WHO´s checklista för säker kirurgi är ett världsomfattande verktyg som implementerats i större delen av världen sedan dess introduktion 2008. Studier visar att korrekt användande av checklistan leder till en minskning av både mortalitet, morbiditet samt postoperativa komplikationer. Trots bevisade fördelar finns fortsatt brister i följsamheten gällande checklistan. Ett stort antal patienter drabbas av skador i samband med kirurgi som skulle kunna undvikas. Vårdskador får konsekvenser för patienter, närstående, personal och samhället som helhet. Syftet med studien var att identifiera faktorer som påverkar operationsteamets användning av WHO´s checklista för säker kirurgi i den perioperativa vården. Metoden som användes var en integrativ litteraturöversikt. 13 vetenskapliga artiklar analyserades med ett integrativt förhållningssätt enligt Whittemore och Knafl (2005). Resultatet visar att faktorer som teamkänsla, utbildning och stöd till personalen påverkar om och i vilken utsträckning WHO´s checklista för säker kirurgi används. Efter analysen framträdde två huvudteman; betydelsen av teamsamverkan för patientsäkert arbete och WHO´s checklista; stöd för patientsäkert arbete. Dessa två huvudteman mynnade ut i fyra subteman. Teamkänsla och kommunikation, samverkan mellan professioner, kompetens och utbildningsbehov samt förbättringsarbete och motsättningar. Operationssjuksköterskan vakar över och skyddar patienten från vårdskador. Checklistan är ett verktyg som lyfter detta. Genom att använda forskning som påvisar faktorer som påverkar användandet av checklistan för säker kirurgi kan implementeringen av rutiner och checklistor inom operationssjukvården underlättas / The Safe surgery checklist by WHO is a worldwide tool that has been implemented in most of the world since its introduction in 2008. Studies show that correct use of it leads to reduction in mortality, morbidity and postoperative complications. Despite proven benefits, there are shortcomings in compliance with the checklist. A large proportion of patients suffer injuries in connection with surgery that could have been avoided. Medical injuries have consequences for patients, relatives, staff and society as a whole. The purpose of this study was to identify factors that influence the surgical team's use of the WHO's checklist for safe surgery in perioperative care. The method was integrative literature review. The 13 scientific articles were analyzed with the integrative approach further developed by Whittemore and Knafl (2005). The results show that factors such as teamspirit, training and supporting the staff are the ones that primarily influence whether and to what extent the checklist will be used. In the analysis, two main themes emerged; The significance of team cooperation as a patient safety measure and the WHO surgical safety checklist as a tool for patient safety work and four sub-themes. The four subthemes were teamspirit and communication, cooperation between professions, competence and educational needs and the last subtheme work improvement with contradictions. The operating room nurse is watching over and protecting the patient from harm in the operating room. The checklist is one tool to highlight this. With research that demonstrates factors that affect use of the Safe surgery checklist any implementation of routines and checklists within the surgery care can be facilitated

In 1998 World Health Organisation Europe outlined a vision of a new community-based nurse called the Family Health Nurse (FHN) who would help individuals, families and communities to cope with illness and to improve their health. Scotland was the first European country to develop this idea through policy, education and practice. The two phase national pilot project (2001-2006) primarily involved remote and rural regions. Despite its vanguard position, Scottish family health nursing has been subject to little in-depth critical analysis. This thesis addresses this deficit by analysing why and how family health nursing developed in Scotland. The research methods used are: critical review of textual sources; empirical research into policy, education and practice; and critical review and application of relevant theoretical perspectives to enable interpretation. Grounded primarily in constructivism, this approach builds explanation of the development of family health nursing in Scotland as a phenomenon in contemporary nursing history. This explanation highlights the importance of key factors and processes, particularly: agency at policy formulation level; use of the piloting mechanism to mediate knowledge production, containment and expansion; tensions between generalism and specialism as manifest within the promulgated FHN concept, the educational programme, and the FHN role as it was variously enacted in practice; related difficulty in engaging substantially with families; and the strong influence of local context on the nature and scope of FHN role development, especially in terms of situated power and embedded culture of place. The explanation is summarised as a synoptic story. A new integrative, explanatory model of the development of family health nursing in Scotland is also posited. This knowledge is then examined in relation to contemporary community nursing and primary care in order to understand influence and implications. This highlights the importance of the development of family health nursing in shaping the new Community Health Nurse (CHN) role which emerged from the Review of Nursing in the Community in Scotland 2006. The new explanatory model constructed within the thesis is then applied in its more generic MAPPED format (Model for Analysing Policy to Practice Executive Developments) to analyse the new policy formulation advancing the CHN role and to anticipate key developmental factors and processes. On this basis, the thesis argues that the MAPPED model is potentially valuable for the analysis of developments that require purview from policy through to practice. The thesis concludes by summarising its contributions to understandings of community nursing policy, practice, research and theory, and makes a number of related recommendations.

This essay examines the themes of paranoia and claustrophobia as elements of horror in John Campbell’s novella “Who Goes There?” (1938) and John Carpenter’s film-adaptation of said novella, called The Thing (1982). The novella and the film utilize the lack of trust and reliability in between the characters as elements of fear as well as supernatural elements in the form of a monster. This essay focuses on the different parts of the story running through both versions, mainly the setting, the characters and the monster, to show how the themes of paranoia and claustrophobia are used throughout these as elements of fear and horror. With the help of Sigmund Freud’s concept of the uncanny, as well as other sources, this essay argues that while the monster plays an important role throughout the story, the threats created by the paranoia and claustrophobia are equal to the monster itself.

My Master of Fine Arts thesis film is a 60-minute film that blends documentary and feature film elements entitled Who Is Singing There. It’s a story about Totem, a rock band formed seven years ago. Right before it was to release its second album, lead singer Suming and drummer A-shing were determined to leave the group. Band members held a meeting to work out a solution. Before they knew it, however, they were reminiscing about the time they took part in music competitions in from 2003 to 2005. They realized that the root to why they were coming apart could be traced back to that time and if they wanted the band go any further, they needed not only to rekindle their passion for music but something more. This is an account of the filmmaking process from the initial idea to the finished film. / text

<p>Användandet av obehandlat avloppsvatten inom jordbruket är en växande företeelse i många delar av världen. Speciellt i vattenfattiga områden där avloppsvattnet ses som en värdefull och pålitlig resurs. Det höga näringsinnehållet minskar behovet av konstgödsel och detta ökar böndernas inkomster. Men med användandet av avloppsvattnet följer vissa hälsorisker. Bland annat har man sett en högre förekomst av inälvsmaskar hos bönder som använder orenat avloppsvatten jämfört med de som använder rent vatten. Den här vattenkvalitetstudien har utförts längs floden Musi i Andhra Pradesh, Indien. Musi rinner igenom staden Hyderabad och mycket av stadens avloppsvatten dumpas i floden. Nedströms Hyderabad används detta vatten för bevattning. Längs med floden är dammar byggda, för att avleda vattnet i bevattningskanaler. Reservoirer bildas då flödeshastigheten minskar. Studieområdet sträcker sig från Hyderabad och 28.7 km nedströms. Hypotesen var att reservoirerna fungerar som biodammar och syftet var att kvantifiera dammarnas inverkan på vattenkvaliteten och utvärdera dess lämplighet utifrån ett hälso- och jordbruksperspektiv. Inom studieområdet är reningen med avseende på BOD, Nematoder och E coli 86,9%, 99,9% respektive 99,9%. Trots att reningen är så hög överstiger Nematod- och E coli-koncentrationerna Världshälsoorganisationens riktlinjer och utgör en hälsorisk för bönder och konsumenter. Syre- och salthalt ökar nedströms och den höga salthalten kan ha negativ inverkan på jordbrukets avkastning. Genom att titta på reningsmönster och förändring av olika vattenkvalitetsparametrar är en av slutsatserna av detta arbete att reningen i dammarna motsvarar den rening som sker i de anaeroba bassängerna i ett biodammsystem.</p> / <p>The use of untreated domestic sewage in agriculture is a growing practice in many parts of the world. It is being looked upon as a valuable and reliable resource in water scarce communities. Wastewater is usually rich in nutrients and the use results in high yields without the need for artificial fertilisers. But with the use of untreated wastewater follows a number of associated health risks, e.g. a higher prevalence of helminth infections has been seen among wastewater users compared to non-users. This water quality study was performed along the River Musi in Andhra Pradesh, India. The Musi River flows through the city of Hyderabad carrying the most of the town’s wastewater. Downstream of Hyderabad the wastewater is used by farmers for irrigation. Along the river weirs are constructed which diverts the irrigation water into canals and reservoirs are formed where the flow velocity slows down. The study area stretches from Hyderabad and 28.7 km downstream. The hypothesis was that the existing irrigation infrastructure acts like Wastewater Stabilisation Ponds and the aim was to quantify the impact of the weirs on water quality and to evaluate the irrigation water quality in reference to associated health risks and agricultural suitability. Within the study area the BOD, E coli and Nematode removals were 86.9%, 99.9% and 99.9% respectively. Despite the high removal the E coli and Nematodes, the concentrations exceed WHO guidelines for unrestricted and restricted irrigation, and there exists an excess risk of intestinal nematode- and enteric infections for farmers. Dissolved oxygen and salinity increases downstream and due to the high salinity farmers could experience reduced crop yields. By looking at removal patterns, and the change in water quality parameters, the conclusion can be made that the reservoirs act like anaerobic ponds in a Wastewater Stabilisation Pond system.</p>

Background: Men who have sex with men (MSM) are heterogeneous with respect to sexual behavior. We examined differences in sexual risk behaviors and HIV protective behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO). Among MSMW, we also examined associations between partner gender and disclosure of same-sex attraction to sexual risk behaviors. Methods: Data for this analysis were from MSM who participated in National HIV Behavioral Surveillance (NHBS) in 2011 and 2014. Prevalence differences comparing MSMW and MSMO were calculated for demographics and behaviors. Adjusted prevalence ratios comparing MSMW to MSMO were calculated for the outcomes condomless sex, exchange sex, testing for HIV, and disclosure of same-sex behavior. Results: MSMW were less likely than MSMO to have condomless sex with male partners (aPR 0.77; 95%CI 0.73-0.80), to have been diagnosed with another STD (aPR 0.83; 95%CI 0.73-0.95), and to disclose their same-sex behavior to healthcare providers (aPR 0.72; 95%CI 0.69-0.76). However, MSMW were more likely than MSMO to engage in exchange sex (aPR 2.43; 95%CI 2.17-2.72) and to have ever injected drugs (aPR 2.00; 95%CI 1.76-2.28) Conclusions: MSMW have distinctive sexual risk behaviors and could benefit from tailored interventions to reduce the prevalence of HIV in this population.

Master of Public Health / Department of Diagnostic Medicine and Pathobiology / M. M. Chengappa / Rabies is the most deadly disease on earth and has a 99.9% human fatality rate. Rabies kills 61,000 humans annually and results in an economic burden of $124 billion USD annually. Each day 3.3 million people live with the risk of rabies. It is estimated that 95% of human rabies cases are a result of coming in contact with an infected canine, majority of these cases being children 15 years and younger. It is estimated that 1 person every 8 minutes dies of rabies. Rabies is a highly neurotropic disease which attacks the brain and central nervous system. Once clinical symptoms are presented, death is invariably the outcome as no cure exists for rabies. Rabies is 100% preventable in humans by proper wound management and proper administration of prophylaxis. Rabies can be adequately controlled in animal populations by contraception and animal rabies vaccine efforts. Whilst it is known that rabies can be prevented in humans and controlled in animal populations, further scientific efforts are still warranted to fully understand this deadly virus so that a cure can one day be discovered. As human and animal populations continue to grow, so does the cost and burden of this horrific disease. As a result, the importance of prophylaxis and passive immunity are critical in the event of medically managing an exposure, and preventing exposures. The World Health Organization has defined global recommendations for individuals and animals who have received prophylaxis to be adequately protected. Measuring this protection is performed using a variety of approved testing methodologies, virus-neutralizing assays and antigen-binding assays. Whilst the WHO recommendations were defined from clinical studies performed with virus-neutralizing assays, the assumption that these recommendations are suitable for the antigen-binding assays is inaccurate. The testing methodologies, virus-neutralization and antigen-binding, share similarities, as they are measuring an immune response to the rabies virus. However; enough differing characteristics are presented such that exact comparisons cannot be made. Establishing the same standards and recommendations for both testing methodologies will never be sufficient.

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Syfte och Frågeställningar Syftet med undersökningen var att mäta sambandet mellan fysisk aktivitet och psykiskt välbefinnande inom ett begränsat urval av gymnasieelever. Undersökningen syftade också till att mäta respondenternas psykiska välbefinnande, stillasittande och fysiska aktivitet samt att mäta sambandet mellan respondenternas stillasittande och psykiska välbefinnande. Hur psykiskt välmående, stillasittande och fysiskt aktiva är respondenterna? Finns det ett samband mellan fysisk aktivitet och psykiskt välbefinnande? Finns det ett samband mellan stillasittande och psykiskt välbefinnande? Metod Som metod för studien användes en kvantitativ metod med enkäter. Den byggde på färdiga frågor från Socialstyrelsen (2010) och WHO (2010) och gick ut till 86 respondenter i gymnasieålder. 82 godkända enkäter från respondenterna analyserades genom IBM SPSS Analytica för att mäta sambanden. I korrelationsanalysen användes Spearmans RhoRho för att undersöka samband. Undersökningen ägde rum på ett skolområde i Uppsala, Sverige. Resultat Resultatet visade att 42 procent av respondenterna utför mindre fysisk aktivitet än den rekommenderade dosen om 150 minuter i veckan. Resultatet visade också att 51 procent av respondenterna var stillasittande 10 timmar eller mer, varje dag. I välbefinnande-indexet fick 39 procent av respondenterna ett resultat som rekommenderade kontakt med vården. Samband mellan fysisk aktivitet och psykiskt välbefinnande fick en positiv korrelationskoefficient på 0,443 (p=0,000), vilket tyder på att det finns ett moderat samband. Sambandet mellan stillasittande och psykiskt välbefinnande visade ingen tydlig korrelation. Slutsats Den studerade populationen rör sig mindre än genomsnittet i Sverige och sitter mer än genomsnittet i Sverige. Det finns ett tydligt moderat samband mellan fysisk aktivitet och psykiskt välbefinnande, men det går inte att förkasta andra påverkansfaktorer. Min slutsats är att det krävs en vidare studie för att säkerställa sambandet mellan variablerna, där fler parametrar mäts och analyseras. Sambandet mellan stillasittande och psykiskt välbefinnande visade ingen tydlig korrelation., men det går inte att avfärda att dikotomiseringen av data påverkade resultatet. / <p>Fristående kurs Idrott III</p>

Magister Public Health - MPH / Background and Rationale The World Health Organization (WHO) has shown that the provision of Water Sanitation and Hygiene (WASH) in Health Care Facilities (HCFs) of many low and middle-income countries is poor. This is compounded by the lack of national plans and consolidated data on WASH in HCFs. This study assessed the availability and adequacy of Water Sanitation and Hygiene (WASH) infrastructure in 13 mission hospitals spanning 13 districts in Zambia. The objectives of this study were to identify the different kinds of WASH infrastructure available, and their adequacy, and factors influencing the status of WASH infrastructure and services in the selected hospitals. Methodology This study had a mixed methods design with semi-quantitative, descriptive and qualitative components. Assessments were conducted of the WASH infrastructure on the hospital property, and specifically in the male medical wards and outpatient facilities as two tracer areas, using a WHO checklist adapted and administered by the researcher. Checklist items were assigned scores (0=absent/bad to 2=on target/good) and total WASH scores for each facility compiled. For the qualitative component, individual semi-structured interviews using an interview guide were conducted, also by the researcher, with the facility managers and the head staff of the male medical wards. Results Overall coverage with an improved water source was reasonably good with 11 of the 13 hospitals reporting availability of improved water sources within the facilities. Hand washing basin coverage was similarly good. In contrast, coverage by well-functioning toilets was not as high, with 5 hospitals reporting toilets that were either broken, blocked, or having no running water and no toilet paper. Facility WASH scores varied from 22 (38%) to 57 (97%) out of a possible total of 58 points. Most of the Facility Managers indicated that the hospital WASH infrastructure was old, and with frequent breakdowns. This was worsened by lack of readily available spares and materials for repairing once there was a fault. Conclusion This study reveals an uneven coverage of WASH across facilities and elements, with poor sanitation a challenge across facilities. This is compounded by ongoing challenges in WASH infrastructure maintenance. Moving forward, there is need for government to develop a clear policy on WASH in HCFs. A national plan with resources and a monitoring framework need to be in place for streamlined support and tracking of progress by all stakeholders.