No description available.

Background: The health determinant model indicates that certain sociocultural, sociodemographic, environmental, and lifestyle factors influence health status and wellbeing of any population group in any given nation (Dahlgren & Whitehead, 1991). Previous studies have suggested the need for regional and interregional comparison of health inequalities due to the interaction of these factors. However, few studies have undertaken such investigation, especially among university students in developing countries. The aim of this study was to investigate the health status and lifestyle behaviours by sex and ethnicity among university students in Nigeria. Method: The study was cross sectional. Full time university students were recruited from six universities within three ethnic groups in Nigeria for the study. Data collection was both subjective and objective. The subjective data was based on an anonymous questionnaire, while the objective data involved direct measurements of height in (m) weight in (kg), and blood pressure (mmHg). Ultimately, 1549 responses were valid, while 563 responses were rejected for various reasons including missing data especially sex and ethnicity. The variables examined were, socio-demographic, general health, mental health, cognitive resources and lifestyle behaviours. Descriptive tests, chi-square tests and analysis of variance (ANOVA) tests were conducted. Results: Regarding regional characteristics in socioeconomic status, the result indicated sex and ethnicity effects, and irrespective of ethnicity, female students had better monthly income than male students did. The result suggested that students from the Hausa ethnic group reported better monthly income than students from the other ethnic groups. There is evidence that income have a significant effect on health determinant factors. For example, income affects the choice of residential location, ability to pay for health care services, register for gym for physical activity, afford healthy lifestyles, (e.g. eating fruits and vegetables), participate in social activities and maintain positive self- esteem (WHO, 2006; Varela-Mato et al., 2012). With regard to social support, the result indicated sex*ethnicity effects, where female students from the Hausa and Igbo ethnic groups reported better social support than male students, in contrast to the Yoruba ethnic group, where male students reported better social support than females. Students from the Hausa ethnic group saw their GPs more often, had regular medications and had depression more than other ethnic groups. In addition, the result indicated higher prevalence of smoking and the use of psychotic drugs among students from the Hausa ethnic group than other groups. On the other hand, the Yoruba ethnic group had the lowest monthly income, saw their GPs few times and had less frequent medication than the other ethnic groups. In addition, students from the Yoruba ethnic group had low consumption of fruits and are more physically inactive compared to other ethnic groups. Regarding sex characteristics, the study suggested that irrespective of ethnicity female students are less healthy when compared to male students. In addition, significant sex *ethnic interaction effects (P < 0.001) were observed, in most variables examined in the study, indicating that the students health and lifestyles are both sex and ethnicity dependent. The study suggested that female students from the Hausa ethnic group reported better income and social support, compared to students from the other ethnic groups; however, they also reported regular medication, overweight or obesity, mental health problems, and poor cognitive health than female students from Igbo and Yoruba ethnic groups. In addition, the Hausa male students’ preferred smaller female body size compared to male students from the other ethnic groups. On the other hand, Igbo female students had a better cognitive health and preferred small female body size than female students from the other ethnic groups. The Yoruba female students are less overweight or obese, but had the highest preference for big female body size and are the least depressed group in the sample. With regard to male students, the result suggested that Igbo male students had regular medication and depression more than other male groups. They also preferred bigger female body size and had better cognitive health than other male groups. On the other hand, Yoruba males reported overweight or obese, than the other male groups. Conclusion: The findings indicated that the health of female students in the sample was poorer than the health of male students; with female students from the Hausa ethnic group, demonstrating the worst possible health outcome. The result also suggested that both high and low socioeconomic statuses are associated with health compromising behaviours among university students in Nigeria. The findings indicated that high cognitive health appraisal might be related to students reporting better mental health especially depression in both male and female students. This study is the first to report that there is an interaction between the different layers of health, in the health determinant model proposed by Dahlgren and Whitehead (1991). Secondly, this study has made a major contribution to the understanding that people who live among regions with conflict and violence may report poor health (both physical and mental) compared to those that live in a conflict free zones. Consequently, the results of the present study suggest that conflict and violence be included among the health determinant factors in the health determinant model proposed by Dahlgren and Whitehead (1991).

A qualidade dos serviços desenvolvidos por uma instituição de saúde depende muito da competência técnica e da habilidade de interação e comunicação de seus trabalhadores para com o usuário. As intervenções técnicas realizadas pela equipe de enfermagem requerem avaliações permanentes face aos riscos que comportam. Este estudo, observacional e seccional, analisou a qualidade e o tempo de execução dos procedimentos, banho e curativo, realizados pela equipe de enfermagem em pacientes internados na unidade médico-cirúrgica de um Hospital Universitário no estado do Paraná, tomando por referência o grau de dependência assistencial desta clientela. A população alvo foi constituída dos seguintes procedimentos: banho, em três tipologias (aspersão, aspersão com auxílio de cadeira de banho e banho no leito) e curativos executados em pacientes classificados segundo grau de dependência da assistência de enfermagem (I, II, III e IV). A amostragem para ambos os procedimentos foi por conveniência. Os dados foram coletados por meio de observação direta com a utilização de um instrumento tipo check list (lista de verificação). A qualidade dos procedimentos foi analisada com base no Índice de Positividade (IP) para cada item do instrumento e no escore de acertos, obtidos em cada procedimento; o tempo de execução foi avaliado em minutos. A qualidade da execução do procedimento foi considerada satisfatória quando a mediana do IP e do escore mediano de acertos fosse ? 70%. Foram observados 258 banhos de aspersão (42,6% grau I, 42,6% grau II e 14,8% grau III); 98 de aspersão com auxílio de cadeira de banho (12,5% grau I, 26,5% grau II, 54,1% grau III e 7,1% grau IV) e 46 banhos no leito (4,3% grau I, 37% grau III e 58,7% grau IV). O IP superou 70% apenas no banho de aspersão com auxílio de cadeira de banho em pacientes classificados no grau IV e no banho no leito no grau I. Os itens mais comprometidos estão relacionados à orientação/comunicação/interação com o paciente, higiene oral, desinfecção concorrente do leito, inspeção das condições da pele e valorização das queixas do paciente. Os resultados obtidos nos scores medianos de acertos nas três tipologias de banho, nos quatro graus de dependência também evidenciaram baixa qualidade, uma vez que somente no banho de aspersão com auxílio de cadeira de banho, grau IV e banho no leito grau I, 50% dos procedimentos alcançaram scores de até 80% e 76,5% de acertos, respectivamente. No procedimento curativo dos 168 observados, 33,9% foram em pacientes de grau I, 38,7% de grau II, 19,6% de grau III e 7,8% de grau IV. Em todos os graus de dependência, alcançou-se o índice de positividade total recomendado (? 70%). Entretanto, itens como preparo adequado do ambiente, conferência do prazo de validade dos materiais, respeito aos princípios de assepsia e manutenção da seqüência lógica do procedimento mostram baixa positividade. Os scores medianos de acertos foram superiores a 70% em todos os graus de dependência, indicando que o procedimento atende um padrão de qualidade. Tanto nos banhos como nos curativos não foram observadas diferenças no tempo despendido entre os diferentes graus de dependência. / The quality of services offered by a health institution depends greatly on worker?s technical competence and interaction and communication abilities towards the client. Technical interventions performed by the nursing team require permanent evaluations of the risks involved. This observational and sectional study analyzed quality and time of execution of bathing and wound dressing procedures performed by the nursing team on hospitalized patients in a medical-surgical unit of a University Hospital in the State of Paraná, based on care dependency degrees of these clients. Target population was constituted by the following procedures: bathing, in three typologies (shower bath, shower bath with aid of a wheel chair and bed bath) and changing wound dressings on patients classified according to the nursing care dependency degree (I,II,III and IV). Convenience sampling was employed for both procedures. Data was collected through direct observation while using a check list instrument for documentation (verifying list). Procedure quality was analyzed based on the Positive Index (IP) for each item on the instrument and on the correct procedures score; execution time was evaluated in minutes. Quality of procedure execution was considered satisfactory when the IP median and the median correct procedure score was ? 70%. In this study 258 aspersion baths (42,6% degree I, 42,6& degree II and 14,8% degree III); 98 shower baths aided by wheel chair (12,5% degree I, 26,5% degree II, 54,1% degree III and 7,1% degree IV) and 46 bed baths (4,3% degree I, 37% degree III and 58,7% degree IV). The IP surpassed 70% only in the shower bath with aid of a wheel chair on patients classified as degree IV and on bed bath, degree I. The most frequently compromised items were related to orientation/communication/interaction with the patient, oral hygiene, bed disinfection, skin condition inspection and valuing patient complaints. Results obtained on the median of the correct procedures scores on the three bathing typologies, on the four dependency degrees also highlight low quality, because only in the shower bath with aid of a wheel chair, degree IV, and bed bath, degree I, 50% of the procedures reached 80% and 76,5% correct procedure scores, respectively. In the observed wound dressing procedures of the 168 patients, 33,9% were patients of degree I, 38,7% of degree II, 19,6% of degree III and 7,8% of degree IV. In all dependency degrees the recommended positivity index was reached (? 70%). Items such as adequate environment preparation, validity time frame checking, respect to aseptic principles and maintenance of procedure?s logical sequence, however, show low positivity. Medium scores were also superior to 70% in all dependency levels, indicating that the procedure meets a quality standard. It was not observed difference on time frame spent in the different dependency degrees in bathing and wound dressing procedures.

No description available.

With congressional passage of the BEACH Act in October of 2000, Coastal and Great Lakes states were mandated to assess coastal recreation waters for the application of ambient water quality standards. This research encompasses two components involved in applying the BEACH Act statues to Oregon. The first component was to select beach sites in Oregon. The second component involves applying bacterial recreational water standards to select Oregon beaches. Using the guidelines provided by the United States Environmental Protection Agency (EPA), this study develops a method to appraise Oregon marine recreational waters taking into account the following factors: use, available information, pollution threats, sanitary surveys, monitoring data, exposure considerations, economics, and development. In an effort to protect the public from swimming-associated illness attributable to microbial pollution, 24 beaches were identified in Oregon. Of these, 19 beaches were classified as tier 1, or high priority, and five sites were classified as medium priority, or tier 2. Future studies should be directed at ascertaining the beach lengths utilized by Oregon marine recreators since this is an important parameter in targeting bacterial monitoring. Ongoing monitoring of these 24 sites is warranted and new information could be used to update beach tier levels in Oregon. In the second phase of this study, bacterial monitoring data was used for comparison to recreational water quality standards. In October of 2002, the Oregon Department of Environmental Quality (ODEQ) sampled 26 beaches for enterococci and Escherichia coli (E. coli) densities. Of the water sampled from all 26 beach sites, nine exceeded s single sample maximum density of 104 enterococci colony forming units (cfu) per 100 milliLiters (mL). The Oregon beach with the highest exceedance occurred at Otter Rock's South Cove where the enterococci concentration was 4352 most probable number (MPN)/100 mL. A comparison of the 26 sampled beaches to ODEQ's estuarine E. coli standard of 406 organisms/100 mL resulted in two beaches with exceedances. Otter Rock at South Cove had the highest E. coli concentration at 1850 MPN/100 mL. Based on the limited data used in this study, should Oregon adopt the enterococci standard in lieu of the current ODEQ estuarine E. coli standard, more beaches will have exceedances of the recreational water standard. Additional bacterial monitoring is warranted to further characterize the nature and extent of the problem in Oregon. To protect the health of the marine recreating public, future Oregon marine water quality studies should delineate the "no swim" zone around creeks and model the impacts of rainfall on beach sites. / Graduation date: 2004

Neracionaliai naudojant paplūdimių ir jų maudyklų pajūrio bei vidaus vandenis, iškyla grėsmė žmonių sveikatai ir vandens išteklių naudingumui. Siekiant išvengti vandens telkinių devastacijos ir besimaudančiųjų susirgimų rizikos, būtina gerinti vandens telkinių stebėseną, kuri atitiktų ES direktyvų keliamus reikalavimus, darnaus vystimosi aspektus. Šiuo principu Aplinkosauginis švietimo fondas Europoje ir už jos ribų yra pristatęs Mėlynosios vėliavos programą. Darbo tikslas − įvertinti įteisintų Kauno miesto paplūdimių ir jų maudyklų atitikimą Mėlynosios vėliavos programos reikalavimams. Darbo tikslui pasiekti išanalizuota paplūdimių ir jų maudyklų teisinė bazė Europos Sąjungoje ir Lietuvoje, nustatyta įteisintų Kauno miesto paplūdimių ir jų maudyklų mikrobiologinė tarša, atliktas įteisintų paplūdimių galimybių vertinimas pagal privalomus Mėlynosios vėliavos programos paplūdimių kriterijus (aplinkosauginio švietimo ir informavimo, vandens kokybės, aplinkosauginio valdymo, saugumo ir paslaugų). Nustatant įteisintų Kauno miesto paplūdimių ir jų maudyklų mikrobiologinę taršą, naudojami Kauno visuomenės sveikatos centro 2000-2006 m. ir Lietuvos Higienos instituto 2007-2008 m. mikrobiologiniai maudyklų vandens kokybės tyrimų duomenys. Apibendrinus tyrimų rezultatus nustatyta, kad Europos Parlamento ir Tarybos Direktyvos 2006/7/EB dėl maudyklų vandens kokybės valdymo nuostatos perkeltos į LR higienos normą HN 92:2007 „Paplūdimiai ir jų maudyklų vandens kokybė“ bei Maudyklų vandens... [toliau žr. visą tekstą] / Unreasonable using of inland water recourses for recreation may cause a risk for human health and ecosystems’ stability. In order to avoid the devastation of ponds and the risk of infectious diseases, it is necessary to improve the water ponds monitoring, that should fulfil the requirements of European Union (EU) directives of sustainable development. For this reason the Foundation for Environmental Education has created the Blue Flag program, that is applied both for European and other countries. The aim of this work is to evaluate the possibilities of valid Kaunas town beaches to get the certificate of the Blue Flag program. For this reason, it was analyzed the bathing-places juridical basis in EU and Lithuania and determined the microbiological pollution of valid Kaunas town beaches. Evaluation of beaches was done according to the Blue Flag program compulsory criteria for water ponds: environmental education and information, water quality, environmental management, security and services. The water monitoring data of Kaunas public health centre and Lithuanian Institute of Hygiene were used for the assessment of water microbiological pollution. It was found out that the statements of the European Parliament and of the Council directive 2006/7/EB for bathing water quality were transferred to the LR Hygiene Norm HN 92:2007 “Beaches and Bathing water quality“ and to the bathing water quality monitoring project for the years of 2009-2011. The highest microbiological pollution... [to full text]

This thesis is concerned with young women's health and well-being, with a specific focus on young women's beliefs, behaviours and attitudes towards smoking, substance use, sexual health, diet and exercise and well-being. These issues are identified as priorities in 'The Health of the Nation: a Strategy for Health in England', (Department of Health, 1992). This document which was published by a previous (Conservative) government in July 1992,set objectives and targets relating to health status to be met by the year 2000. (There are similar separate documents for both Wales and Scotland.) It identified five key areas for action: coronary heart disease and stroke; cancers; mental illness; HIV/AIDS and sexual health and accidents. Some of its targets apply specifically to young women. Informed by a feminist theory and using ethnographic and qualitative research techniques, this study examines young women's health-related beliefs and behaviours within the context of their day-to-day lives.

A qualidade dos serviços desenvolvidos por uma instituição de saúde depende muito da competência técnica e da habilidade de interação e comunicação de seus trabalhadores para com o usuário. As intervenções técnicas realizadas pela equipe de enfermagem requerem avaliações permanentes face aos riscos que comportam. Este estudo, observacional e seccional, analisou a qualidade e o tempo de execução dos procedimentos, banho e curativo, realizados pela equipe de enfermagem em pacientes internados na unidade médico-cirúrgica de um Hospital Universitário no estado do Paraná, tomando por referência o grau de dependência assistencial desta clientela. A população alvo foi constituída dos seguintes procedimentos: banho, em três tipologias (aspersão, aspersão com auxílio de cadeira de banho e banho no leito) e curativos executados em pacientes classificados segundo grau de dependência da assistência de enfermagem (I, II, III e IV). A amostragem para ambos os procedimentos foi por conveniência. Os dados foram coletados por meio de observação direta com a utilização de um instrumento tipo check list (lista de verificação). A qualidade dos procedimentos foi analisada com base no Índice de Positividade (IP) para cada item do instrumento e no escore de acertos, obtidos em cada procedimento; o tempo de execução foi avaliado em minutos. A qualidade da execução do procedimento foi considerada satisfatória quando a mediana do IP e do escore mediano de acertos fosse ? 70%. Foram observados 258 banhos de aspersão (42,6% grau I, 42,6% grau II e 14,8% grau III); 98 de aspersão com auxílio de cadeira de banho (12,5% grau I, 26,5% grau II, 54,1% grau III e 7,1% grau IV) e 46 banhos no leito (4,3% grau I, 37% grau III e 58,7% grau IV). O IP superou 70% apenas no banho de aspersão com auxílio de cadeira de banho em pacientes classificados no grau IV e no banho no leito no grau I. Os itens mais comprometidos estão relacionados à orientação/comunicação/interação com o paciente, higiene oral, desinfecção concorrente do leito, inspeção das condições da pele e valorização das queixas do paciente. Os resultados obtidos nos scores medianos de acertos nas três tipologias de banho, nos quatro graus de dependência também evidenciaram baixa qualidade, uma vez que somente no banho de aspersão com auxílio de cadeira de banho, grau IV e banho no leito grau I, 50% dos procedimentos alcançaram scores de até 80% e 76,5% de acertos, respectivamente. No procedimento curativo dos 168 observados, 33,9% foram em pacientes de grau I, 38,7% de grau II, 19,6% de grau III e 7,8% de grau IV. Em todos os graus de dependência, alcançou-se o índice de positividade total recomendado (? 70%). Entretanto, itens como preparo adequado do ambiente, conferência do prazo de validade dos materiais, respeito aos princípios de assepsia e manutenção da seqüência lógica do procedimento mostram baixa positividade. Os scores medianos de acertos foram superiores a 70% em todos os graus de dependência, indicando que o procedimento atende um padrão de qualidade. Tanto nos banhos como nos curativos não foram observadas diferenças no tempo despendido entre os diferentes graus de dependência. / The quality of services offered by a health institution depends greatly on worker?s technical competence and interaction and communication abilities towards the client. Technical interventions performed by the nursing team require permanent evaluations of the risks involved. This observational and sectional study analyzed quality and time of execution of bathing and wound dressing procedures performed by the nursing team on hospitalized patients in a medical-surgical unit of a University Hospital in the State of Paraná, based on care dependency degrees of these clients. Target population was constituted by the following procedures: bathing, in three typologies (shower bath, shower bath with aid of a wheel chair and bed bath) and changing wound dressings on patients classified according to the nursing care dependency degree (I,II,III and IV). Convenience sampling was employed for both procedures. Data was collected through direct observation while using a check list instrument for documentation (verifying list). Procedure quality was analyzed based on the Positive Index (IP) for each item on the instrument and on the correct procedures score; execution time was evaluated in minutes. Quality of procedure execution was considered satisfactory when the IP median and the median correct procedure score was ? 70%. In this study 258 aspersion baths (42,6% degree I, 42,6& degree II and 14,8% degree III); 98 shower baths aided by wheel chair (12,5% degree I, 26,5% degree II, 54,1% degree III and 7,1% degree IV) and 46 bed baths (4,3% degree I, 37% degree III and 58,7% degree IV). The IP surpassed 70% only in the shower bath with aid of a wheel chair on patients classified as degree IV and on bed bath, degree I. The most frequently compromised items were related to orientation/communication/interaction with the patient, oral hygiene, bed disinfection, skin condition inspection and valuing patient complaints. Results obtained on the median of the correct procedures scores on the three bathing typologies, on the four dependency degrees also highlight low quality, because only in the shower bath with aid of a wheel chair, degree IV, and bed bath, degree I, 50% of the procedures reached 80% and 76,5% correct procedure scores, respectively. In the observed wound dressing procedures of the 168 patients, 33,9% were patients of degree I, 38,7% of degree II, 19,6% of degree III and 7,8% of degree IV. In all dependency degrees the recommended positivity index was reached (? 70%). Items such as adequate environment preparation, validity time frame checking, respect to aseptic principles and maintenance of procedure?s logical sequence, however, show low positivity. Medium scores were also superior to 70% in all dependency levels, indicating that the procedure meets a quality standard. It was not observed difference on time frame spent in the different dependency degrees in bathing and wound dressing procedures.

Les eaux traitées rejetées par les stations de traitement des eaux usées (STEU) et les effluents d’élevages sont à l’origine de contaminations des milieux aquatiques et des sols agricoles par des micro-organismes fécaux d’origines humaine et animale. Les eaux contaminées, et en particulier les eaux de baignade, peuvent présenter un risque sanitaire pour les humains si les concentrations en micro-organismes fécaux sont élevées, indiquant la présence potentielle de souches pathogènes et/ou résistantes aux antibiotiques. Les sols et les productions végétales peuvent également être contaminés par ces micro-organismes fécaux lors de l’épandage d’eaux traitées de STEU recyclées pour l’irrigation des cultures. Il est donc obligatoire de contrôler la qualité microbiologique des eaux de baignade et des eaux traitées de STEU pour limiter les risques sanitaires.D’un point de vue réglementaire, les contrôles de la qualité microbiologique des eaux traitées et des eaux de baignade sont basés sur la quantification de deux indicateurs bactériens de contamination fécale que sont les Escherichia coli (E. coli) et les entérocoques intestinaux (EI). Cependant, les méthodes disponibles actuellement présentent un voire plusieurs des inconvénients suivants : temps de réponse élevé, coût important, complexité de mise en œuvre, utilisation ex-situ, analyse d’un seul indicateur.Pour pallier ces inconvénients, le premier objectif de la thèse a été la mise au point d’une méthode de détection ampérométrique des E. coli et des EI, via la mesure d’activités enzymatiques spécifiques à l’aide de capteurs sérigraphiés à usage unique. Le travail réalisé a mis en évidence que la méthode ampérométrique permet d’obtenir des dénombrements en E. coli et en EI comparables à ceux obtenus avec les méthodes normalisées ISO 9308-3 et 7899-1 lors de l’analyse d’échantillons d’eaux traitées de STEU tout en offrant un temps d’analyse beaucoup plus court (en 4 à 6 h contre 36 à 72 h). De plus, l’application de la méthode à l’analyse d’échantillons d’eaux de baignade a permis de montrer que, contrairement aux 36 h minimum nécessaires avec les méthodes normalisées, la détection ampérométrique permet de déterminer en seulement 7 h si les échantillons respectent les normes de qualité sanitaires pour les eaux de baignade.Dans un second temps, une méthode de quantification ampérométrique des souches d’E. coli producteurs de β-lactamase à spectre étendu (BLSE) a été mise au point et appliquée à l’analyse d’échantillons d’eaux de STEU. Les résultats ont montré que les dénombrements ampérométriques obtenus en seulement 4 - 5 h étaient très proches de ceux fournis par une méthode de dénombrement sur milieux de culture sélectifs après un délai de 24 h. De plus, ce travail a permis de confirmer le rejet de souches productrices de BLSE par la majorité des STEU et ce, qu’elles reçoivent ou non des effluents hospitaliers.En conclusion, la méthode de détection ampérométrique des E. coli et des EI proposée autorise une détermination plus rapide de la qualité sanitaire des eaux traitées de STEU et des eaux de baignade que les méthodes normalisées qui servent actuellement de références. De plus, la détection et le dénombrement de souches d’E. coli producteurs de BLSE dans les eaux de STEU permet d’évaluer leur impact dans la dissémination environnementale de souches résistantes aux antibiotiques. L’avenir des outils électrochimiques étant prometteur, la poursuite de ce travail consistera à développer un dispositif d’analyse portable pour des applications sur le terrain. / Treated wastewaters discharged from wastewater treatment plants (WWTP) and livestock effluents are the main sources of contamination of aquatic environments and of agricultural soils by human and animal fecal micro-organisms. Contaminated waters, especially bathing waters, may present a sanitary risk for humans if the concentrations of fecal micro-organisms are high, thus indicating the potential presence of pathogenic and/or antibiotic resistant strains. Soils and crops also can be contaminated by these micro-organisms when treated wastewaters are used to irrigate cultivated soils. Consequently, microbiological quality controls are mandatory for bathing waters and treated wastewaters to manage and limit sanitary risks.According to the regulation, the microbiological controls of treated wastewaters and bathing waters rely on the quantification of two fecal indicator bacteria: Escherichia coli (E. coli) and intestinal enterococci (IE). However, the methods currently available have one or more of the following disadvantages, i. e. long response time, high cost, complexity of implementation, ex-situ use, analysis of a single indicator.To overcome these disadvantages, the first objective of the thesis was the development of an amperometric method for the detection of E. coli and IE, via the measurement of specific enzymatic activities using single-use screen-printed sensors. It was demonstrated that the amperometric method allowed to enumerate E. coli and IE in treated wastewaters samples and that the results were comparable to those obtained with the ISO 9308-3 and 7899-1 standardized methods, while offering a much shorter analysis time (in 4 to 6 h against 36 to 72 h). Moreover, the application of the amperometric method to the analysis of bathing water samples showed that contrary to the minimum 36 hours required with standardized methods, the amperometric detection provided answers regarding the sanitary quality standards for bathing waters within only 7 hours.Then in a second time, we developed an amperometric method to quantify extended-spectrum β-lactamase (ESBL)-producing E. coli in wastewaters samples. The results showed that amperometric counting obtained in only 4 - 5 h were very close to those provided by the enumeration on selective culture medium obtained after a delay of 24 h. In addition, this work confirmed the release of ESBL-producing strains by most of WWTP, whether or not they received hospital effluents.In conclusion, the proposed amperometric method to detect E. coli and IE provided more rapidly results regarding the sanitary quality of treated wastewaters of WWTP and bathing waters than the standardized methods currently used as references. Moreover, the amperometric detection and enumeration of ESBL-producing E. coli in the wastewaters of WWTP allowed to monitor their role in the environmental dissemination of antibiotic-resistant strains. Owing to the advantages of the developed electrochemical tools, further work will consist in developing a portable analysis device for field applications.

Bakgrund: Folkhälsa innebär en god hälsa som ska vara jämnt fördelad bland de olika samhällsgrupperna. Folksjukdomar förekommer i en utsträckning som har stor inverkan på folkhälsan. De påverkar samhällets funktioner och ekonomi på grund av många individers nedsatta arbetsförmåga och stora insatser från hälso- och sjukvården. Primärvården och distriktssköterskan spelar här en viktig roll genom förebyggande och hälsofrämjande insatser, och i detta har egenvård en central funktion. Behov finns att hitta hållbara, lättillgängliga och kostnadseffektiva sätt för att öka välmående och aktivering. Syfte: Syftet är att undersöka vilka hälsorelaterade effekter skogsbad kan bidra till, och utifrån resultatet reflektera kring distriktssköterskans möjlighet att ge egenvårdsråd. Metod: En systematisk litteraturstudie genomfördes, enligt Bettany-Saltikov och McSherry. Resultat: Positiva resultat som direkt kan kopplas till folkhälsa och folksjukdomar lyftes fram, bland annat en ökad återhämtning, avslappning och kraftkänsla samt minskade tendenser till trötthet, ångest och depressivitet. Fysiologiska faktorer som lägre blodtryck och puls, förbättrad lungfunktion och stelhet i artärer samt en ökad aktivitet i parasympatiska nervsystemet respektive lägre aktivitet i sympatiska nervsystemet sågs. Slutsats: De positiva effekterna på såväl den fysiska som psykiska hälsan indikerar att skogsbad kan vara en effektiv intervention att införa i distriktssköterskans arbete i primärvården, som enskild åtgärd eller tillsammans med andra hälsofrämjande åtgärder. / Background: Public health means good health that should be evenly distributed among society's various groups. Public diseases occur to an extent that has a major impact on public health. They affect the functions and finances of society due to affected individuals' reduced ability to work and the major efforts required from health care. Primary care and district nurses have an important role in efforts concerning prevention measures and promotion of healthy behavior, and in this context, self-care is a fundamental aspect. There is a need to find sustainable, accessible and cost-effective ways to increase well-being and physical activity.  Aim: The aim is to investigate which health-related effects forest bathing can entail, and based on the result reflect on the district nurse's ability to provide self-care advice. Method: A systematic literature study was conducted, in accordance with Bettany-Saltikov and McSherry. Result: Positive results that are directly linked to public health and diseases were highlighted such as an increased feeling of recovery, relaxation and vigor, as well as reduced tendencies towards fatigue, anxiety and depression. Physiological factors included lowered blood pressure and heart rate, improved lung function, stiffness of the arteries as well as an increased activity of the parasympathetic nervous system and decreased activity in the sympathetic nervous system. Conclusion: The positive effects on both physical and mental health implies that forest bathing could be an effective intervention to be introduced into the district nurse's work in primary care, either as an isolated measure or as an addition to other health promotion measures.