Antibiotics are essential drugs in modern medicine. After consumption antibiotics are excreted in unmetabolized form in the urine and reach our sewage treatment plants (STP). STP are not able to degrade all antibiotics leading to release of antibiotics into the aquatic environment. Aquatic animals are thus continuously exposed to antibiotics. This study involved assessment of the toxicity of eight antibiotics previously detected in the river Fyrisån, Uppsala, Sweden, in developing zebrafish (Danio rerio) embryos up to day six of age. The experiments included assessment of embryonal toxicity for the individual antibiotics as well as mixtures of all antibiotics.  The mixtures were based on previously measured concentrations in river Fyrisån and tested in increasing concentrations up to 1000-times higher concentrations. In the toxicity assessment different lethal and sublethal endpoints were observed, such as early movements, heart rate, hatching time and length. These experiments were followed by behaviour study observing the swimming activity during alternating dark-light alternations. Lastly, a bioaccumulation study was performed on mixtures of antibiotics to determine if these antibiotics were bioaccumulative in zebrafish embryos. The results showed that these eight antibiotics, individually and as a mixture did not affect any of the endpoints. As for bioaccumulation, none of the eight antibiotics were bioaccumulating in zebrafish embryos. These antibiotics seem to be non-toxic during fish embryonal development. However, the results cannot determine the long-term effects of antibiotic exposure and thus further studies are needed to assess the potential toxicity of environmentally present antibiotics to fish.

Oral health is a part of general health and the two are connected in many ways as well as impact each other. Oral diseases are some of the most common chronic diseases of mankind. Diseases such as caries and periodontitis are two of the most common ones affecting the oral cavity. Bacteria associated with these two diseases are Streptococcus mutans and Aggregatibacter actinomycetemcomitans respectively. Our hypothesis is that extracts from guava leaf or matcha tea affect adhesion of A. actinomycetecomitans or S. mutans to human epithelium. The aim of this study is to investigate a DNA-based method for studying attachment of bacteria to epithelial cells. Two different concentrations of the two bacterial species, high and low, were treated with matcha or guava leaf extract and adhesion on the human epithelial cell cultures was analyzed. The results were then analyzed using qPCR-based methods to test the amount of bacterial adhesion to the epithelial cells. Furthermore, the results showed that matcha was more effective for inhibition of bacterial adhesion than guava leaf.In conclusion, our results show that bacterial adhesion of A. actinomycetecomitans and S. mutans to human epithelial cells can be quantified by DNA-based methods, and the adhesion altered by plant extracts.

Zikaviruset är ett virus som fått stor uppmärksamhet i framför allt Sydamerika från 2015 och framåt då allt fler fall uppmärksammats. Detta arbete har utförts som en litteraturstudie med mål att sammanfatta kunskapsläget kring Zikavirusets morfologi, spridning, historia, komplikationer, diagnostik samt rådande behandlingsmöjligheter. Som källor används information från Folkhälsomyndigheten, CDC, PAHO och WHO samt MeSH-sökningar via PubMed. Viruset tillhör familjen Flaviviridae. Liknande andra virus i samma grupp kan infektionen ge feber, makulopapulösa hudutslag, konjunktivit, ledvärk, huvudvärk och myalgi. Det beskrevs först redan på slutet av 1940-talet i Afrika och har sedan rapporterats ha spridit sig till Asien, Oceanien, Stilla havsöarna och nu senast med utbrott i Sydamerika. Virusinfektionen har blivit mycket omdiskuterad då allt mer bevis kunnat läggas fram för att den kan leda till Guillain-Barrés syndrom samt även utöva teratogena effekter med mikrocefali som följd. Man har kartlagt spridning framför allt via myggarten Aedes men bevis finns även för att sexuell spridning kan ske samt att sjukdomen förefaller även kunna spridas från mor till foster. Diagnostiken baseras på RT-PCR och serologiska tester. I nuläget finns ingen aktiv behandling. Sammanfattningsvis har Zikavirus spridit sig snabbt genom Syd- och latinamerika sista åren och visat sig utgöra ett hot mot folkhälsan i dessa områden varför ett framtagande av ett fungerande vaccin är önskvärt.

Tuberkulos (tbc) är en luftburen droppsmitta orsakad av mykobakterium tuberkulosis. Tbc är den sjukdom som efter AIDS orsakar flest dödsfall, trots att botande behandling finns. Behandlingen är krävande för den tbc-smittade att genomgå och bygger på en kombination av en rad antibiotika som måste intas under minst sex månader. Ett avvikande i behandlingen kan resultera i att mykobakterium tuberkulosis blir resistent mot de ordinerade antibiotika. Följsamhet av långtidsbehandlingar som tbc-behandling graderas till 50 %. Syftet med litteraturstudien var att ur ett globalt perspektiv beskriva hur sjuksköterskan kan påverka följsamhet vid tbc-behandling i syfte att minska resistensutvecklingen av mykobakterium tuberkulosis. Studien genomfördes som en litteraturstudie där 12 vetenskapliga artiklar granskades och analyserades. Resultatet visar tydligt att specifika faktorer påverkar följsamhet och därigenom resistensutvecklingen. Faktorerna innefattar patientundervisning, behandlingsstrategier, omgivningens påverkan och stöd.  Undervisningen resulterar i att patienten får ökad förståelse för behandlingen. För att minska stigmatiseringen och det lidande den innebär för den tbc-smittade är även omgivningen i behov av ökad kunskap och information om tbc. Ett flertal studier visar att DOTS-strategin är betydelsefull för ökad följsamhet vid antituberkulos behandling. Litteraturstudien medför ett förslag om att sjuksköterskeprogrammet ska öka fokuseringen på följsamhet vid läkemedelsanvändning. Sjuksköterskan är i behov av att redan under grundutbildningen få kunskap om ansvarsfull antibiotikahantering som leder till en följsamhetsomtanke. / Tuberculosis (TB) is an airborne droplet infection caused by mycobacterium tuberculosis. TB is the disease after AIDS that is most deadly, even though curative treatment exists. The treatment is demanding for the TB-infected to undergo and consists of a combination of a number of antibiotics that must be administered for at least six months. A dissenting in anti-tuberculosis treatment might result in mycobacterium tuberculosis strains that are resistant to antibiotics. As adherence to long-term treatment is graded at a low percentage (50 %) the aim of the literature study was from a global perspective to develop a working-strategy for nurses that promote compliance in TB-treatment in order to reduce resistance development of mycobacterium tuberculosis. The study was conducted as a literature study where 12 research articles were reviewed and analyzed. The results describe specific factors that are essential to compliance. These factors comprise patient education, treatment strategies, social influences and support. As knowledge gives the patient a better understanding for the treatment it provokes compliance. The social environment of the TB-infected patient demands increased knowledge in order to reduce stigma. Several studies show that the DOTS strategy is important for increasing compliance in anti-tuberculosis treatment. The literature study results in a proposal for the nursing program to focus more on compliance in taking medication. The nursing program’s attendants need to gain knowledge about prudent antibiotic treatment that leads to a compliance concern.

Ljungan virus (LV) is a recently identified picornavirus of the genus Parechovirus. LV has been isolated from voles trapped in Sweden and also in the United States. LV infected small rodents may suffer from diabetes type 1 and type 2 like symptoms, myocarditis and encephalitis. LV has been proposed as a human pathogen, with indications of causing diabetes type 1, myocarditis and intrauterine fetal deaths. In this thesis, cell culture adapted LV strains were utilised for development and adaptation of several basic methodological protocols to study the LV biology, e.g. real time PCR, highly specific antibodies and a reverse genetics system. These methods allowed detailed studies of this virus and how it interacts with the host cell. The genomic 5'-end was identified and modelling showed unique secondary structure folding of this region. The LV encodes an aphthovirus-like 2A protein with a DvExNPGP motif. This motif was found to mediate primary cleavage of the LV polyprotein in vitro and is proposed to constitute the carboxy terminus of the structural protein VP1 in LV. Rabbit polyclonal antibodies generated against recombinant structural proteins were used to verify that the LV virion is composed of the structural proteins VP0, VP1 and VP3. Cell culture studies showed that LV replicates to low titer with an absent or delayed cell lysis. LV is proposed to be able to spread by a, for picornaviruses, not previously demonstrated direct cell-to-cell transmission. All results taken together suggest a maintenance strategy of LV including low amounts of the LV genome and persistently infected hosts. Stability studies showed that the LV virion not only maintain activity in acidic and alkaline environments but also exhibit resistance to the commonly used disinfectant Virkon®.The results presented in this thesis show that LV has several unique properties, not previously observed for a picornavirus.

Recently Whole Genome Sequencing (WGS) has become the new high-resolution tool used to trace the source of foodborne outbreaks. There are often only a few genetic differences that can distinguish closely related bacterial isolates, and variability in data quality between different laboratories may influence the results. In this project, a data set from ten laboratories where the same bacterial samples were sequenced using different library preparation kits and sequencing methods in an interlaboratory study, has been used. Factors that could be responsible for the different performance in terms of how well the raw WGS data from the different labs assembles were investigated. The raw data from the different labs assembled very differently. One lab showed adapter sequences in their reads and filtering them improved the assembly substantially. All labs utilizing the transposase-based library preparation kit Nextera, had base composition bias in the beginning of the reads. For many labs, as the coverage was increased, the number of contigs first increased and then decreased. This was due to low number of contaminating reads from other species. However, these contaminations were barely visible in the plots generated by Kraken/Krona. Filtering out contigs with very low coverage removed this problem. Two labs performed much worse than the others. Some of their reads showed quality drop towards the ends, whereas their data also had the longest read length. However, quality trimming the read ends did not improve the assembly. These two labs had higher GC content in their reads compared to the other labs, the reason for this needs further investigation.

Background: Health-related infections (VRI) have a negative impact on public health and cause suffering for the patient and costs to society. Problematization: VRI is a patient safety problem and risks affecting both patient and nurse. Aim: The aim of the study was to describe nurses' experiences of preventive work against healthcare-associated infections. Method: A literature review based on 11 articles based on a qualitative method was analyzed through thematization. Results: The results showed that the nurses had varied attitudes to hygiene and prevention of infections. Some experienced the need for training to better prevent infections, while others showed different considerations for maintaining hygiene in the workplace, depending on previous experience and the opportunities offered by the nursing environment. The nurses experienced a challenging work environment with a high workload and a lack of work motivation. They wanted their nursing environment to be upgraded to increase the chances of infection prevention. Conclusion: One conclusion and implication were that nurses need to take more consideration to each patient's individual need in the prevention work against infections. Continued research can examine patients 'experiences of nurses' work towards VRI.

Expanding urbanization, climate change, and population growth contribute to increased transmission and spread of arthropod-borne viruses (arboviruses), many of which cause severe disease in humans. Pathogenic arboviruses include dengue, Zika, tick-borne encephalitis, and sindbis viruses, which together threaten more than half the global population. Thus, there is a constant need for safe, specific, and sensitive molecular tests to identify early-stage infections for accurate diagnosis and molecular epidemiological data for disease prevention and control. The study tested the biosafety of using FTA™ cards when working with pathogenic arboviruses by conducting an infectivity assay using sindbis virus. Conditions for RNA extraction and storage of arboviruses on FTA were analyzed by measuring viral RNA (vRNA) stability using a SYBR-Green, Pan-Flavi RT-qPCR method composed of degenerate primers able to detect a variety of flaviviruses. Data from a Pan-Flavi RT-qPCR study comprising of 222 clinical blood and serum samples collected from a 2018 dengue virus outbreak in Hanoi (Vietnam) was analyzed to establish applicability of FTA for molecular epidemiology and diagnosis. Results showed that sindbis virus infectivity was inhibited by FTA-adsorption. FTA-adsorbed arboviruses were extracted with the highest yield using Trizol extraction and were preserved at storage at 4-20ºC for up to 30 days. The results showed that clinical blood samples acquired higher yields of vRNA for molecular testing than serum samples and that it may be possible to perform sequencing for genomic analysis. The study suggests that FTA cards may facilitate the storage and transportation of adsorbed arboviruses for downstream molecular epidemiological and diagnostic tests.

Under 2018, mitt i en global miljökris, en nationell ökning av sociala klyftor och segregation, accepterade den svenska regeringen en ny nationell arkitekturpolitik, Politik för Gestaltad livsmiljö (Policy for Designed Living Environment). Politiken är förankrad i en marknadsekonomi och förmedlar olika strategier för hållbar utveckling. De sträcker sig från social hållbarhetsteorier om inkludering och tillgänglighet, ner till resurshantering, lokalt hantverk och återvinning av byggmaterial. Politiken är ett resultat av en förändrad förståelse för arkitektur, arkitekturpolitik, arkitekten och hans eller hennes roll, eller som teoretiker Kaminer och Kossak skulle hävda: roller. Detta arbete i Hållbar samhällsplanering och stadsutformning utforskar och presenterar vad som kan vara ett relevant innehåll i arkitekturbestämmelser i Lidköpings kommun. Det är resultatet av en dokumentstudie som innehåller den svenska nationella arkitekturpolitiken, lokala tolkningar av den i 12 kommuner över hela Sverige och Lidköpings kommuns Stadsutvecklingsplan för staden Lidköping. Samt, en enkät och en utökad dialog i form av en designworkshop med sex ungdomar i Lidköping om Lidköpings framtid. Detta projekt syftar till att stödja utvecklingen av lokala tolkningar av den svenska nationella politiken, och fungera som en bas för diskussion kring ämnet arkitekturpolitik i Sverige. / In 2018, in the midst of a global environmental crisis, a national increase in social gaps and segregation, the Swedish government accepted a new national architectural policy, Politik för Gestaltad livsmiljö (Policy for Designed Living Environment). The policy is situated in a market economy and conveys different strategies for sustainable development. They range from social sustainability theories of inclusion and accessibility, down to resource management, local craftsmanship and recycling of building materials. The policy is a result of a changing understanding of architecture, architectural politics, the architect and his or her role, or as theorists Kaminer and Kossak would argue, roles. This Master’s degree project in Sustainable Urban Planning and Design explores and puts forth what could be a relevant content in an architectural policy in Lidköping municipality. It is the result of a document study containing the Swedish national architectural policy, local interpretations of it by 12 municipalities across Sweden and Lidköping municipality’s City plan. As well as a questionnaire and an extended dialogue in the shape of a design workshop with six teenagers in Lidköping about the future of their town. This project aims to aid the development of local interpretations of the Swedish national policy, and, act as a base for discussion on the topic of architecture politics in Sweden.