Purpose- The purpose of this project is to contribute to the knowledge of creating customer value through streamlining and coordination of patient flows for children and youth with frequent need of care on child and youth medical clinics.Method- One of the methods used for achieving the project's purpose is a case study on the Child and Youth Medicine Clinic at Länssjukhuset Ryhov in Jönköping. The case study has been used for collecting the empirical data that has been generated through interviews, observations and documents from the Child and Youth Health Clinic. Except the case study the authors also made studies in literature, which the collected empirical data has been anchored and related to. Together this led to the project's analysis and results.Results- When investigating the questions found in chapter one, it was determined standardized work is of great importance to create structure and implement procedures for the patient flows. A weak link in the patient flow has been identified, which is the sub-process coordination and planning.

60 million years ago the horse was the size of a small dog, and walked on four toes. Today it can weigh up to 500-1000 kg and has evolved to walking on only one phalanx. The anatomy of the horses? legs and hooves allow them to run at high speeds, and at the same time enables them to bear the extremely high concussions applied to the foot at high speeds or jumps. Every horse owner has his or her own opinion on how to manage their horses? hooves, and whether the horse should be shod or unshod. The knowledge, commitment and attention of the owner determine the quality of the hoof care, but also the time between the arising of symptoms of abnormalities of the hoof until care is sought with a farrier or veterinarian. New laws will be applied at the beginning of 2015 which bring on changes in authorization for farriers.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Changes in blood pressure by replacing regular coffee with decaffeinated coffee,in healthy, normotensive subjectsAuthor: Linnéa Adolfsson and Hillevi Pilgren SautterSupervisor: Lena HulthénExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 ECTSDate: April 12, 2012Background Hypertension is a risk factor for developing cardiovascular disease, which is themost common cause of premature death. Contributing factors to hypertension are genetics,lifestyle and nutrition. Earlier studies have shown that coffee may increase blood pressure.Objective To investigate the scientific basis whether replacing regular coffee with decaffeinatedcoffee would affect blood pressure in healthy, normotensive subjects.Search strategy Searches have been done in databases; PubMed and Scopus in February 2012.Keywords used were: ?coffee blood pressure?, ?coffee cardiovascular disease?, ? kaffeblodtryck?, ?kaffe hjärtkärlsjukdom?, ?coffee and decaffeinated coffee?, ?decaffeinated coffeeand blood pressure?, ?decaffeinated coffee and cardiovascular disease? and ?exchangedecaffeinated coffee?.Selection criteria Studies with healthy, normotesive subjects, >15 years old, BMI < 30, morethan one week of intervention, randomized controlled trails and human trials were included.Only trials using caffeine from coffee versus decaffeinated coffee and studies in English andSwedish were accepted. Exclusion criteria were other interventions such as weight loss, changesin diet, medications or stress tests.Data collection and analysis Studies were selected after inclusion and exclusion criteria.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Artificial sweeteners in beverage and their effecton hunger and energy intakeAuthor: Sofia Andersson and Sofia JakobssonSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 11, 2012BackgroundIn 2010 the total consumption of soft drinks in Sweden was estimated to 69 litres per person and17 % of the domestic production was estimated to consist of soft drinks sweetened with artificialsweeteners. The effects of artificial sweeteners on hunger is not yet fully understood. It isspeculated that they might increase hunger and hence increase energy intake.ObjectiveThe aim was to compile the evidence regarding the effects of an intake of a beverage sweetenedwith artificial sweeteners compared to sucrose on subsequent hunger and energy intake.Search strategyA systematic search for literature was performed in the databases PubMed and Scopus.Selection criteriaThe inclusion criteria were RCT, human studies, articles published in Swedish or English, studieson healthy adults and studies measuring hunger with a subjective scale or energy intake. Theexclusion criteria were studies who measured energy intake under other forms than standardisedor controlled, studies without a standardised dose of the beverage and articles needed to beordered against payment.Data collection and analysisFour articles were selected and examined according to a template developed by SBU. Theevidence for each outcome was weighed together and graded according to GRADE based on asummarised evidence form developed by the Sahlgrenska Academy.Main resultsAll four articles measured subjectively rated hunger.

Title: A study of how active therapist talks about the FMT method. FMT-therapists use music as a means of communication. The method is non verbal and uses musical codes to create a framework for the apprentice. The instruments that are being used are piano, drums, a variety of flutes and whistles. The FMT-method is a musical form of therapy that targets all functional disabilities.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Does the number of chews affect satiation and satiety?Author: Madeleine Johansson och Helena AnderssonSupervisor: Heléne Bertéus ForslundExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 27, 2014Background: Overweight and obesity is a growing problem worldwide. In 2008, 35% of theworld's population were overweight and 11% obese , which is almost doubling since 1980,according to WHO. Recommendations on overweight and obesity is not just about what weeat but how we eat. A generally accepted recommendation is to eat slowly and chew yourfood properly in order to increase fullness and reduce energy intake.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Coconut water and recovery/water-electrolyte balance after physicalexcercise ? A systematic overviewAuthor: Irene Eriksson and Alexandra ÖquistSupervisor: Henriette PhilipsonExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 09, 2014Background: During physical exercise, it is common with dehydration, which affectsperformance negatively. To restore the fluid balance it is optimal to drink fluids containingsalt and carbohydrates. In theory, coconut water should be a good recovery drink because oftheir nutrient content.Objective: To evaluate the scientific evidence available, to investigate whether coconut wateris better than water or sports drinks for rehydration after physical exercise.Search strategy: PubMed, Scopus and Cochrane Library have been used in the literarysearch. Keywords used were recovery, fluid balance, fluid therapy, water-electrolyte balance,rehydration, dehydration, hydration, exercise, physical activity, resistance training, activity,sports, training, coconut water in varying combinations, in order to cover as wide area aspossible.

Sahlgrenska Academy at University of GothenburgDepartment of Department of Internal Medicine and Clinical NutritionAbstractTitle: Does coffee consumption affect the risk of stroke?Author: Jenny KällSupervisor: Heléne Bertéus ForslundExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012___________________________________________________________________________Background: The widespread consumption of coffee worldwide makes this drink interesting to study from a public health perspective. Even minor health effects may be important for the whole population. Stroke patients require the largest number of days spent in hospitals and nursing homes than any other medical condition group. Risk factors for stroke include smoking, high alcohol intake, physical inactivity, hypertension, hypercholesterolemia, high waist-hip ratio and diabetes.

The purpose of the study was to investigate whether or not Icelandic horses are less severely affected in clinical symptoms of cough or decreased performance than other breeds of horses. A breed variation in chronic respiratory disease severity was suspected based on clinical experience at the Institution for surgery & medicine, large animal, SLU Uppsala. A retrospective journal study of 17 Icelandic horses and 17 Swedish Standardbred horses with chronic problems with cough and/or decreased performance compared several measurements of disease severity. The clinical signs, physical examination and laboratory testing results compared were respiratory rate, abdominal breathing, lung auscultation, endoscopy results, broncho-alveolar lavage (BAL) results and the blood gases pO2 and pCO2. All parameters were available for all 34 individuals except for the blood gases, which were analysed, in only four Icelandic horses and four Swedish Standardbred horses. The only parameters that appeared different between the two groups were respiratory rate and pO2. The four Icelandic horses, which had blood gases analysed, had more severe hypoxemia.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Does low fat dairy products reduce blood pressure?Author: Emma Bergman and Naman LimaniSupervisor: Lena HulthénExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 26, 2014Background: It is estimated that at least a third of the population in Sweden have a high blood pressure with genetics, unhealthy diet and physical inactivity as the main contributing causes. High blood pressure is one of the greatest risk factors to develop cardiovascular diseases, which is the leading cause of death worldwide. Milk is a nutritional food product and previous research suggests that low fat dairy products may have blood pressure lowering effect.Objective: The aim was to examine the scientific basis of how low fat dairy products affect blood pressure.Search strategy: Twelve searches were conducted on PubMed and Scopus, where the chosen search terms were combined to produce a broad search as possible in the particular area. The search terms used were dairy, dairy products, milk, blood pressure and hypertension.Selection criteria: Studies on normotensive or hypertensive individuals who received low fat dairy products were included.

Traditionellt sett har gurkmeja använts för medicinskt bruk i många olika länder och kulturer för en rad olika besvär på både djur och människor. Användningen idag är framför allt som kosttillskott, som del i digestionsbefrämjande medel och för att lindra ledbesvär. I Sverige idag är Galexir det enda godkända traditionellt växtbaserade läkemedlet innehållande gurkmeja. Gurkmeja har visat sig ha låg biotillgänglighet, men höga koncentrationer uppnås lokalt i tarmen vilket skulle kunna göra mag-tarmbesvär till en bra indikation för användandet av gurkmeja. Den här litteraturstudien syftar till att ta reda på om gurkmeja kan ha potential att användas på hundar med gastrointestinala besvär. Sjukdomar såsom gastrit, magsår, enterit, kolit, Inflammatory bowel syndrome (IBS) och Inflammatory bowel disease (IBD) kan ses hos hund.

Sahlgrenska AcademyAt University of GothenburgDepartment of internal medicine and clinical nutritionAbstractTitle: D for depression: Does vitamin D supplementation have apalliative effect on depressive symptoms? ? A systematic reviewAuthor: Emelie Nacksten and Lua Ferreira RangelSupervisor: Fredrik BertzExaminer: Ingrid LarssonProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22th, 2013BackgroundDepression is one of the major diseases in the world and is ranked by the WHO as the leading causeof disability. Several studies suggest that there is a correlation between low s-25(OH)D levels and theoccurrence of depression. Current research has found enzymes required for synthesis of the active formof vitamin D and its receptors (VDR) in the brain. The potential role of the vitaminas a neuroactive steroid has resulted in an increased interest in investigating the role of vitamin D in thetreatment of depression.ObjectiveStudy the scientific evidence to determine if vitamin D supplementation can relieve depressive symptomsin adults.Search strategyThe literature search was conducted in the databases Scopus, Pubmed, Cochrane and PsychInfo.

Sahlgrenska Academy at University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Coconut water as a rehydration fluid. - Can coconut water be recommended as a better choice than water or sports drink after moderately intense training?Author: My Green, Joakim LundSupervisor: Henriette PhilipsonExaminer: Frode SlindeProgram: Dietician study program, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 26th, 2014Background: Already in the 1960s an alternative to water as a rehydration fluid occurred, the so-called sports drink. Coconut water has in recent years been claimed as the "natural sports drink" in media. Coconut water is sold in shops and fitness centers around the world and has established itself as an alternative to water and sports drink in terms of rehydration after a workout.Objective: To investigate whether there is scientific evidence to recommend coconut water as a rehydration drink after moderately intense exercise ahead of water or sports drink.Search strategy: The search for articles in this systematic review was performed in the databases PubMed, Scopus, Cochrane and GUPEA.

The main aim of this master thesis was to examine the visual ergonomics and the systematic work environment management concerning lighting issues for nurses within domiciliary care. Further aims were to examine a few existing lighting solutions, to come up with ideas for future possible lighting solutions, and to evaluate if the legal regulations for lighting is satisfying and if the regulations are obeyed in domiciliary nursing.The methods used were a questionnaire completed by 55 nurses, field studies of used lightings in cooperation with a student in industrial esign, test of ten existing lighting solutions in a laboratory environment, and a field test of five existing lighting solutions tested by nine nurses in the home of the patient.The result indicates that 40 % of the asked nurses were dissatisfied with the working light in the patient?s homes. All respondents reported poor working light close to the patient, 50 % reported that this problem occurred daily. One third reported that they had to work in uncomfortable working postures due to insufficient working light, and 15 % reported risk of making mistakes due to the same reason.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: Alcohol consumption after training and its effects on muscle gain and recovery adult menAuthor: Frida Carlstedt, Puck JanssonSupervisor: Frode SlindeExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 09, 2014Background: Today, the Swedish population exceeds the recommendations for alcohol intake while advised to move at least thirty minutes a day. It is well established what happens if you drink alcohol before a workout or if you workout the day after an alcohol intake, but it is less well established how muscle gain and recovery are affected by an intake of alcohol in the phase of recovery.Objective: The objective of this review is to investigate if there is a relation between alcohol intake after a workout and effected recovery and muscle gain. This was performed by measuring the outcomes cortisol, testosterone, creatine kinase as well as different measures of muscle strength. The issue was ?Does an intake of alcohol after training affect recovery and muscle gain??Search strategy: A systematic review in the databases PubMed and Scopus with the MeSH-terms: exercise, muscles, recovery of function, training, athletic performance, performance, sport, alcohol drinking, alcohols, alcohol and ethanol.Selection criteria: Criteria for articles to be included in this review were that they would be RCT- and human studies in healthy subjects as well as containing an ethanol intake after a physical activity that consisted of weight training in the form of resistance training or other forms of activity that promotes strength.Data collection and analysis: A systematic search for literature as mentioned above (search strategy) was performed as well as an analysis with the SBU quality review template for randomized studies, and a quality review for each measure of outcome according to Gothenburg University summarized evidence template for measures of outcome.4Main results: Many studies are authored by the same group of researchers and/or are of a lower quality.