Sick People Research Articles

Standard Precautions among HealthCare Workers in a Tertiary Health Facility in Enugu Metropolis, South-East Nigeria

BackgroundThe work environment of Health Care Workers (HCWs) can be described as a potential risk zone due to numerous hazards endemic to the environment. The hospital is not just only a place where the sick people recover from their illness, but also where the healthy get infected.ObjectivesTo assess the knowledge, attitude and practice of Standard Precautions (SP) among HCWs in a tertiary government health facility in Enugu Metropolis, Nigeria.MethodsA descriptive cross-sectional design that used mixed method approach. Qualitative data was collected using an in-depth interview. The quantitative data instrument was a semi-structured, self-administered questionnaire. Manual content analysis was done for the qualitative data. Quantitative data was analysed using SPSS version 22.ResultsSixty-four (32.0%), 131(65.5%) and 5(2.5%) had good, fair and poor knowledge of SP respectively while 117(58.5%), 70(35.0%) and 13(6.5%) had good, fair and poor attitude to SP respectively. Fifty-nine (29.5%), 140(70.0%) and 1(0.5%) had good, fair and poor practice of SP respectively.ConclusionThere was fair knowledge and practice of SP among the studied HCWs while attitude was good.Rwanda J Med Health Sci 2021;4(3):366-378

Application of the constitutional-typological approach in the study of the morphometric features of the dentition in people with the brachypalatinal type of the palatine arch

The fundamental problem of precision medicine is the division of the population of sick and healthy people into separate individuals, differing in the likelihood of disease occurrence and the ability to respond to various types of therapy. This is mainly due to the individual, constitutional features of the structure, including the dentoalveolar system. The introduction of a constitutional-typological approach in a comprehensive study of the human dentition is an important task of modern dentistry, since it allows one to determine the characteristic morphological and functional characteristics of each individual individual to improve the methods of diagnosis and treatment of dentoalveolar pathology. The article examines the morphometric features of the dentoalveolar system in people with brachypalatinal («wide» and «low») type of palatine vault, as well as their relationship with the shape of dental arches and the size of the inter-incisal angle at a physiological occlusal norm. As a result of the study, the following regularity was determined: the brachypalatinal type of the palatine vault corresponds to «wide» dental arches of the brachygnathic type with an inter-incisal angle of more than 145 degrees. The value of the brachypalatinal index of the palatine fornix, as the ratio of the height of the palate to its width, exceeds 45 percent, and the gnathic index of the dental arches is 0.59 ± 0.03. The data obtained can be used in the clinic of orthodontics, orthopedic dentistry, maxillofacial surgery to assess the parameters of the hard palate, diagnose pathological forms of the palatine fornix and determine the effectiveness of the treatment.

COVID-19 immunizations in occupational medicine

This article discusses issues related to exposure to SARS-CoV-2 in the work environment and employee's vaccination against COVID-19. The new SARS-CoV-2 coronavirus identified as the etiologic agent of COVID-19 prompted the World Health Organization (WHO) to declare a pandemic in March 2020. The droplet route transmits the virus. Therefore, health care workers in contact with sick people and anyone employed in direct contact with large numbers of people are particularly vulnerable to infection. The introduction of COVID-19 vaccination removes the need for quarantine, reduces the risk of disease, limits transmission within the workplace, and reduces sickness absence. The role of the occupational health services is to promote vaccination against COVID-19 by providing reliable information on the safety and efficacy of immunization and organizing and carrying out vaccination in workplaces. Med Pr. 2021;72(6):701-10.

Some features of the influence of nitrogen oxide on humans at rest, physical activity and pathology

The literature data on the general characteristics and mechanisms of action of nitric oxide, its role in the regulation of the functioning of the cardiovascular system and the body as a whole are used in the work. The existing NO-dependent mechanism of regulation of vascular reactivity in the conditions of endothelial dysfunction is stated; cGMP-independent mechanism of NO action on calcium homeostasis and sensitivity of smooth muscle myofibrils to calcium ions. Interesting are the results of studies that reflect the importance of nitric oxide in health. Age-related changes in vascular endothelial function due to increasing age and their importance in the development of age-related pathology are shown. Materials that reflect the importance of the use of nitric oxide donors for the treatment of diseases of various body systems, as well as factors of pharmacological correction of disorders of NO metabolism and associated with these changes endothelial dysfunction. Much attention is paid to the work, which reflects the role of nitric oxide in improving physical performance and the importance of this effect in the lives of athletes. The effect of nitric oxide on microorganisms, the use of nitric oxide in the treatment of infectious diseases, in particular during viral infection, is proved. The contribution of Ukrainian scientists in studying the effects of nitric oxide on the body of healthy and sick people, the elderly and senile, as well as the role in the creation of pharmacological drugs, nitric oxide donors for the prevention and treatment of diseases.

Endogenous Endophthalmitis in COVID-19 Patients

Intrinsic endophthalmitis is indeed behavior that causes eye disease that spreads into the bloodstream from a distant primary site. The intraocular disease caused by hematogenous microbial proliferation is known as indigenous endophthalmitis. Extrinsic and intrinsic endophthalmitis are the two types of endophthalmitis that exist. The presence of an external point of entry is linked to extrinsic endophthalmitis. Intrinsic endophthalmitis is a kind of septicemia caused by a blood-borne infection. Endophthalmitis is a disease of all the inner coating of the eyeball except the sclera and cornea, which is accompanied by substantial, increasing vitreous swelling. Endophthalmitis is a severe ocular crisis with severe visual and general consequences. An exterior injury of the entrance, such as injury, operation, or an inflamed cornea, is the most prevalent route of entry for potential pathogens. Endophthalmitis has a complex etiology, with many pathogenic species and substantial regional heterogeneity. The treatment of endophthalmitis has evolved dramatically during the last century. Endophthalmitis induced by direct inoculation dissemination of pathogenic microbes is a rare occurrence that occurs most commonly in sick or disadvantaged people. Intravenous medication usage, diabetes mellitus, immunological impairment, cancer, prolonged hospitalization, or systemic antibiotic therapy have all been linked to a 0.04 percent incidence rate. Haden described metastatic endophthalmitis in a seriously sick patient with pneumococcal cerebrospinal encephalopathy treated with intravenously anti-meningococcal serum in the 1918 volume of the Journal Ophthalmology. Endogenous endophthalmitis, unlike extrinsic endophthalmitis, needs comprehensive systemic antibiotic treatment. In indigenous endophthalmitis, the illness originates not in the eye but elsewhere in the body. As a result, it is necessary to obtain comprehensive cultures. Patients are sometimes unable to carry out their functions in society or household. As a rest, the person cannot cope financially and socially in his environment. Many social and influential factors are disturbed, and the patients are often depressed. Cosmetically the surgeries are not satisfying. Artificial prosthetics can be used, but they're seldom of minimum functional importance. Such interventions can be helpful for the patient. The focus should be made to deliberately save the patients and not just the cosmetic value of the surgery. Persons with chronic endophthalmitis had more excellent eyesight than people with symptomatic or subacute endophthalmitis. Improvements in eyesight were observed in individuals with persistent or subacute keratitis several months after the surgery more frequently than in people with symptomatic endophthalmitis. Nevertheless, in 40 percent of the overall all instances with an abrupt start, there have been no improvements or even decrease in visual acuity.

Robert Erskine — the first archiater and creator of military medicine and military medical education in Russia

This study aimed to analyze many archival published documents and contemporary testimonies at the beginning of the 18th century, which reflects little-known facts of medicine history. The creation history of military medicine in Saint Petersburg, an integral part of the military history of Russia, was presented against the background of the most important events of the Northern War against Sweden (17001721) and military reform. The role of Robert Erskine (16771718), the reformer of Russian medicine, the head of the entire military medical service of Russia since 1706, the first Russian archiater, Surgeon in Ordinary to the King, and loyal companion and friend of Peter I was carefully studied, as he played a crucial role in establishing military medicine and medical education in Russia, mainly in Saint Petersburg. R. Erskine, who had encyclopedic-level knowledge, was also the creator and head of the Kunstkamera, the first public natural science museum in Russia (1714). The report of the head of the Moscow hospital on Yauza, Doctor N.L. Bidloo, to the Holy Synod (1722) with description and analysis of the most important facts of the Russian medicine history was also studied. Detailed documents on the number of sick and wounded people in Saint Petersburg since 1708 were presented. Not only military hospitals but also medical students in the military capital of Russia before 1715, had been documented. The documentary lists of Navy doctors from Saint Petersburg and lists of medical students who stayed in Saint Petersburg at the Navy Hospital, with the indication of the salary by articles (categories) for 1710, as well as documents on the number of sick and wounded people of the ground forces for 1712 and 1713 (Russian State Archives of the Navy), were presented. The medical staff lists of the Russian army for 1711 were examined. The absence of a large specialized medical complex at Vyborg side and insufficient suitable hospitals of any medical units located in wooden barracks at other territories cannot be proof of the absence of any hospitals until 1715 or medical schools until 1733. Ignorance of the military history of Russia can lead to numerous mistakes by historians who are interested in military medicine.

Positive clinical outcomes in two phase 2a studies: ADAS‐COG in Alzheimer’s and MDS‐UPDRS in Parkinson’s patients plus markers of toxic cascade that leads to nerve cell death

AbstractBackgroundOverexpression of neurotoxic proteins drives dysregulation of axonal transport, inflammation, nerve cell death, and loss of function. By inhibiting translation of amyloid precursor protein, tau and alpha‐synuclein our drug has been shown in animal models to restore axonal transport, lower inflammation and protect nerve cells and to restore full function in 7 animal models ‐ Down Syndrome [Chen 2020], Alzheimer’s [Teich 2018], stroke [Turcato 2018], traumatic brain injury [Chesselet], Parkinson’s [Kuo 2019], frontotemporal dementia [Davies], and acute glaucoma [Sundstrom]. We showed safety in over 130 healthy and sick people [Maccecchini 2012].MethodsWe are conducting a 2‐part double‐blind, placebo‐controlled phase 2a study in 14 AD and 14 PD patients, collected blood, CSF, conducted safety evaluations and psychometric tests. The patients were treated for 25 days. At the end of the study again safety, psychometric tests, blood and CSF. The plasma and CSF samples are being analyzed for AD and PD specific biomarkers, markers of axonal transport, inflammation, neurodegeneration and synapse health. The second part of the study is enrolling an additional 40 patients with the same study design.ResultsIn AD patients, we are reporting statistically significant improvements in a number of ADAS‐Cog variables: Number of Cancellations, Word Recall, Commands, Spoken Language, Remembering Test Instructions, and ADAS‐Cog 11. In PD patients, we also see statistically significant improvements in speed, coordination and motor function. The first step of the toxic cascade to have been measured is inflammation. Specific markers measured are: YKL40, sTREM2 and GFAP. The statistical significance holds whether the levels are compared within at 0 and at 25 days or between placebo treated and Posiphen treated at 25 days.ConclusionsWe showed that our drug improves cognition in AD and motor function in PD. The PD data is substantiated by the lowering of inflammatory markers. We are in the process of showing that by lowering more than one neurotoxic protein, our drug reverses the toxic cascade that leads to nerve cell death and loss of function. We still have a lot of markers to measure in CSF and plasma and expect to finish by July.

Atypical presentation of septic hip arthritis with tuberculosis

Background: Mycobacterium tuberculosis is a rare form of septic arthritis, it remains the major cause of skeletal infection in developing area. Tuberculosis mainly involves the large weight- bearing joints particularly hips, knees and ankles. We describe one of the rarest cases of isolated tuberculosis septic hip without involvement of pulmonary and other extrapulmonary manifestations. Case report: A 15 years old Saudi girl was referred to our hospital with compline of chronic hip pain not response to regular analgesia. The patient becomes unable to bear weight in which she uses a wheelchair. There is no history of trauma. She denied any history of fevers, chills, cough, weight loss, or pulmonary symptoms. There is no history of travel, no history of contact with sick people no history of contact with people who prove to be positive with tuberculosis. She receive all vaccines since birth. Radiological investigation with Acid Fast Bacilli and TB PCR show tuberculosis septic hip. She underwent Arthrotomy and we start Anti TB medication. Conclusion: This case shows the importance of constant care and methodical approach to help ease the early diagnosis of tuberculosis septic arthritis. In all cases of septic arthritis, especially when there is no obvious cause, tuberculosis should be suspected and maintained. Investigations should include a chest radiograph, tuberculin test, microscopy for acid-fast bacilli, and culture for Mycobacterium tuberculosis. And to minimize the delay of diagnosis, a synovial biopsy is suggested to be taken at the initial arthroscopic washout, and request histology.

Simulation model for Covid-19 pandemic

This paper outlines computer modeling algorithms designedto predict and forecast a COVID-19. In this paper, we considera deterministic model. Theongoing COVID-19 epidemic quicklyspread across the globe. Significant behavioural, social initiativesto limit city transport, case identification and touch tracking,quarantine, advice, and knowledge to the public, creationof detection kits, etc. and state measures were conducted toreduce the epidemic and eliminate coronavirus persistence inhumans around theworld from stopping the global coronavirusoutbreak. In this paper, we propose a basic SIR epidemic modelto show a simulation, the MATLAB algorithm using bouncingdots to depict safe and sick people to simulate infection spread.The graphical model shown here is implemented using MATLABpackage version 3.0.In this paper, we discuss the importance of models becausethey help one explore what could happen. They demonstratehow different possible futures might be shaped by what weare doing now. We can examine the effects of specific interventionsin different ways such as quarantine or a lockdown &explore how simulations may predict, how infectious diseasesadvanced to show the possible result of an outbreak, and betterguide initiatives in public health regarding the pandemicresponse andpandemic past including an overview of the keycharacteristics of adverse pandemic consequences and epidemicoutbreak.

The Effect of Pepper Nigrum, Olea Europaea Mouthwash with Non Surgical Periodontal Therapy on Clinical Outcome And Oxidative Stress in Chronic Periodontitis Patients

Introduction: gargles are liquid topical drugs  that action  by gargling and  rinsing into mouth. Many  mouthwashes are  existences   and by prescription with a broad  level  of active components  which can be manipulated as a  helper  to aid in the multifactorial therapy of complicated  oral situation ,  consisting  of gingivitis, halitosis, and  periodontal illness. Newly ( Pepper Nigrum  , Olea Europaea )  are herbal  with   antibacterial, anti-inflammatory, antioxidant and antifungal influences, using plant extracts as mouthwash , in addition to being safe and inexpensive. Aim :To measure  the effect of herbal mouthwash (Pepper Nigrum , Olea Europaea) and non-surgical periodontal therapy  in comparison with periodontal therapy alone  on oxidative stress , total antioxidant capacity , antioxidant  enzyme activities in all spit of sick person with chronic periodontitis. To investigate association amidst oxidative stress parameter, antioxidant enzymes, total antioxidant capacity and  periodontal parameter Material  and ways : A flow up study was conducted on a randomly selected sample of 72 patients (39male and 33femal) aged 25-55 years from patients  attending college of dentistry ,department of periodontology from December 2020, to April  2020 .participants  were assigned into three categories  , every catigory consist of 24 patients : first group receiving non-surgical periodontal treatment NSPT and Pepper Nigrum  mouthwash, second groups receiving Olea Europaea  and NSPT  while the third group control receiving NSPT only. Clinical attachment loss (CAL) and  Plaque Index (PI) were recorded. Salivary oxidative stress eight hydroxy  deoxyguanosine (8-OHdG),salivary  Catalase(CAT) and salivary Total antioxidant capacity (TAOC), were measured Result : The concentration of salivary antioxidants (CAT)  significantly increase p-value <0.006, the periodontal parameter (CAL , PI) and oxidative stress 8-OHdG significantly decrease p-value   <0.0001  and  <0.001 respectively after two weeks following the NSPT  in group of  Pepper Nigrum, while TAOC was not changed .Moreover, for Olea Europaea  group the clinical parameters of CAL, PI showed a significant decrease  and p-value was (P<0.0001) .Also  CAT   and TAOC express  a significant increase  (P<0.0001) .In addition to oxidative stress 8-OHdG marker showed a significant decrease (p <0.0001)  Conclusion: According to our research, Pepper Nigrum, Olea Europaea mouthwash with NSPT reduced  OS and bettering  periodontal status and elevated salivary antioxidant  . So, it is advised that Pepper Nigrum  , Olea Europaea  mouthwash   with NSPT could  be further efficient in control of inflammation in sick people with CP positive and negative correlations were found  between biochemical and clinical parameters in Pepper Nigrum group  while more positive correlation was  found in Olea Europaea  group. It indicates that periodontitis can be one of the factors for decreased antioxidant level in our body. It indicates that periodontitis can be one of the factors for decreased antioxidant level in our body  

Mathematical modeling of the epidemic of influenza and acute respiratory viral infections processes (ARVI) in the Yaroslavl region

In the structure of infectious diseases in the Yaroslavl region, more than 90 % are influenza and acute respiratory viral infections (ARVI). Influenza occupies a special place among human infectious diseases. This is due to its ability to epidemic and pandemic spread in a relatively short time. In this regard, scientific research on the analysis and forecasting of probable scenarios for the development of epidemic processes is of particular importance. The work used the data of the forms of the federal state statistical observation No. 2 “Information on infectious and parasitic diseases”. Fourier analysis was used to process time series. The significance of the mathematical model was checked using the Fisher test. The table of critical values of the Fisher criterion was used to assess the statistical significance, the significance level was taken equal to 0.05. Data processing was carried out using MS Excel 2013 software. During the study of the dynamics of the epidemic process, the trend of reducing the incidence of influenza and ARVI in the Yaroslavl region over the past 36 years has been determined. The dynamics of the incidence of influenza and ARVI in the Yaroslavl region over the past 36 years has a tendency to decrease. As a result of calculations, we obtained cyclical components with periods equal to 3 and 5 years. This is due to the accumulation of people who are not immune to these infections. Mathematical calculations have confirmed the values of seasonal fluctuations in 6 and 12 months. The maximum number of sick people is recorded in the winter-spring period (February — March). In accordance with the calculations, a decrease in the incidence of influenza and ARVI in the Yaroslavl region is expected in the period from 2020 to 2022: in 2020 the number of sick people (per 100 thousand population) is predicted to be 20 962.64, in 2021 — 18 138.58.

Medical Schools in National Capital Territory–A Historical and Functional Perspective

Establishment of a medical school is predominantly a political decision. Its basic aim is to further the cause of medical education. Inbuilt within this objective is looking after sick people, bringing improvement in their health, and indirectly improving their understanding of health. Delhi, being the capital city of the country, is governed by the state as well central authorities, thereby enjoying dual benefits. Currently, it has some 10 medical schools/institutes with the objectives of providing quality medical education, research and health to its people. Notably, each one has its own historical legacy and distinctive character, as evident in their respective names, logo, motto and mission statement. This article briefly discusses the historical, socioeconomic, geopolitical, and distinctive characters of each of these institutions.

Impact of regional water supply, sanitation et hygiene (WASH) program in Senegal on rural livelihoods and sustainable development

Abstract In 2006, Senegal benefited from the African Development Bank's (AfDB) Rural Water Supply and Sanitation Initiative (RWSSI) a WASH sub-program for 17,100 households in rural areas in the regions of Louga, Ziguinchor and Kolda. A project results assessment was conducted in 2016 by the AfDB Independent Development Evaluation (IDEV) to measure the sub-program impacts on the living conditions of the communities. This approach allowed the measurement of project impacts based on comparative pre-and post-intervention data, as well as beneficiaries and non-beneficiaries' groups considering collected quantitative data (963 households, 38 schools, 23 health centres and 46 GPS points of infrastructures) and qualitative data (31 individual interviews and 4 focus group discussions). Several analyses (descriptive statistics, correlative analysis, effects and impact analysis with Average Treatment Effect (ATE) and cartographic treatment) were carried out to determine the project's results indicators as well as their overall effects. The results show an access rate of 73% for drinking water among beneficiaries against 6% among non-beneficiaries, and an access rate of 72% for sanitation (improved latrine) in the treatment areas against 33.7% in the control areas. In sub-program focus areas, an increase in the quantity of water used per household by 157 liters, a reduction in water price by 0.072 USD and reduction in time taken to supply drinking water of 65 minutes were observed. Also, it was noted a reduction in arduousness of carrying water by 2 km from the supply point, an increase in the schooling rate of children, especially girls, in income-generating activities, a decrease in the number of sick people avoided by 2 persons and increase in medical treatment avoided were noted. The progress made by the project's achievements demonstrate that improvement in water access, sanitation and hygiene access is one of the main drivers and levers of change and transformation of the households' living conditions in rural areas, often explaining the priority given to this area of intervention within the implementation of the MDGs and SDGs. HIGHLIGHTS Increase of water and sanitation level access in rural areas. Links between WASH and improved living conditions of communities. Water and sanitation are major issues for communities' sustainable development. Water and sanitation are main determinants for reducing poverty incidence, improving well-being and health and community development.

Cartographies on COVID-19 and functional divisions of the territory: an analysis on the evolution of the pandemic based on Basic Health Areas (BHA) in Castile and Leon (Spain)

In the face of the confusion and uncertainty that COVID-19 has caused over the last year, Geography has proven to be a useful aid in the interpretation of the spatial dynamics that explain the transmission of the virus. Applied cartography and GIS analysis of epidemiological data have been consolidated as essential tools for interpreting the health crisis. This paper explores the usefulness of maps for the study of the evolution of the pandemic in Castile and Leon, one of the Spanish regions with the highest levels of infection and mortality. Based on the statistical variables of sick and dead people at the scale of the Basic Health Area (BHA), a first analytical approach is carried out by means of a sequence of dynamic maps during the first wave. Afterwards, a systematic study is carried out using thematic mapping for the period of the three waves, a period between March 2020 and March 2021. The analysis unravels the differential impact of the disease between rural and urban areas and reveals the problems of the mismatch between the functional divisions of the territory (BHA, as units of health analysis) and the scale of administrative management (municipalities, as the effective scale of action).

Sanitary parasitological and sanitary–bacteriological condition of the soil in the astrakhan region

This article analyzes the sanitaryparasitological and sanitarybacteriological state of the soil of the Astrakhan region for 2015 to 2019. In total, 7587 soil samples taken from various environmental objects were studied, and 18.197 studies have been performed. Of the samples, 333 (4.4%) samples did not meet the hygiene standards. For parasitic purity, 4566 (60.2%) soil samples were examined, and 9132 (50.2%) studies have been performed. The largest number of soil samples were collected and examined in 2015 and 2016, which amounted to 943 (20.7%) in 2015 and 1046 (22.9%) in 2016. The number of samples that do not meet hygienic standards was 62 (6.6%) in 2015 and 91 (8.7%) in 2016. In 2015, the positive findings were helminthiasis caused by unfertilized eggs of Ascaris lumbricoides (4 [0.5%]), eggs of Toxocara canis (37 [3.9%]), and larvae of Strongyloides stercoralis (21 [2.2%]). For microbiological indicators, the largest number of soil samples were collected and examined in 2019 and amounted to 694 (23.0%), of which positive findings in the form of common coliform bacteria of Escherichia coli amounted to six (0.9%). Studies for bacteriological indicators in 2016 have used 662 (21.9%) samples, which is 0.9 times less than the samples taken in 2019. The sanitary condition of the soil of the Astrakhan region remains stably tense, as evidenced by positive findings in the form of eggs and larvae of helminths, as well as pathogenic bacteria of Escherichia coli. The presence of ascarid eggs, toxocars, and strongylid larvae in the soil indicates contamination of these objects with the feces of infected people and animals. The presence of coliform bacteria of Escherichia coli in the soil also indicates contamination with the feces of sick people.

Prevention and Management of COVID -19

According to the WHO, total confirmed cases of Coronavirus up to October 07, 2021: 237,091,792 , Deaths: 4,840,927 , and total Recovered case 214,263,057 from COVID-19, triggered by the novel SARS-CoV-2 , the rate of case in major countries USA44,918,565 India33,894,312 Brazil21,517,514 Russia 7,662,560 Italy4,689,341 keeps expanding geographically. SARS-CoV-2 is a 29.9 kb RNA beta-coronavirus that is enveloped, positive-sense, and single-stranded. Close contact with infected patients and exposure to aerosol viruses from medical devices and procedures, such as endoscopy, may put healthcare workers at risk of infection. Current data suggests that children under the age of 18 have a low rate of infection (2.4 present). The current gold standard and confirming test for COVID19 is the detection of viral nucleic acid using reverse transcriptase polymerase chain reaction (RTPCR). The World Health Organization (WHO) has indicated that controlling infectious diseases like COVID19 requires education, isolation, prevention, transmission control, and treatment of sick people. By following the steps one can help to keep the illness from spreading. Protection consists of staying at home (home quarantine) and avoiding direct contact with healthy (potentially asymptomatic) or diseased patient.

Learning lessons about muscle wasting from insect larvae

Muscle loss is an inevitable aspect of ageing, but disease and injury can also cause muscles to waste, leading to weakness and instability. ‘Unfortunately, low muscle mass limits normal daily activities – even simple tasks, such as eating or stair climbing – thus reducing quality of life’, says Erika Geisbrecht from Kansas State University, USA, who would like to understand why muscles waste with age in the hope of designing treatments to help people remain active for longer. However, investigating the molecular components of muscle deterioration is not ideal in a species that routinely lives for more than 70 years. Fortunately, Geisbrecht knew of an animal that experiences muscle wasting as a natural part of its 1–2 month life cycle, the tobacco hawk moth (Manduca sexta): ‘[muscle] atrophy occurs normally in a subset of muscles, called the intersegmental muscles, during the pupal stage’, says Geisbrecht, adding that the large pupae are ideal for identifying key components of the molecular machinery from individual animals.She and David Brooks set about investigating how the muscle proteins changed over the course of the tobacco hawk moth's metamorphosis. ‘The hardest part … was carefully controlling temperature and time points to make sure our developmental stages were precise’, says Geisbrecht, who had to collect muscles from the pupae first thing in the morning 15 days after the eggs were laid – just before the muscles began to waste – and then 3 days later, toward the end of the wasting process. Then, Brooks painstakingly removed the pupae's muscles and analysed the proteins that comprised them, identifying 244 that differed between the normal and wasted muscles. Not surprisingly, the insects had mobilised proteins that digest and dispose of proteins as the muscle broke down over 3 days, in addition to increasing the levels of the proteins that contribute to energy generation, to fuel protein digestion. They also discovered that the metamorphosing moth pupae were producing less of the proteins that comprise the contracting muscle filaments: actin and myosin. However, Geisbrecht was most surprised when she realised that the quantity of myosin in the muscle increased as the actin dwindled, suggesting that the wasting process is tightly coordinated.So, how does this help us to understand muscle loss in elderly and sick people, which look nothing like moth pupae? Fortunately, at a genetic level, humans and insects share ∼75% of the same genes, so, having identified some of the key proteins involved in muscle wasting in the tobacco hawk moth, Geisbrecht could switch to focus on muscle wasting in another insect, Drosophila, which comes complete with a sophisticated box of molecular tools that could be used to uncover the roles of specific genes in the process. But first she had to identify a gene in the versatile insect that she could switch off to prevent muscle wasting on demand. Kumar Vishal and Simranjot Bawa (both from Kansas State University) tested six Drosophila strains that had been adapted to allow specific genes to be switched off and struck gold when they found that deactivating an actin filament regulator, Ciboulot – which promotes the growth of actin filaments on one face of the actin molecule – prevented the muscle from wasting during metamorphosis.The team had found a gene in the insect that they can now use to control muscle wasting to begin identifying key components in the process. In addition, Giesbrecht is eager to find out whether Ciboulot is also a key player in muscle loss in elderly and ill people, in the hope of developing new treatments for people suffering from muscle loss.

Registered Nurses' Perceptions After a Patient with Ebola Virus Disease Is Admitted to Their Hospital.

Emerging diseases affect the nursing workforce, but little is known about the willingness of registered nurses (RNs) to work during outbreaks (eg, Ebola virus disease, COVID-19). The objective of our study was to examine the perceptions and attitudes of RNs in the United States regarding their duty to care and willingness to work after a patient infected with the Ebola virus was admitted to their hospital. We performed a quantitative, descriptive study using social media to recruit critical care RNs to complete an online survey. A total of 72 RNs completed the survey. While only 20 respondents reported providing direct care, more than half (n = 38) reported that family members asked them not to work with patients infected with the Ebola virus. A majority of respondents (n = 63) agreed that healthcare workers have a duty to help sick people despite high risks to themselves or their families; however, 59 agreed that family responsibilities would take priority. Respondents were less likely to work if their partners (n = 11) or children (n = 7) were ill but more likely to work if colleagues were infected (n = 48) or dying (n = 40). Shunning was experienced by 32 respondents, and 25 knew of others who were shunned. We observed several factors that affect RNs' willingness to provide care when patients are admitted, including moral conflict between their duty to treat sick people and their duty to protect their family. As part of infectious disease emergency planning, health policy managers should consider these complex factors, which may modulate effective patient care. While this study was limited to RNs in the United States during an Ebola virus disease outbreak, the results signal a need for similar research on other emerging infections such as COVID-19.

PELAKSANAAN PASTORAL CARE OLEH PERAWAT DI RUANGAN INTENSIVE CARE UNIT RUMAH SAKIT ELISABETH MEDAN TAHUN 2019

Introduction:Pastoral care activities to actualize the love of God in the life of the faith community. The problem in this case is the large number of pastoral care that has not been well implemented in the hospital, in this case it is important to be carried out as motivated, provide comfort, feel supportive, relax, calm and peaceful because it can reduce anxiety and anxiety in dealing with internal pain healing process. Aim: this study aim to determine the implementation of pastoral care by nurses in the trigger room of Elisabeth Medan Hospital in 2019. Method: the type of research used is descriptive research with the type of cross sectional approach. The population in this study were 30 nurses in the ICU room at Elisabeth Medan Hospital. The sampling technique uses total sampling. The results of this study in the implementation of pastoral care by nurses in the trigger room were both 80% (24 nurses), enough 16% (5 nurses) and less carried out were 4% (1 nusres). Conclusion: the implementation of pastoral care by nurses in the trigger room of Elisabeth Medan Hospital was well implemented, with activities carried out by nurses such as religious assistance, spiritual assistance, pastoral counseling, sick people's visits and mentoring. From the implementation of pastoral care, the role of health workers or nurses is very important in implementing pastoral care for healing, sustaining, guiding and reconciling.

Asihan (Mantra) sebagai adat budaya masyarakat Lampung Pepadun

This research is motivated by an interest in the asihan or mantra of the Lampung Pepadun cultural community, North Lampung Regency which functions to strengthen mental and self-confidence, expel evil spirits, treat sick people, defeat the forces of nature, and subdue one's heart. The purpose of this study is to describe the function and meaning of asihan or mantra for the culture of the people of Lampung Pepadun, North Lampung Regency. The data in this study were taken from the traditional elders of Lampung Pepadun in North Lampung district. Data were collected by observation, interview, and recording methods.