The Awareness and Empowerment Aspects of the Needlesticks and Other Sharps Injuries and Reporting in Nursing Education: A Cross-Sectional Survey

Background Occurrence and underreporting of needlesticks and other sharps injuries (NSIs) are still immediate concerns among nursing students. This study examined the relationship between occupational health and safety (OHS) awareness and empowerment levels of nursing students and the occurrence and reporting of NSIs. Methods This cross-sectional study was conducted among purposively selected 840 students in a nursing school in 2018–2019. A self-report questionnaire was used to collect data about students’ sociodemographic characteristics, OHS awareness and empowerment levels, and NSIs characteristics. After bivariate analyses, multivariate logistic regression was used. Results The number of evaluated questionnaires was 469, for a response rate of 55.8%. Participants, 21.2% ( n = 99), had suffered NSIs, and 47.8% had reported their injuries. The NSIs were statistically related to age, academic year, working night shift, OHS awareness level of students, and the number of clinical placements completed by students. The odds of experiencing NSIs was 2.3 (95% confidence interval [CI] = [1.0, 5.3]) times higher in male students, 4.3 (95% CI = [2.4, 7.4]) times higher in those beyond the second academic year, and 2.5 (95% CI = [1.4, 4.4]) times higher in those who had received OHS training for a shorter period than the average duration. Conclusion/Application to practice The levels of awareness and empowerment were higher in students who received OHS and NSIs prevention training and those who received OHS training for the above-average duration. Increasing awareness and empowerment levels of nursing students through training can reduce the occurrence and the underreporting of NSIs.

Effects of COVID-19 Lockdown on Managing Diabetes Mellitus Among Sudanese Insulin Pump Users, A Cross-Sectional Study

Background COVID-19 lockdown has affected diabetes management among the insulin pump users by changing their life style, affected their mental health, limited diabetes and insulin pump supplies and more difficult communication with the healthcare providers Objectives The aim of this research is to study the effects of COVID-19 lockdown on managing diabetes mellitus among Sudanese insulin pump users, Sudan (March- September 2020). Methodology: This is a descriptive cross-sectional community based study which was done in contact with Shimaa medical CO. LTD. 26 insulin pump users were chosen by total coverage and the data was collected throughout phone call interviews. All statistical analyses were performed using IBM SPSS Statistics software, version 20. Results The mean age of 22 participants was 25.3 ± 17.2 years, and the majorities (63.6%) were females. The average duration of diabetes was 6.9 ± 3.9 years, and the average duration of insulin pump use was 3 ± 1 years. Of the 22 patients (90.9%) used glucometer for monitoring blood sugar. 9 (40.9%) were less subjective to depression, 9 (40.9%) had moderate susceptibility to have depression. 8 patients (36.4%) reported weight gain, 12 patients (54.5%) reported no weight changes, while 2 patients (9.1%) reported weight loss. The level of physical activity decreased in 10 patients (45.5%), and the dietary habits remained unchanged in 50%. Moreover, participants who reported a decrease in physical activity levels were more likely to report weight gain (P = 0.004) compared with those who reported an increase in physical activity levels. Most of the patients have unchanged behaviors regarding experiencing hyper and hypoglycemic symptoms 45.5%, 72.7% respectively. Most of the patients have unchanged adherence to the insulin pump behaviors, carb counting (63.6%), bolus wizard during mealtime (68.2%), and bolus wizard for hyperglycemia correction (68.2%), self-monitoring of blood glucose (40.9%). (40.9%) of the patients had scheduled phone call appointments, 5 patients (22.7%) received virtual education (VE) from the insulin pump technician. 12 patients (54.5%) reported difficulty obtaining at least one type of insulin pump supply. Conclusion COVID-19 lock down has led to the decrease in physical activity with unchanged dietary habits. Getting the insulin pump supplies was difficult for most of the patient’s, and there was shortage and increase prices for diabetes care supplies. Telemedicine should be considered seriously to ease the communication between the patients and the health care providers.

Symptom Burden and Factors Associated with Acute Respiratory Infections in the First Two Years of Life—Results from the LoewenKIDS Cohort

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10–17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7–14). The median age for the first ARI episode was 91 days (IQR: 57–128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

Technical Overview and Evaluation of Heartune App: Mapping Music to Heartbeat for Recreational or Medical Purposes (Whitepaper)

This paper aims to verify the feasibility of utilizing the novel application Heartune as a supplemental treatment for Autism, Alzheimers, Depression/anxiety and developmental delays using passive music therapy. The studies and meta-analyses discussed within this whitepaper illustrate the ability of music therapy in general to benefit the wellbeing and behavioural tendencies of those diagnosed with the aforementioned illnesses, and hence the results obtained by this whitepaper justify the utilization of Heartune as a source for the supplemental treatment for over 100 million patients worldwide. Music therapy has been proven to help several children with developmental delays and Autism especially considering the behavioural changes caused by music therapy. Moreover, the therapy has led researchers to conclude that within the average duration of a song ~3 minutes, the user’s heartbeat can change up to 12%, indicating that the application can be utilised to change the heartbeat and hence the user's mood up to a certain extent. The concluding remarks do state that the application is complementary to the current treatment of the patients and does not in any manner propose a complete recovery from the given illness but proposes to reduce the impacts it has on the lives of the patients.

COVID-19 Pandemic: How Effective Are Preventive Control Measures and Is a Complete Lockdown Justified? A Comparison of Countries and States

For fighting the COVID-19 pandemic, countries used control measures of different severity, from “relaxed” to lockdown. Drastic lockdown measures are considered more effective but also have a negative impact on the economy. When comparing the financial value of lost lives to the losses of an economic disaster, the better option seems to be lockdown measures. We developed a new parameter, the effectiveness of control measures, calculated from the 2nd time derivative of daily case data, for 92 countries, states and provinces. We compared this parameter, and also the mortality during and after the effective phase, for countries with and without lockdowns measures by means of the Mann–Whitney test. We did not find any statistically significant difference in the effectiveness between countries with and without lockdowns (p > 0.76). There was also no significant difference in mortality during the effective phase (p > 0.1); however, a significant difference after the effective phase, with higher mortality for lockdown countries, was identified. The effectiveness correlated well with a parameter derived from the reproductive number (R2 = 0.9480). The average duration of the effective phase was 17.3 ± 10.5 days. The results indicated that lockdown measures are not necessarily superior to relaxed measures, which in turn are not necessarily a recipe for failure. Relaxed measures are, however, more economy-friendly.

Features of temporary disability of various categories of employees

The purpose of the study was to analyze the materials of temporary disability due to illness or injury of employees engaged in various types of activities. The data is presented for two years (2018-2019). One group - employees of offices, the second group-employees of working specialties. In each group of employees, temporary disability sheets received in connection with an injury or illness for two years (2018-2019) were analyzed. A number of relative indicators that do not depend on the number of employees of these organizations are determined: the multiplicity of disability (the number of cases of disability per 1 employee with disability); the duration of disability (the number of days of disability per 1 case of disability). It is shown that the share of sick leaves for diseases and domestic injuries among employees of the office and industrial organization differs in the age groups: 20-29 years and 30-39 years: making up, respectively: 10.1% and 83.7%; 60.6% and 77.7%. The multiplicity of domestic injuries in employees of a production organization is 1.4 times higher than the corresponding indicator of office employees, equal to 1.0, and the average duration of each case of domestic injuries in employees of a production organization is shorter than in office employees by 2.3-2.6 times. The average duration of each case of the disease is longer in office employees than in employees of a production organization: 9.9 days and 6.3 days on average per year, respectively.

Methotrexate Use in Generalized Autoimmune Myasthenia Gravis: A Case series

Methotrexate (MTX) is an inexpensive and well-tolerated immunosuppressive medication that is used anecdotally in autoimmune myasthenia gravis (MG). However, the efficacy in MG is unclear at this time. This retrospective analysis describes six patients with acetylcholine receptor antibody positive MG who were treated with MTX and corticosteroids. The efficacy of MTX was measured by steroid-sparing effect and the Myasthenia Gravis Foundation of America (MGFA) classification. MTX initiation was associated with a reduction in prednisone dosage in all patients. Minimal manifestation status was reached at an average duration of 10 months in 5 patients. No patients were hospitalized for myasthenia gravis exacerbations. There were no major side effects experienced with MTX use. This retrospective analysis suggests that MTX is safe and probably efficacious as a corticosteroid-sparing agent in the management of MG.

OMPARATIVE ASSESSMENT OF THE TIME-BASED PARAMETERS OF COWS’ LACTATION PERFORMANCE WITH THE USE OF AN AUTOMATIC DEVICE

Проведена сравнительная оценка времени пребывания коров-первотелок в доильном боксе с минимальной, максимальной и средней продолжительностью молоковыведения из всех четвертей вымени высоко- и низкопродуктивных при доении на автоматической установке «Astronaut A». У высокопродуктивных животных по сравнению с низкопродуктивными установлено увеличение длительности исследуемых четырех периодов молоковыведения на 34,5—60,6%. Между изученными временными параметрами молоковыведения выявлена тесная взаимосвязь (r=0,69-0,98; P<0,001). Выведено уравнение регрессии между периодом доения, рассчитанного путем определения максимальной продолжительности выдаивания одной из четвертей вымени, и средней продолжительностью молоковыведения из всех четвертей вымени (r=0,96; P<0,001). Установлено, что доля технологических операций, не связанных с процессом молоковыведения, составляет 24,1—31,6% от длительности периода пребывания в доильном боксе. Показана возможность использования для оценки интенсивности молоковыведения на автоматической установке «Astronaut A4» наряду с продолжительностью пребывания коровы в доильном боксе показателей максимальной и минимальной продолжительности молоковыведения из одной четверти вымени, а также средней продолжительности молоковыведения из всех четвертей вымени у высоко- и низкопродуктивных коров. Comparative assessment of the time of stay of first-calf cows in a milking box with minimum, maximum, and average duration of milk production from all udder quarters with high and low productivity when milked using the Astronaut A automatic device was carried out. When compared to low-productive animals, high-productive ones showed the increase in duration of the studied milk production periods by 34.5—60.6%. Close relationship between the time-based parameters of milk production was established (r=0.69-0.98; P<0.001). Equation of regression between the milking period, calculated by determining the maximum milking duration of one of the four udder quarters, and the average duration of milk production from all four udder quarters (r=0.96; P<0.001) was derived. It was established that the share of technological operations not connected to milk production process amounts to 24.1—31.6% from the duration of stay in the milking box. The possibility for using the parameters of maximum and minimal duration of milk production from one of udder quarters, as well as the average duration of milk production from all four quarters of the udder in high- and low-productive cows along with the length of cow’s stay in the milking box for the evaluation of milk production intensity using the Astronaut A4 automatic device was shown.

Reversal of Myopic Correction for Patients Intolerant to LASIK

Purpose. To evaluate the outcome of the reversal of myopia correction in patients intolerant to LASIK. Methods. This study is a retrospective and case series of patients who decided to reverse their previous myopic LASIK correction between July 2012 and July 2020. It was conducted at a private refractive surgery centre, Ismailia, Egypt. The patients were followed up after reversal treatment for one year. Primary LASIK and reversal treatment were performed by a 500 kHz Amaris excimer laser platform. The main outcomes included refractive predictability, stability, efficacy, and safety and any reported complications. Results. This study included 48 eyes of 24 patients (6 male and 18 female patients). The average duration between the primary LASIK surgery and reversal treatment was 3.20 ± 0.30 months (range 3 to 4 months). Reversal treatment was bilateral in all patients. The mean age of the patients was 38 ± 1.9 years (range 37 to 45 yrs). After reversal, the mean postreversal cycloplegic refraction spherical equivalent was −1.82 ± 0.34 D (range −1.50 to −3.00 D). The mean ablation depth was 34.10 ± 7.36 μm (range 20 to 46 μm), and the mean of the central corneal thickness 12 months after reversal treatment was 510.2 ± 14.4 μm (range 515 to 487 μm). The mean keratometric reading was 42.6 ± 1.6 (range 42.5 to 44.8). The mean of CDVA was 0.2 ± 0.03 log MAR (range −0.10 to 0.4 log MAR). The mean optical zone of reversal treatment was 6.1 ± 0.3 mm (range 5.9 to 6.2 mm). UDVA was 0.4 log MAR in 87.5% of the patients, 0.5 log MAR in 8.3% of the patients, and 0.6 log MAR in 4.2% of the patients. CDVA remained unchanged in 83.3% of patients; 2.1% of the patients gained one line of CDVA (Snellen); 8.3% of the patients lost one line of CDVA; 6.3% of the patients lost two lines of CDVA. No cases of corneal ectasia were recorded. The only postoperative complications were flap microfolds in 3 eyes (6.25%). Conclusion. In conclusion, this study demonstrates that reversal of myopic LASIK treatment is a safe, stable, and effective option for intolerant patients.

Early full enteral feeding in very low birth weight babies on day one

Background: Nutrition in very low birth weight babies is most important factor in early improvement of neonate. It also decides duration of stay in intensive care unit. Objectives of the current study were to initiate required full enteral feed at the earliest and to know the outcome of such neonates.Methods: It is a hospital based retrospective study conducted from October 2019 to December 2019 in Gulbarga institute of medical sciences, Kalaburagi. 40 clinically stable VLBW neonates on day 1 started on enteral feeding are included in the study. Babies with birth weight more than 1.5 kgs or less than 1 kg, hemodynamically unstable at start of feeds are excluded from the study. Collected data is analysed by SPSS 17.Results: Total 40 VLBW babies were included in the study. Among them, 28 neonates tolerated feeds, were improved & discharged early with an average duration of stay of 16days with early birth weight gain by 14 days. 10 neonates had feed intolerance with signs of Necrotizing enterocolitis during course of treatment, were improved and discharged with an average duration of stay of 22 days. Mortality was seen in 2 neonates due to associated sepsis. Conclusions: Initiation of full enteral feeds in stable VLBW babies is effective mode for improvement, weight gain and early discharge from hospital.