolates were tested on Brilliance ESBL-­?agar for their ability to grow. Out of the total number of isolates, 30 were selected, preferably Enterobacteriaceae or Pseudomonas spp., based on their high similarity to library strain during the identification in the Omnilog-­?system. These were further characterized using Etest-­?sticks. Three selected strains were picked for further analyses using exogenous isolation for attempts to simulate horizontal gene transfer, and Omnilog PM-­?panels containing various antibiotics of interest. Selections of samples were chosen for molecular tests targeting plasmid-­?borne resistance genes CTX-­?M1, CTX-­?M2 and SHV. The method for assessing community-­?resistance patterns showed ambiguous data that was difficult to interpret; further optimization is recommended. For all tested PM-­?plates, generally greatest differences between substances were found among wells with the strongest concentration of antibiotic substance. A total of 175 isolates displayed ability to grow on ESBL-­?agar. Etests confirmed ability of isolates to resist many ?-­?lactam antibiotics and many were clinically resistant to certain substances. No plasmids were transferred during exogenous isolation. During molecular tests, a few matches were found for the CTX-­?M1 gene. Isolates analyzed with Omnilog PM-­?plates showed resistance to most compounds tested. The isolates showed greatest resistance toward penicillin G, ampicillin, amikacin, kanamycin and trimethoprim. In the study, it was established that resistance among bacteria was frequently occurring in the irrigation water, and ?-­?lactamase producing bacteria was very common. Extended studies are needed to assess the frequency-­? and occurrence of horizontal gene transfer (HGF) in this environment. Although some potential corresponding data is found, it is at this point not possible to determine whether the resistances are due to antibiotics used in veterinary medicine, human medicine or one additional reason is travel and trade. in irrigation water using the Omnilog PM-­?plate system. The growth of community microbiota in the presence of the following antibiotic substances was assessed; amikacin, gentamicin, kanamycin, penicillin G, ampicillin, piperacillin, trimethoprim, potassium tellurite and ciprofloxacin. Isolates were pure cultured using semi-­?selective media: LB, Rainbow Agar, mEnterococcus, 0.1 TSA and VRBD. A total of 177 isolates were isolated randomly. Each isolate was identified using the Omnilog GENIII-­?system of biochemical characterization. Further, the isolates were tested on Brilliance ESBL-­?agar for their ability to grow. Out of the total number of isolates, 30 were selected, preferably Enterobacteriaceae or Pseudomonas spp., based on their high similarity to library strain during the identification in the Omnilog-­?system. These were further characterized using Etest-­?sticks. Three selected strains were picked for further analyses using exogenous isolation for attempts to simulate horizontal gene transfer, and Omnilog PM-­?panels containing various antibiotics of interest. Selections of samples were chosen for molecular tests targeting plasmid-­?borne resistance genes CTX-­?M1, CTX-­?M2 and SHV. The method for assessing community-­?resistance patterns showed ambiguous data that was difficult to interpret; further optimization is recommended. For all tested PM-­?plates, generally greatest differences between substances were found among wells with the strongest concentration of antibiotic substance. A total of 175 isolates displayed ability to grow on ESBL-­?agar. Etests confirmed ability of isolates to resist many ?-­?lactam antibiotics and many were clinically resistant to certain substances. No plasmids were transferred during exogenous isolation. During molecular tests, a few matches were found for the CTX-­?M1 gene. Isolates analyzed with Omnilog PM-­?plates showed resistance to most compounds tested. The isolates showed greatest resistance toward penicillin G, ampicillin, amikacin, kanamycin and trimethoprim. In the study, it was established that resistance among bacteria was frequently occurring in the irrigation water, and ?-­?lactamase producing bacteria was very common. Extended studies are needed to assess the frequency-­? and occurrence of horizontal gene transfer (HGF) in this environment. Although some potential corresponding data is found, it is at this point not possible to determine whether the resistances are due to antibiotics used in veterinary medicine, human medicine or one additional reason is travel and trade..

The market for management training programs is growing and the supply of the service is increasing and getting further diversified. A consequence is a market with a wide variety of definitions of the very concept of development, and subsequently a wide variety of practices and methods to achieve development. The individuals that are subject to these programs seldom know what they are purchasing, or what to expect. When assuming a transfer of the developers view on development to the subject, a need for a greater understanding of the concept arises. The purpose of this thesis is to understand what views on development do exist among management trainers and map underlying dimensions of the views to increase the understanding of the concept of development.

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.

Scania provides a fleet management system for hauliers who want to control their fleets in anefficient way. The system includes an onboard computer with touch screen called ScaniaInteractor where the driver can access GPS navigation, order support, message service and otherfunctionalities. The purpose of this thesis is to develop a concept for logging the user interactionon the Interactor and analyze the result which enables further development and optimization ofthe interface.A demonstration application is designed, implemented and tested for the purpose of showing thepossibilities and difficulties with logging of interaction. The result shows that logging is quiteeasy to implement and that the amount of produced data is small and therefore not expensive totransfer via GPRS to a central server where searching and analysis can be done. On the otherhand, the biggest challenge lies in the analysis and interpretation of the logged data and to applyit to the development of the interface.

Information handling has been a key issue for different companies for a long time. Electronic Data Interchange (EDI) is used to transfer different business documents from one company to another. This is done in such way that the information itself is separated from how this information is stored and handled in the companies internal systems. As different companies have different systems there is a need for a standardised format for this exchange. There is a big difference between EDI-systems based on what kind of EDI-standard is used.

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.

Syftet med detta arbete är att undersöka vilken progression som sker med elevernas kunskap inom fyra delområden i biologi. Progressionen har undersökts från årskurs nio till avslutade kurser i naturkunskap på gymnasiet. Studien har genomförts med hjälp av enkäter där eleverna har fått besvara öppna frågor kring fotosyntes, växthuseffekt, matspjälkning och genetik. Svaren kategoriserades utifrån tidigare forskning. Resultatet pekar mot en marginell progression i frågorna kring fotosyntes, växthuseffekt och genetik samt en stagnation kring frågan om matspjälkning.

Vår studie är inriktad på att finna en heltäckande modell för lönsamhetsberäkningar på utbildning mellan företag. Genom en fallstudie har vi studerat Axis Communications' Academy, där Axis Communications utbildar sina kunder inom nätverkskameror. Vi har fört samman avkastningsberäkningar (RoI) med kunskapsöverföring och utvärdering av utbildning till en modell vi kommit att kalla Modell för Kunskapsöverföring, Utvärdering och Lönsamhet, KUL-modellen. Modellen har sammanfört tidigare forskning inom Knowledge Transfer och Human Resource Development, för att komplettera RoI. I modellen framgår att det går att mäta kunskapsöverföringen i en utbildning genom faktorerna Erfarenhet, Avstånd, Relation, Motivation, Reaktion, Implicitet och Specificitet.

Kunskapsöverföring har ansetts vara av vikt inom företag och organisationer för att bevara kunskapen, informationen och för att kunna förmedla den vidare till andra medlemmar. Studiens primära syfte var att genom forskningsteorier och intervjuer effektivisera Rädda barnens Ellen och Allan projekt i deras kunskapsöverföring. 5 aktiva medlemmar inom Ellen och Allan projektet intervjuades samt 1 kontrollintervju genomfördes med en rutinerad projektledare från Svenska kyrkan, för att få fram dennes syn på projektets nuvarande situation gällande kunskapsöverföring.     Resultatet visade att det finns en viss otrygghet i rollerna och framförallt hos projektledarna, som inte har någon specifik roll- eller uppdragsbeskrivning. Genom resultatet kunde vi även se att kunskapsöverföringen bör vara ett ingående moment i organisationens projektbeskrivning för att det ska fungera på bästa sätt. Fysiska möten och god kommunikation mellan deltagarna bör även prioriteras för att effektivisera kunskapsöverföringen inom projektet..