Knowledge of Healthcare Workers Regarding Road Traffic Child Safety in South Backa District, Serbia.

Introduction: Healthcare workers (HCW) can have an important role in educating parents about child road safety, but research on the topic shows that they usually do not have adequate knowledge. Thus, the aim of our study was to analyze their knowledge in the field of child road safety. Methods: The cross-sectional study was conducted among HCW from South Backa district, Serbia, using a specially created questionnaire for assessing knowledge on road traffic injuries in children. Results: The research involved the participation of 317 healthcare workers (86 physicians and 231 nurses). Healthcare workers from primary healthcare made up almost 70% of all respondents, followed by those from tertiary (21.8%) and secondary (11.3%) level institutions. The average percentage of correct answers on the knowledge test was 74.3% (mean=22.3, SD=4.0). Out of all respondents, HCWs employed in the paediatrics department had a significantly higher percentage of correct answers at 77.7% (mean=23.3, SD=3.4) compared to other health workers at 73% (mean=21.9, SD=4.1) (p=0.002). Association analysis demonstrated that HCW employed at paediatric departments on average scored 1.37 (95% CI: 0.40-2.33, p=0.006) points higher in comparison with other HCW. Conclusion: This research demonstrated an unsatisfactory level of knowledge on child road safety by HCW, and the variability across different question domains, which underlines the need for continuous educations in order to improve their knowledge. Our results may serve in planning additional public health measures and can provide a reference for future studies.

Comparison of diagnostic accuracy for eight SARS-CoV-2 serological assays.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serological tests have been suggested as an additional diagnostic tool in highly suspected cases with a negative molecular test and determination of seroprevalence in population. We compared the diagnostic performance of eight commercial serological assays for IgA, IgM, and IgG antibodies to the SARS-CoV-2 virus. MATERIALS AND METHODS: The comparison study was performed on a total of 76 serum samples: 30 SARS-CoV-2 polymerase chain reaction (PCR)-negative and 46 SARS-CoV-2 PCR-positive patients with asymptomatic to severe disease and symptoms duration from 3-30 days. The study included: three rapid lateral flow immunochromatographic assays (LFIC), two enzyme-linked immunosorbent assays (ELISA), and three chemiluminescence immunoassays (CLIA). RESULTS: Agreement between IgM assays were minimal to moderate (kappa 0.26 to 0.63) and for IgG moderate to excellent (kappa 0.72 to 0.92). Sensitivities improved with > 10 days of symptoms and were: 30% to 89% for IgM; 89% to 100% for IgG; 96% for IgA; 100% for IgA/IgM combination; 96% for total antibodies. Overall specificities were: 90% to 100% for IgM; 85% to 100% for IgG; 90% for IgA; 70% for IgA/IgM combination; 100% for total antibodies. Diagnostic accuracy for IgG ELISA and CIA assays were excellent (AUC ≥ 0.90), without significant difference. IgA showed significantly better diagnostic accuracy than IgM (P < 0.001). CONCLUSION: There is high variability between IgM assays independently of the assay format, while IgG assays showed moderate to perfect agreement. The appropriate time for testing is crucial for the proper immunity investigation.

Telepsychiatry in graduate medical education: a narrative review.

OBJECTIVE: Telepsychiatry is an innovation that addresses disparities in access to care. Despite rigorous clinical research demonstrating its equivalence and effectiveness relative to face-to-face care, many providers are unfamiliar with this technology. Training residents in telepsychiatry is critical to building mental health care capacity in rural and underserviced communities. However, many questions remain regarding the competencies that future psychiatrists require with respect to telepsychiatry, and technology generally, and regarding pedagogical approaches that will promote their attainment. This literature review aims to elucidate evidence-based approaches to developing residents' competence to practice telepsychiatry. METHODS: The authors conducted a literature search of telepsychiatry training for psychiatry residents. The authors searched MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane, and ERIC using subject headings and keywords; and hand searched reference lists, forward citations of relevant articles, and tables of contents of relevant journals. Articles were included if they were in English, discussed teaching psychiatry residents to provide direct or indirect clinical care via real-time videoconferencing technology, and were published by January 2014. RESULTS: In total, 215 unique references yielded 20 relevant publications. The literature on graduate training in telepsychiatry is sparse, heterogeneous, and primarily descriptive. Even brief learning experiences may increase the likelihood that residents will incorporate telepsychiatry into their future practice. Training should address competencies that are (1) technical, (2) collaborative/interprofessional, and (3) administrative. Training typically consists of supervised provision of clinical care to build modality-specific clinical skills and may also include didactic teaching to provide health systems and transcultural and medicolegal perspectives. CONCLUSIONS: A more evidence-based approach to telepsychiatry training is needed, including an assessment of residents' learning needs, use of multiple learning modalities, and evaluations of educational curricula. Pedagogically sound curriculum development and evaluation of postgraduate education in telepsychiatry could promote social accountability, cultural competence, interprofessional care, and, ultimately, improve clinical outcomes.

Relation between lipid peroxidation and iron concentration in mouse liver after acute and subacute cadmium intoxication.

In this study the effect of acute and subacute cadmium (Cd) intoxication on iron (Fe) concentration and lipid peroxidation (LPO) was investigated in the livers of Swiss mice. Animals were divided into two groups: the Cd group--mice intoxicated with Cd and controls. In acute time-response studies, Fe and malondialdehyde (MDA) levels were determined at 4, 6, 12, 24 and 48 h after a single oral dose of Cd (20 mg Cd/kg b.w.). In the subacute experiment, mice were given 10 mg Cd/kg b.w. orally every day for 14 days; Fe and MDA contents were determined in liver after 1 and 2 weeks. Acute Cd intoxication induced a significantly increased hepatic Fe content after 4 and 6h, and a statistically significant increase in MDA 6, 12 and 24h after Cd administration, although a significantly decreased MDA level was observed after 48 h. The results suggest development of early oxidative stress in livers of mice after acute intoxication with Cd. The decreased MDA observed after 48 h occurred presumably due to the adaptive response of the organism. Subacute Cd intoxication induced a significant decrease of hepatic Fe and MDA levels at both investigated time intervals compared with control. These results indicate a positive correlation between hepatic Fe and MDA content and suggest that prolonged Cd intoxication decreases hepatic LPO indirectly, by reducing the Fe content of mouse liver.

The role of nitric oxide in paraquat-induced oxidative stress in rat striatum.

The role of nitric oxide (NO) in paraquat (PQ)-induced neurotoxicity is still not fully understood. In this study we used NG-nitro-L-arginine methyl ester (L-NAME), a non-selective nitric oxide synthase (NOS) inhibitor, in order to examine the effects of NO, reactive oxygen species (ROS) generation and lipid peroxidation (LPO) development during PQ-mediated neurotoxicity. Oxidative stress development in the striatum of Wistar rats intrastriatally (i.s.) poisoned with PQ (and in some cases pre-treated with L-NAME) was investigated by measuring superoxide anion (O2.-), malondialdehyde (MDA) and nitrate (NO3-), 30 min, 24 hours and 7 days after treatment. L-NAME pre-treatment provided the possibility to distinguish the role of ROS from reactive nitrogen species (RNS) in oxidative stress development induced by PQ. Our results confirm the involvement of NO in PQ-mediated neurotoxicity and reduced LPO by L-NAME pre-treatment implying that the latter has a protective role.