Immune-mediated haemolytic anaemia (IMHA) is an immune-mediated destruction of erythrocytes and is one of the most common haematological diseases diagnosed in dogs. The haemolysis is a type II immunoreaction and is initiated by IgG or IgM antibodies or complements. This retrospective study includes 63 dogs suffering from primary IMHA. The study was based on information from records from the Swedish University of Agricultural Sciences, Department of Small Animal Clinical Sciences in Uppsala and from the Animal Hospital in Strömsholm. The aim of the study was to evaluate the progress of the disease, treatment and the prognostic factors in different breeds, gender and age. Following criteria were used for the dogs to be allowed in the study: the dogs were diagnosed with anaemia, the anaemia was regenerative and autoagglutination and/or spherocytes were seen in the blood. About 50 % of the dogs in the study were diagnosed with IMHA within 2-6 years of age. Wire-haired dachshund was remarkably one of the most common breeds in this study together with Cocker and Springer spaniel.

This thesis looks at two sides of the same coin: how to support the production and future development at a specialist medical technology department at Danderyd Hospital. The two sides are; a pilot study of a product management system (PDM) and an interview based study on the characteristics of the silent knowledge of the technicians. The department (National respiratory centre, NRC) is facing retirement of several key employees.The technical study shows that the success of an implementation is largely dependent on the users? prior knowledge and use of a 3D Computer aided design system (CAD).The system itself is shown to fulfill the Lifecycle requirement of tracking the products (mostly tracheostomy tubes) but without a CAD centered workflow, some substantial education and preferably some new recruits, an implementation of the PDM system will fail. The author recommends development of the current ?low-tech? system of MS Excel and Access rather than redistribute the dependency from technician towards a complex, commercial software and its vendor.The analysis of the technicians? silent knowledge with the newly developed method, epithet for silent knowledge (ETK), shows that the longer employment time:the more differentiated technicians become in describing their work,practical knowledge are regarded higher andthe social and collective problem solving factors of the work becomes more important.Typically, it is shown that a new employee should preferably enjoy problem solving, being pragmatic and social as well as having some prior education or work experience in a CAD and/or a PDM system..

The purpose of this thesis is to discuss how an instrument originally developed for measuring changes toward lean thinking inservice organizations in general should be adjusted in order to be of use in service organizations within the healthcare sector, andin Hospital organizations in specific. The adjustments are suggested based on difficulties specifically arising when implementinglean within the healthcare sector.Thesis starting point is a pre-existing lean assessment instrument developed for service organizations in general. The thesis appliesa qualitative method and integrates literature from the health care sector and lean production movement with the expertise of tenacademics and practitioners in order to find difficulties associated with the implementation of lean within the healthcare sector.These difficulties then lie as the substratum for the adjustments suggested to be made on the instrument.The thesis finds that lean, as a philosophy, does not differ between service organizations in general and service organizationswithin healthcare settings. However, due to deficits in the general understanding of lean some adaptions on the instrument mustbe made. First, some words associated with production must be changed to words associated with healthcare.

Abstract. Aim: The aim of this study is to determine certain health, demographic and socioeconomic factors that affect the costs for specialized health care between the municipalities within the Västra Götaland region. Method: The method is explorative and analytical. The costs for specialized health care was divided into three different subgroups; independent somatic specialized health care, specialized health care provided by private practices or outside the region and psychiatric specialized health care. The data was age-standardized.

Background In Nyanza in western Kenya are 30,5% of children estimated as malnourished. It is a family situation that nurses often come in contact with. Therefore it is of interest to know how nurses work with parents of malnourished children when they have a significant role in developing the family's knowledge and child health. Aim. The aim is to investigate how nurses experience that they are working with parents of malnourished children.

Every spring you can see newborn foals running on fields among the mare. But some unfortunate end up visiting the equine Hospital requiring surgery. This is a challenge for the anesthetist because of the neonatal foal?s unique physiology. Therefore you need to take these differences under consideration when you anesthetize foals.

Fall orsakar de allra flesta höftfrakturerna och en tredjedel av alla över 65 år i Sverige faller varje år. En persons self-efficacy kan påverka hur aktiv personen vågar vara efter en höftfraktur vilket torde påverka den postoperativa rehabiliteringen. Syfte: Syftet var att vid hemgång från ortopedavdelning efter operation för höftfraktur undersöka om fallrelaterade self-efficacy skiljer sig i olika äldre åldersgrupper samt samband mellan fallrelaterad self-efficacy, gångförmågan och antalet vårddagar. Metod: Medelåldern i studien var 78 år. 14 personer ingick i studien.

Abstract? Background: ?Breast?cancer is the?most?common cancer for?women,?with?over 8000?of?cancer?cases?per?year.?Surgery?is the?most?common form?of?treatment. Basis?of?illness?and?the?loss?of?a?breast?can?be a?big?trauma for the?individual?and?affect?many?aspects.?Aim: The?aim?of?this?study?was?to?investigate?health-related?quality?of?life?and?psychosocial?situation and the?need?for support and?care?for?women?who?undergone?a?mastectomy?with?or?without?reconstruction.?Method: The?study?design?was?a?descriptive?study?with?qualitative?approach.?The?selection?was?strategically?consisting?of?the?eight?women?from?five?cities?which?had?undergone?mastectomy?with?or?without?reconstruction. The?interviews?were?semi-structured?individual?that?analyzed?using? content?analysis.?Results:All?of?the?women?felt?that?the?body?changed?after?the?mastectomy.? Feelings?of?insecurity?and?discomfort?were?common.?Among?those?who?underwent?reconstruction?were?all?dissatisfied?with?the?results.

Sweden's aging population makes the need for a viable health care urgent and telemedicine can be a solution to enable older people to receive or give themselves care in their homes. Furthermore, implementation of telemedicine has the potential to realise profits in society by increasing the accessibility of health care and minimizing travel costs. Sweden?s low population density and geographical configuration makes the advantages of telemedicine even more appealing. To illustrate the differences between the county councils? use of telemedicine and thus increasing the possibility for coordinated care between them, the authors have on behalf of the Innovation Centre at the Karolinska University Hospital mapped the amount of telemedicine technologies that are available in the Swedish county councils? today. To collect information an electronic survey and video or telephone interviews were used.

ABSTRACTIntroduction: An increasing number of patients in Sweden receive epidural anaesthesia (EDA) in connection to surgery. Caring for patients with acute pain is a responsibility that is strongly established within the profession of the nurse anaesthetist. If the care provided by the nurse anaesthetist for patients who receive epidural anaesthesia is to evolve then further insight and knowledge is required regarding the individual´s experience.Aim: To describe patients' experiences in receiving epidural anaesthesia based on an earlier perioperative start-up of the EDA.Method: Based on a qualitative approach, the aim is to conduct semi-structured interviews with patients who receive EDA in connection to abdominal or gynaecological surgery. Research subjects' statements in the context of the interviews will be transcribed and then analysed using qualitative content analysis. In order to evaluate the chosen method regarding data collection and analysis model an exploratory pilot study was conducted.

Introduction: In January 2005, a nationwide mandatory bicycle helmet law for children under the age of 15 was introduced in Sweden. In the current study, the effect of this law was evaluated by analyzing national trends in Hospital admissions due to bicycle-related head injuries during the period 1998-2011.Methods: An interrupted time-series design with segmented regression analysis was used to evaluate the intervention effect on head injuries as a percentage of all injuries (%HI) among cyclists in age- and sex-specific groups. Effect was measured as a change in level and/or slope of the trend at the time of legislation.Results: A total of 35261 cyclists (0-54 years) were Hospitalized due to a bicycle injury during the study period. Linear regression analyses of the entire study period (not segmented) showed significant year-to-year decreases in the %HI of 1.3-1.7% in all age and sex-specific groups (p < .0001). Results from the segmented regression analysis showed that, at the time of legislation, a significant drop in level occurred among males under 15 years (-4.5% [95% CI: -7.7% to -1.3%], p = .01) and a significant change in slope occurred among females aged 30-54 years (-1.6% [95% CI: -2.9% to -0.2%], p = .025).Conclusions: The law seems to have had an effect on males in the target population (<15 years).

Syfte: Syftet med studien var att ta del av hur vårdpersonal på Hospice beskriver sina olika känslor som uppstår i vården av patienter i livets slutskede, vilka copingstrategier de använder sig av för att bearbeta dessa känslor samt vilka faktorer som de upplever påverkar valet av copingstrategier. Metod: En kvalitativ metod med semistrukturerade intervjuer användes. Åtta kvinnliga deltagare ur vårdpersonalen på Hospice (lika fördelade mellan sjuksköterskor och undersköterskor med varierande ålder och erfarenhet) blev intervjuade. Resultat: Känslor av skuld, frustration, maktlöshet, stress och otillräcklighet upplevdes betungande. För att bearbeta dessa användes främst aktiv och problemfokuserad coping, framförallt samtal och stöd.

Självmord erkänns som ett stort folkhälsoproblem i många länder. Enligt världshälsoorganisationen är det årligen upp emot en miljon människor som tar sitt liv världen över. Årligen begår cirka 1100 människor i Sverige självmord. Det är ungefär tre självmord om dagen. I den preHospitala vården möter ambulanssjuksköterskor ofta patienter med psykisk ohälsa.

AbstractAim of the study: Aim of the study was to investigate whether there were any connections in time between different parts of care in patients with cardiac arrest and hypothermia treatment and cognitive and physical function six months after cardiac arrest and to investigate neurological outcome related to primary registered cardiac arrest rhythm after six months and if there were any changes in cognitive and physical functions as well as self-related health between discharge from Hospital and six months after cardiac arrest.Method: The study included 39 patients admitted to three Swedish Hospitals between 2008-2011. Cognitive and physical function was evaluated with Cerebral Performance Cathegory, CPC completed with Mini Mental State Examination, MMSE for cognitive function and Bartels Index, BI for physical function and Euroqol-VAS for evaluating the self-related health.Result:  A significant connection was shown between time to start hypothermia treatment and BI, patients with longer time showed improved physical function after six months.Majority of the participants (66,7 %) had Ventricular fibrillation/Ventricular tachycardia, VF /VT, as primary registered cardiac arrest rhythm and in this group CPC and BI was significant better compared with the asystole /Pulsless Electrical Aktivity, PEA group.CPC, MMSE, BI and Euroqol-VAS were all improved over time.Conclusion: Participants with VF /VT as primary registered cardias arrest rhythm had significant better cognitive and physical function 6 months after hypothermia-treated cardiac arrest compared with participants with asystole/PEA as primary registered rhythm. This shows the importance of access to defibrillators in public places in the society and in Hospitals and optimal education of lay people and medical staff. Cognitive and physical function and self-rated health improves over time, which might be a very important reason to convey patients, relatives and medical staff to continue cognitive and physical rehabilitation. Keywords: Cardiac arrest, hypothermia, cognitive and physical function, wellbeeing.

Background: Isolation care may be necessary when a patient is carrying infection or is being inflicted with disease that causes deficit immune system. Being isolated means that the patient is in a confined space and may stay only there. Even in ancient times, people discovered the importance of isolating people carrying an infection from the rest of society. According to the Infectious Diseases Act, patients should be isolated in order to reduce the spread of infection both from the patient to the surroundings as well as the opposite. Isolation care can be psychologically stressful for some patients.