Job stress and burnout syndrome among critical care healthcare workers

Background: Among healthcare professions, critical care healthcare workers (HCWs) have one of the most stressful jobs. This study was conducted to determine the relationship between job stress and burnout syndrome (BOS) among nurses and healthcare technicians at the surgical emergency department and intensive care unit of Critical Care department at the Alexandria University Hospital.Methods: A cross-sectional approach was conducted from October 2014 to March 2015. Eighty-two nurses and healthcare technicians participated in the research (response rate = 80.39%). Data was collected by an interview questionnaire using selected subscales of NIOSH Generic job stress Questionnaire and Maslach Burnout Inventory of Health and human service Questionnaire. The relationship between BOS and job stress was examined using bivariate and multivariate analyses.Results: Although majority of participants reported variation of workload (84.15%), quantitative overload (76.8%), responsibility for peoples’ life (69.5%) and lack of perceived control (63.41%), yet, 85.4% were satisfied with their job. Moreover, high levels of emotional exhaustion was reported by the majority of participants (80%), while less than one third reported either high levels of depersonalization or low levels of personal accomplishment domains of BOS. In multiple regression analysis, skill underutilization, variation in workload, and intragroup conflicts were negatively associated with BOS domains. While, job satisfaction and responsibility for peoples’ life were positively associated with personal accomplishment domain of BOS.Conclusion: Critical care HCWs had high BOS. The study concluded that reducing intragroup conflict, improving skills utilization, and raising job satisfaction are crucial to reduce BOS among critical care HCWs. More attention and psychological support is recommended to critical care HCWs.Keywords: Burnout syndrome, Critical care, Healthcare workers, Job stress, Nurse

The Ishraq Program for out-of-school girls: From pilot to scale-up

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities of local facilitators and partners to implement the program. This report identifies ways to continue expanding Ishraq, for which community demand remains high, including a new generation of girls’ programs to support graduates in exercising their rights and becoming active members of the community; and notes many important lessons on recruitment strategy, program structure and implementation, capacity-building, and partnerships

Hepatitis-c virus infection and exposure to blood and body fluids among nurses and paramedical personnel at the Alexandria University Hospitals, Egypt

Background: Worldwide, prevalence of anti-HCV positivity in health care workers (HCWs) ranges from 0% to 9.7%. The current study was conducted to calculate prevalence of HCV infection, frequency and characteristics of blood and body fluid (BBF) exposure among HCW at the Alexandria University Hospitals.Methods: Hospital-based cross-sectional approach was adopted. At the Hospitals, 62.2% of available nurses and paramedical personnel voluntarily participated (n = 499), and were interviewed, screened for HCV antibodies. Quantitative estimation of HCV-RNA was done to seropositive cases.Results: Prevalence of anti-HCV antibodies and HCV infection was 8.6%, and 4.4% respectively. The frequency of BBF exposures was 66.7%. Blood/blood products were mainly involved (92.1%). More than half of exposed HCWs reported not wearing personal protective devices. Anatomical site of exposure was mainly right hand palm (36.2%). Regarding needle-stick injuries, two thirds of injured HCWs were the original user of sharp item which was contaminated in 79.7% of injuries. In 70.2% of injuries, disposable syringes were involved and occurred during item disposal. About 61% of injuries were superficial.Conclusion: Prevalence of HCV infection among HCWs is similar to that among general population in the country. Nurses and housekeepers are frequently exposed to BBF. Adherence to infection control measures according to the National Guidelines is crucial to reduce HCV transmission.Keywords: Hepatitis C, Infection, Needlestick injuries, Nurses, Paramedical personne

The Ishraq Program for out-of-school girls: From pilot to scale-up [Arabic]

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities of local facilitators and partners to implement the program. This report identifies ways to continue expanding Ishraq, for which community demand remains high, including a new generation of girls’ programs to support graduates in exercising their rights and becoming active members of the community; and notes many important lessons on recruitment strategy, program structure and implementation, capacity-building, and partnerships

Bioassay-guided isolation, metabolic profiling, and docking studies of hyaluronidase inhibitors from Ravenala madagascariensis

Hyaluronidase enzyme (HAase) has a role in the dissolution or disintegration of hyaluronic acid (HA) and in maintaining the heathy state of skin. Bioassay-guided fractionation of Ravenala madagascariensis (Sonn.) organ extracts (leaf, flower, stem, and root) testing for hyaluronidase inhibition was performed followed by metabolic profiling using LC–HRMS. Additionally, a hyaluronidase docking study was achieved using Molecular Operating Environment (MOE). Results showed that the crude hydroalcoholic (70% EtOH) extract of the leaves as well as its n-butanol (n-BuOH) partition showed higher HAase activity with 64.3% inhibition. Metabolic analysis of R. madagascariensis resulted in the identification of 19 phenolic compounds ranging from different chemical classes (flavone glycosides, flavonol glycosides, and flavanol aglycones). Bioassay-guided purification of the leaf n-BuOH partition led to the isolation of seven compounds that were identified as narcissin, rutin, epiafzelechin, epicatechin, isorhamnetin 7-O-glucoside, kaempferol, and isorhamnetin-7-O-rutinoside. The docking study showed that narcissin, rutin, and quercetin 3-O-glucoside all interact with HAase through hydrogen bonding with the Asp111, Gln271, and/or Glu113 residues. Our results highlight Ravenala madagascariensis and its flavonoids as promising hyaluronidase inhibitors in natural cosmetology preparations for skin care

Study of Visfatin Level in Type 1 Diabetic Children and Adolescents

BACKGROUND: Visfatin is an intracellular enzyme, known as nicotinamide phosphoribosyltransferase (Nampt) and pre-B-cell colony-enhancing factor (PBEF-1). It has insulin-mimetic effects and lowers plasma glucose levels.AIM: The aim of the work was to assess serum concentration of Visfatin in type 1 diabetic children and adolescents and study its relationships with duration of diabetes, body mass index (BMI), glycemic control, insulin dosage, lipid profile and microvascular complications.MATERIAL AND METHODS: Fifty children and adolescents with type 1 diabetes mellitus were recruited with 30 ages and gender-matched healthy subjects. They were subjected to history taking; anthropometric measurements and chronic diabetic complications were recorded if present. Laboratory analysis included urinary microalbumin, serum triglycerides, HDL, LDL, cholesterol, fasting blood glucose, glycosylated Hb (HbA1c) and serum visfatin which was measured with enzyme-linked immunosorbent assay.RESULTS: Diabetic patients showed highly significant decrease in the level of visfatin compared to the control group (P = 0.0001).There was significant further decrease in visfatin level in diabetics with microalbuminuria (n = 13) compared to normoalbuminuric patients (n = 37) (P = 0.015). There was highly significant inverse correlation between visfatin level with age (r = -0.379, p = 0.007), BMI (r = -0.418, p = 0.003), waist circumference (r = -0.430, p = 0.002), hip circumference (r = -0.389, p = 0.005) and microalbuminuria (r = -0.323, p = 0.022).CONCLUSIONS: Type 1 diabetic children and adolescents had a significantly lower visfatin level compared to controls. A marked decrease in the level of visfatin was shown in patients with microalbuminuria with an inverse correlation with BMI suggesting an important role of visfatin in the pathogenesis of type 1 diabetics and type 1 diabetic nephropathy

A Device to Quantify Sweat in Single Sweat Glands to Diagnose Neuropathy

We devised an objective "Sensitive Sweat Test" (SST) that detects and quantifies early changes in the function of sudomotor nerves that activate sweat glands (SGs). The SST is designed to diagnose peripheral neuropathy early, when the probability for reversal is greatest. Chemotherapy induced and diabetic neuropathy are very common causes of neuropathy in the USA. Both result in peripheral numbness, pain, decreased sweating, abnormal circulation, and eventual weakness. Early recognition can provide a better opportunity to treat and halt neuropathy than discovery after the onset of nerve degeneration. We contend that early diagnosis can be achieved by sensitive monitoring of sweating. Unfortunately, the changes that first signal impending sweat deficiency escape detection by conventional clinical examination and current tests We contracted with several MN small business concerns (SBCs) to construct the SST miniature camera device Methods Skin sites on the medial calf and foot dorsum, each measuring 2 cm 2 were stimulated to sweat maximally by iontophoresis of 1% pilocarpine (2 ma, 5 min; Transparent tape thinly coated with starch was attached over the lens of the SST miniature camera. The skin test sites were prepped with a 1% iodine solution. The skin was wiped dry and immediately the camera was pressed against the skin, activating a switch to begin image collection and storage. As sweat water exited from each sweat pore it contacted iodine and starch and formed a tiny dark spot. The tape prevented formation of a drop. Instead, sweat was forced to flow centrifugally to form a flat expanding dark spot. The SST device imaged spots from >200 SGs at 1 frame/sec (area of 2 cm 2 ) for 60 to 90 seconds, until adjacent spots coalesced. The process was performed twice. Image analysis was done in the Mathworks Software, MATLAB version R2012a. Each individual sweat spot was identified and followed from frame to fram

Surveillance on A/H5N1 virus in domestic poultry and wild birds in Egypt

The endemic H5N1 high pathogenicity avian influenza virus (A/H5N1) in poultry in Egypt continues to cause heavy losses in poultry and poses a significant threat to human health. Here we describe results of A/H5N1 surveillance in domestic poultry in 2009 and wild birds in 2009-2010. Tracheal and cloacal swabs were collected from domestic poultry from 22024 commercial farms, 1435 backyards and 944 live bird markets (LBMs) as well as from 1297 wild birds representing 28 different types of migratory birds. Viral RNA was extracted from a mix of tracheal and cloacal swabs media. Matrix gene of avian influenza type A virus was detected using specific real-time reverse-transcription polymerase chain reaction (RT-qPCR) and positive samples were tested by RT- qPCR for simultaneous detection of the H5 and N1 genes. In this surveillance, A/H5N1 was detected from 0.1% (n = 23/) of examined commercial poultry farms, 10.5% (n = 151) of backyard birds and 11.4% (n = 108) of LBMs but no wild bird tested positive for A/H5N1. The virus was detected from domestic poultry year- round with higher incidence in the warmer months of summer and spring particularly in backyard birds. Outbreaks were recorded mostly in Lower Egypt where 95.7% (n = 22), 68.9% (n = 104) and 52.8% (n = 57) of positive commercial farms, backyards and LBMs were detected, respectively. Higher prevalence (56%, n = 85) was reported in backyards that had mixed chickens and waterfowl together in the same vicinity and LBMs that had waterfowl (76%, n = 82). Our findings indicated broad circulation of the endemic A/H5N1 among poultry in 2009 in Egypt. In addition, the epidemiology of A/H5N1 has changed over time with outbreaks occurring in the warmer months of the year. Backyard waterfowl may play a role as a reservoir and/or source of A/H5N1 particularly in LBMs. The virus has been established in poultry in the Nile Delta where major metropolitan areas, dense human population and poultry stocks are concentrated. Continuous surveillance, tracing the source of live birds in the markets and integration of multifaceted strategies and global collaboration are needed to control the spread of the virus in Egypt

Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor (VDR) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of VDR polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for VDR single nucleotide polymorphisms (SNPs), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of VDR polymorphism rs228570 and rs1544410 between the study groups (p \u3c 0.001). No difference was observed in the allelic discrimination of VDR polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar (FBS), glycated hemoglobin HbA1c, 2-h post-prandial blood sugar (PP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), total cholesterol, and triglycerides (p \u3c 0.001), while High-Density Lipoprotein (HDL) Cholesterol (HDL-C) was significantly decreased (p = 0.006). (4) Conclusions: VDR polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM