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Source at https://www.fhi.no/ I november 2021 ble Folkehelseinstituttet varslet om at tre intensivpasienter hadde dødd av blodbaneinfeksjon med bakterien Pseudomonas aeruginosa ved Universitetssykehuset Nord-Norge i Tromsø i løpet av kort tid. De hadde identiske isolater forenlig med et klonalt utbrudd. Helgenomsekvensering viste at det var en ny sekvenstype, ST3875, som ikke har vært påvist i Norge eller andre land. Nye tilfeller uten epidemiologiske sammenhenger, ble etter hvert funnet i flere andre sykehus, noe som indikerte en felles smittekilde. Den 17. januar 2022 var det påvist utbruddstilfeller i tre av fire helseregioner, og det ble 19. januar erkjent som et nasjonalt utbrudd. FHI overtok da koordinering av utbruddsarbeidet, og 20. januar ble det etablert en Sentral utbruddsgruppe med fagpersoner fra alle helseregionene. Den 21. januar var det 23 tilfeller i 9 sykehus i 3 regioner. Kasusdefinisjonen var en person med laboratoriebekreftet P. aeruginosa ST3875 fra oktober 2021 i sykehus i Norge, uavhengig av avdeling. Etter systematiske laboratorieundersøkelser av over 300 produkter påviste Oslo Universitetssykehus 18. mars 2022 utbruddsbakterien i pre-fuktede engangs vaskekluter av merket Oasis BedBath Unperfumed produsert i Lancashire, England. Sykehusene sluttet umiddelbart å bruke produktene. Vaskeklutene er definert som et kosmetisk produkt, og Mattilsynet er tilsynsmyndighet. Mattilsynet avdekket at produsenten og importøren ikke hadde full oversikt over produksjonslinjene og hvilke produkter som var forurenset. Det ble også avdekket at P. aeruginosa var blitt påvist i produkter under den interne kvalitetskontrollen i september 2021, uten at produktene var blitt stanset. Den 14. april tilbakekalte den engelske produsenten Vernacare produktene fra markedet både i Norge og internasjonalt. Per 14. juni 2022 omfattet utbruddet 388 tilfeller i 40 sykehus. Gjennomsnittsalder var 68 år og median alder 70 år (interkvartilområde 59- 79 år). Flertallet (63 %) av tilfellene var menn, og seks sykehus rapporterte Pseudomonas som sterkt medvirkende årsak til død hos totalt 8 tilfeller. Til sammen hadde 15 % av tilfellene ST3875 i blodkultur, 21 % i luftveier, 38 % i urin, 19 % i sår og 7 % i andre prøvematerialer, noe som tydet på flere mulige inngangsporter for bakterien. Antall nye tilfeller falt raskt etter at kilden var identifisert, og bruk av produktet ble stoppet i sykehus.

Lack of trained personnel is a major obstacle to providing the full package of emergency obstetric and newborn care (EmONC) services in Ethiopia and other low-income countries. The aim of this study was to evaluate whether a blended learning approach to in-service EmONC training could be as effective as a conventional learning approach while reducing costs.A quasi-experimental study design assigned providers in need of EmONC training to blended learning (12 days of offsite training followed by daily SMS and weekly phone calls) or conventional learning (18 days of offsite training followed by a facility visit to mentor participants). A self-administered questionnaire measured provider knowledge before training and three months afterwards. Provider skills were assessed three months post-training with an Objective Structured Clinical Examination (OSCE). Independent sample t-test and multiple linear regression analysis were used to assess differences in mean percentage knowledge and skills scores between learning groups. The direct costs and cost-effectiveness of each learning approach were calculated.Knowledge scores were similar for the blended and conventional learning groups before training (58.5% vs 61.5%, p = 0.358) and three months post-training (74.7% vs 75.5% = 0.720), with no significant difference in gains made. Post-training skills scores were significantly higher for conventional than blended learning (85.8% vs 75.3%, p 0.001). After controlling for other factors in the multiple linear regression analysis, providers with a university degree had significantly higher skills scores than those with a diploma (p 0.001). Training costs were lower for blended learning than conventional learning (1032 USD vs 1648 USD per trainee).Blended learning approach using SMS and phone calls was as effective as conventional one to increase providers' knowledge with substantially lower costs. Further study is warranted to examine the effect of blended learning on providers' skills.

The amount of IoT devices in society is increasing.With this increase there is an inherently higher risk of hackersexploiting the vulnerabilities of such a device, accessing sensitivepersonal information. The objective of this project was to assessthe security level of a home security camera through findingvulnerabilities and exploiting them. The method used for thiswas to analyze the system and its communication, threat modelthe system to identify threats, perform vulnerability analysisand exploit the vulnerabilities through penetration testing. Theattacks on the system did not succeed and the system wasdeclared secure in the vulnerability analysis. From the aspectstested in this project, it can be assumed that safety precautionshave been taken to secure the home security camera frommalicious hackers. Antalet IoT-produkter i samhället ökar ochmed fler och fler uppkopplade produkter i våra hem ökarrisken att hackare utnyttjar produkters sårbarheter för ondaavsikter, till exempel för att komma åt känslig personlig data.Målet med det här projektet var att hitta sårbarheter i ensäkerhetskamera för hemmet, attackera dem och utifrån resultatetbedöma hur säker produkten är. Detta gjordes genomatt analysera systemet och dess kommunikation, göra en hotmodellför att identifiera hot, genomföra sårbarhetsanalys ochsedan penetrationstesta hoten. Hackningsattackerna misslyckadesoch produkten bedömdes som säker i sårbarhetsanalysen.Utifrån de aspekter som testades i projektet kunde det bedömasatt grundläggande säkerhetsåtgärder vidtagits för att skyddasäkerhetskameran från hackare. Kandidatexjobb i elektroteknik 2021, KTH, Stockholm

ZusammenfassungSchlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle“ stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.

Zusammenfassung Hintergrund In Deutschland existiert die Zusatzbezeichnung Handchirurgie als weiterführende Qualifikation für Fachärzte für Chirurgie, Plastische Chirurgie sowie Unfallchirurgie und Orthopädie. Dennoch werden Verletzungen und Krankheiten der Hand auch durch Ärzte ohne diese Qualifikation versorgt. Es stellt sich die Frage, ob durch diese Versorgung gegebenenfalls mehr Behandlungsfehler auftreten. Material und Methodik Es wurden die Daten von 376 Fällen von Behandlungsfehlervorwürfen bei chirurgischen Eingriffen an der Hand und am Unterarm, die in den Jahren 2014 und 2015 abgeschlossen wurden, durch die Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern (Norddeutsche Schlichtungsstelle) zusammengestellt.Die Fälle mit nachgewiesenen Behandlungsfehlern wurden anhand der Qualifikation der behandelnden Ärzte unterteilt und analysiert. Eine statistische Auswertung wurden mit Hilfe des Programm SPSS (IBM) durchgeführt. Ergebnisse Ärztliche Behandlungsfehler mit einem daraus folgenden Schaden wurden bei Fachärzten mit Zusatzbezeichnung Handchirurgie bei 42 von 113 von Fällen festgestellt (37,2 %). Bei Fachärzten ohne diese Zusatzbezeichnung waren es in der Gruppe der Unfallchirurgen und Orthopäden bei 79 von 155 (51,0 %) und in der Gruppe der Allgemeinchirurgen bei 54 von 108 (50,0 %). Der Unterschied zwischen den Handchirurgen und Unfallchirurgen und Orthopäden (p = 0,017) sowie zwischen den Handchirurgen und Allgemeinchirurgen ist signifikant (p = 0,037). Schlussfolgerung Fachärzten mit Zusatzweiterbildung Handchirurgie wurden signifikant weniger ärztliche Behandlungsfehler nachgewiesen als Fachärzten ohne diese Zusatzweiterbildung. Es lassen sich dabei folgende Trends bei den Chirurgen ohne Zusatzbezeichnung Handchirurgie feststellen: Das Unterschätzen der Schwere von Weichteilverletzungen und Infektionen der Hand, häufiger Fehler in der handchirurgischen Untersuchung wie der Überprüfung der Funktion von Sehnen und Nerven sowie in der diagnostischen Befunderhebung nach Röntgenuntersuchungen der Hand.

The coagulase-negative bacterium Staphylococcus condimenti and closely related species are commonly isolated from or found in starter cultures of fermented sausage as well as fish and soy sauces, and have traditionally been considered nonpathogenic. Recently, however, a case of catheter-related bacteraemia caused by S. condimenti was reported. In the present study we identified and characterized a strain of S. condimenti isolated from a patient with a severe soft tissue infection, comparing it to S. condimenti and S. carnosus type strains in order to elucidate the virulence potential of the clinical strain. Genome comparison showed high degree of conservation between the clinical strain and the type strain used in food industry, as well as with S. carnosus. The genome of the clinical S. condimenti strain contains few horizontally transferred regions and 37 putative virulence genes, including genes with similarity to leucocidin and genes involved in immune evasion, proinflammatory and cytolytic activity. However, it remains to be tested whether these putative virulence genes are expressed and functional. Although uncommon, S. condimenti may cause severe infection in previously healthy persons. © 2017 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.This is an open access article under the CC BY-NC-ND license.

ZusammenfassungSchlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle“ stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.

Background Improved training approaches have the potential to overcome barriers to the use of postpartum intrauterine devices (PPIUDs) in Pakistan, including a shortage of female providers who are able to insert the device. This study assessed the effectiveness and acceptability of a competency-based onsite training approach that employed a newly developed anatomic model (the Mama-U) to train doctors and midwives on postpartum family planning (PPFP) and the insertion of PPIUDs. Methods An observational, mixed methods study conducted training evaluations and knowledge and skills assessments with 11 trainers and 88 doctors and midwives who participated in eight PPIUD training sessions. Two months later, follow-up interviews and clinical assessments were conducted with 20 providers, and interviews and a focus group discussion were conducted with 85 married women who received a PPIUD from a trained provider. Results The training significantly improved provider knowledge (p

Negative experiences of care may act as a deterrent to current and/or future utilization of facility-based health services. To examine the situation in Tanzania, we conducted a sub-analysis of a cross-sectional household survey conducted in April 2016 in the Mara and Kagera regions of Tanzania. The sample included 732 women aged 15&ndash, 49 years who had given birth in a health facility during the previous two years. Log binomial regression models were used to investigate the association between women&rsquo, s experiences of care during childbirth and the receipt of early postnatal checks before discharge. Overall, 73.1% of women reported disrespect and abuse, 60.1% were offered a birth companion, 29.1% had a choice of birth position, and 85.5% rated facility cleanliness as good. About half of mothers (46.3%) and newborns (51.4%) received early postnatal checks before discharge. Early postnatal checks for both mothers and newborns were associated with no disrespect and abuse (RR: 1.23 and 1.14, respectively) and facility cleanliness (RR: 1.29 and 1.54, respectively). Early postnatal checks for mothers were also associated with choice of birth position (RR: 1.18). The results suggest that a missed opportunity in providing an early postnatal check is an indication of poor quality of the continuum of care for mothers and newborns. Improved quality of care at one stage can predict better care in subsequent stages.

Highlights • Diagnosis of HBoV1 has been based on detection of DNA or mRNA. • Rapid HBoV1 antigen detection is beneficial for diagnosing acute HBoV1 infections. • HBoV1 antigen detection is attractive for point-of-care use., Background Diagnosis of human bocavirus 1 (HBoV1) has been based on qualitative PCRs detecting HBoV1 DNA or detection of HBoV1 mRNA. Objective This study aims to assess whether a rapid and automated HBoV1 antigen test is suitable for diagnosis of acute HBoV1 infection. Study design HBoV1 antigen detection has been compared with quantitative HBoV1 DNA PCR and HBoV1 mRNA RT-PCR. Results and conclusion We conclude that HBoV1 antigen detection has higher clinical specificity and positive predictive value than HBoV1 DNA qualitative PCRs, yet a lower sensitivity than HBoV1 mRNA detection. Additionally, HBoV1 antigen detection is beneficial in its rapidity and availability as a point-of-care test.

Performance Standards for PPIUD Counseling and Services. (PDF 775 kb)