Environmental exposures to cadmium and lead as potential causes of eye diseases

Humans are exposed to cadmium and lead in various regions of the world daily due to industrial development and climate change. Increasing numbers of preclinical and clinical studies indicate that heavy metals, such as cadmium and lead, play a role in the pathogenesis of eye diseases. Excessive exposure to heavy metals such as cadmium and lead can increase the risk of impaired vision. Therefore, it is essential to better characterize the role of these non-essential metals in disease etiology and progression. This article discusses the potential role of cadmium and lead in the development of age-related eye diseases, including age-related macular degeneration, cataracts, and glaucoma. Furthermore, we discuss how cadmium and lead affect ocular cells and provide an overview of putative pathological mechanisms associated with their propensity to damage the eye.

Camp "Sababa" (awesome) - The world of children with burns

AIMS

Camp "Sababa" operates in Israel through the Burn Advocate Network of New Jersey, to help children with burn injuries cope with consequences of injury. The study assessed adolescents' perceptions of their participation in the camp, and its effect on their self-esteem and quality of life.

METHODS

Ten adolescents from diverse cultural backgrounds attended Camp "Sababa" in 2017. All the participants and parents signed an informed consent form, responded to a demographics questionnaire, and participated in in-depth interviews and focus groups. Phenomenological analysis revealed three themes, reflecting the chronological sequence of rehabilitation: (1) coping with emotional and physical scars, (2) formulating coping strategies, (3) belonging to a group, and (4) implications of camp experience.

RESULTS

Social participation engendered a feeling of safety and trust, enabling adolescents to share their burn experiences, and thus cope better with the physical and emotional challenges of their injuries. Participation in camp activities strengthened their confidence and social bonding; and their return to typical adolescent behaviour while at camp, and ultimately in the community.

CONCLUSIONS

The positive results suggest that burn camps should be part of the rehabilitation process of adolescents with burn injury, with emphasis on challenging, age-appropriate activities, and peer group participation.

Between a rock and a hard place: Ethics, nurses' safety, and the right to protest during the COVID-19 pandemic

AIM

In this paper, we critically discuss the ethics of nurses' choice to strike during the COVID-19 pandemic, considering legal and ethical arguments, overlaying the Ubuntu philosophy, an African ethic.

BACKGROUND

The recent unprecedented coronavirus disease pandemic and the increased reports on the absence of personal protective equipment in South Africa places many health workers' lives at risk. Nurses spend most of their time with patients, which exposes them to fatal risks as they work in unsafe environments.

RESEARCH METHODS

Exploratory literature review was conducted using Pubmed, CINAHL, Google Scholar and Science Direct) and law cases repository.

FINDINGS

Nurses thus may be justified in striking to protect their safety. State healthcare entities are obliged to ensure safety and protect the health of professionals during the pandemic. According to their Code of Practice and Pledge of Service, they are ethically obliged to put patients first, and as a result, they are legally barred from engaging in strike action.

CONCLUSION

We conclude that there may be constitutional human rights arguments to support strike action. We also find that ethical principles alone do not provide clear direction to guide nurses in making justified and ethical decisions regarding service provision in an environment threatening to compromise their safety.

Toward safe environment: injection device disposal among diabetic patients attending tertiary care academic clinic in Middle Delta, Egypt

In Egypt, there are 8.9 million adult diabetics using almost 16 million insulin injection devices daily. Unsafe disposal of these sharps will result in many environmental and public health hazards. This study aimed at evaluating knowledge and practice of diabetic patients toward safe disposal of insulin injection devices. Cross-sectional study and health education sessions were carried out at diabetic outpatient clinic of the Internal Medicine Department, Tanta University Hospitals in Middle Delta, Egypt, during a period of 2 months (November through December 2019). The study enrolled diabetics who were > 12 years age, using insulin therapy for > 1 year, and females that do not have gestational diabetes. By using systematic random sampling, 450 patients were selected from diabetic patients attending the clinic during the period of the study. Patients' knowledge and practice of insulin injection device disposal were assessed and evaluated using predesigned questionnaire. Verbal health education message and printed pamphlet were given to illustrate safe disposal. Out of the selected samples, 429 completed the questionnaires. Out of those participants, 85.5% had poor knowledge and only 13.5% had good practice. A total of 86.5% dispose at household collection bin, 65.3% reuse syringe, and 63.21% throw it at the nearest garbage bin when takes the injection outside home. Binary logistic regression revealed that female sex (adjusted odds ratio [AOR], 2.37; 95% confidence (CI), 1.13-4.94; p = 0.022), rural residence (AOR, 3.05; 95% CI, 1.62-5.72; p = 0.001) and low income (AOR = 2.11; 95% CI, 1.06-4.18; p = 0.033) were the main predicting sociodemographic factors for poor practice. Meanwhile, syringe usage (AOR = 2.81; 95% CI, 1.31-6.03; p = 0.008), twice daily schedule (AOR = 2.82; 95% CI, 1.51-5.26; p = 0.001), patient himself as injection provider (AOR = 2.268; 95% CI, 1.18-4.36; p = 0.014), and unawareness of how to dispose sharps safely (AOR = 7.33; 95% CI, 3.58-14.99; p < 0.001) were the predicting factors of bad practice related to patient and treatment characteristic. Vast majority of studied diabetic patients do not use or dispose insulin injection devices safely. As the problem is nationwide, an integrated nationwide program is needed including a structured health education module for diabetic patients and a system for collection of home insulin sharps from those patients and disposing them safely.