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Background: Communication is the process of exchanging information or messages from one group to the other through mutually understood verbal or non-verbal ways. Communication barrier is anything that prevents receiving and understanding the messages. poor communication between patients and the nurses’ result in an increased length of stay, wastage of the resource, patient dissatisfaction, absence of confidence, and frustration for both the nurses and the patients. This study will provide basic information on the level of nurses to patients’ communication and perceived barriers in government hospitals of Bahir Dar city. Objective: The objective of this study was to assess the level of the nurse to patient communication and perceived barriers in government hospital of Bahir Dar city, Ethiopia, 2020. Methods: Institution based cross-sectional mixed-methods study was conducted from February 24 – March 9/2020 in government hospitals of Bahir Dar city. A total of 380 nurses were included in the quantitative study by using simple random sampling. For both the quantitative and qualitative study, at the initial stage of data collection and interview; informed consent was obtained from respondents. Data were entered into Epi Data 4.6 and analyzed with a statistical package of social science version 25. Data were mainly analyzed using descriptive statistics and binary logistic regression. For the qualitative study, purposive sampling technique was employed, and 7 participants were interviewed. Thematic analysis was used. Results: From the total participants 36.5% of nurses were found to have poor communication. Variables which have statistically significant associations with the level of communication were educational level, work experience, the unwillingness of nurses, and lack of communication skill. The highest perceived communication barriers were lack of continuous training with 82.7% followed by workload with 80.7% and lack of medical facilities with 79.2% as reported by nurses. All environmental-related barriers were the perceived barriers of the nurse to patient communication. Conclusion: In this study, the communication of nurses to patients is found to low. To enhance communication with the patients; nurses and other stakeholders like the ministry of health, the health bureau, and hospital authorities need to recognize the communication barriers. Giving awareness on the communication barrier for the nurses helps to minimize the barriers and improve the nurses to patients’ communication.

Since the discovery of glare illuminators, considerable efforts have been devoted to achieving a breakthrough of high light intensity on the order of magnitude. In this paper, we prepared strong flash blinding agents for the first time by using aluminum powder, oxidant, and adhesive as the main materials, and tris-(8-hydroxyquinolinato) aluminum (Al2Q3), triazoindolizine, or nano zinc oxide, etc. as electronic output brightener after mixing and granulation according to the developed formulation. It was discovered that the luminescence intensity was related to the thermal effect of the substance while the brightener only served as an auxiliary brightening effect to achieve energy non-destructive conversion. With the same formula, the luminescence intensities of glaze agents with ADN and potassium perchlorate as oxidants were slightly higher than that of ammonium perchlorate oxidant; the brightening effect of nano-zinc oxide was slightly higher than those of tris-(8-hydroxyquinolinato) aluminum (Al2Q3) and triazoindolizine. The luminescence intensity of the substance with a high thermal effect value was high, but the luminescence time was slightly short. Under identical conditions, the luminescence effect of nano-aluminum powder was obviously better than that of micro-aluminum powder with the highest luminescence intensity of 3.9 × 1010 ~ 1.9 × 1011 cd and the luminescence time of 39 - 48 ms. The effects of shell material and structure and the effect of heat-induced mode on the luminescence intensity were also investigated. The luminescence intensity of the glare agent with a high shell strength was high, but the luminescence time was slightly short. Moreover, the energy level of the brightener is excited under the induction of high temperatures, which leads to a blue shift to promote the chemical reaction of the material in a favorable direction. Finally, the optical radiation of the thermally induced high-temperature combustion system was analyzed from the aspects of thermal effect, combustion temperature, and chemiluminescence effect. A way to improve the optical radiation intensity of a high-temperature combustion system was proposed.

Oguta LGA is surrounded by 44 oil wells located around different communities. Preliminary investigations indicated that crude wastes were not properly managed and oil spillage occurred regularly in the LGA. Therefore, assessment of both radionuclide contents in yam matrix and health risks in Oguta was carried out to determine possible radiological health risks associated with improper management of crude wastes, and also evaluate haematological health profile in the LGA for future reference and research. A well calibrated NaI (Tl) detector was deployed for the radiological investigation, and about 5 ml of blood samples were collected from 190 participants each from Oguta and the control LGAs for haematological assessment. Mean activity concentrations due to 40K, 226Ra and 232Th in yam samples from Oguta LGA were 189.99 ± 59.14 Bqkg-1, 23.75 ± 5.69 Bqkg-1 and 30.99 ± 9.51 Bqkg-1, respectively while mean activity concentrations due to natural radionuclides in yam samples from control LGA were 110.40 ± 78.53 Bqkg-1, 10.12 ± 3.34 Bqkg-1 and 18.39 ± 8.74 Bqkg-1 for 40K, 226Ra and 232Th, respectively. Committed effective dose equivalent values in Oguta and the control LGAs were 704.95 ± 183.30 μSvy-1 and 403.65 ± 172.19 μSvy-1, respectively which are less than world average value of 1.1 mSvy-1. Crucially, one-way ANOVA at α0.05 has indicated that effects of radiological parameters due to natural radionuclides in yam from Oguta are significantly different from effects of radiological parameters due to natural radionuclides in yam from the control LGA. However, the percentage contributions of natural radiation exposures to incidence of cancer in Oguta and the control LGAs are just 1.7% and 1.4%, respectively, and haematological investigations have shown that overall health of the communities in the study LGAs has not been compromised due to environmental and human factors. Hence, natural radioactivity may have been elevated in Oguta but the concentration levels are not yet alarming. Radiological health risks could result from consistent exposure to those natural radionuclides in the long term.

Objective: The FITT (Frequency, Intensity, Time, and Type) principle is an effective foundation in EP. However, the CORRECT components; C–Combination of interventions, O–Order of the Interventions, R–Repetitions, R–Rest period between sets and between sessions, E–Exercise at home, C–Cognitive domain, T–Total dose and re-evaluation plans, should be considered. The purpose of this paper was to describe the updated dynamic and evidence based FITT-CORRECT principle of EP and demonstrates its application using a case study. Results: Literatures, related to EP, clinical reasoning and clinical decision-making, were critically reviewed. Established evidence is summarized to describe an updated dynamic and evidence-based principle of EP. The gaps within the FITT and other related principles of EP are addressed. The FITT-CORRECT principle was introduced and an effective outcome of the updated principle was demonstrated using a case study. The FITT-CORRECT principle integrates many components that are missing in the FITT and other related EP principles. Based on the reported case study, the FITT-CORRECT principle of EP should optimize patients’ intervention outcomes. Physiotherapists can potentially improve their EP by utilizing the FITT-CORRECT in clinical practice.

The article describes the necessary conditions for the phenomenon of thermal energy release in a magnetic fluid placed in a high-frequency rotating magnetic field. The minimum amplitude of the magnetic field was calculated and the thermal power released (by the rotating spherical nanoparticles in the viscous medium) was estimated. The estimations were based on the assumption that the magnetic relaxation times (τN and τB) and the magnetic field rotation period (τrot) meet the condition: τN>>τrot>>τB. The principle of operation and construction of the device generating a high-frequency rotating magnetic field is described. Preliminary experimental studies were carried out using a magnetic fluid with magnetite nanoparticles that indicated magnetic relaxation as the cause of the released heat. The value of the absorption rate in the experiment and its dependence on the strength of the magnetic field were determined.

Background: Post exposure chemoprophylaxis can prevent human immunodeficiency virus (HIV) infection in risk healthcare workers; however routine adoptions of these practices by the workers have been limited. Objective: To assess knowledge and attitude of health workers on HIV post-exposure prophylaxis and exposure to sharp injuries in Dessie referral hospital. Methods: Across-sectional study was conducted on 422 health care workers of Dessie referral Hospital. The study subjects were selected by proportional allocation of each sample in its respective department/ward. Simple random sampling method was used to select study participants. The data was cleaned coded and analyzed by using statistical package for social sciences (SPSS) version 23. Finally the result was presented by graphs, pie chart and statements. Results: A total of 422 study subjects were participated in the study. Among 422 participants 72.5% had good knowledge of post exposure prophylaxis for HIV and the rest 27.5% had poor knowledge of post exposure prophylaxis for HIV. Among 422 study participants 75.2% had positive attitude towards PEP. 283(67.1%) of them had exposure to sharp injuries. Conclusion: Generally most of health care workers had good knowledge about post exposure prophylaxis against HIV/AIDS. This study had shown that a significant number of individuals had a negative attitude with regard to post exposure prophylaxis. Therefore, formal training that aims to improve attitudes and support to improve PEP implementation and completion are needed. 

Fifty years of Washington’s fixes for healthcare have brought us to the brink: insurance is unaffordable and care is unavailable, certainly not in time. The way to make healthcare work for We the Patients (all Americans) is to take healthcare authority away from third-parties – government and insurance – and restore the direct doctor-patient connection with no bureaucrat in between. The cure for patient Healthcare is StatesCare combined with market-based medicine. Financial models confirm this approach will make care both affordable and accessible in a timely manner. 

The nurse in Poland may have a secondary level of education (secondary school or post-secondary) or high level (BSc and MSc). She can have a specialization of one the parts of medicine. After the MSc studies she can take the doctor’s degree. But we must take as a fact that with the high level of education and specialization she can be the Court Expert i.e. in nursing anesthesiology, intensive therapy, nursing first aid, palliative medicine as well as in many other cases. As about nursing we should remember that woman and man can practice this specific profession [1].

Background: Even if pain and psychological symptoms experienced by university students are common, the prognosis of these symptoms is unknown. Objective: To examine the incidence and the outcome of frequent musculoskeletal and psychological symptoms in a 4-year follow-up of first-year university students. Methods: In 2008, a national random sample (N=2750) of Finnish university students completed a questionnaire concerning pain and psychological symptoms. Of the 416 first-year students, 123 responded to the same questionnaire also in their fourth study year in 2012. Results: Of the first-year university students with frequent pain or psychological symptoms, ­one half (47% - 65%) reported frequent symptoms also four years later. Almost all (78% – 95%) of the symptom-free first-year students were symptom-free also in their fourth study year. Conclusion: Our findings indicate that pain and psychological symptoms in university students are rather persistent during the first four study years. On the other hand, as half of those with frequent symptoms become symptomless and as the prognosis of symptom-free students is favourable, there is still need for further cohort studies on this issue.

Background: Respiratory muscle strength can be reduced in patients diagnosed with stroke, which reasonably justifies the use of respiratory muscle training in this population. This study determines the comparative efficacy of inspiratory, expiratory, and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors. Method: Forty-five acute stroke survivors (15 in each group) completed all protocols of the study. Participants were randomly assigned to any one of three groups. In addition to the conventional exercise therapy, participants received any one of the three respiratory muscle training protocols (inspiratory muscle training, expiratory muscle training or combined respiratory muscle training). Chest expansion was assessed using tape measure and pulmonary function parameters were assessed using a spirometer. Results: Paired t-test analysis showed significant improvements in the chest expansion and the pulmonary function parameters following training in each group. One-way ANOVA showed significant improvements in the pulmonary function parameters across the three groups but not in the chest expansion with p - value = 0.405. Least significant difference (LSD), post-hoc analysis shows that the significant difference for FEV1, FVC and FEV1/FVC lies between inspiratory muscle training group and expiratory muscle training group. Conclusion: When the three training methods were compared, it was found that expiratory muscle training was the most beneficial in improving the pulmonary functions and chest expansion in acute stroke survivors.

In this work the statistical and squeezing properties of light-driven by sub-harmonic generation with two-mode coherent light are studied. With interaction Hamiltonian of both two-mode coherent and sub harmonic generation, we have driven master equation of system under consideration. From the master equation, the solution of the C-number Langevin equation is derived. It helps us to solve quadrature variance, quadrature squeezing, mean, and variance of photon number for light produced by sub-harmonic generation with the two-mode coherent light state. And the result shows that; the squeezing occurs in plus quadrature with the maximum squeezing of 87%. The photon statistics of the system under consideration is subpoissonian in which both mean & variance are increasing as kappa increase.

COVID-19 created a public health crisis shutting down many normal day-to-day activities and adversely affecting life, as we know it. Not only did this affect vulnerable, senior populations and people with poorly managed diabetes and hypertension [1-4], it displaced nursing students from clinical experiences putting them at risk of not graduating. Given the projected shortages of RNs in 2030, in California alone of 44,500 FTEs [5], this delay would have added a ripple effect increasing already dire predictions. This displacement created an emergency and with the aid of the Board of Registered Nursing, Assembly Bill 2288 [6] passed allowing student nurse clinical experience requirements to be revised to help meet graduation requirements.

Plasma stability is the biggest challenge facing the nuclear fusion industry. One of the best methods of stability study is magnetohydrodynamic (MHD) equations, which has two linear and nonlinear states. Usually linear stability analysis is used to describe the MHD state, which is obtained by linearizing nonlinear equations. The reactor under study is the W7-X reactor, which is an optimal example of a stellaratoric system. The question raised in this research is how to create suitable conditions for the formation of plasma and heat transfer produced by the melting reaction. Many efforts have been made in this direction, but still the record holder for plasma state maintenance belongs to the international ITER project and around 1000. However, IPP researchers at the Max Planck Institute in Germany (maker of the W7-X reactor) predicted that by 2020 they would produce a pulse of 30 minutes. The numerical method is used to investigate the stability of the reactor. In this paper, boundary conditions were expressed in terms of resistance wall. With the help of the mathematical Matlab software, magnetic field values ​​were obtained from experimental reports extracted from the Max Planck Institute for various values ​​of β. From the values ​​obtained, it was concluded that the appropriate field value is β = 5 according to the ideal MagnetoHydroDynamic state and the interval defined by the Max Planck Institute.

Objective: In primary care, during treatments, nurses may need to wear surgical masks, namely for control of infection contamination, or to minimize unpleasant odors. The goal of this study is to inspect the effect of nurses wearing the mask on patient perception of the nurse-patient relation. Methods: A pre-post-test, control-experimental group design was employed with 60 patients treated in family health units. Patients responded to the Patient Satisfaction Questionnaire III (PSQ-III) regarding nurses’ communication, interpersonal manner, technical quality, as well regarding general satisfaction with the encounter. An additional question asked both patients and nurses how long they felt that the visit lasted. Results: Results show that nurses wearing the surgical mask had significantly negative effects in all dimensions of PSQ-III and increased the perceived visit duration among both nurses and patients. Conclusion: When a previous relationship exists, nurses wearing the surgical mask in primary care in Portugal negatively affects patient satisfaction with both the patient-nurse relation and the nurses’ technical quality. Practice implications: Is important the nurse understand this impact to discuss with the colleagues the best strategy to minimize the negative impact to the patient- family nurse relation and manager this situation in the best way to the patient. 

Einstein’s special and general relativity revolutionized physics. The predictions of general relativity are Strong Lensing, Weak Lensing, Microlensing, Black Holes, Relativistic Jets, A Gravitational Vortex, Gravitational Waves, The Sun Delaying Radio Signals, Proof from Orbiting Earth, Expansion of the universe. The density of the universe determines the geometry and fate of the universe. According to Freedman’s equations of general relativity published in 1922 and 1924, the geometry of the universe may be closed, open and flat. It all depends upon the curvature of the universe also. Various results of Cosmic Microwave Background Radiation (CMBR), NASA’s Wilkinson Microwave Anisotropy Probe (WMAP), and ESA’s Planck spacecraft probes found that our universe is flat within a margin of 0.4% error. In this short work, by applying the laws of quadratic equations, we attempt to show that OUR UNIVERSE IS FLAT.

Pain is a complex phenomenon which is unpleasant. Different cosmetic procedures are associated with varying degrees of pain. Various modalities are adopted to decrease the severity of pain. The commonly used is the administration of analgesics (opioid or non-steroidal). The pain is carried to the brain by pain fibres. There are various theories about the pain [1,2]. Many attempts have been undertaken to find the modalities which decrease the perception of pain by the brain. The famous ‘gate theory’ was proposed in 1965 by Melzack et al. [3]. It was proposed that the pain experience can be reduced by the activation of nerve fibres that conduct non-toxic stimuli. The theory suggested that the stimulation of larger diameter fibres (A-beta) can close a neural ‘gate’ to nocioceptive signals and can reduce the perception of the pain. The ‘gate’ is proposed to lie within the spinal cord/brainstem and inhibits the transmission of nocioceptive action potentials to higher centres in the central nervous system [4]. The “post-synaptic inhibitory and fascilitatory mechanism” provide a basis for explaining the pain reducing strategies such as rubbing the painful area or applying cold or vibration to decrease the perception of the pain. Various topical irritants used in a few ‘magic’ creams also work on the same principle. Every effort is made to decrease the perception of pain in cosmetic surgery procedures especially hair restoration. A surgeon who can perform a hair restoration without pain has an edge over his competitors. The potential patients undergoing hair restoration are very anxious about the pain level to be perceived during the procedure. Vibration anaesthesia is becoming increasing used in hair restoration to decrease pain perception. Various recent studies have demonstrated the effective use if vibrations to decrease the pain of local anaesthesia injections [5,7]. The pain of the injection has basically two components; the first is the actual needle prick and second is the discomfort felt due to the tissue stretch by the local anaesthetic drugs [8]. The following study was conducted to compare the pain level of ring block in the patients undergoing hair restoration with and without the use of vibration

Multiple studies have investigated the relationship between androgenetic alopecia and cardiovascular disease, including studies that have identified elevated rates of cardiovascular disease in patients with vertex hair loss, vertex and frontal hair loss, early onset hair loss and rapidly progressive hair loss. In addition, increased risks for hypertension, excess weight, abnormal lipids, insulin resistance, carotid atheromatosis and death from diabetes or heart disease have been reported in this population. Studies investigating an association between androgenetic alopecia and metabolic syndrome have yielded conflicting findings. Distinct guidelines for the detection and prevention of cardiovascular disease in individuals with androgenetic alopecia have not been established. In addition to the traditional risk factors for developing cardiovascular disease, included in the definition of the metabolic syndrome, several skin diseases have recently been shown to be markers of conditions relating to the patient’s overall health. Physicians should be aware of the possible connection between relatively frequent skin diseases, such as psoriasis and hair growth disruptions, including androgenetic alopecia and female pattern hair loss and cardiovascular disease. This review is concentrated on the association between insulin resistance, type 2 diabetes, abdominal fat, cardiovascular disease and hair growth disruptions as an early indicator of these underlying conditions. We have investigated the importance of robust primary clinical treatment measures to address the manifestation of hair loss due to a disruption caused by metabolic syndrome as an effective means to alleviate further stress induced hair loss, which can exacerbate the underlying cause.

The NIH has published treatment guidelines for treating COVID-19 patients in the hospital. However, as of this writing, there are no established protocols for treating COVID-19 positive patients in primary care. Accordingly, this investigator has taken on the task of reviewing the medical literature to be able to propose evidence-based protocols for treating COVID-19 positive patients in primary care. The CDC is advising people to do nothing when they find out they are positive for COVID-19 unless they have symptoms. The evidence from the literature irrefutably shows COVID-19 infection evokes a massive and deadly hyperinflammatory response called the “Cytokine storm” and that Cytokine levels in the blood have a predictive value in identifying an impending Cytokine storm. With such data primary care providers can effectively lower Cytokine levels and prevent critical illness and death. Accordingly, this paper presents identification of the problem of not having standard practices in primary care for people who are positive for COVID-19 and not knowing who is at risk. Moreover, the evidence shows that knowing vitamin D levels and correcting deficiencies can go a long way in reducing Cytokine levels. Additionally, the literature review presents evidence that undeniably shows the stark possibility that many of the COVID-19 related deaths can be prevented by identifying who is at risk for the Cytokine storm and other complications and providing early treatment even before symptoms appear.

Purpose: In an aspect of qualitative treatment, this research gathered lung cancer patients’ actual experiences to understand deeply, such as their expectation for treatment results, their difficulties during treatment, and their various requests to their family and medical teams. Methods: From May to June 2013, semi-structured interviews were conducted with 9 lung cancer patients. Data were collected through a tape-recorded in-depth interview. The analysis of the data was made through the qualitative method. Results: 124 themes regarding the experience were found. From these 35 concepts, 24 subcategories were emerged. The core category was enduring hardship of the treatment with the hope for full recovery. Six categories included ‘Wishing to be cured but concern about recurrence’, ‘Receiving radiation treatment with pleasure and difficult at the same time’. ‘Being sorry for their family’s full support and trying to stand alone‘, ‘Having confidence in their medical team’, ‘regretting for their old days’, and ‘Wanting to live a long life without illness and pain’. Conclusion: The results of this study would help oncology nurses to understand the lung cancer patients receiving concurrent chemo-radiotherapy (CCRT) and to develop a quality of life improvement program for physical, psychosocial, and spiritual aspects of nursing.

Lichen Planopilaris is known as the form of Lichen Planus typical of the scalp. It is classified as a lymphatic disease and is characterized by chronic inflammation which leads to cicatricial alopecia. Its causes are not yet well characterized but its etiology seems to strongly correlates with infection, sensitization and pollution. A clear and objective diagnosis of Lichen Planopilaris is not simple but the evolution and strongly negative outcomes on scalp of people affected by, pose the need of an early diagnosis. In this work we report the case of a 27-year-old male and a 54-year-old female, respectively, in which a correct diagnosis of Lichen Planopilaris, followed the incorrect previous ones, was made by means of dermatoscopy and histopathological analysis, decisive tools for the diagnosis of this kind of pathology.