Guidance for health care worker surveys in humanitarian contexts in LMICs

Developed by the Social Sciences Analysis Cell (CASS) and the Research Roadmap to support those working with communities and healthcare workers in humanitarian and emergency contexts This document has been developed for response actors working in humanitarian contexts who seek rapid approaches to gathering evidence about the experience of healthcare workers, and the communities of which they are a part. Understanding healthcare worker experience is critical to inform and guide humanitarian programming and effective strategies to promote IPC, identify psychosocial support needs. This evidence also informs humanitarian programming that interacts with HCWs and facilities such as nutrition, health reinforcement, communication, SGBV and gender. In low- and middle-income countries (LMIC), healthcare workers (HCW) are often faced with limited resources, equipment, performance support and even formal training to provide the life-saving work expected of them. In humanitarian contexts1 , where human resources are also scarce, HCWs may comprise formally trained doctors, nurses, pharmacists, dentists, allied health professionals etc. as well as community members who perform formal health worker related duties with little or no trainingi . These HCWs frequently work in contexts of multiple public health crises, including COVID-19. Their work will be affected by availability of resources (limited supplies, materials), behaviour and emotion (fear), flows of (mis)information (e.g. understanding of expected infection prevention and control (IPC) measures) or services (healthcare policies, services and use). Multiple factors can therefore impact patients, HCWs and their families, not only in terms of risk of exposure to COVID-19, but secondary health, socio-economic and psycho-social risks, as well as constraints that interrupt or hinder healthcare provision such as physical distancing practices. The development and dissemination of training and guidance for HCWs is important for any new infectious disease outbreak. Equally, evaluation of their appropriateness and utility, their impacts on HCW performance and behaviour, and their effectiveness (perceived or measured against programmatic outcome indicators) is important to adapt and improve the appropriateness and effectiveness of resources for HCWs. We recommend HCW surveys are included as a critical component of research associated to humanitarian programming for communities and community health outcomes

Efeitos da aplicação do laser de baixa potência na regeneração do nervo isquiático de ratos

Os nervos periféricos sofrem constantes lesões de origem traumática, o que resulta em perdas funcionais. A terapia com laser de baixa potência vem sendo utilizada para minimizar os efeitos maléficos da inflamação e acelerar o processo de cicatrização dos tecidos lesados. Este estudo teve como objetivo verificar o efeito da irradiação do laser 830 nm no comportamento do nervo isquiático de ratos submetido a esmagamento. Foram utilizados 20 ratos, todos tendo tido o nervo isquiático esmagado, divididos em 4 grupos (n=5): P7 e P14, tratamento placebo por 7 e 14 dias; L7 e L14, tratamento por laser (dosagem de 4 J/cm²) por 7 e 14 dias. Os animais dos grupos P7 e P14 foram submetidos aos mesmos procedimentos, mas com o laser desligado. Os parâmetros analisados foram presença de infiltrado inflamatório e fibroblastos, destruição da bainha de mielina e degeneração axonal. Na análise estatística foi observada diferença estatística com relação a três parâmetros: os animais do grupo L14 apresentaram maior quantidade de fibroblastos (p=0,0001), menor degeneração da bainha de mielina (p=0,007) e menor quantidade de infiltrado inflamatório (p=0,001). A aplicação do laser de baixa potência contribuiu para a redução do processo inflamatório decorrente da lesão do nervo isquiático de ratos.Peripheral nerves are commonly subject to traumatic injuries, leading to functional loss. Low-power laser therapy has been used in order to minimize harmful effects of inflammation and to accelerate healing of injured tissues. The purpose of this study was to assess the effect of 830 nm-laser irradiation on rat sciatic nerves submitted to crush. Twenty male Wistar rats had their sciatic nerve crushed and were divided into 4 groups (n=5): Sham7 and Sham14, placebo-treated for 7 and 14 days; L7 and L14, laser-treated (at 4 J/cm²) for 7 and 14 days. Sham group animals were submitted to the same procedures, but with the laser turned off. Assessed parameters were inflammatory infiltrates, fibroblasts, myelin sheath destruction, and axonal degeneration. The statistical analysis showed significant differences in three parameters: L14 animals showed more fibroblasts (p=0.0001), lesser myelin sheath degeneration (p=0.007), and lesser inflammatory infiltrates (p=0.001). Low-power laser therapy hence contributed to reduce the inflammatory process due to rat sciatic nerve injury

Origin of intrinsic irregular firing in cortical interneurons

Cortical spike trains are highly irregular both during ongoing, spontaneous activity and when driven at high firing rates. There is uncertainty about the source of this irregularity, ranging from intrinsic noise sources in neurons to collective effects in large-scale cortical networks. Cortical interneurons display highly irregular spike times (coefficient of variation of the interspike intervals >1) in response to dc-current injection in vitro. This is in marked contrast to cortical pyramidal cells, which spike highly irregularly in vivo, but regularly in vitro. We show with in vitro recordings and computational models that this is due to the fast activation kinetics of interneuronal K(+) currents. This explanation holds over a wide parameter range and with Gaussian white, power-law, and Ornstein–Uhlenbeck noise. The intrinsically irregular spiking of interneurons could contribute to the irregularity of the cortical network