Respiratory disease with airway inflammation as main characteristic is common in the horse. It is a syndrome that is not yet fully understood. The etiology, pathogenesis and classification into different disease states are subjects for discussion and under continuous revision. Despite a number of modern techniques, the diagnostic procedure is challenging. There is no test considered to be gold standard when diagnosing these diseases.

Dysfunction of the upper respiratory tract is a common cause of impaired performance and intolerance to exercise in racehorses and include several upper airway obstructions. The ones termed dynamic obstructions are primarily seen during physical exertion and affected horses often appear to be normal during endoscope examination at rest. The correlation between diagnoses made at rest respectively exercise is low, suggesting that an examination at rest alone is likely to be insufficient. The upper respiratory tract is exposed to great differences in pressure throughout the respiratory cycle; variations that are further altered during strenuous exercise and affect the rigidity of upper airway structures. In presence of great fluctuations in pressure, stability is achieved through coordinated and synchronous neuromuscular mechanisms. Due to nerve damage or anatomical abnormalities, these functions may be disrupted and further cause a dynamic collapse of the upper respiratory tract when pressure changes become too severe. The etiology behind the neuromuscular dysfunction is not yet fully understood.

The purpose of this study was to explore nurses' experiences of obstructed airways in the prehospital work.A qualitative interview study with a descriptive and explorative design was used. The sample consisted of nine registered nurses whereof three were women and six were men, with or without further education and varying length of experience in the ambulance service.Prehospital personnel builds up a vast plan of action based on the emergency information provided by SOS. Simple methods for managing obstructed airways were stated often enough. Problems with obstructed airways are considered so unusual that it never becomes a routine. Several factors affect the identification and managing of obstructed airways, both external factors and the different patient categories are considered important.

Recurrent Airway Obstruction, RAO, är en icke infektiös luftvägssjukdom hos häst. Sjukdomen karaktäriseras av perioder med reversibel luftvägsobstruktion och inflammation orsakad av bronkospasm och ansamling av mucus och neutrofiler i luftvägarna. Sjukdomsorsaken anses vara multifaktoriell med ett samspel mellan dålig miljö och en viss genetisk predisposition. Den immunologiska bakgrunden till sjukdomen är fortfarande oklar men både den förvärvade och medfödda immuniteten anses delta i luftvägsinflammationen. Toll-lika receptorer, TLR, hör till de viktigaste receptorerna i den medfödda immuniteten.

Patienter med morbid obesitas har en ökad risk för atelektasbildning och postoperativarespiratoriska komplikationer efter generell anestesi på grund av sänkt vitalkapacitet (VC),funktionel residualkapacitet (FRC) och total lungkapacitet (TLC). Tidigare forskning har visat attPostoperativ Bi-level Positiv Airway Pressure (BIPAP) ventilations behandling minskar denna risk.Denna studie avsåg att utvärdera om postoperativ BIPAP-behandling förbättrar patienternas SpO2,paO2 , paCO2 och pH i arteriellt blod efter genomgången elektiv gastric bypass kirurgi jämfört medtraditionell postoperativ behandling. Insamlat material från 18 patienter huvudsakligen bestående avarteriella blodgaser och bakgrundsdata analyserades med analytisk statistisk. För att kunna beskrivahur patienterna upplevde BIPAP-behandlingen ställdes två öppna frågor ställdes till patienterna,.Resultatet visar att postoperativ behandling med BIPAP under 3 timmar ger högre SpO2 och lägrepaCO2 än traditionell postoperativ behandling efter elektiv gastric bypass kirurgi. Vid bådabehandlingarna sjunker paO2 och pH är oförändrat.

 Syfte: Att undersöka huruvida patienterna upplever det postoperativa förloppet avseende smärta i hals, heshet, smärta vid sväljning samt generellt obehag beroende på om endotrakealtub (ETT) eller i-gel supraglottic airway device (SAD) använts i samband med generell anestesi vid elektiv kirurgi.Metod: I denna kvantitativa tvärsnittsstudie samlades informationen in på formulär. Parametrarna skattades av patienterna med hjälp av visuell analog skala (VAS). 60 patienter tillfrågades konsekutivt till studien och 13 föll bort vilket resulterade i 47 patienter som fullföljde studien.Resultat: Gällande graden av smärta i hals, heshet, sväljsvårigheter och allmänt obehag postoperativt så skattade sammanlagt sju deltagare i grupperna med ETT och i-gel ett VAS värde över 3. Patienter som haft ETT upplevde signifikant mer heshet, och sväljsvårigheter än patienter som haft i-gel.Slutsats: Denna studie visar att patienter som får ETT eller i-gel skattar sina besvär avseende smärta i hals, heshet, sväljsvårigheter och allmänt obehag i en låg frekvens. Dessutom påvisas att majoriteten av de som skattar besvär gör detta i de lägre segmenten av VAS skalan..

Osteoartrit är en vanligt förekommande sjukdom hos våra hundar som associeras med kronisk smärta. Som behandling mot smärtan används ofta non-steroid antiinflammatory drugs (NSAID) som hämmar enzymet cyklooxygenas (COX). De traditionella NSAID-preparaten har vid långtidsbehandling gett upphov till allvarliga biverkningar såsom mag- och tarmslemhinneskador. Upptäckten av de två isoenzymerna COX1, som uttrycks kontinuerligt i alla vävnader, och COX2 som uttrycks kontinuerligt i vissa vävnader samt uppregleras vid inflammation, ledde till utvecklingen av coxiberna. Det är en typ av NSAID som utvecklades med intentionen att minska biverkningsfrekvensen genom att selektivt inhibera COX2.

ABSTRACTBackground: Obesity and overweight are health issues that more than every tenth person around the world suffers from and the number of individuals with BMI >30 is every growing. As a result, more patients that are subjects to anesthesia will have an increased BMI. Changes in respiration, airway anatomy, altered drug metabolism and multiple physiological changes in the body makes general anesthesia, of the patient with obesity, an anesthesiological challenge.Purpose: The aim of this study is to identify the specific anesthesiological nursing care of the patient with a BMI >30, undergoing general anesthesia.Method: A research plan is created and to test its credibility, a pilotstudy of 15 surveys in two surgical departments will be conducted. This study has a qualitative inductive design and the data collected through semistructured questionnaires. The result was analyzed using qualitative content analysis.Result: The result showed a clear focus on three main areas; airway management, pharmaceuticals and positioning of the patient.

ABSTRACTBackgroundWhen faced with an unexpected cardiac arrest the ambulance nurse is in responsible for taking advanced actions to create a clear airway. Two accepted methods for this is endotracheal intubation and application of laryngeal mask.AimThe purpose of this study was to examine the use of endotracheal intubation compared to application of the laryngeal mask in unexpected cardiac arrest.MethodLiterature study with quantitative approach. A systematic search of 21 articles comparing the laryngeal mask with the endotracheal intubation has been made using Pub-Med and CINAHL. A quality review according to Forsberg and Wengström has been made.ResultsLaryngeal mask had a higher rate of successful applications compared with endotracheal intubation. Time for applying the laryngeal mask was shorter in seven out of ten of the studied articles.

The aim of this study was to research how social-work professionals apprehend, manage and influence difficult conversation.  This study is based on a qualitative method and we did qualitative interviews with eleven social-work professionals in three municipalities located in southern Sweden. In addition to our research on difficult conversation we decided to study easy conversation. Our result show that there isn?t any special subjects that creates difficult conversation, but it is the absent of conversation that makes it difficult.

Background:When the patient is critically ill the family is in a vulnerable position. The nurse's role is to support and help the family to find meaning in the difficult situation and to provide realistic hope. Balancing between the patient's and the family's needs is difficult. Knowledge about how nurses experience difficulties in the interaction with family is required in order to grant good care too critically ill patients and their family-members.Aim:To describe nurses' perceived difficulties in the interaction with family-members of critically ill patients.Method:The study is a qualitative literature-based study based on qualitative research. Results: The analysis resulted in four main themes; difficult disunion, environmental constraints, interpersonal difficulties and communicative difficulties.

This qualitative study is aimed to explore the leaders? experiences of difficult conversations in their work. We have examined if they take on a different role during the difficult conversations and how communication can affect their leadership during the conversation. We have also examined the importance of the leaders? ability to distance themselves from the sensitive subject and situation, to maintain their role as leaders.

Bakgrund: Nya tekniska lösningar för att intubera patienter börjar bli tillgängliga för operationsavdelningar. Glidescope är ett videolaryngoskop som visar lovande resultat när det gäller underlättande av intubationer för personal framförallt vid svåra luftvägar och intubationer. Forskningen pekar på att Glidescope reducerar antalet intubationsförsök och ökar andelen lyckade förstagångsintubationer. Studier pekar på att det för patienten är fördelaktigt med så få intubationsförsök som möjligt.Syfte: Att undersöka anestesipersonals erfarenheter av att arbeta med Glidescope.Metod: Semistrukturerade individuella intervjuer genomfördes med nio anestesisjuksköterskor och två läkare. En kvalitativ beskrivande ansats med en kvalitativ innehållsanalys som analysmetod har använts.

Background:When the patient is critically ill the family is in a vulnerable position. The nurse's role is to support and help the family to find meaning in the difficult situation and to provide realistic hope. Balancing between the patient's and the family's needs is difficult. Knowledge about how nurses experience difficulties in the interaction with family is required in order to grant good care too critically ill patients and their family-members.Aim:To describe nurses' perceived difficulties in the interaction with family-members of critically ill patients.Method:The study is a qualitative literature-based study based on qualitative research. Results: The analysis resulted in four main themes; difficult disunion, environmental constraints, interpersonal difficulties and communicative difficulties.

The aim in this essay is to investigate students? attitudes to homework in grade six, and closerstudy the attitudes of the students who think homework is difficult and boring. I have chosento investigate and find out why homework is perceived as boring and cumbersome for somestudents in sixth grade. I hope to identify the aspects that contribute to the negativeconsequences that arise in connection with the homework. The following questions are usedto make the study: Do some students experience homework as boring and difficult? Do somestudents get any form of support at home, if so, how do students perceive the support fromhome? How do students feel that homework affects their leisure?What is the reason that the homework is perceived as difficult and boring according to thestudents? How should the shape of homework change according to the students who believethat homework is difficult and boring?I have chosen to do the study with older students who have more experience with homework.I used both qualitative and quantitative methods, those are interviews and questionnaires.