Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis.

Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.

A survey of E-learning methods in nursing and medical education during COVID-19 pandemic in India.

BACKGROUND: COVID-19 pandemic has necessitated mandatory e-learning in medical and nursing education. How far are developing countries like India (with wide socioeconomic and cultural diversity) geared up for this challenge remains unexplored. At this critical juncture, we aim to evaluate if online teaching methods are as feasible, acceptable, and effective as in-class teaching for medical/nursing students. OBJECTIVES: The questionnaire captured: (1) practicability/feasibility of online classes, (2) health issues from online classes, (3) current methods for e-teaching, and (4) student attitudes and preferences. DESIGN: Cross-sectional survey. SETTINGS: Population-based study in India. PARTICIPANTS: Nursing and medical undergraduate students (I-IV year). METHODOLOGY: The online questionnaire was distributed to 200 medical and nursing colleges across India. Categorical variables were analyzed using chi-square tests. Binary logistic regression was done to analyze factors predicting health issues in students. p < 0.05 was considered significant. RESULTS: Overall, 1541 medical and 684 nursing students completed the survey from 156 cities. The availability of laptop (p < 0.0001), Wi-Fi (p < 0.0001), dedicated room (p < 0.0001), and computer proficiency was more in students of affluent families and those from cities (p < 0.0001). Class duration >4 h/day (p < 0.0001), each class >40 min (p < 0.009) and pre-existing health issues (p < 0.0001) predicted the occurrence headache, eyestrain, anxiety, neck/back pain, and sleep disturbance. Power-point presentation was the most widely (80%) used method of teaching. Only 30% got adequate time to interact with teachers. Only 20.4% felt e-learning can replace conventional teaching. Students preferred: 3-6 classes/day, each class <40 min, 10-20 min break between classes and interactive sessions. CONCLUSION: There is a need to improve information and communication infrastructure to enhance feasibility of e-learning for nursing/medical students in India. There should be guidelines (number of classes/day, length of each class, break between classes, curriculum, etc) to improve the retention capacity in students and reduce health issues. Continuous feedback from teachers and students will be required to make e-learning effective.

Overexpression of PgDREB2A transcription factor enhances abiotic stress tolerance and activates downstream stress-responsive genes.

The DREB transcription factors comprise conserved ERF/AP2 DNA-binding domain, bind specifically to DRE/CRT motif and regulate abiotic stress mediated gene expression. In this study we show that PgDREB2A from Pennisetum glaucum is a powerful transcription factor to engineer multiple stress tolerance in tobacco plants. The PgDREB2A protein lacks any potential PEST sequence, which is known to act as a signal peptide for protein degradation. Therefore, the transgenic tobacco plants were raised using full-length cDNA without modification. The transgenics exhibited enhanced tolerance to both hyperionic and hyperosmotic stresses. At lower concentration of NaCl and mannitol, seed germination and seedling growth was similar in WT and transgenic, however at higher concentration germination in WT decreased significantly. D15 and D46 lines showed 4-fold higher germination percent at 200 mM NaCl. At 400 mM mannitol seed germination in WT was completely arrested, whereas in transgenic line it was more than 50%. Seedlings of D15 and D46 lines showed better growth like leaf area, root number, root length and fresh weight compared to wild type for both the stresses. The quantitative Real time PCR of transgenic showed higher expression of downstream genes NtERD10B, HSP70-3, Hsp18p, PLC3, AP2 domain TF, THT1, LTP1 and heat shock (NtHSF2) and pathogen-regulated (NtERF5) factors with different stress treatments.

The evolution of freestanding children's hospitals in Canada.

OBJECTIVE: The purpose of the present article is to examine the evolution of freestanding children's hospitals in Canada over the past century. The results include documentation of the number of freestanding children's hospitals in Canada that have since closed, merged with other institutions or remained freestanding. Similar data are presented for the United States (US). Also included is an analysis of factors in the internal and external environment that contributed to the changing structure of children's hospitals. METHODS: Sources of information included a review of the literature, publicly available data and statistics on children's hospitals in Canada and the US. RESULTS: Nine of the 16 children's hospitals in Canada were freestanding at one time. Today, only two remain freestanding. Three formerly freestanding children's hospitals have merged with maternal health facilities and four formerly freestanding children's hospitals have merged with adult institutions. Similar trends are seen in the US. CONCLUSIONS: The structure of children's hospitals in North America has changed significantly over the past century. This can be attributed to a number of factors, including the evolution of the health status of children due to medical advances, as well as external forces such as demographics and the rising cost of health care. The impact on the health of children and the mission of children's hospitals in terms of patient care, teaching and research remains to be seen.