Three Potential Sources of Microfungi in a Treated Municipal Water Supply System in Sub-Tropical Australia

Some microfungi are known to be opportunistic human pathogens, and there is a body of scientific opinion that one of their routes of infection may be water aerosols. Others have been implicated as causative agents of odours and off-tastes in drinking water. This study was undertaken to investigate three potential sources of microfungi in a treated, oligotrophic municipal water supply system in sub-tropical Australia. Formation of the microfungal component of developing biofilm on hard surfaces in water storage reservoirs was also assessed. Inside and outside air samples were collected from two reservoirs using two types of Burkard air samplers. Biofilm and soft sediment samples were collected from the inner surfaces of asbestos cement water pipes and from pipe dead ends respectively. These were analysed for microfungal growth and sporulation using Calcofluor White stain and epifluorescent microscopy. Artificial coupons of glass, PVC and concrete were immersed in two reservoirs to assess microfungal biofilm formation. This was analysed periodically using Calcofluor White stain and epifluorescent microscopy, cultures of coupon swabs and scanning electron microscopy. Fungal spores were recovered from all air samples. The number of colonies and the genera were similar for both inside and outside air. Microfungal filaments and sporulating structures were recovered from most of the pipe inner surface biofilm and dead end sediment samples, but were sparser in the biofilm than in the sediment samples. No recognisable, vegetative filamentous fungi were found in the slowly developing biofilm on coupons. This study indicates that airborne spores are an important potential source of microfungi found in water storage reservoirs. It has also demonstrated conclusively that filamentous microfungi grow and sporulate on water pipe inner surfaces and in soft sediments within the water distribution system

Incidence and Distribution of Microfungi in a Treated Municipal Water Supply System in Sub-Tropical Australia

Drinking water quality is usually determined by its pathogenic bacterial content. However, the potential of water-borne spores as a source of nosocomial fungal infection is increasingly being recognised. This study into the incidence of microfungal contaminants in a typical Australian municipal water supply was carried out over an 18 month period. Microfungal abundance was estimated by the membrane filtration method with filters incubated on malt extract agar at 25 °C for seven days. Colony forming units were recovered from all parts of the system and these were enumerated and identified to genus level. The most commonly recovered genera were Cladosporium, Penicillium, Aspergillus and Fusarium. Nonparametric multivariate statistical analyses of the data using MDS, PCA, BEST and bubble plots were carried out with PRIMER v6 software. Positive and significant correlations were found between filamentous fungi, yeasts and bacteria. This study has demonstrated that numerous microfungal genera, including those that contain species which are opportunistic human pathogens, populate a typical treated municipal water supply in sub-tropical Australia

Time series analysis of the admission to the emergency department due to respiratory and cardiovascular diseases between 2010 and 2014 in Kirklareli, Turkey

Aim: The aim of this study was to estimate the admissions to the emergency department due to cardiovascular and/or respiratory diseases for the next twelve months. Material and Method: This research was characterized as an ecological study. The data were obtained from the hospital database between years 2010 and 2014. Emergency department admissions (N=148.169) from >= 15 years due to cardiovascular and/or respiratory diseases were evaluated according to the monthly average. Multiplicative Seasonal Auto-Regressive Integrated Moving Average (SARIMA) modeling method was used for the research. Results: It is observed that the emergency department admissions display seasonal changes. ARIMA(1,1,2)(1,0,1)12 model (MAPE-98,039) was ascertained to be the most suitable model with the success of 99.6% in the predictions. It was predicted that the admissions would be higher in the winter period. Model success for admissions according to disease groups vary between 752% and 89.2% and was estimated the highest level of admissions in January and February. The most suitable models used to estimate the number of admissions were the ARIMA(2,1,3)(1,0,0)12 for respiratory diseases, the ARIMA(2,1,2)(1.0,0)12 for cardiovascular diseases and the ARIMA(1,1,1)(1,0,0)12 for both for cardiovascular and respiratory diseases. It was estimated that the admissions due to cardiovascular diseases which had a conjuncture structure would increase mostly in April and the admissions due to respiratory diseases and both of the diseases would be higher mostly in the winter period. Discussion: SARIMA models are a good prediction model that can be used to estimate emergency department admissions due to cardiovascular and/or respiratory diseases. The estimations derived comprise a good evidence-based source for policymakers and health service providers

The Correlations Between Nursing and Medical Students' Values and Social Innovation Tendencies

Aim: This study aimed to determine the correlation between values and social innovation tendencies of nursing and medical students and examine the effect of values on social innovation tendencies

A model in environmental training the university/elementary school municipality cooperation

This study targets development of an effective training scheme model that can be implemented at elementary school level with focus on recovery and recycling of wasted papers in Turkey. For this purpose, three schools were chosen from a district within Istanbul. They were separated from one another as full intervention (FI), semi-intervention (SI) and control (C) schools. Different levels of educational activities carried out in the schools, mostly in the FI school, were directed toward being informative as regards recycling and the development of a positive attitude. Afterwards, in order to evaluate the effects of the training, paper wastes were collected in recycle bins placed at appropriate points in schools and weighed on a weekly basis. Quite a significant result was found (p = 0.0001), when the difference was calculated through the Kruskal Wallis Variance Analysis method, regarding the weekly average amount of paper in each of the three schools against per person. Furthermore, when the results were evaluated and compared as to the ones before the 2.5 months summer vacation and the ones after it, the seven measurements taken before (p = 0.001) and the eight taken afterwards (p = 0.0001), were found to have valid differences, once again, as against schools. The results show that the approach we provided to education is an effective method not only for the collection of paper wastes but also for applications in various areas of health education

Assessment of Under-5 Mortality Rates in Istanbul Using the Geographic Information System

WOS: 000372329600003Objective: Analyzing mortality rates and the reasons for these in Turkey's urban allocations using geographic information systems (GISs) is a new research area. While planning health services, knowing the mortality rates and reasons according to age and residential area are a big source of information for health planners and people who provide health services. The aim of this research is to analyze the deaths of children under the age of 5 years in big cities depending on a socioeconomic range using GIS. Further, this should make it possible to determine geographically risky places. Materials and Methods: The deaths of children under the age of 5 years that occurred between 2005 and 2009 were analyzed. Date from the Turkish Statistical Institute (Turk Stat) concerning population and age-specified deaths, Istanbul Metropolitan Municipality (IMM) cemetery directorate death records, and the Ministry of Finance land unit prices (to determine the socioeconomic level of the districts) were used as data resources. The Z value of each year's death rate, depending on the districts age ranges and average of all years' Z values, was calculated and is shown on the map. Results: While the under-5 mortality rate was 19.37 per 1000 in 2005, it was 14.31 per 1000 in 2009. Deaths of children under the age of 5 years took place particularly in Istanbul on the European side (in districts where the land value is low). Conclusion: Priority should be given to health promotion programs in areas with a low socioeconomic level in particular where premature death rates are observed to be more common

Heterotrophic bacteria and filamentous fungi isolated from a hospital water distribution system

In recent years, hospital infections caused by opportunist micro-organisms in immunosupressed patients groups have become increasingly important. These micro-organisms grow easily in water distribution systems even to the extent of producing bio-film. In the present study the aim was to determine microbial populations in water samples collected from the distribution system of a big hospital. Water samples were collected from one hundred different points around the water distribution system in different sections of the hospital. To analyse the water a membrane filter method was used. In eighty-four samples heterotrophic bacteria were isolated. The most frequent bacteria determined were Bacillus spp. (77%), Bacillus cereus (11%), Pseudomonas spp. (5%) and Staphylococcus spp. (4%). In fifteen samples more than one species of bacteria were isolated. In fifty-one samples, sixteen species of fungi were isolated, the most frequent being Penicillium spp. (24%), Aspergillus spp. (8%) and Acremonium spp. (5%). In thirteen samples more than one type of fungi was determined. In only six samples was no growth of fungi or bacteria observed. Over all the one hundred samples the counts of heterotrophic bacteria were not significantly correlated with the filamentous fungi counts (rs = -012, p = 0.05). Differences in the level of isolation or the concentration of bacteria and fungi between water from three old buildings and water from four new buildings were not significant (p > 0.05)

Epidemiology of superficial mycosis (Tinea pedis, onychomycosis) in elementary school children in Istanbul, Turkey

The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent

The effect of air pollution and meteorological parameters on chronic obstructive pulmonary disease at an Istanbul hospital

In this study, the relation between emergency admissions for chronic obstructive pulmonary disease (COPD) at an Istanbul University Hospital between the years 1997 and 2001 and the meteorological and air pollution parameters has been analysed. Admissions were calculated for each month, and the relations between the number of admissions for each month and the corresponding month's meteorological parameters (pressure, temperature, moisture) and the average pollution values (CO, SO2, NO, NO2, PM10) were determined. There were 1586 patients included in this study. COPD admissions had a negative significant correlation with temperature (r = -0.72, p < 0.001), a positive significant correlation with pressure (r = 0.41, p = 0.001) and humidity (r = 0.34, p = 0.007), and also had a positive significant correlation with SO2 (r = 0.64, p < 0.001), NO (r = 0.40, p = 0.002), CO (r = 0.57, p < 0.001) and PM10 (r = 0.27, p = 0.03). No significant relationship was found for NO2. When the meteorological and clinical parameters were evaluated, it was found that the only variable related to the COPD admissions was temperature. These results for COPD admissions were found to be considerably higher in seasons other than summer (p < 0.001). When summer seasonal values were taken as reference (RR = 1), RR = 1.24 (95% CI: 1.049-1.475) for autumn, RR = 1.86 (95% CI: 1.541-2.115) for spring and RR = 2.08 (95% CI: 1.793-2.434) for winter. Air pollution and meteorological parameters should be seen as a widespread public health problem, which can trigger admission and even death due to COPD

Socially Responsible Leadership: A study with nursing and medical students in Turkey

This study determined the levels of Socially Responsible Leadership of students studying in the nursing and medical faculties of a public university as well as the influencing variables. The sample of this descriptive and correlational study consisted of the students studying in the nursing and medical faculties of a public university (n = 464). The data were collected using the Socially Responsible Leadership Scale. The total and all subscale scores obtained by the nursing and medical students from the Socially Responsible Leadership Scale were in the middle level. The effects of the department and participation in student clubs were statistically significant in the model when examining the variables affecting leadership level. The results of this study revealed the necessity of improving the Socially Responsible Leadership levels in the basic professional education programs for physicians and nurses