Introduction Every tenth patient in Sweden is affected by nosocomial infections. Among these, urinary tract infection (UTI) is the most frequently occurring within the hospital environment. Nosocomial infections lead to increasing costs for care, more suffering among the patients, increasing use of antibiotics, and longer treatment spells. The Academic hospital have engaged all wards in the so called VRISS-project (“nosocomial infections must be stopped”) in order to reduce the number of nosocomial infections. Aim In connection to the VRISS-project new routines for removal of uretrahl catheters are introduced at ward 70E2 at the Academic hospital. The new routines imply that the catheter should be removed during the first post-op day. According to the old routines the catheter was to be removed no later than on the third post-op day. The authors of this study choose to investigate whether the new routines for uretrahl catheter removal have any effect on the occurrence of nosocomial UTI’s. Methods The study is a restrospective record study with quantitative, descriptive design. 411 journals from 2007 (188) and 2009 (223) have been reviewed. All patients that underwent knee or hip operations during January, February, March, and April 2007 and 2009 are included in the sample. Results The study shows that the new routines at ward 70E2 had some, but not full, influence on the share of patients with nosocomial UTI. Among women under 71 years of age and men older than 70 years, the number of days with uretrahl catheter and the share of patients with nosocomial UTI have decreased. However, among the younger men (<71 years) and the older women (>70 years) no effects of the new routines are detected. Conclusion To summarize it can be concluded that the routines for how to use uretrahl catheters at ward 70E2 work fairly well. However, the results also show that the number of days with uretrahl catheter and the share of patients with nosocomial UTI among risk patients, above all among the older women, are the same in spite of the new routines for removal of uretrahl catheters. Thus, strategies for detecting risk patients in an early stage can be improved upon. Such measures can reduce the risk for nosocomial UTI among these patients.

Cross infection is a global health problem. The cost for cross infection increases every year. Florence Nightingale focused her attention on preventing cross infections by using good hygiene and as a nurse that is one of your more important tasks. Nurses have guidelines for how hygiene should be implemented in practice. The aim of this study is to investigate factors that influence nurses´ compliance to guidelines regarding hygiene. A literature review was used to analyze scientific articles related to the topic. The result showed that education increases nurses´ compliance to follow guidelines. Furthermore compliance to hand hygiene was higher after contact with the patient then before. The result also showed that the nurses were more worried about attracting an infection from the patient then giving an infection to the patient. The studies revealed that nurses want more education about guidelines and the latest research on the subject. The authors think that nurses need more education about hygiene in order to understand the importance of following guidelines. Nurses also need time for both reading updated information infection control and implementing the hygiene guidelines more frequently in practice.

Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA). Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom) or traditional (e.g., periodic abstinence, withdrawal) forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment into family planning programs. Women on hormonal contraceptives should be encouraged to continue to use condoms for HIV-prevention.

Schistosomiasis is a parasitic disease affecting over 200 million people worldwide. This study reports the design and development of a microfiltration device for isolating schistosome eggs in urine for rapid diagnostics of urogenital schistosomiasis. The design of the device comprises a linear array of microfluidic traps to immobilize and separate schistosome eggs. Sequential loading of individual eggs is achieved autonomously by flow resistance, which facilitates observation and enumeration of samples with low-abundance targets. Computational fluid dynamics modeling and experimental characterization are performed to optimize the trapping performance. By optimizing the capture strategy, the trapping efficiency could be achieved at 100% with 300 mu l/min and 83% with 3000 mu l/min, and the filtration procedure could be finished within 10 min. The trapped eggs can be either recovered for downstream analysis or preserved in situ for whole-mount staining. On-chip phenotyping using confocal laser fluorescence microscopy identifies the microstructure of the trapped schistosome eggs. The device provides a novel microfluidic approach for trapping, counting and on-chip fluorescence characterization of urinal Schistosoma haematobium eggs for clinical and investigative application.

published_or_final_version / Pathology / Doctoral / Doctor of Philosophy

published_or_final_version / Mechanical Engineering / Doctoral / Doctor of Philosophy

An outbreak of neonatal diarrhoea was investigated in a herd of known susceptibility to infection by K88- positive Escherichia coli. The probable cause of the majority of diarrhoea cases was identified as a K88- positive E. coli strain. Diarrhoea was confined to susceptible piglets born to resistant sows. Susceptible sows protected their susceptible offspring and resistant piglets were unaffected. Potential protective mechanisms of the colostrum of susceptible sows were compared to the same properties in colostrum of resistant sows. Colostrum from susceptible sows (a) inhibited the binding of K88 antigen to intestinal epithelial cell brush borders, and (b) opsonized E. coli strain G205 and promoted in-vitro killing by porcine neutrophils significantly better than colostrum from resistant sows. Fractionation of colostrum by gel filtration and ion-exchange chromatography permitted identification of the immunoglobulin classes most efficient in both these activities. Both IgM and IgA, but not IgG, inhibited binding of K88 antigen to brush borders and opsonic activity was predominantly mediated by IgM. The importance of opsonic activity depends on the ab.ility of neutrophils to phagocytose bacteria within the intestinal lumen. In intestinal ligated loop experiments emigration of neutrophils into the lumen and phagocytosed bacteria were demonstrated by light microscopy and scanning and transmission electron microscopy. Neutrophil emigration only occurred when piglets had received maternal antibody_ No equivalent neutrophil emigration was observed in susceptible .piglets deprived of colostrum. There was also little or no neutrophil response in colostrum-fed resistant piglets probably du~ to a lower concentration of bacterial antigens close to the epithelial cell surface .or lack of specific antibody. Experiments to determine the numbers of organisms killed by neutrophils in the intestinal lumen failed to demonstrate any reduction, attributable to phagocytosis, in viable K88-positive E. coli.

No description available.

No description available.

No description available.