No description available.

No description available.

No description available.

Valley fever, or coccidioidomycosis, is a disease caused by the Coccidioides immitis and Coccidioides posadasii fungal species that dwell in the soil but can become airborne and infect a human or mammalian host through their respiratory tract. Disease rates in the western U.S. have significantly increased over the past two decades, creating an emerging public health burden. Studies have been conducted that attempt to elucidate the association between environmental conditions and the growth and dispersal of the pathogen, yet the specific ecology of and environmental precursors to the disease remain uncertain. This research project investigates the relationship between environmental variables and valley fever by modeling the spatial and temporal dynamics of the disease using varying techniques. Chapter 1 discusses relevant literature before discussing the challenges associated with studying valley fever. Chapter 2 analyzes the temporal relationships between valley fever and climatic variables, focusing on Kern County, California, an understudied region in the U.S. where valley fever is highly endemic. Chapter 3 focuses on a regional spatial analysis using ecological niche modeling to better understand the environmental factors that influence the overall spatial distribution of valley fever in the U.S. Finally, combining both spatial and temporal components, Chapter 4 uses a hierarchical Bayesian spatio-temporal model to investigate the patterns and drivers of this disease, focusing on state of California, which saw an approximate 200% increase in cases from 2014 to 2018. Cumulatively, this work offers new insights on relationships between climate, landcover, and valley fever disease risk. Significant findings include climate variables explaining up to 76% of valley fever variability in Kern County, California, the significance of both climatic and landcover variables in characterizing the geographic distribution of the disease, and identification of patterns increasing risk in geographic regions of California not currently considered highly endemic. These findings advance scholarly understandings of valley fever's environmental disease drivers. The results of this research can be applied by public health officials in the allocation of surveillance and public education resources, focusing upon regions that are most likely to encounter the illness. / Doctor of Philosophy / Valley fever is a fungal disease that causes illness in over ten thousand people in the western U.S. every year. Disease rates have been increasing for the past two decades for unknown reasons, although previous research suggests that climatic variations are likely contributing factors. This research evaluated environmental factors with hypothesized relationships to valley fever disease rates. First, this dissertation explored time-series relationships between climatic factors and valley fever incidence in an understudied county in California. Research findings identified that climatic factors including precipitation from previous seasons and temperature were significantly associated with valley fever incidence in this county. Second, this dissertation assessed where valley fever is found in the western U.S. The likely spatial distribution for the disease was mapped and environmental variables influential to this distribution were identified; they included both climate and landcover variables. Finally, a model was developed to analyze patterns of disease risk in California that considered both space and time, and environmental risk factors potentially contributing to the observed patterns were assessed. Counties with increased risk were identified and significant environmental relationships with valley fever risk were confirmed. The results of this research can be applied by public health officials in allocating surveillance and public education resources, focusing upon regions that are most likely to encounter the illness.

BAKGRUND: Meticillinresistenta Staphylococcus aureus (MRSA) är ett växande problem globalt. I Sverige är cirka 30 procent av befolkningen ovetandes bärare av MRSA. Bakterien kan ställa till problem när de kommer till antibiotikabehandling eftersom bakterien är resistent. Sjuksköterskor kan uppleva MRSA som skrämmande vilket leder till att patienten upplever stigmatisering. SYFTE: Syftet med studien varatt beskriva sjuksköterskans erfarenhet av att vårda patienter med MRSA. METOD: En kvalitativ intervjustudie har genomförts. Datainsamlingen har bestått av semistrukturerade intervjuer och materialet från intervjuerna har analyserats med en kvalitativ innehållsanalys. RESULTAT: Resultatet visar god kunskap om hur basala hygienrutiner används och hur stress påverkar sjuksköterskans arbete. Det framkommer även kunskap om hur de ska bemöta patienter med MRSA för att minska stigmatisering. SLUTSATS: Erfarenheten av att vårda patienter med MRSA var individuellt hos sjuksköterskorna som deltog. En oro som fanns hos alla informanter var att de skulle bidra till smittspridning. Informanterna beskrev även att patientens upplevelse är viktig. FÖRSLAG PÅ FORTSATT FORSKNING: Studien har utförts på en kirurgisk vårdavdelning. Det skulle därför vara intressant att göra en studie på andra vårdavdelningar för att jämföra sjuksköterskornas erfarenhet. / BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing global problem. In Sweden, about 30 percent of the population are unaware that they are carriers of MRSA. The bacteria can cause problems when it comes to treatment via antibiotics due to the fact the bacterium is resistant. Nurses may experience MRSA as frightening which can lead to patients feeling stigmatized. AIM: The purpose of this study was to describe the nurse's experience of caring for patients with MRSA. METHOD: A qualitative interview study was conducted, with data collection consisting of semi-structured interviews. The material from the interviews has been analysed with a qualitative content analysis. RESULT: The result shows good knowledge of basic hygiene routines and how stress affect nurses work. They also show good knowledge about how to receive and care for patients with MRSA to reduce stigmatization. CONCLUSION: All participating nurses had individual experiences when it came to caring for patients with MRSA. A concern that existed in all informants was that they would be contributing to the spread of infection. The informants also describe that the patient's experience is important. PROPOSAL FOR CONTINUED RESEARCH:The study has been performed at a surgical care department. It would therefore be interesting for a study to be conducted in another care department to compare experience of the nurses.

Over 9 million new cases of tuberculosis (TB) were reported worldwide in 2013. While the TB rate is much lower in the US, its uneven distribution and associated explanatory variables require interrogation in order to determine effective strategies for intervention and control. However, paucity of case data at fine geographic scales precludes such research. This research, using zip code level data from 837 confirmed TB cases in Tarrant County obtained from Texas Department of State Health Services, explores and attempts to explain the spatial patterns of TB and related risk markers within a framework of place vulnerability. Readily available census data is then used to characterize the spatial variations in TB risk. The resulting model will enable estimations of the geographic differences in TB case variables using this readily available census data instead of time-consuming and expensive individual data collection.