Seasonal patterns of viral and bacterial infections among children hospitalized with community-acquired pneumonia in a tropical region

Community-acquired pneumonia (CAP) is a common cause of morbidity among children. Evidence on seasonality, especially on the frequency of viral and bacterial causative agents is scarce; such information may be useful in an era of changing climate conditions worldwide. To analyze the frequency of distinct infections, meteorological indicators and seasons in children hospitalized for CAP in Salvador, Brazil, nasopharyngeal aspirate and blood were collected from 184 patients aged < 5 y over a 21-month period. Fourteen microbes were investigated and 144 (78%) cases had the aetiology established. Significant differences were found in air temperature between spring and summer (p = 0.02) or winter (p < 0.001), summer and fall (p = 0.007) or winter (p < 0.001), fall and winter (p = 0.002), and on precipitation between spring and fall (p = 0.01). Correlations were found between: overall viral infections and relative humidity (p = 0.006; r = 0.6) or precipitation (p = 0.03; r = 0.5), parainfluenza and precipitation (p = 0.02; r = -0.5), respiratory syncytial virus (RSV) and air temperature (p = 0.048; r = -0.4) or precipitation (p = 0.045; r = 0.4), adenovirus and precipitation (p = 0.02; r = 0.5), pneumococcus and air temperature (p = 0.04; r = -0.4), and Chlamydia trachomatis and relative humidity (p = 0.02; r = -0.5). The frequency of parainfluenza infection was highest during spring (32.1%; p = 0.005) and that of RSV infection was highest in the fall (36.4%; p < 0.001). Correlations at regular strength were found between several microbes and meteorological indicators. Parainfluenza and RSV presented marked seasonal patterns.

Procalcitonin is useful in identifying bacteraemia among children with pneumonia

Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN-alpha) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infiltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN-alpha were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN-alpha (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56-7.56), non-bacteraemic typical bacterial (1.47; 0.24-4.07), atypical bacterial (0.18; 0.06-1.03) and only viral (0.65; 0.11-2.22) subgroups was significant (p = 0.02). PCT was >= 2 ng/ml in 52 (33%) cases. The presence of IFN-alpha was associated with PCT <2 ng/ml (90% vs. 64%, p = 0.02). The negative predictive value (95% confidence interval) of PCT >= 2 ng/ml was 95% (89-100%), 89% (78-100%), 93% (85-100%) for differentiation of bacteraemic from viral, atypical bacterial and non-bacteraemic typical bacterial infection, respectively, and 58% (49-68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN-alpha was uncommonly detected.

Sole infection by human metapneumovirus among children with radiographically diagnosed community-acquired pneumonia in a tropical region

Background Limited information is available on the role of human metapneumovirus (HMPV) as the unique pathogen among children hospitalized for community-acquired pneumonia (CAP) in a tropical region. Objective We aimed to describe HMPV infection among children with CAP investigating bacterial and viral co-infections. Patients and methods A prospective study was carried out in Salvador, North-East Brazil. Overall, 268 children aged <5 years hospitalized for CAP were enrolled. Human metapneumovirus RNA was detected in nasopharyngeal aspirates (NPA) by reverse transcription polymerase chain reaction. Sixteen other bacterial and viral pathogens were investigated by an expanded panel of laboratory methods. Chest X-ray taken on admission was read by an independent paediatric radiologist unaware of clinical information or the established aetiology. Results Human metapneumovirus RNA was detected in NPAs of 11 (4.1%) children, of which 4 (36%) had sole HMPV infection. The disease was significantly shorter among patients with sole HMPV infection in comparison with patients with mixed infection (4 +/- 1 versus 7 +/- 2 days, P = 0.03). Three of those four patients had alveolar infiltrates. Conclusion Sole HMPV infection was detected in children with CAP in Salvador, North-East Brazil. HMPV may play a role in the childhood CAP burden.

The role of respiratory viral infections among children hospitalized for community-acquired pneumonia in a developing country

We report an investigation for 16 bacteria and viruses among 184 children hospitalized with pneumonia in Salvador, Brazil. Etiology was established in 144 (78%) cases. Viral, bacterial, and mixed infections were found in 110 (60%), 77 (42%), and 52 (28%) patients, respectively. Rhinovirus (21%) and Streptococcus pneumoniae (21%) were the most common pathogens. Our results demonstrate the importance of viral and pneumococcal infections among those patients.

The Da Vinci Code : En arketypisk saga : En djupstrukturell studie med didaktisk inriktning

Syftet med uppsatsen är att visa på likheten mellan Dan Browns The Da Vinci Code och sagans struktur, aktörer och handling, samt att påvisa romanens didaktiska möjligheter. Utifrån Vladimir Propps sagoteori och Northrop Fryes arketyper och historiska kategorisering samt ett studium av populärromanens likheter med sagan utifrån Ulla Lundqvists undersökning görs en strukturalistisk analys. Vidare har en mindre enkätundersökning gjorts för att skapa en uppfattning om hur en grupp elever på en gymnasieskolan uppfattat romanens didaktiska möjligheter. Resultatet visar att The Da Vinci Code innehåller sagans struktur, med endast några få avvikelser från den kronologiska ordningen, samt att romanens aktörer överrensstämmer med Propps teori och Fryes arketyper. Handlingen uppvisar tydliga inslag från sagan, och överrensstämmer med de sagoelement som Lundqvists undersökning visar, så som exempelvis dualism, magi, i överförd bemärkelse, och ett lyckligt slut. Den didaktiska undersökningen visar att eleverna uppfattar att romanen, trots kritiken kring dess fiktion, kan bidra till att ge kunskaper i ämnen som historia, religion och språk.

En titt på arbetar- och kvinnorörelsekamp åren 1900-1910 i spåren på Helene Ugland

Helene Ugland, f. 11 feb.1877 i Norge. lärarinneexamen 1895 vid Strömsbo Laerarinde-skole, vilket betydde möte med socialistiska och kvinnopolitiska idéer och som blev avgörande för hennes fortsatta verksamhet. Det var också då som rätten till fria tankar började vibrera i hennes sinne. År 1895, arton år gammal, samma år som hon tar examen vid Kristiansand Seminarium, reser hon till Stockholm och håller föredrag om utilitarismen. Hon flyttade till Sverige år 1900 och bosatte sig så småningom i Göteborg. 1903 blev hon skriven i Masthuggets församling samtidigt som hon gifte sig med redaktören vid Ny Tid Anton Andersson och kom att kalla sig Ugland-AnderssonNär hennes man blev chefredaktör vid Östergötlands Folkblad flyttade de till Norrköping. Här fick också Helene arbete på tidningen och som den socialist hon var utnyttjade hon flitigt sitt utrymme i tidningen med att agitera. Dessutom reste hon mycket och höll föreläsningar inte minst om mänskliga rättigheter. Hon ansåg att kristendomen var humbug och tyckte att den hade för stor plats i skolan.Hon deltog i socialdemokratiska kvinnokonferenser där hon propagerade för fri kärlek, rätten till preventivmedel och annat som gynnade kvinnors kamp för jämställdhet. Dock blev hon missförstådd då hennes belackare skyllde henne för att förespråka lösaktigt leverne.Sina sista verksamma år tillbringade hon i Gnesta där hon blev kommunalpolitiker. Hon dog 1 aug.1940.

Patienters och sjuksköterskors upplevelser av omvårdnaden i den palliativa vården

Syftet med denna systematiska litteraturstudie var att beskriva hur patienterna upplevde omvårdnaden i den palliativa vården samt hur sjuksköterskan upplevde omvårdnaden av patienter i palliativ vård. Vetenskapliga artiklar som använts har sökts via databaserna ELIN, PubMed, EBSCO och Wiley InterScience. Inklusionskriterierna för artiklarna var att de inte var äldre än tio år, skrivna på engelska och svenska. Kvalitetsgranskningen av de vetenskapliga artiklarna resulterade i 16 kvalitativa studier som var publicerade mellan 2000 och 2006. Artiklarnas resultat visade att både sjuksköterskor och patienter upplevde information och kommunikation som en viktig aspekt i den palliativa omvårdnaden. Patienterna uppgav att sjuksköterskans betydelse i omvårdnaden bestod i att ha tid att lyssna, vara tillgänglig och flexibel. Det var också av stor vikt att patienterna kunde känna tillit och förtroende till vårdpersonalen. Sjuksköterskan uppgav att kollegorna spelade en stor roll för palliativ omvårdnad. Att ha kollegor att diskutera med och relationen dem emellan var viktigt för att kunna ge en professionell och god omvårdnad. Sjuksköterskorna uppgav också att om de var harmoniska i sig själva blev omvårdnaden bättre.

Besökshundens påverkan på arbetssituationen inom den särskilda omsorgen

This essay is about dogs that visit is used, whitin care of elderly. The dogs found caretakers once a week and one hour at a time. The focus has been placed on the dogs that go to the municipality's special accommodation and the research was done in a medium-sized municipality in Sweden. The focus of the narrowing of the work was done to the work situation for care staff to assess the impact of the visits the dogs presence. It was distributed questionnaires answered by care staff in which it concluded their visit to the dog's presence felt and how it impacted the situation. There has been much previous research done on how dogs affect the elderly in care. This has been done to see if the care staff perceive the same thing, and in turn experience any possible help of visiting dogs. What emerged in this study is that most are in favor of visits dog and they're older. The majority of respondents agreed that their work situation has become neither better nor worse then visit the dogs started to meet caretakers. This may be due to visit the dog is not enough time on site at each visit. Even the fact that care staff are not practicing with the caretakers memory to get them to remain in the state of mind that research shows that the older gets in. These can have an impact on how care staff perceive a possible means in visits of the dog.

Lokalsamhällen och familjeliv i omvandling

Sociologisk Forsknings digitala arkiv

Acupuncture with manual and electrical stimulation for labour pain : a longitudinal randomised controlled trial

Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.  Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals. 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.  Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).  Conclusions: Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.

Kvinnors och mäns återhämtning från psykisk ohälsa

The overall aim with this thesis is to describe and analyze women’s and men’s recovery processes. More specifically, the aim is to determine what women and men with experience of mental illness describe as contributing to the personal recovery process. The point of departure for the studies was 30 in-depth interviews conducted with 15 men and 15 women. The selection of interview subjects was limited to individuals who had been treated in 24-hour psychiatric care and diagnosed as having schizophrenia, psychosis, a personality disorder, or a bipolar disorder.   Four studies have been carried.  Study 1 was a baseline article that examined what people in recovery from mental illness outline as facilitating factors to their recovery. The results that emerged from that study indicated areas for further analysis to condense the understanding of the recovery process. In study 2 the similarities and the differences in recovery described by women and men were examined. In Study 3 women’s and men’s meaning-making with reference to severe mental illness facilitate the recovery process were studied. The forth study explored how peer-support contribute to women’s and men’s recovery from mental illness.   The results emphasize recovery from mental illness as a social process in which relationships play a key role in creating new identities beside the mental illness. For a majority of the participants meeting peers facilitated the recovery process. The participants described how peer support meant an end to isolation and became an arena for identification, connection, and being important to others. Throughout these recovery processes the impact of gender has been emphasized. The results from this thesis provide new insight into gender as an important factor in understanding the recovery processes. The results from the four studies emphasize the mental patient, the psychiatric interventions and the individual recovery strategies as being influenced by gender constructions.

Sociologförbundet har ordet : Världskongress i Sverige nästa år. Internationella sociologförbundets XVII kongress i Göteborg den 11-17 juli 2010

Sociologisk Forsknings digitala arkiv