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Nordin P.,The Skaraborg Institute for Research and Development | Nordin P.,Umeå University | Thielecke M.,Franklin University | Ngomi N.,African Population and Health Research Center | And 3 more authors.
Tropical Medicine and Health | Year: 2017

Background: Tungiasis (sand flea disease) is caused by the penetration of female sand fleas (Tunga penetrans, Siphonaptera) into the skin. It belongs to the neglected tropical diseases and is prevalent in South America, the Caribbean and sub-Saharan Africa. Tungiasis predominantly affects marginalized populations and resource-poor communities in both urban and rural areas. In the endemic areas, patients do not have access to an effective and safe treatment. A proof-of-principle study in rural Kenya has shown that the application of a two-component dimeticone (NYDA®) which is a mixture of two low viscosity silicone oils caused almost 80% of the embedded sand fleas to lose their viability within 7 days. Methods: In this study we compared the efficacy of two distinct modes of application of NYDA®; one targeted application to the area where the parasite protrudes through the skin and one comprehensive application to the whole foot. Results: Independent of the two modes of application, the dimeticone caused more than 95% of embedded sand fleas to lose all signs of viability within 7 days. The targeted application killed embedded sand fleas more rapidly compared to when the whole foot was covered. The proportion of viable lesions at day two were 7.0 versus 23.4% (p < 0.01) and at day five 3.9 versus 12.5% (p < 0.02). Conclusions: Our findings suggest that the dimeticone could provide a safe and effective treatment for tungiasis in areas with difficult access to health care. Trial registration: ISRCTN ISRCTN74306878 © 2017 The Author(s).

Nordin P.,The Skaraborg Institute for Research and Development | Poggensee G.,Nigerian Field Epidemiology and Laboratory Training Program | Mtweve S.,Kilimanjaro Christian Medical Center | Krantz I.,The Skaraborg Institute for Research and Development
Global Health Action | Year: 2014

Background: Clinical schistosomiasis in endemic countries is treated with a single dose of praziquantel per 40 mg/kg body weight. Treating according to weight, in resource-poor settings when thousands of doses are to be administered in mass treatment campaigns, is considered problematic. A calibrated dose-pole based on height was developed and is now used in mass treatment campaigns for determining the doses for schoolchildren. The dose-pole will generate dose errors since every child population contains individuals that are either short or tall for weight. The aim of this study is to explore whether the WHO praziquantel pole is a satisfactory dose instrument for mass treatment of S. haematobium. Methods: In 1996 and 2002, 1,694 children were surveyed in the Kilimanjaro Region, Tanzania. We compared doses given by weight to doses given by height using descriptive statistics and regression. Conclusions and interpretation: The WHO dose-pole for praziquantel is based on height of the patient; however, children with the same height will differ in weight. Our study shows that children with the same weight could qualify for up to four different dose levels based on their height. The largest variation of doses based on the WHO dose-pole will be found in children below 20 kg of bodyweight. Using bodyweight and tablet halves as the smallest tablet division unit to determine the doses of praziquantel, one only has to identify every 6th kilogram of bodyweight; the doses will then vary a lot less than when using the WHO dose-pole. © 2014 Per Nordin et al.

PubMed | The Skaraborg Institute for Research and Development and Gothenburg University
Type: | Journal: The open nursing journal | Year: 2015

Acquired cranial asymmetry is prevalent in infants today and largely attributed to the supine sleep position recommended for infant safety. There is a risk of permanent cranial asymmetry, so prevention and early detection are important. A prevention project was initiated in Sweden, and an intervention was planned. The aim of this study was to evaluate reliability of assessors judging infant cranial asymmetry in order to evaluate if they could be considered reliable interchangeable assessors in the planned intervention.Five assessors were taught how to assess infant cranial asymmetry using illustrated severity assessments. They were intra-rater and inter-rater reliability tested by taking a photograph test-retest and an infant test. Agreement matrices were devised to illustrate assessor agreement based on both type and degree of cranial asymmetry. Agreement based on degree of asymmetry was analyzed by calculating AC2 using quadratic weights. Results were adjusted to arrive at the perceived genuine agreement and interpreted according to Landis and Kochs strength of agreement intervals.In the photograph test, mean percentage of perfect intra-rater agreement was 73. Adjusted mean intra-rater AC2 was 0.69 [0.63; 0.76], and adjusted inter-rater AC2s were 0.72 [0.64; 0.81] and 0.71 [0.63; 0.79]. In the infant test, the adjusted inter-rater AC2 was 0.73 [0.60; 0.87]. Results indicate substantial strength of assessor agreement.Assessors were reliable and interchangeable. In a larger clinical context, results indicate that educating child health care nurses to assess infant cranial asymmetry can be used for early detection.

PubMed | The Skaraborg Institute for Research and Development and Gothenburg University
Type: Journal Article | Journal: Journal of pediatric nursing | Year: 2016

Acquired cranial asymmetry is prevalent in infants today. This is largely attributed to the supine sleep position recommended for infant safety. The condition can become permanent, so prevention and early detection are important. A prevention project was initiated where guidelines for Swedish child health nurses were developed, tested in a pilot study, revised, and then incorporated into a short cranial asymmetry prevention program for nurses. The program included detailed information on what to teach parents of newborns. An intervention study was initiated where one group of nurses was taught according to the program and the other group followed the standard recommendations. The aim of this survey was to compare intervention and control group parents responses regarding the cranial asymmetry prevention information that they had received from their nurses during their infants first four months. Participants included 272 parents (180 intervention group, 92 control group) at 26 child health centers. A checklist was distributed to parents in conjunction with infants four month health checkup. A significantly higher percentage of intervention group parents were aware of regular recommendations - alternate direction of the infants head when putting the child to bed (82%: 64%, p=0.001), which pillow to use (92%: 80%, p=0.01), and when to remove the pillow (48%: 31%, p=0.006) - and five newly introduced recommendations compared to controls. Results indicate that educating child health nurses on prevention of cranial asymmetry works to increase parental awareness of what to do and how to do it safely.

PubMed | The Skaraborg Institute for Research and Development and University College West
Type: | Journal: Nurse education today | Year: 2016

Students motivation and ways of engaging in their schoolwork are important for their performance, including passing exams. Attendance at learning activities has also been argued to be of major importance, although no causal relationship with passing exams has been established in nursing education.The aim of this study was to describe the impact of attendance at nonmandatory learning activities on attainment, in terms of passing or failing of exams, in nursing education courses including both mandatory and non-mandatory activities.A prospective quantitative design.The nursing education programme at a Swedish university.Nursing students (n=361) from two courses and four classes within the nursing programme.Attendance was registered at every non-mandatory teaching activity by asking the students to note their attendance on a list. Data such as sex, age, and whether the students had passed the exam were also collected for each course and each semester separately.Increased participation was associated with an increasing proportion of students passing the exam. The chance of passing the exam increased by 13% for every additional learning occasion attended. Logistic regression showed an OR of 5.4 for an attendance of 100%.An increase in attendance gave a higher proportion of exam passes. Encouraging students to attend non-mandatory learning activities could be of value, and potentially contribute to an increased graduation rate for nursing students.

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