| 11. |
- Axelsson, Louise, et al.
(författare)
-
Friska kalvar vid förmedling av tvåveckors tjurkalvar
- 2022
-
Annan publikation (populärvet., debatt m.m.)abstract
- Det har i dag blivit allt vanligare att mjölkproducenter genom gårdsavtal levererar sina tjurkalvar vid 2–4 veckors ålder till gårdar som föder upp dem till slakt. Kalvarna har vid den här låga åldern inte helt hunnit utveckla sitt eget immunförsvar utan är beroende av det skydd som de får från kon via råmjölken. När man för samman många unga individer från olika gårdar på en ny plats uppstår lätt ”dagiseffekten”. Kalvarna som kommer från olika besättningar kan bära med sig olika smittämnen och smitta varandra. De vanligaste sjukdomarna som drabbar den unga kalven är diarré och lunginflammation. Det är vanligast att kalvarna får diarré under den första levnadsmånaden. Olika smittämnen kan orsaka diarrén t.ex. bakterien E. coli, Rotavirus eller Cryptosporidier. Om kalven har fått för liten mängd råmjölk eller råmjölk av dålig kvalitet finns en ökad risk för att kalven får diarré. Kalvar som har drabbats av diarré och därmed blivit nedsatta kan lättare insjukna i andra sjukdomar som t.ex. lunginflammation. Lunginflammation är ett vanligt förekommande hälsoproblem i besättningar som föder upp ungnöt. Kalvar som insjuknar i lunginflammation får feber, hosta och påverkat allmäntillstånd med slöhet och försämrad eller upphörd aptit. Kalvar som har lunginflammation behöver ofta få behandling med antibiotika för att de ska tillfriskna. Kalvar som har haft lunginflammation kan få en sämre tillväxt. En ökad sjuklighet bland kalvarna leder till en ökad antibiotikaförbrukning samt ekonomiska förluster för lantbrukaren, i form av veterinärkostnader, merarbete med sjuka djur, nedsatt tillväxt och ökad dödlighet. Det är därför viktigt att hitta faktorer både i besättningen där kalven föds och i den mottagande besättningen, som har en positiv effekt på kalvarnas hälsa och överlevnad. Genom att hitta de faktorerna och omsätta dem i praktiken kan det leda till en minskad antibiotikaförbrukning, ökad djurvälfärd och positiv ekonomisk effekt för djurägaren. Den här broschyren tar upp ett antal faktorer som har betydelse för att kalven ska få en bra start i livet och hur man som djurägare kan arbeta förebyggande med kalvhälsan i sin besättning.
|
|
| 12. |
- Axelsson, Lena
(författare)
-
Living with haemodialysis close to death - patients' and close relatives' experiences
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to generate understanding and knowledge a bout the experiences of patients living with haemodialysis, and their close relati ves, near the end of life. In studies I and II we conducted a series of 31 qualitative interviews over a period of 12 months with 8 severely ill patients (aged 66–87) treated with haemodialysis. For study I the text of the interviews was analysed using phenomenological hermeneutics to describe and to el ucidate the meanings of being severely ill living with haemodialysis when nearing end of life. For study II the text was analysed using qualitative content analysis to describe inner thoughts and feelings relating to death and dying of these patients. For studies III and IV, we conducted 14 retrospective qualitative interviews with close relatives of deceased patients treated with haemodialysis about th eir experiences during end of the patient’s life. For paper III the interview text was analysed usi ng phenomenological hermeneu tics to describe and elucidate the meanings of being a close relative at the end of life of a severely ill family member treated with maintenance haemodialysis. For paper IV the text was analysed using qualitative content analysis to describe end of life for the patients from the perspective of their close relatives. The findings of study I suggest that being severely i ll and living with haemodialysis near the end of life means living with suffering from a deteriorating body, a high symptom burden, and dependence on advanced medical technology, simultaneously with r econciliation and well-being. The meanings of living with illness and dialysis are intertwined with the meanings of being old. Study II shows that thoughts and feelings about deat h and dying are significant and complex for those living with haemodialysis as they approach the end of life. Patients experience a multifaceted presence of death. Their awareness of approaching death may include their repressing of thoughts of death, not as denial, but to allow them to focus on living as fully as possible the time they have left. Study III shows that close relatives strive to maintain balance and well-being for themselves and for the patient, which we interpreted as their striving to regain balance, and inner equilibrium in their changed and challenged rhythm of life. Study IV shows that after gradual deterioration and increasing care needs, older patients in haemodialysis care with co-morbidities follow three different main paths at the end of life: uncertain anticipation of death; awaiting death after dialysis withdrawal; and sudden but not unexpected death. The ends of their lives are marked by complex symptoms and existential issues related to haemodialysis treatment and withdrawal, and their uncertainty of what to expect at the end of life suggests the need for increased continuity and coordination of whole person care. Both patients and their close relatives are often alone with their existential thoughts. In their complex lifeworlds, intertwined meanings of living with illness and maintenance of life with haemodialysis treatment near the end of life show that patients live in a borderland of living-dying that is shared by the close relative. Patients and close relatives focus on living when death is close but uncertain, with severe illness and the maintenance of life through advanced technology. Integrating the philosophy of palliative care (with a focus on symptom relief, team work, communication, relationships, and support of family members) into dialysis care, may support health care professionals in haemodialysis units and other re nal contexts, to improve the care of severely ill patients, both earlier in their illness and as they approach the end of their lives.
|
|
| 13. |
- Axelsson, Lena, et al.
(författare)
-
Living with haemodialysis when nearing end of life
- 2012
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:1, s. 45-52
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim of this study was to describe and to elucidate the meanings of being severely ill living with haemodialysis when nearing end of life.INTRODUCTION: To have end stage renal disease and to be treated with maintenance haemodialysis implies being dependent on lifelong treatment. Several studies have reported that these patients suffer a high symptom burden and an impaired quality of life due to both disease and treatment. In the dialysis unit, where the focus is on handling technology and maintaining life, end of life care may be neglected or overlooked. Nevertheless, mortality rates show that about one-fourth of patients in haemodialysis care are in their last year of life.DESIGN: A qualitative interpretative design was used.METHODS: Serial qualitative interviews over a period of 12 months were conducted with eight patients (aged 66-87). Altogether text of 31 interviews was interpreted using a phenomenological hermeneutical method in three phases. The study is ethically approved.FINDINGS: The structural analysis resulted in 11 subthemes and thereafter the following three themes were formulated; being subordinate to the deteriorating body, changing outlook on life and striving for upheld dignity. The comprehensive interpretation revealed that being severely ill living with haemodialysis near the end of life means living with suffering simultaneously with reconciliation and well-being. Further, the meanings are understood as intertwined with being old.CONCLUSIONS: Findings contribute to an increased awareness of the complexities of these patients' life worlds and their meanings, and thus of the importance to listen to their experiences and their understandings. Findings suggest that to integrate the philosophy of palliative care in haemodialysis units may improve care for patients who are living with haemodialysis and approaching the end of their lives.
|
|
| 14. |
- Axelsson, Lena, et al.
(författare)
-
Meanings of being a close relative of a family member treated with haemodialysis
- 2015
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:3/4, s. 447-456
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES:To describe and elucidate the meanings of being a close relative of a severely ill family member treated with maintenance haemodialysis approaching the end of life.BACKGROUND:End-stage renal disease together with comorbidities, haemodialysis treatment and high mortality rates also affects the lives of close relatives, who report burdens and impaired quality of life. To improve care, more understanding is needed of close relatives' experiences during these patients' end of life.DESIGN:This study has a qualitative interpretative design.METHODS:Fourteen retrospective qualitative interviews were conducted with close relatives (aged 48-93 years) of deceased patients who had been treated with haemodialysis. The interview text was interpreted using a phenomenological hermeneutical method in three phases.RESULTS:The findings of the structural analysis were formulated as six themes: Striving to be supportive and helpful without doing harm to the ill person's self; Needing increasing strength and support; Balancing the will to help with one's own ongoing life; Increasing responsibility involving dilemmas; Striving for a good life together in the present and Living with awareness of death.CONCLUSIONS:Close relatives strive for balance and well-being accompanying their ill family member through the end of life. They are facing moral dilemmas and growing demands as their responsibility increases with the deterioration of their family member. Support from and interaction with the healthcare professionals is then of significance.RELEVANCE TO CLINICAL PRACTICE:Findings challenge healthcare professionals in haemodialysis settings to identify close relatives' individual resources and needs towards the patients' end of life. Healthcare professionals in haemodialysis settings need to offer close relatives opportunities to talk about the future and what may be expected at end of life, with or without haemodialysis. They should also contact the closest relative after the death as they may need confirmation and closure.
|
|
| 15. |
- Axelsson, Lena, et al.
(författare)
-
Thoughts on death and dying when living with haemodialysis approaching end of life
- 2012
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 21:15-16, s. 2149-59
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe inner thoughts and feelings relating to death and dying when living with haemodialysis approaching end of life.BACKGROUND: Patients who undergo maintenance haemodialysis suffer a significant symptom burden and an impaired quality of life. The high mortality rate in these patients indicates that about one-fourth of them are in their last year of life, suggesting the presence of death and dying in the haemodialysis unit.DESIGN: A qualitative descriptive design was used. Methods. A total of 31 qualitative interviews were conducted with eight patients (aged 66-87) over a period of 12 months. Qualitative content analysis was used to analyse data.RESULTS: The analysis revealed 10 subthemes that were sorted into three main themes. Being aware that death may be near comprises being reminded of death and dying by the deteriorating body, by the worsening conditions and deaths of fellow patients, and by knowing haemodialysis treatment as a border to death. Adapting to approaching death comprises looking upon death as natural, preparing to face death, hoping for a quick death and repressing thoughts of death and dying. Being alone with existential thoughts comprises a wish to avoid burdening family, lack of communication with healthcare professionals and reflections on haemodialysis withdrawal as an hypothetic option.CONCLUSIONS: Living with haemodialysis approaching, the end of life involves significant and complex existential issues and suffering, and patients are often alone with their existential thoughts.RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals in haemodialysis settings need to combine technical and medical abilities with committed listening and communication skills and be open to talking about death and dying, with sensitivity to individual and changeable needs.
|
|
| 16. |
- Axelsson, Malin, et al.
(författare)
-
Living in the Wake of Chronic Obstructive Pulmonary Disease and Long-Term Oxygen Therapy
- 2016
-
Ingår i: Open Journal of Nursing. - : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 6, s. 376-385
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD is a progressive disease that could lead to chronic hypoxemia, which requires treatment as domiciliary Long-Term Oxygen Therapy (LTOT). There is a need for increased knowledge about self-care strategies used by individuals living with COPD and LTOT. Objective: The aim was to explore experiences and self-care strategies in patients living with both COPD and LTOT. Sample: The sample consisted of five men and five women diagnosed with COPD being prescribed LTOT for more than one year. Method: Ten interviews were undertaken and analyzed for both manifest and latent content. Results: Living with COPD and LTOT was associated with experiences of guilt although there were doubts about what had caused the lung disease. Both the lung disease and the oxygen therapy had a negative impact on their self-image. Anxiety was expressed when thoughts about the remaining time occurred. There was a constant balance between diminishing abilities and increasing restrictions related to the lung disease and the therapy. In order to compensate for arising imbalance, self-care strategies had been initiated aimed at preserving the present state of health, enabling and facilitating physical activity and promoting a positive attitude. Conclusion: The current study suggests that individuals living with COPD and LTOT are encouraged to adopt self-care strategies directed towards maintaining stability with regard to the lung disease, the oxygen therapy, physical capability and emotional reactions.
|
|
| 17. |
- Axelsson, Susanna, et al.
(författare)
-
Effect of combined caries-preventive methods: a systematic review of controlled clinical trials.
- 2004
-
Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 163-9
-
Forskningsöversikt (refereegranskat)abstract
- The aim of this systematic review was to evaluate the caries-preventive effect of combined caries-preventive methods, defined as two or more different interventions in combination, each expected to prevent dental caries. The Medline database was searched for articles published in the period January 1966 to June 2003. Twenty-four controlled studies met the inclusion criteria, and their value as evidence was assessed according to predetermined criteria. The level of evidence for the overall conclusion regarding each method was graded according to the protocol of the Swedish Council on Technology Assessment in Health Care. The scientific evidence for the combination of treatments involving fluoride that had a preventive effect on caries in children and adolescents was graded as moderate. However, for elderly patients the scientific evidence for the caries-preventive effect of different combinations of treatments was found to be incomplete. No conclusion could be drawn regarding the evidence for combinations of treatments being effective for groups at high caries risk, as the results from the identified clinical studies were conflicting.
|
|
| 18. |
|
|
| 19. |
- Axelsson, Östen, et al.
(författare)
-
A principal components model of soundscape perception
- 2010
-
Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 128:5, s. 2836-2846
-
Tidskriftsartikel (refereegranskat)abstract
- There is a need for a model that identifies underlying dimensions of soundscape perception, and which may guide measurement and improvement of soundscape quality. With the purpose to develop such a model, a listening experiment was conducted. One hundred listeners measured 50 excerpts of binaural recordings of urban outdoor soundscapes on 116 attribute scales. The average attribute scale values were subjected to principal components analysis, resulting in three components: Pleasantness, eventfulness, and familiarity, explaining 50, 18 and 6% of the total variance, respectively. The principal-component scores were correlated with physical soundscape properties, including categories of dominant sounds and acoustic variables. Soundscape excerpts dominated by technological sounds were found to be unpleasant, whereas soundscape excerpts dominated by natural sounds were pleasant, and soundscape excerpts dominated by human sounds were eventful. These relationships remained after controlling for the overall soundscape loudness (Zwicker’s N10), which shows that ‘informational’ properties are substantial contributors to the perception of soundscape. The proposed principal components model provides a framework for future soundscape research and practice. In particular, it suggests which basic dimensions are necessary to measure, how to measure them by a defined set of attribute scales, and how to promote high-quality soundscapes.
|
|
| 20. |
- Axelsson, Östen, et al.
(författare)
-
A Swedish instrument for measuring soundscape quality
- 2009
-
Ingår i: Euronoise 2009. - Edinburgh : Institute of Acoustics.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In 2008 the International Organization for Standardization (ISO) decided to put together a new expert working group ISO/TC 43/SC 1/WG 54 named “Perceptual assessment of soundscape quality”. The purpose of this expert group is to propose the first ever, international standard on how to measure the perceived quality of soundscapes, by means of questionnaire techniques. This work is chiefly motivated by a need to harmonise methods in soundscape research internationally in order to improve the comparability of research results across countries and over time. Within the Swedish research program Soundscape Support to Health, the present authors developed such a technique based on field work and laboratory studies. In the present paper we present research in which we validated our initial findings and finalised our questionnaire protocol. We propose that the measurement of perceived soundscape quality must include: (1) identification of perceived sounds sources, such as, technological sounds, human sounds, and natural sounds, (2) classification of soundscape quality on a good–bad scale, and (3) qualitative measurement of a set of eight perceived-soundscape attributes defined in a two-dimensional Pleasantness–Eventfulness measurement model.
|
|
