Made available in DSpace on 2016-08-11T14:41:31Z (GMT). No. of bitstreams: 1 DeboraNJR_DISSERT.pdf: 1718335 bytes, checksum: d44051499461c839e06ab5fc2aaa7215 (MD5) Previous issue date: 2015-02-26 / Fundação de Apoio a Pesquisa do Estado do Rio Grande do Norte / Toxoplasmosis is a cosmopolitan infection caused by the protozoan Toxoplasma gondii, achieving high rates of infection in Brazil and worldwide. The infective forms of the parasite (taquezoítos, bradyzoites and oocysts) that allow humans and other species of animals become infected in several ways, by transplacental form (congenital, from mother to child); handling feces of cats; handling of soil (sand); eating raw or undercooked meat, among other forms. However, infection with Toxoplasma gondii can be mitigated by carrying out preventive measures, such measures are directly related to behavioral and hygienic habits of the population. Thus, starting from pre supposed that the knowledge about the modes of transmission and preventive measures of toxoplasmosis would be precursor to inhibit the increase of infection, the study aimed to assess the population's knowledge about the modes of transmission and preventive measures of toxoplasmosis in Mossoró - RN. Then, a field study was conducted in the municipality, and followed by visits to the Basic Health Units in six districts, with a population of 384 women in the age group classified as reproductive (18-49 years). They were submitted to a questionnaire containing 40 questions, which dealt with the knowledge of transmission and preventive measures of toxoplasmosis. The data obtained from the questionnaires were statistically analyzed with the aid of R program, and use of non-parametric test to compare Fisher Exact women's knowledge about the modes of transmission and their schooling. It was found that most women are unaware of the main frame forms of transmission of toxoplasmosis, this ignorance, had statistical relationship with the education of the respondents. In what refers to preventive measures, most of the population practices without even having knowledge about the ways of transmission. It was concluded that the fact that women practice preventive measures, even knowing the modes of transmission, can is related to lifestyle and custom of the population. It was also observed that most of the women surveyed do not know the IgG test for toxoplasmosis, adding yet, the fact of not having the examination or not knowing respond if at some point would have already done / A toxoplasmose é uma infecção cosmopolita, causada pelo protozoário Toxoplasma gondii, atingindo altos índices de infecção no Brasil e no mundo. As formas infectantes do parasita (taquezoítos, bradizoítos e oocistos) permitem que o ser humano e as outras espécies de animais se infectem de várias formas como, pela forma transplacentária (congênita, de mãe para filho); manuseio de fezes de felinos; manuseio de solo (areia); ingestão de carne crua ou mal passada, entre outras formas. No entanto, a infecção pelo Toxoplasma gondii pode ser atenuada com a realização de medidas preventivas, tais medidas, estão diretamente relacionada a hábitos comportamentais e higiênicos da população. Dessa forma, partindo do pré-suposto que o conhecimento sobre as formas de transmissão e medidas preventivas da toxoplasmose seria precursor para inibir o aumento da infecção, a pesquisa teve como objetivo avaliar o conhecimento da população sobre as formas de transmissão e medidas preventivas da toxoplasmose em Mossoró RN. Então, foi realizado um estudo de campo no município, e seguiu por visitas as Unidades Básicas de Saúde em seis bairros, com uma população de 384 mulheres na faixa etária classificada como reprodutiva (18 a 49 anos). As mesmas foram submetidas a um questionário contendo 40 questões, as quais versavam sobre o conhecimento das formas de transmissão e medidas preventivas da toxoplasmose. Os dados obtidos nos questionários foram submetidos à análise estatística com auxílio do Programa R, e utilização do teste não paramétricos Exato de Fisher para comparar o conhecimento das mulheres sobre as formas de transmissão e sua escolaridade. Constatou-se que a maioria das mulheres desconhecem as quatro principais formas de transmissão da toxoplasmose, esse desconhecimento, teve relação estatística com a escolaridade das entrevistadas. Já no que se refere às medidas preventivas, a maioria da população pratica, mesmo sem ter conhecimento sobre as formas de transmissão. Concluiu-se que o fato das mulheres praticarem as medidas preventivas, mesmo desconhecendo as formas de transmissão, pode está relacionado aos hábitos de vida e costume da população. Observou-se também, que a maioria das mulheres pesquisadas não conhecem o teste de IgG para toxoplasmose, somando-se ainda, o fato de não terem realizado o exame ou não saberem responder se em algum momento já teriam o realizado

En viktig del i operationssjuksköterskors arbete är att genom lämpliga omvårdnadsåtgärder förhindra att patienter drabbas av postoperativa sårinfektioner. Operationssjuksköterskan är ansvarig för att operationsområdet är sterilt tills operationen är avslutad. Detta innebär bland annat att hudrengöring efter hudförslutning av operationssåret och steril förbandsläggning görs på ett korrekt sätt. Syfte: Syftet med studien var att beskriva operationssjuksköterskornas erfarenheter av hudrengöring efter hudförslutning av operationssåret samt förbandsläggning. Metod: En kvalitativ intervjumetod med semistrukturerade frågor användes. Sex operationssjuksköterskor deltog i studien. Kvalitativ innehållsanalys användes för att analysera intervjuerna som varade mellan 30 - 40 minuter. Resultat: Resultaten visade ett tema ”Stolt yrkeskunskap men begränsande faktorer gällande fortsatt förbättring av arbetsmetoder” samt tre kategorier och sju subkategorier. Konklusion: Rengöring av ett avslutet operationssår utförs i nuläge enligt beprövad arbetserfarenhet och rutiner men det krävs en ny evidensbaserad kunskap tillämpas i det dagliga arbetet för att bedriva en evidensbaserad omvårdnad. Även tydliga riktlinjer för uppföljningen av postoperativa sårinfektioner skall implementeras i det dagligen utkommande arbete. / Introduction: An important part of the occupational nurse's work is to prevent patients from postoperative wound infections through appropriate care measures. The operation nurse is responsible for the operation area being sterile until the operation is complete and that the cleaning and reorganization of the completed operating wound with a sterile dressing is correct and aseptic, which prevents postoperative wound infections. Purpose: The purpose of the study was to describe the occupational nurse's experiences of skin cleansing after skin closure and dressings. Method: A qualitative interview method with semistructured questions was used. Six occupational nurses participated in the study. Qualitative content analysis was used to analyze interviews ranging between 30-40 minutes. Result: The results showed a theme "Proof of professionalism but limiting factors for further improvement of working methods" as well as three categories and seven subcategories. Conclusion: Cleaning a completed surgery wound is performed in the current state according to proven work experience and routines, but it is required that a new evidence-based knowledge is applied in the daily work of carrying out evidence-based nursing. Clear guidelines for the follow-up of postoperative wound infections should also be implemented in the daily work.

Orientadores : Thales Rocha de Mattos Filho, Francisco Carlos Groppo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T03:41:21Z (GMT). No. of bitstreams: 1 Motta_RogerioHeladioLopes_D.pdf: 659292 bytes, checksum: 254fb5f4f10c3501c081c5129d2db30f (MD5) Previous issue date: 2005 / Doutorado / Farmacologia, Anestesiologia e Terapeutica / Doutor em Odontologia

Objectives: To develop and validate a survey that can be used to measure key infection prevention and control (IP&C) structures and processes in LTC facilities. Methods: This study was designed using a three-phase methodology. In Phase I, six structural and process composite indices were developed based on the 2004 PHAC recommendations for IP&C in LTC and other literature. During the second phase of the study, a group of 7 experts in LTC IP&C used the Delphi methodology to validate and further develop the survey based on group consensus. Five Safety Principles published by the Institute of Medicine were also provided to the experts so they could be used to complement and further develop the concepts covered by the survey. The Delphi phase began in April and ended in October 2007; 114 worksheets were sent to experts to support the consensus-reaching process. Once the validity of a survey draft had been established based on expert-group consensus, it was pilot-tested in Phase III using 20 randomly selected LTC facilities in Fraser Health. Findings: The three-phase methodology used in this study was very useful and innovative way to further develop and validate the literature-based survey developed in Phase I for IP&C in long term care. In addition, by merging two bodies of knowledge and thought into the process, concepts and components that are not explicitly described in IP&C literature yet were felt to be key in program success, were incorporated into the measurement tool. Using Delphi, the experts expressed a need for IP&C professionals working in LTC to increase their knowledge, understanding and use of safety theory and strategies. They also felt that interdisciplinary work, the development of a culture of safety, and the development clear and simple IP&C systems are key ways in which infections can be prevented and outbreaks quickly controlled. In Phase III, the pilot-study analysis demonstrated the utility, validity and reliability of the survey. In addition, the analysis showed that there is a tendency for facilities to have lower levels of components within the Leadership Index and the ICP Index. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

The objectives of this thesis are : 1) To provide a review of the literature on the significance, pathogenesis, diagnosis and management of secondary infections in the Intensive Care Unit. 2) To present the findings of a study of the technique of selective parenteral and enteral antisepsis regimen (SPEAR) in the patient population of the Respiratory ICU at Groote Schuur Hospital, aimed at reducing the incidence of secondary infection and, further to evaluate the study in terms of the effect of SPEAR on the incidence of secondary infection and its influence on the mortality due to secondary infection. 3) To present the findings of the effect of SPEAR on patient bacterial colonisation in the ICU, and to evaluate its longterm influence on the microbial flora of the ICU.

Master of Public Health - MPH / Hospital acquired infections are a huge public health concern, contributing to increased hospitalisation and death in developing countries. Infection prevention and control (IPC) is a discipline which relies on practical evidence-based approaches to preventing both patients and health workers from hospital avoidable infections. However, most of these infections, in many developing countries including Zimbabwe can be attributed to lack of compliance with infection prevention and control measures by health care workers. / 2023

Master of Public Health - MPH / In the Maseru district, the high prevalence of unintended pregnancies among adolescents aged between 15 to 19 years may be due to non-use of modern contraceptive methods. It is therefore important to investigate possible barriers adolescents in Maseru in Lesotho face in accessing contraceptive methods and services. This research has therefore focused on the factors that affect the accessibility and usage of contraceptive services among in-school adolescent girls in Maseru City, Lesotho.The study was an observational, analytical, cross-sectional study. A sample of 10 high schools in Maseru city was selected as study sites, using computer-generated random numbers. A stratified random sampling method was used to enrol a total of 368 sexually active respondents, aged 15-19 years into the study. Data was collected using a structured one-on-one interviewer administered questionnaire and analysis was conducted using the STATA 14 statistical software programme. Ethical approval was obtained from the Biomedical Research and Ethics Committee (University of the Western Cape) and the Lesotho Ministry of Health and Social Welfare. Written parental/caregiver informed consent and written participant consent and assent, as per the Lesotho law were obtained.

Approximately 55% of intensive care unit (ICU) patients require the use of a central venous catheter (CVC). CVCs are often an essential component of care; however, CVCs can create avenues for pathogens to enter the bloodstream and cause a central line-associated bloodstream infections (CLABSI), which can lead to increased mortality and morbidity, prolonged length of stay, increased cost of care, decreased patient satisfaction, and increased workload. In 2017, the CLABSI rate at the project site was 4.3 per 1,000 catheter days as compared to the national rate of 0.8 per 1,000 catheter days. Based on Piaget's theory of constructivism, a simulation-based staff educational program was developed and implemented by ICU staff (n=20). Following the implementation of the simulation-based program, adherence to CVC maintenance guidelines improved from 41.5% to 87.9%. A sample t-test showed that this improvement was statistically significant and the CLABSI rate declined to 1.24 per 1,000 catheter days in the 4-week period following implementation of the program. Findings show that introducing a simulation-based training program might help to reduce CLABSI rates in the ICU setting and contribute to positive social change by improving health outcomes in ICU patients with a CVC.

INTRODUCTION: For persons with diabetes, surgery is fraught with complications; of primary concern is postoperative infection. A postoperative infection rate of up to 13% has been noted in patients with diabetes undergoing elective surgical procedures compared with less than 3% in nondiabetic populations. OBJECTIVE: The objective of this study was to provide preliminary evaluation of the efficacy of a novel bioresorbable microfilm matrix (20 µm thick) containing very low amounts of silver (0.16 mg/in²) in preventing surgical site infections when placed at the level of subcutaneous tissue and dermis prior to primary closure in the patient with diabetes undergoing elective surgery. MATERIALS AND METHODS: Twenty-two patients with diabetes undergoing nonemergent or elective foot or ankle surgery and who met at least 1 of the following 6 criteria were included in the study: neuropathy, infection, open wound, history of recurrent infection, nonhealing wound, or peripheral vascular disease. Patients underwent amputation, removal of exostosis, midfoot bone removal, Achilles tendon repair, bunionectomy, or an elevating osteotomy with primary closure of the wound. After hemostasis was obtained and subcutaneous closure achieved, if applicable, the bioresorbable microfilm matrix was applied just deep to the incision at the level of subcutaneous tissue and dermis, and the incision primarily closed. A nonadherent cover dressing was applied over the suture line, and routine follow-up was scheduled for 3 to 5 days later. RESULTS: No patient exhibited signs of infection at initial follow-up, and all adherent patients achieved complete healing during the 3-month follow-up period. Eighteen patients healed at a rate typical for the respective procedure. In 2 patients, time to healing was delayed secondary to weight-bearing dehiscence. Two patients were not included in the results secondary to multiple infractions of nonadherence with the postoperative protocol. CONCLUSIONS: The application of microfilm matrix in surgical incisions at the level of subcutaneous tissue and dermis prior to primary closure is safe for and has the potential to prevent postoperative surgical site infections in at-risk patients with diabetes..

A review of literature related to community-acquired Clostridium difficile- associated disease (CA-CDAD) was conducted. Information was collected from Cumulative Index to Nursing and Allied Health (CINAHL) and MEDLINE-EBSCOhost databases. Clinical practice recommendations were obtained from the CDC. Studies were examined for epidemiology of infection due to C. difficile in the community and interventions to reduce transmission. Findings demonstrated a mirroring of to CA-CDAD to community-acquired Methicillin-resistant Staphylococcus aureus (MRSA). Multiple studies found underlying gastrointestinal disorders and use of cephalosporin antibiotics to be a risk factor. Another identified risk factor was use of gastric acid suppressive drugs. Also, no particular C. difficile strain was more likely to cause recurrence. Many positive cases for CA-CDAD lacked traditional risk factors such as recent antibiotic exposure. To reduce transmission of community-acquired MRSA the CDC recommends MRSA should be considered in the differential diagnosis of soft skin tissue infections. Clinicians should also collect specimens for culture and antimicrobial susceptibility testing from all patients with abscesses. The CDC recommends clinicians should teach their patients to limit transmission and ask about similar cases in household members and close contacts. Therefore, to reduce transmission of CA-COAD, Clostridium difficile- associated disease should be considered in the differential diagnosis of diarrhea. Clinicians should collect specimens for culture based on patient history & current clinical presentation for patients with diarrhea. It is important that patients be taught the proper hygiene and cleaning protocols to reduce transmission