During the last years, meticillin resistant Staphylococcus pseudintermedius (MRSP) have caused an increasing number of infections in Swedish dogs. MRSP is resistant against a majority of the antimicrobials available for dogs in Sweden, making it difficult to treat the infection. Our knowledge of the bacterium is limited, making it hard to handle infected dogs in a proper way. The aim of this study was to investigate for how long time dogs, who have an infection caused by MRSP, become carriers of the bacterium. Other factors like treatment with antimicrobials, the correlation between clinical symptoms and carriage, common diagnoses and institutionalization where also looked upon.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

Our society is based on a heterosexual norm. This may lead to the fact that LGBT-persons have a poorer health status than the heterosexual population. The nurse education lacks information and courses that highlights sexual identity. This is defective since healthcare staff needs knowledge on the subject to be able to treat patients in a professional and respectful manner. The purpose of this study was to illustrate how heteronormativity influences the treatment of patients within a healthcare context.

The aim of this study was to conduct an instrument test of the Canadian questionnaire Alberta Context Tool (ACT) version Long-Term care for Swedish conditions. ACT is designed in order to measure the context in the care environment and different behaviours related to the changes in clinical practice. In total, 159 Licensed Practical Nurses (LPNs) and Registered Nurses (RNs) within municipality care of the elderly were included in the survey. The test included the instrument's reliability and face validity.The reliability test was implemented through calculation of Cronbach´s Alpha, and showed internal consistency for five of the scales of the ACT-instrument with Cronbach´s Alpha values ranging between 0,728 and 0,873. However, three dimensions got lower values (0,558 - 0,683).The analysis was carried out with content analysis and carried out for LPNs and RNs in separate groups.

Bakgrund: Liverpool Care Pathway (LCP) är en vägledning för att vårda patienter i livets slutskede. Den är framtagen i syfte att överföra den palliativa modellen av vård till annan vårdkontext. LCP ger vägledning i kommunikation inom det multiprofessionella teamet, med anhöriga och med patienten som är döende. LCP utgör en guide för läkare om att förskriva läkemedel mot de vanligaste symtomen som kan uppträda i livets slut, för att förbättra symtomhanteringen.  LCP används idag i Sverige på flera håll inom olika ramar av vårdinrättningar. Syfte: Syftet var med denna litteraturöversikt att ur ett sjuksköterskeperspektiv beskriva vård i livets slutskede med tillämpning av Liverpool Care Pathway på akutvårdsavdelningar.

A quart of the of the adult population worldwide havemetabolic syndrome. A sedentary lifestyle, low physicalactivity, combined with wrong eating habits, stress,smoking and psychosocial factors, are the main causes ofdevelopment of the metabolic syndrome. The purpose ofthe literature review was to illuminate the physicalactivity in persons who have the metabolic syndrome, andwhat sort of advice a nurse use in the promotion ofphysical activity. The study was conducted as a literaturereview, including 15 scientific quantitative articles. In tenarticles, the focus was on physical activity at themetabolic syndrome, and five articles focused on variousforms of counselling for physical activity.

Att ha ett sår är en belastning och påverkar människors vardag, oavsett om såret är akut efter ett olycksfall eller efter en operation, alternativt svårläkande som vid bensår, diabetesfotsår, trycksår eller maligna tumörsår. Syftet med studien var att undersöka kunskaper hos sjuksköterskor och undersköterskor om sårbehandling inom kirurgisk verksamhet. Metoden utgjordes av en enkätundersökning hos sjuksköterskor (n=56) och undersköterskor (n=38). Resultatet visar att sjuksköterskorna kände sig mer osäkra i sitt val av behandling av svårläkande sår jämfört med undersköterskorna. Kunskaperna om sårbehandling visar att skattade kunskaper inte motsvarar svaren på kunskapsfrågorna.

Introduction: Palliative care is based on an active total care where the patient's independence and participation are included. Few studies have been based on a concept of freedom in relation to this target group.Aim: The aim of this study was to describe the perception the nurse has about "freedom" - its significance and meaning from an existential perspective for patients with palliative care needs.Method: A qualitative content analysis based on a narrated and written down text from focus groups with adequate examples. The starting point in the focus groups was to focus on existential issues in relation to patients near death. Based on the concept of freedom, has the printouts been analyzed, categorized and codedFindings: Nature, identity, integrity and self-esteem are important aspects for our approach to freedom but freedom is also about existential questions where hope, reconciliation, freedom and forgiveness are included.Discussion: Discussion: We all have our own definitions and meanings of freedom. The largest and perhaps most important fullest freedom is our inner freedom - our own existential freedom.

The Bovine respiratory syncytial virus (BRSV) causes bronchiolitis and interstitial pneumonia, predominantly in calves, and is a major cause of bovine respiratory disease worldwide. In humans, BRSV is paralleled by the closely related Human respiratory syncytial virus (HRSV), an important cause of respiratory disease, most severe in infants.The clinical signs and pathology during RSV infection is caused, not only by the direct effects of viral replication, but also by the response of the host immune system. The immunopathology of RSV has long obfuscated our understanding of the disease, and development of effective treatment and vaccines will be very difficult until greater knowledge is gained.One of the components of the immune system that has come into focus in RSV research the last few years, is the Toll-like receptor 4 (TLR4). The TLR4 receptor is well known as the receptor that binds lipopolysaccaride (LPS), and initiates the host response to bacterial infection. Recently, it has been shown that the fusion protein of RSV also interacts with, and up-regulates the expression of, the TLR4 receptor.

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.

Bakgrund: Sjuksköterskor verksamma inom psykiatrisk vård upplever svårigheter med att artikulera sin yrkesidentitet. Bakgrunden beskriver sjuksköterskans roll inom psykiatrisk vård ur ett historiskt samt nutida perspektiv. Bakgrunden visar att sjuksköterskor tenderar att lämna den psykiatriska vården när de upplever att deras kompetens inte tas tillvara, vilket i förlängningen även drabbar patienterna.Syfte: Syftet var att beskriva hur sjuksköterskor yrkesverksamma inom psykiatrisk vård uppfattar sin yrkesidentitetMetod: Fem sjuksköterskor intervjuades med hjälp av ostrukturerade intervjuer. Kvalitativ design användes i studien.Resultat: Resultatet presenteras i temat en komplex yrkesidentitet samt tre kategorier: att vårda unika människor, att vara arbetsledare och den egna utvecklingen samt åtta underkategorierDiskussion: Resultatet diskuteras utifrån Imogene Kings begrepp roll, organisationer, auktoritet, makt, status och stress, samt utifrån genusteoretiskt perspektiv..

The purpose of this study is to increase understanding of how parents of children in need of special support have experienced their interaction with the pre-school. Our three main areas of interest were to investigate how several parents experienced their contact with the pre-school, if there were any experienced factors that had played a part in the contact with the pre-school and if we could conclude anything about how the curriculum had been followed in these cases, with assistance of the parents? experiences.Our study is qualitative and we chose to interview six parents. We both participated in all of the interviews. The theoretical base of this study is rooted in the phenomenological theory and we also used the framework factor theory to complement our analysis.One of our conclusions was that the parents expressed so many different experiences that we decide not to try compare them in general.

Bakgrund Handledning av sjuksköterskestudenter finns väl beskriven i litteraturen men erfarenheter av att handleda i kontexten studentsal har endast i ringa omfattning fokuserats i tidigare studier.Syftet med denna studie var att beskriva handledning i studentsal utifrån handledande sjuksköterskors erfarenheter.Metod Studiens ansats var kvalitativ och datainsamling genomfördes genom åtta semistrukturerade intervjuer. Intervjuerna utfördes med respondenter från två sjukhus i en svensk storstad. Data har bearbetats genom innehållsanalys.Resultatet Analysen resulterade i fem kategorier. Ur dessa framträdde två teman, Förändrade förutsättningar i lärandemiljön och en utmanande pedagogik. Respondenterna beskrev både utmaningar, vinster och brister i handledningssituationen som skedde mer på distans på studentsalen.

Background: The district nurses profession has traditionally been health promotion. In order to find patients with excessive alcohol intake, district nurses use AUDIT. Research shows that health professionals find it difficult to face alcohol abusers in primary care. AIM: The aim is to describe how district nurses work with AUDIT. Method: Semi-structured interviews with six informants were carried out.