Diagnostics serve as the frontline defense for the containment and mitigation of infectious diseases. The emerging synthetic biology field established numerous useful applications of engineered biological systems and networks that led to the development of living biosensors. Significant effort has been made to develop G-coupled protein receptor (GPCR)-based yeast biosensors for applications in drug discovery, environmental monitoring, and clinical diagnostics of small molecules and fungal pathogens. Of the living biosensor chassis, yeast-based biosensors offer exceptional advantages over other in vitro diagnostics, such as long-term storage in a reagent-free and dried dormant state, an engineered colorimetric readout for yes/no result interpretation, and high scalability through industrial fermentation. These advantages could be the next innovation as a low-cost, low-tech, and reliable diagnostic alternative in point-of-care and at-home contexts. Chapter 1 provides background information related to synthetic biology, living biosensors, direction evolution, and point-of-care diagnostics. Chapter 2 covers the development of engineered living yeast as a diagnostic tool for viral infections by tailoring the biosensing recognition element to sense any amino acid-based biomarker of choice via directed evolution. Chapter 3 describes the development of living yeast biosensor for the detection of the pathogenic fungus, Aspergillus fumigatus, in clinical supernatants and patient samples. Chapter 4 describes the progression of a living yeast biosensor for the multi-drug resistant pathogenic fungus, Candida auris, and its detection in clinical culture supernatants and samples.

Bakgrund   Smittsamma sjukdomar har präglat mänskligheten genom tiderna och kommer enligt forskning att öka i framtiden, dels på grund av klimatförändringar och en ökad antibiotikaresistens. Isoleringsvård på sjukhus är en vanlig vårdform vid smittsamma sjukdomar för att förhindra ytterligare smittspridning. Det finns olika typer av isolering där restriktionerna för patienten skiljer sig åt. Covid-19 och MRSA är exempel på sjukdomar som kräver isolering eller isoleringsåtgärder i dagsläget. Omvårdnad av patienter i isolering kan vara utmanande då lager av skyddsutrustning och munskydd kan försvåra vården av patienterna. Det är därför av vikt att belysa patienternas upplevelser av att vårdas i isolering för att ge sjuksköterskan en ökad förståelse. Syfte  Syftet var att belysa patienters upplevelser av att vårdas i isolering på sjukhus vid smittsamma sjukdomar.  Metod  En icke-systematisk litteraturöversikt genomfördes av femton vetenskapliga artiklar med både kvalitativ och kvantitativ metodansats. Artikelsökningarna skedde i databaserna PubMed och CINAHL med sökord tydligt kopplade till syftet. En kvalitetsgranskning skedde av de utvalda artiklarna enligt Sophiahemmet Högskolas granskningsmall. Artiklarnas resultat tolkades med integrerad analys samt med stöd av Katie Erikssons omvårdnadsteori.  Resultat Resultatet mynnade ut i tre huvudkategorier samt sju subkategorier. Huvudkategorierna var: Känslor och attityder, Upplevelse av vårdpersonalen och Upplevelse av stigma. Negativa och positiva upplevelser framkom, där majoriteten var negativa. Upplevelsen av att vara isolerad frammanade mycket känslor, där känslan av att vara instängd var ett tydligt tema bland studiedeltagarna. Slutsats Denna icke systematiska litteraturöversikt påvisade att det var utmanande på olika sätt för patienterna att vårdas i isolering. Känslomässiga reaktioner såväl som att ensamheten upplevdes som besvärlig och att hälso- och sjukvårdspersonalen inte förmedlade information på ett adekvat sätt framkom. En del patienter använde sig av copingstrategier och några upplevde sig privilegierade över att få vårdas i isolering. / Background Communicable diseases have plagued humanity through the ages and will, according to research, increase in the future partly due to climate change and increased antibiotic resistance. Isolation care in hospitals is a common form of care for communicable diseases in order to prevent further spread of infection. There are different types of isolation, where the restrictions for the patients differ. Covid-19 and MRSA are examples of diseases that currently require isolation or isolation measures. Nursing patients in isolation can be challenging as layers of protective equipment and facemasks can make patient care difficult. Aim The aim of this study was to shed light on patients experiences of isolation care in a hospital setting while infected with a communicable disease.  Method Non-systematic review of fifteen scientific articles with both quantitative and qualitative methodological approach. The article search was carried out in PubMed and CINAHL databases with keywords clearly linked to the aim. The articles went through a substantial quality control according to Sophiahemmet University’s assessment basis. The results from the articles were analysed through an integrated analysis method and with Katie Eriksson’s nursing theory.  Results Three main categories were identified as well as seven subcategories. The main categories were: Emotions and attitudes, Experience of healthcare workers and Experience of stigma. Both negative and positive experiences emerged, where the majority were negative. The experience of being isolated brought forth numerous emotions, in which feeling trapped was a clear theme among the study participants. Conclusions This non-systematic literature review showed it was challenging in different ways for the patients' receiving care in isolation. Emotional reactions and loneliness were negative experiences as well as lack of adequate information from the healthcare workers was viewed as bothersome. Some patients used coping strategies and others felt privileged to be in isolation.

This study demonstrates the first case report in which an NK Cell deficiency initially presented as an asymptomatic disseminated herpes simplex viremia (HSV). A pre-term 13- day- old patient presented with disseminated HSV after investigation because his twin brother was found to have HSV vesicular lesions. The patient remained asymptomatic throughout the entire hospital course. While 40% of neonates never exhibit vesicular lesions, most of the infants will be symptomatic with DIC and/or respiratory and/or hepatic failure. The HSV development in his twin brother prompted immediate multiple HSV PCR testing even though he was asymptomatic. The results were positive for HSV in both plasma & nasopharynx. He received intravenous acyclovir treatment for 21 days. Both CSF & brain MRI studies demonstrated no CNS involvement. He was discharged home with oral acyclovir for one year. Two months after being off acyclovir he developed herpetic vesicles which resolved with acyclovir treatment. Currently, he is on chronic acyclovir treatment. Lymphocyte enumeration tests demonstrated NK cell deficiency. Typically, HSV is a virulent symptomatic infection especially when it presents with viremia. Here we have a case of asymptomatic HSV viremia. Likewise, HSV infection does not usually recur after 1 year of acyclovir treatment. Here, we have a child presenting with what seems to be recurrent congenital HSV infection even with adequate treatment. These atypical HSV presentations may have been due to NK cell deficiency. We, therefore, propose that clinicians should consider NK cell deficiency as possible etiology when HSV presents in an atypical manner as described in our case.

Adherence to masking recommendations and requirements continues to have a wide variety of impacts in terms of viral spread during the ongoing pandemic. As governments, schools, and private sector businesses formulate decisions around mask requirements, it is important to observe real-life adherence to policies and discern subsequent implications. The CDC MASCUP! observational study tracked mask-wearing habits of students on higher-education campuses across the country to collect stratified data about mask typologies, correct mask usage, and differences in behaviors at locations on a college campus and in the surrounding community. Our findings from a single institution include a significant adherence difference between on-campus (86%) and off-campus sites (72%) across the course of this study as well as a notable change in adherence at the on-campus sites with the expiration of a county-wide governmental mandate, despite continuance of a university-wide mandate. This study, completed on and around the campus of East Tennessee State University in Washington County TN, was able to pivotally extract information regarding increased adherence on campus versus the surrounding community. Changes were also seen when mask mandates were implemented and when they expired.

Bakgrund: Isolering kan användas som åtgärd då en patient har en infektion eller en smittsam sjukdom och måste separeras från omgivningen för att förhindra smittöverföring. Smittsamma sjukdomar beskrivs som sjukdomar som kan innebära en fara mot människors hälsa och som kan överföras till eller mellan människor. Sjuksköterskor har ett ansvar att förebygga och begränsa utbrott eller spridning av smittsamma sjukdomar. Patienter i isolering uttrycker ett missnöje över sjuksköterskors hantering av vården och upplever att inte bli behandlade med värdighet och respekt. Sjuksköterskor ska ha ett holistiskt synsätt, se individen bakom sjukdomen och stärka patientens känsla av värdighet. Syfte: Syftet var att beskriva sjuksköterskans erfarenheter av att vårda patienter med smittsamma sjukdomar i isolering. Metod: Studien var en allmän litteraturstudie och inkluderade 10 vetenskapliga artiklar som bearbetades i en innehållsanalys. Resultat: Tre huvudkategorier identifierades; utmaningar i omvårdnaden, sjuksköterskans egna reaktioner och arbetsmiljöns betydelse. Resultatet visar att sjuksköterskor upplevde utmaningar med att bedriva högkvalitativ omvårdnad för patienter i isolering. Konklusion: Det finns behov av vidare forskning och förbättringsarbete för att skapa en mer gynnsam arbetsmiljö för sjuksköterskor och en personcentrerad vård av hög kvalitet för patienter i isolering. / Background: Isolation can be used when a patient has an infection or a communicable disease and must be separated from the environment to prevent infection transmission. Communicable diseases are described as diseases that may pose a danger to human health, and which can be transmitted to or between people. Nurses have a responsibility to prevent and limit disease outbreaks or spread of communicable diseases. Patients in isolation express dissatisfaction with nurses’ handling of care and not being treated with dignity and respect. Nurses must have a holistic approach, see the individual behind the illness and strengthen the patient's sense of dignity. Aim: The aim was to describe the nurse's experiences of caring for patients with communicable diseases in isolation. Method: The study was a general literature study that included 10 scientific articles that were processed in a content analysis. Results: Three main categories were identified; challenges in nursing care, the nurse’s own reactions and the importance of the work environment. The results show that nurses experienced challenges in providing high-quality care for patients in isolation. Conclusion: There is a need for further research and improvement work to create a more favorable work environment for nurses and high-quality, person-centred care for patients in isolation.

No description available.

INTRODUCTION: Non-communicable diseases (NCDs) burden has increased significantly over the past decade in Saudi Arabia (SA). Disparities of NCDs disease prevalence have been documented; however, little is known regarding inequities in NCDs health services access and delivery especially at the primary health care (PHC) level. Moreover, equity considerations have not explicitly been part of allocative financial decision-making criteria. The goal of this study is to assess equity-related challenges in accessing NCDs services as well as the current NCDs priority setting and financial resources allocation process to support the ongoing health system transformation efforts. METHODS: This study used a mixed methods approach. The quantitative data was obtained from existing secondary data of 10,000 households’ surveys, The Kingdom of SA World Health Survey, 2019. The primary collected qualitative data consist of 33 in-depth interviews (IDIs) with public officials from national and regional level using an interview guide supported by documents review. A multiple logistic regression and thematic analysis were used for the analysis. RESULTS: More than 35% of people with diagnosed diabetes, hypertension or dyslipidemia have an unmet need of primary care services. Only 20% of surveyed women had a cervical cancer screening during their last pelvic exam while only 18% of eligible women ever had a mammogram. Significant factors affecting primary care services utilization were region of residence, population density, wealth, income and education. Findings from the interviews revealed that NCDs and PHC are top priorities of the Saudi health reform with strong political commitment and major investments. However, there is no clear strategic direction to improve NCDs services given the highly centralized financial system with suboptimal resources allocation towards PHC and where increasing efficiency focuses mainly on higher level care. Governance-related challenges include accountability and power struggle, partly due to financial and human resources variations across the region. DISCUSSION: Improving budget formulation for primary care and NCDs programs, and harmonizing NCDs programs funding across sectors apart from the health sector while defining what equity and allocative efficiency mean for the Saudi health system transformation are priorities to achieve the health system transformation goals. / 2025-12-11T00:00:00Z

付記する学位プログラム名: グローバル生存学大学院連携プログラム / 京都大学 / 新制・課程博士 / 博士(社会健康医学) / 甲第23823号 / 社医博第123号 / 新制||社医||12(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 川上 浩司, 教授 木村 剛, 教授 山本 洋介 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

The severity of flood events is predicted to increase as a consequence of climate change and may lead to a higher burden of waterborne infectious diseases in the United States. Contaminated floodwater transports bacterial, protozoal, and viral pathogens that typically cause moderate intestinal or respiratory disease, but can also lead to more serious disseminated infections among immunocompromised, young, and older people. Hydroclimatology and drinking water infrastructure influence the transmission of disease, but their roles are not well-understood and may vary by pathogen-type or geographic region. Specific outbreaks of waterborne disease have been attributed to major floods and cases have been positively associated with some meteorological variables, but the association between infections and flooding has not been systematically examined. In this dissertation, we examine the association between seasonal and extreme floods and parasitic and bacterial infections using multiple flood-indicator variables and exposure definitions. In Chapter 2, we use multimodel inference and generalized linear mixed models to determine the effect of seasonal meteorology on hospitalizations across the US. We found that hospitalization rates were generally higher in rural areas and in places that relied on groundwater for drinking water sources. Soil moisture, precipitation, and runoff were associated with significant increases in hospitalizations for Legionnaires' disease, Cryptosporidiosis, and Campylobacteriosis, respectively. In Chapter 3, we use 23 years of weekly case data to examine the effect of cyclonic storms on six waterborne infections in a conditional quasi-Poisson statistical model. Storm exposure was defined separately for distinct storm hazards, namely wind speed and cumulative rainfall, and effects were examined over 3 weeks post-storm. We found that exposure to storm-related rainfall was associated with immediate and lagged increases in cases. In Chapter 4, we use a nonparametric bootstrap to examine the effect of anomalous meteorological conditions, i.e. extremes unrelated to cyclonic storms, on Legionnaires' disease hospitalizations. We also assess the effect of exposure to specific cyclonic storms in a GLMM framework and compare these approaches. Extreme precipitation and months with cyclonic storms were positively associated with Legionnaires' disease hospitalizations. Determining the effect of flooding on Legionnaires' disease is particularly important as it causes severe illness and has steadily increased in incidence for 20 years. An objective of this dissertation was to develop a framework for examining flood-disease dynamics in the context of hydrometeorological and infrastructure-related factors that may influence transmission. We demonstrated that drinking water source, rurality, and geography may play an important role in these dynamics; the analyses also underscored, however, the urgent need for more extensive epidemiological surveillance and water quality data. Climate change will likely place a considerable strain on aging water infrastructure in the US. A nuanced understanding of flood-disease dynamics is central to mitigating these effects.

M.S.