Screening av nutritionsstatus hos kritiskt sjuka : en systematisk litteraturstudie

Syftet med denna studie var att kartlägga screeningsinstrument som mäter nutritionsstatus hos kritiskt sjuka samt se hur de används i vården. Studien genomfördes som en systematisk litteraturstudie. Artiklar söktes i databaserna Cinahl och Medline. Tretton artiklar identifierades, efter kvalitetsgranskning, till studien. I resultatet framkom flera nutritionsscreeningsinstrument och tre utav dessa; SGA, MUST och NRS 2002, var mer anpassade för screening av kritiskt sjuka. NRS 2002 hade av dessa tre högst specifitet, då instrumentet bedömer sjukdomens eller skadans svårhetsgrad som en risk för undernäring. Resultaten om hur screeningsinstrumenten används i vården visar att användandet av dessa instrument var sällsynt, rekommendationer följs inte. Orsaker till det är bland annat personalens attityder och kunskapsbrist, ansvarsfördelning och rutiner. Några sjuksköterskor föredrog att använda sig av egna bedömningar av patienternas nutritionsstatus. I studier där nutritionsförbättringsprojekt införts ökade nutritionsscreeningen och dokumentationen signifikant. Slutsatsen är att NRS 2002 är det nutritionsscreeningsinstrument som passar bäst för kritiskt sjuka. Screeningsinstrumenten används dock inte som rekommenderat och orsaker till det är bland annat personalens kunskapsbrist och attityder.

Internally Displaced Persons Rights in Human Rights Perspective(Specifically Focused on Pakistani IDPs Example) : “Basic Human Rights of IDPs to Attain Equality in Dignity and Rights”

After the WWII, there was much concern to protect human rights situation all over the world. During the cold wars, huge displacement took place within different countries due to internal arms/ethnic conflicts. Millions of IDPs, who were uprooted by armed conflict or ethnic strife faced human rights violence. In 2002, there were estimated between 20-25 millions IDPs in the world (Phuong, p.1). Internally displacement is a worldwide problem and millions of the people displaced in Africa and Asia. These all Internal displacements of the people are only the result of the conflicts or the violations of the Human Rights but also sometimes it happened because of the natural disasters. “All human beings are born free and equal in dignity and rights..."(Streich, Article 1) This article works as the foundation of human rights which gives every human being an equal rights and opportunity to maintain his/her dignity. Human Rights issues related to human dignity must be taken very seriously and should not be ignored at any level; Many human rights issues are not always visible, issues such as: privacy, security, equality, protection of social and cultural values etc. In this paper I am going to apply theoretical approach of “all human being are equal in dignity and rights” to defend IDPs rights.

Gender Equality a case study of Sweden : Gender Equality Gender Equity and policies of combating inequality at workplace to make the society equal.

The paper analyses Gender Equality, Gender Equity and policies of combating inequality at workplace to make the society equal as a case study of Sweden. The aim of paper is see the gender equality, gender equity, discrimination against women at workplace and to describe the policies combating inequality in the welfare state of Sweden. This work highlights the gender equality in terms of institutionalizing gender equality, gender equity, gender and pay gap, parental leave, gender and the pension system and sexual behavior directed towards women and policies combating inequality to bring equality in society. For my research I used the secondary data the fact sheets, scientific literature, statistics from eurostate of Sweden and case studies about Swedish society and the theoretical explanation to explain the phenomena. To achieve my aim I used the combination of both qualitative and quantitative methods of research. I showed the empirical evidences of these phenomena from the Swedish society and theoretical analysis about equality and equity of gender in different wakes of life. I found an interesting conclusion that there are good policies and legislation to combat inequality to bring society but there are no policies to change the perception of society about male and female role.

Work, care, gender equality and the problem of ‘instrumental’ social policies

Sociologisk Forsknings digitala arkiv

No consensus on gestational diabetes mellitus screening regimes in Sweden : pregnancy outcomes in relation to different screening regimes 2011 to 2012, a cross-sectional study

Background: Although associated adverse pregnancy outcomes, no international or Swedish consensus exists that identifies a cut-off value or what screening method to use for definition of gestational diabetes mellitus. This study investigates the following: i) guidelines for screening of GDM; ii) background and risk factors for GDM and selection to OGTT; and iii) pregnancy outcomes in relation to GDM, screening regimes and levels of OGTT 2 hour glucose values. Methods: This cross-sectional and population-based study uses data from the Swedish Maternal Health Care Register (MHCR) (2011 and 2012) combined with guidelines for GDM screening (2011-2012) from each Maternal Health Care Area (MHCA) in Sweden. The sample consisted of 184, 183 women: 88, 140 in 2011 and 96,043 in 2012. Chi-square and two independent samples t-tests were used. Univariate and multivariate logistic regression analyses were performed. Results: Four screening regimes of oral glucose tolerance test (OGTT) (75 g of glucose) were used: A) universal screening with a 2-hour cut-off value of 10.0 mmol/L; B) selective screening with a 2-hour cut-off value of 8.9 mmol/L; C) selective screening with a 2-hour cut-off value of 10.0 mmol/L; and D) selective screening with a 2-hour cut-off value of 12.2 mmol/L. The highest prevalence of GDM (2.9%) was found with a 2-hour cut-off value of 8.9 mmol/L when selective screening was applied. Unemployment and low educational level were associated with an increased risk of GDM. The OR was 4.14 (CI 95%: 3.81-4.50) for GDM in obese women compared to women with BMI <30 kg/m(2). Women with non-Nordic origin presented a more than doubled risk for GDM compared to women with Nordic origin (OR = 2.24; CI 95%: 2.06-2.43). Increasing OGTT values were associated with increasing risks of adverse pregnancy outcomes. Conclusions: There was no consensus regarding screening regimes for GDM from 2011 through 2012 when four different regimes were applied in Sweden. Increasing levels of OGTT 2-hour glucose values were strongly associated with adverse pregnancy outcomes. Based on these findings, we suggest that Sweden adopts the recent recommendations of the International Association of Diabetes and Pregnancy Study Group (IADPSG) concerning the performance of OGTT and the diagnostic criteria for GDM.