The effects of diet and fluid education administered to patients of hemodialysis on some parameters

Background: It is important to assess the effectiveness of education sessions conducted to increase the quality of life of hemodialysis patients, and reduce mortality and complications.Aim: The study was implemented to evaluate the effect of education given to help hemodialysis patients to adjust to diet and liquid restrictions on the patients’ weight, blood pressure, fluid states and laboratory results.Methods: During the study, every week, two sessions of education were given by the researcher-nurse regarding diet and fluid restriction to patients who received hemodialysis treatment for a period of 8 weeks and parameters were evaluated at the end of the education. The study population consisted of 42 patients who consented to participate in the study between June and December 2014 at the Dialysis Unit of Selcuk University Faculty of Medicine. The study was conducted using the pretest-posttest quasi-experimental research design. Patients aged 18 or above who had been receiving hemodialysis treatment at least for one year, did not have extremity amputation or plegia. The patients’ blood pressures, heights, weights and bioimpedance were measured by the researcher-nurse. Average, standard deviation, frequency, number, percentage and paired t test were used in the evaluation of the data.  The patients who received treatment were given information about the purpose and method of the study and their consents were received. Results: It was found that 59.5 % of the patients were female, 47.6 % had primary level of education, 83.2 % were married and 45.2 % were housewives. It was seen that 50 % of the patients who received hemodialysis treatment did not have other chronic diseases, 38.1 % had been receiving hemodialysis for 0-3 years, 59.5 % knew the amount of fluid they needed to take, 45.2 % received 1500-2000 liters of fluid, 52,4 % did not urinate. Significant changes were observed in the patients’ blood pressures before and after the education (systolic p:0,012, diastolic p:0,013) and in their weight when they received dialysis (p:0,000). On the other hand, as far as laboratory data were concerned, significant differences were found before and after the education only in sodium input and output, potassium input and output values, and in extracellular fluid as far as bioimpedance results were concerned. Conclusion: It was found that significant results were obtained in some parameters as a consequence of the education given to the patients. Given that the best control in long hemodialysis treatments is a decrease in fluid load, patients should definitely be given education emphasizing the importance of diet and fluid restriction. It can be suggested education sessions can be given for longer periods to obtain more significant results

Rethinking trust in the context of mistreatment of women during childbirth: a neglected focus

[Extract] The mistreatment of women during childbirth is a global phenomenon.1 Mistreatment includes physical and verbal abuse, violations of privacy, stigma and discrimination, and neglect and abandonment. To date, much of the focus has been on measuring this phenomenon and the interpersonal relationships between women and health workers and the role of and abuse of power by these workers.2 However, more recently, there have been increasing calls for widening the lens on underlying drivers of mistreatment of women during childbirth to include the considerations of social, gender and economic inequalities,3 and systemic failures both at health facility and the health system levels.1 4 5 This recognition and renewed attention on the wider social, economic and political systems in which health systems are embedded is important for two reasons. First, while much of the mistreatment is often carried out by health workers and especially those at the frontline, it is important to recognise that many of these health workers are located lower in the organisational hierarchy, themselves overworked and abused in under-resourced and poorly supervised environments and overall dysfunctional health systems.6–9 This recognition has underpinned nascent investigation of the role of workplace and institutional trust in some settings.10–1

Newspaper advertising practice in an arabian gulf country

Advertising is an important marketing activity, perhaps more important in Saudi Arabia than in other international markets. According to one observer of the Saudi market, Arabs are lazy buyers (Sisley, 1980). They need to be pushed into shopping behaviour. In addition, the climatic environment prevailing in the country is not conducive to frequent shopping trips. The high humidity in the air which at times reaches 100 per cent, the frequent sand storms which sometimes last several days, and the scorching hot temperatures which can reach 140 degrees Fahrenheit or more are some of the climatic conditions which force people to abandon shopping plans in favour of staying in the air conditioned atmospheres of their homes. The reluctance on the part of the people in Saudi Arabia toward shopping can be overcome with persuasive and persistent advertising. © 1997, MCB UP Limite

Evaluation of information sources in industrial marketing: Implications for media planning in the Arabian Gulf

The top executives of 67 companies located in Saudi Arabia were surveyed to determine the importance of 14 sources of marketing information for making industrial purchases. The study included seven impersonal sources: Arabic magazines and newspapers; English magazines and newspapers; Gulf television; trade shows and exhibitions; billboards; brochures and pamphlets; and direct mail. The study also covered five interpersonal sources: past experience; relatives and family members; friends and colleagues at work; neighbors; and salesmen. The findings of the survey indicate to which sources the top executives attached high importance and which they had mixed feelings about

Provision and uptake of routine antenatal services: a qualitative evidence synthesis

Background Antenatal care (ANC) is a core component of maternity care. However, both quality of care provision and rates of attendance vary widely between and within countries. Qualitative research can assess factors underlying variation, including acceptability, feasibility, and the values and beliefs that frame provision and uptake of ANC programmes. This synthesis links to the Cochrane Reviews of the effectiveness of different antenatal models of care. It was designed to inform the World Health Organization guidelines for a positive pregnancy experience and to provide insights for the design and implementation of improved antenatal care in the future. Objectives To identify, appraise, and synthesise qualitative studies exploring: · Women’s views and experiences of attending ANC; and factors influencing the uptake of ANC arising from women’s accounts; · Healthcare providers’ views and experiences of providing ANC; and factors influencing the provision of ANC arising from the accounts of healthcare providers. Search methods To find primary studies we searched MEDLINE, Ovid; Embase, Ovid; CINAHL, EbscoHost; PsycINFO, EbscoHost; AMED, EbscoHost; LILACS, VHL; and African Journals Online (AJOL) from January 2000 to February 2019. We handsearched reference lists of included papers and checked the contents pages of 50 relevant journals through Zetoc alerts received during the searching phase. Selection criteria We included studies that used qualitative methodology and that met our quality threshold; that explored the views and experiences of routine ANC among healthy, pregnant and postnatal women or among healthcare providers offering this care, including doctors, midwives, nurses, lay health workers and traditional birth attendants; and that took place in any setting where ANC was provided.We excluded studies of ANC programmes designed for women with specific complications. We also excluded studies of programmes that focused solely on antenatal education. Data collection and analysis Two authors undertook data extraction, logged study characteristics, and assessed study quality. We used meta- ethnographic and Framework techniques to code and categorise study data. We developed findings from the data and presented these in a 'Summary of Qualitative Findings' (SoQF) table. We assessed confidence in each finding using GRADE-CERQual. We used these findings to generate higher-level explanatory thematic domains. We then developed two lines of argument syntheses, one from service user data, and one from healthcare provider data. In addition, we mapped the findings to relevant Cochrane effectiveness reviews to assess how far review authors had taken account of behavioural and organisational factors in the design and implementation of the interventions they tested. We also translated the findings into logic models to explain full, partial and no uptake of ANC, using the theory of planned behaviour. Main results We include 85 studies in our synthesis. Forty-six studies explored the views and experiences of healthy pregnant or postnatal women, 17 studies explored the views and experiences of healthcare providers and 22 studies incorporated the views of both women and healthcare providers. The studies took place in 41 countries, including eight high-income countries, 18 middle-income countries and 15 low-income countries, in rural, urban and semi-urban locations. We developed 52 findings in total and organised these into three thematic domains: socio-cultural context (11 findings, five moderate- or high- confidence); service design and provision (24 findings, 15 moderate- or high-confidence); and what matters to women and staff (17 findings, 11 moderate- or high-confidence) The third domain was sub-divided into two conceptual areas; personalised supportive care, and information and safety. We also developed two lines of argument, using high- or moderate-confidence findings: For women, initial or continued use of ANC depends on a perception that doing so will be a positive experience. This is a result of the provision of good-quality local services that are not dependent on the payment of informal fees and that include continuity of care that is authentically personalised, kind, caring, supportive, culturally sensitive, flexible, and respectful of women’s need for privacy, and that allow staff to take the time needed to provide relevant support, information and clinical safety for the woman and the baby, as and when they need it. Women’s perceptions of the value of ANC depend on their general beliefs about pregnancy as a healthy or a risky state, and on their reaction to being pregnant, as well as on local socio-cultural norms relating to the advantages or otherwise of antenatal care for healthy pregnancies, and for those with complications. Whether they continue to use ANC or not depends on their experience of ANC design and provision when they access it for the first time. The capacity of healthcare providers to deliver the kind of high-quality, relationship-based, locally accessible ANC that is likely to facilitate access by women depends on the provision of sufficient resources and staffing as well as the time to provide flexible personalised, private appointments that are not overloaded with organisational tasks. Such provision also depends on organisational norms and values that overtly value kind, caring staff who make effective, culturally-appropriate links with local communities, who respect women’s belief that pregnancy is usually a normal life event, but who can recognise and respond to complications when they arise. Healthcare providers also require sufficient training and education to do their job well, as well as an adequate salary, so that they do not need to demand extra informal funds from women and families, to supplement their income, or to fund essential supplies. Authors' conclusions This review has identified key barriers and facilitators to the uptake (or not) of ANC services by pregnant women, and in the provision (or not) of good-quality ANC by healthcare providers. It complements existing effectiveness reviews of models of ANC provision and adds essential insights into why a particular type of ANC provided in specific local contexts may or may not be acceptable, accessible, or valued by some pregnant women and their families/communities. Those providing and funding services should consider the three thematic domains identified by the review as a basis for service development and improvement. Such developments should include pregnant and postnatal women, community members and other relevant stakeholders

Advertising agency scene in Saudi Arabia

Looks at advertising agencies in Saudi Arabia and describes their strengths and the facilities they can offer. Focuses on five major advertising agencies – Tihama for Advertising, Public Relations and Marketing; United Outdoor Advertising Company Ltd.; Raed Marketing and Advertising; Narwah Public Relations, Advertising and Marketing; and Transworld Publicity Limited – and mentions five others. Explores the history of advertising in Saudi Arabia; it's a relatively new industry built on the crude oil boom of 1973, when the Saudis embarked on an intensive economic development programme. © 1998, MCB UP Limite

The recursive dualizm of technology:

The notion of technology is often consumed with its purely practical, equipmental interpretation in everyday life which assumes the neutrality of technical things, fully justifying the equivocation of the technical with the technological. However, technology, as a major constituent of contemporary society, is intimately connected with politics, economics, culture, and all forms of social and personal life. Previous research followed a variety of approaches and analyzed the technology phenomena in organizations from structural or agency-based perspectives. The structuration theory, attempting to resolve the deep-seated ontological division in social sciences, has offered a way out from the impasse between structure and agency based perspectives, but a number of criticisms have been posed against it in the literature (Clegg 1989; Archer 1982, 1989, 1995; Layder 1987; Callinicos 1985; Mouzelis 1995). Following the structuration theory, Orlikowski (1992) suggested the structurational model of technology and offered the duality of technology model. In this study, the recursive dualism of technology (RDT) model is developed as a new theoretical model to provide an understanding as to how technology is experienced and the way technology adaptation unfolds in organizations. The model explains how technology shapes and also is shaped by organizational affairs at macro, meso, and micro levels in organizations. The RDT model combines structuration and institutionalization perspectives, reconsidering criticisms against the structuration theory. A set of theoretical propositions has been developed also drawing from the power literature to describe the interplay of actors and structures using 'power-based institutionalization mechanisms2 (Lawrence, Winn and Jennings, 2001) during technology adaptation in organizations. Research propositions have been empirically studied in five cases of Enterprise Resource Planning (ERP) software adaptation in four different organizations. ERP is a software technology frequently associated with organizational change and transformation in relation to its adaptation in organizations. Case studies are compared and contrasted to empirically evaluate the RDT model and discuss the process of technology adaptation in organizations in relation to structuration and institutionalization processes. The theoretical and practical implications of the study and potential further studies are also addressed

Women’s perceptions of telephone interviews about their experiences with childbirth care in Nigeria: A qualitative study

Our objective is to investigate women’s perceptions of phone interviews about their experiences with facility childbirth care. The study was conducted between October 2020 and January 2021, in Gombe State, Nigeria. Participants were women aged 15–49 years, who delivered in ten study Primary Health Care centres, provided phone numbers, and consented to a follow-up telephone interview about their childbirth experience. The phone interviews took place 14 months after the delivery and consisted of a quantitative survey about women’s experiences of facility childbirth followed by a set of structured qualitative questions about their experiences with the phone survey. Three months later 20 women were selected, based on their demographic characteristics, for a further in-depth qualitative phone interview to explore the answers to the structured qualitative questions in more depth. The qualitative interviews were analysed using a thematic approach. We found that most of the women appreciated being called to discuss their childbirth experiences as it made them feel privileged and valued, they were motivated to participate as they viewed the topic as relevant and thought that their interview could lead to improvements in care. They found the interview procedures easy and perceived that the call offered privacy. Poor network connectivity and not owning the phone they were using presented challenges to some women. Women felt more able to re-arrange interview times on the phone compared to a face-to-face interview, they valued the increased autonomy as they were often busy with household chores and could rearrange to a more convenient time. Views about interviewer gender diverged, but most participants preferred a female interviewer. The preferred interview length was a maximum of 30 minutes, though some women said duration was irrelevant if the subject of discussion was important. In conclusion, women had positive views about phone interviews on experiences with facility childbirth care