Issues for people living with long-term urinary catheters in the community.

People with a long-term urinary catheter living in the community often experience catheter-related issues, however, the frequency and extent of these issues has not been well described in the literature. A survey on issues clients (n = 62) experience with their long-term urinary catheter was conducted in one community health service. The majority (79%) had experienced at least one issue in the last two years, 62% had urinary tract infections, 33% had an emergency department visit and 29% had leakage. Discomfort at catheter change was at least moderate in 32% and predictive of more interference from the catheter in clients' daily lives and 55% reported at least moderate interference from the catheter in their daily lives. In conclusion, most clients with long-term urinary catheters experience issues and interventions need to be assessed for effectiveness in decreasing these problems.

Frequent detection of a human fecal indicator in the urban ocean: environmental drivers and covariation with enterococci.

Fecal pollution of surface waters presents a global human health threat. New molecular indicators of fecal pollution have been developed to address shortcomings of traditional culturable fecal indicators. However, there is still little information on their fate and transport in the environment. The present study uses spatially and temporally extensive data on traditional (culturable enterococci, cENT) and molecular (qPCR-enterococci, qENT and human-associated marker, HF183/BacR287) indicator concentrations in marine water surrounding highly-urbanized San Francisco, California, USA to investigate environmental and anthropogenic processes that impact fecal pollution. We constructed multivariable regression models for fecal indicator bacteria at 14 sampling stations. The human marker was detected more frequently in our study than in many other published studies, with detection frequency at some stations as high as 97%. The odds of cENT, qENT, and HF183/BacR287 exceeding health-relevant thresholds were statistically elevated immediately following discharges of partially treated combined sewage, and cENT levels dissipated after approximately 1 day. However, combined sewer discharges were not important predictors of indicator levels typically measured in weekly monitoring samples. Instead, precipitation and solar insolation were important predictors of cENT in weekly samples, while precipitation and water temperature were important predictors of HF183/BacR287 and qENT. The importance of precipitation highlights the significance of untreated storm water as a source of fecal pollution to the urban ocean, even for a city served by a combined sewage system. Sunlight and water temperature likely control persistence of the indicators via photoinactivation and dark decay processes, respectively.