Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population

Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.

National strategy for palliative care of severely ill and dying people and their relatives in pandemics (PallPan) in Germany - study protocol of a mixed-methods project

Background In the SARS-CoV-2 pandemic, general and specialist Palliative Care (PC) plays an essential role in health care, contributing to symptom control, psycho-social support, and providing support in complex decision making. Numbers of COVID-19 related deaths have recently increased demanding more palliative care input. Also, the pandemic impacts on palliative care for non-COVID-19 patients. Strategies on the care for seriously ill and dying people in pandemic times are lacking. Therefore, the program ‘Palliative care in Pandemics’ (PallPan) aims to develop and consent a national pandemic plan for the care of seriously ill and dying adults and their informal carers in pandemics including (a) guidance for generalist and specialist palliative care of patients with and without SARS-CoV-2 infections on the micro, meso and macro level, (b) collection and development of information material for an online platform, and (c) identification of variables and research questions on palliative care in pandemics for the national pandemic cohort network (NAPKON). Methods Mixed-methods project including ten work packages conducting (online) surveys and qualitative interviews to explore and describe i) experiences and burden of patients (with/without SARS-CoV-2 infection) and their relatives, ii) experiences, challenges and potential solutions of health care professionals, stakeholders and decision makers during the SARS-CoV-2 pandemic. The work package results inform the development of a consensus-based guidance. In addition, best practice examples and relevant literature will be collected and variables for data collection identified. Discussion For a future “pandemic preparedness” national and international recommendations and concepts for the care of severely ill and dying people are necessary considering both generalist and specialist palliative care in the home care and inpatient setting.

Natural Patterns and Magnetic and Mental Processes of Coronavirus Activation and Neutralization

For twenty years, humanity has seen the third attempt at the transition of coronavirus to humans. The vaccine has been found, but coronavirus transitions will not stop even with the improvement of medicine. Nobel laureate in medicine Professor Luc Montagnier argues that vaccines may not live up to humanity's hopes of getting rid of COVID-19. Collective immunity for coronavirus has not been developed, repeated infections are more and more common, beds of seriously ill people are not empty, and mortality is running high, no one knows what will happen to all of us. In Israel, where vaccination has long been compulsory, and over 60% of the population, including underage children, have been vaccinated, the incidence is not just declining, but still breaking all records. So, the maximum number of cases here was revealed on September 1 - 16,629, which almost caught up with Russia (18,368 confirmed on the same September 1) with our percentage of vaccinated 26.1% of the number of citizens. At the end of September 2021, morbidity and mortality increase, because it is a system. Based on existing monthly pneumonia mortality statistics over the past 15 years, there are three waves each year. Since September 22, there has been a surge of pneumonia, ARI, and even non-communicable diseases. The second wave comes at the end of December - January, it is usually three times larger than the first. Then around March-April there is a third wave. These three waves exist steadily from year to year, their amplitudes can change, then one will be higher, then the other, they are not absolutely hard on schedule, but they are reproduced regularly in other countries. The first wave of the Spanish pandemic covered the world just at the end of September 1918. The coronavirus was the same. The first wave in America is September 2019, an unexplained surge of pneumonia with a rather high mortality rate, which was written off for smoking e-cigarettes and called "vape." Now they decided to watch the surviving tests of patients, and there - COVID-19. In Europe, it was the same.

Differential Peripheral Blood Glycoprotein Profiles in Symptomatic and Asymptomatic COVID-19

Glycosylation is the most common form of post-translational modification of proteins, critically affecting their structure and function. Using liquid chromatography and mass spectrometry for high-resolution site-specific quantification of glycopeptides coupled with high-throughput artificial intelligence-powered data processing, we analyzed differential protein glyco-isoform distributions of 597 abundant serum glycopeptides and non-glycosylated peptides in 50 individuals who had been seriously ill with COVID-19 and in 22 individuals who had recovered after an asymptomatic course of COVID-19. As additional comparison reference phenotypes, we included 12 individuals with a history of infection with a common cold coronavirus, 16 patients with bacterial sepsis, and 15 healthy subjects without history of coronavirus exposure. We found statistically significant differences, at FDR<0.05, for normalized abundances of 374 of the 597 peptides and glycopeptides interrogated, between symptomatic and asymptomatic COVID-19 patients. Similar statistically significant differences were seen when comparing symptomatic COVID-19 patients to healthy controls (350 differentially abundant peptides and glycopeptides) and common cold coronavirus seropositive subjects (353 differentially abundant peptides and glycopeptides). Among healthy controls and sepsis patients, 326 peptides and glycopeptides were found to be differentially abundant, of which 277 overlapped with biomarkers that showed differential expression between symptomatic COVID-19 cases and healthy controls. Among symptomatic COVID-19 cases and sepsis patients, 101 glycopeptide and peptide biomarkers were found to be statistically significantly abundant. Using both supervised and unsupervised machine learning techniques, we found specific glycoprotein profiles to be strongly predictive of symptomatic COVID-19 infection. LASSO-regularized multivariable logistic regression and K-means clustering yielded accuracies of 100% in an independent test set and of 96% overall, respectively. Our findings are consistent with the interpretation that a majority of glycoprotein modifications observed which are shared among symptomatic COVID-19 and sepsis patients likely represent a generic consequence of a severe systemic immune and inflammatory state. However, there are glyco-isoform changes that are specific and particular to severe COVID-19 infection. These may be representative of either COVID-19-specific consequences or of susceptibility to or predisposition for a severe course of the disease. Our findings support the potential value of glycoproteomic biomarkers in the biomedical understanding, and, potentially, the clinical management of serious acute infectious conditions.

Conditioning of nurses’ work in infectious diseases wards in association with the COVID-19 pandemic

Introduction Infectious diseases, due to their specificity and rapid spread, require a special, individual approach, not only to the treatment, but also to the protection of medical staff against infection. Objective: The aim of the study is recognition of the conditioning of work of nurses in hospitals dedicated to COVID-19, at the time of pandemic. Materials and Method The study included 100 nursing staff - 78 females (78%) and 22 males (22%) employed in Polish hospitals dedicated to care of patients with COVID-19 by virtue of the Minister of Health [5]. The research material was collected during the period from 15 January 2021 - do 12 February 2021. The largest group in the study was aged under 30 (32%), and similarly those aged 31 - 40 (31%). The respondents aged 41 - 50 constituted 21% of the nursing staff examined. The smallest group of nurses was aged over 60 (16%). The largest number of the nursing staff lived in urban areas (78%), whereas the reminder in rural areas (22%). The study was conducted by the method of a diagnostic survey, using a questionnaire technique, while the research tool was an author-constructed questionnaire designed for the purpose of the presented study. Conclusions In dedicated hospitals it is necessary to optimize the equipment in the ward indispensable for care of patients with COVID-19, which would improve the working conditions of nurses. It is advisable to adjust the employment of nurses to the demand for nursing care of patients seriously ill with COVID-19, treated in dedicated hospitals. In infectious diseases hospitals, in-hospital training courses should be intensified concerning the OSH and sanitary-hygienic principles in care of patients with COVID-19, because ¼ of the examined nurses indicated such a need.

The Impact of COVID-19 on Healthy Related Issues, A structured Review

Coronavirus: (COVID-19) is a recently discovered viral disease caused by a new strain of coronavirus. The majority of patients with corona-virus infections will have a mild-moderate respiratory disease that recovers without special care. Most often, the elderly, and others with chronic medical conditions such as asthma, coronary disease, respiratory illness, and malignancy are seriously ill. COVID-19 is spread mostly by salivary droplets or nasal secretions when an infected person coughs or sneezes. COVID-19 causes severe acute respiratory illness (SARS-COV-2). The first incidence was recorded in Wuhan, China, in 2019. Since then it spreads leading to a pandemic. The typical incubation time for COVID-19 infection is 2-14 days (normally 5). The common features include fever, cough, tiredness, difficulty in breathing, loss of smell or taste. Occasionally, signs are absent. COVID-19 complications include renal failure, syndrome of cytokine release, pneumonia, respiratory failure, lung fibrosis.

Effect of COVID-19 Infection in the Patients with Diabetes Mellitus

Background: Coronavirus is pandemic virus infection which has recently affected the globe, and as a result, in patients with non-communicable diseases, the associated morbidity and death are substantially greater. One of the most common non-communicable diseases linked to worsening clinical conditions in corona virus patients is diabetes mellitus (dm). Covid-19 is a zoonotic illness that was firstly found in wuhan city of china, and is now recognized a zoonotic disease that spreads from moist animals to people in 2019. The disease has a low fatality rate and only affects the most seriously ill patients. Approximately 80% of the cases involve patients who are seriously to moderately ill. Since the outbreak of the disease, the number of people who have died has continuously increased. Summary: The aim for this study is to determine the receptors involved in diabetes and the pathogenetic relationship btw. Covid-19 and diabetes. Both diseases are characterized by inflammation and the release of inflammatory markers. The roles of angiotensin-converting enzyme molecule and dipeptidyl peptidase in covid-19 and diabetes have been investigated. The effects of glucocorticoids and catecholamines, invasion of pancreatic islet cells, medications used to treat covid-19, and hence the lockdown policy, may have a deleterious impact on diabetes patients' glucose control. The results of covid-19 research involving diabetic and non-diabetic patients were also examined. Various medication trials, such as the dapagliflozin and linagliptin trials are still being conducted to see if certain medications are suitable for diabetic people with covid-19. Conclusion: Diabetes is a risk factor for covid-19 patients, according to the data, leading to their severity and mortality. This article also contains guidelines and recommendations that may be useful in the management and avoidance of diabetic individuals who are infected with covid-19.

A STUDY TO ASSESS THE KNOWLEDGE AND PREVENTIVE BEHAVIOR RELATED TO COVID -19 AMONG HEALTH CARE PROFESSIONALS

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Most people infected with the virus will experience mild to moderate respiratory illness and recover without requiring special treatment. However, some will become seriously ill and require medical attention. The best way to prevent and slow down transmission is to be well informed about the disease and how the virus spreads. Protect yourself and others from infection by staying at least 1 metre apart from others, wearing a properly tted mask, and washing your hands or using an alcohol-based rub frequently. Get vaccinated when it's your turn and follow local guidance. The disease is highly infectious, and further studies identied that the most important route of transmission to humans occurred via respiratory droplets or direct contact, with an incubation period ranging from 2 to 14 days. Healthcare providers are the primary individuals in contact with patients who are the main source of infections; thus, they are at high risk of becoming infected themselves. Their knowledge and risk perception on covid 19 plays an important role in preventing them from acquiring the disease themselves. In the present study we are trying to assess the knowledge and preventive behavior followed by the medical professionals from NRI medical college, sangivalasa.

Transpiloric feeding in gastroesophageal reflux in neonatology

Optimizing nutritional support is essential for critically ill children, and premature infants are particularly vulnerable to the effects of prolonged fasting. There is a lot of evidence in the scientific literature for the benefits of enteral nutrition. It is known that premature babies need an individual approach to nutrition due to the prevalence of catabolic processes, while treatment in the intensive care unit requires a surplus of calories. Timely introduction of enteral nutrition helps to reduce morbidity and mortality in this population. Gastroesophageal reflux is common in preterm infants. When there is a decrease in tolerance to enteral feeding, doctors usually prefer parenteral nutrition. However, its use can be associated with metabolic, infectious and iatrogenic complications. A step-by-step therapeutic approach is recommended in the treatment of GER in preterm infants. Conservative treatment should be considered as first-line therapy in children without clinical complications. Feeding through a gastric tube is not always well tolerated by seriously ill people patients. As for the treatment of complicated GER, extensive studies show that the use of transpiloric feeding is comparable in effectiveness to fundoplication. Transpiloric feeding tube can be justified as a strategy for treating GER that is refractory to conservative therapy.