Factors associated with self-care behavior in persons with heart failure.

Introduction: Heart failure is a serious illness that mostly affects the elderly. It is characterized by progressive deterioration of the heart muscle and affects the quality of life of those living with it. The progression of the illness has been shown to be slower with appropriate self-care. Several studies examined predictors of self-care extensively. The results were inconsistent and usually explained a small fraction of the variance in self-care in persons with heart failure, and they usually overlooked some potential predictors that could be related to self-care in person with heart failure. Purpose: The purpose of this study was to explore impulsivity, perceived control, and perceived stress as predictors of self-care behavior in person with heart failure using the Hot/Cool System Model. This study examined the mechanism by which these variables interact to affect self-care behavior. Methods: A cross-sectional exploratory study was conducted with 100 persons with heart failure from a heart failure clinic affiliated with Norton Healthcare using self-report questionnaires. Inclusion criteria were: a diagnosis of heart failure with no terminal illness or memory problems, at least 18 years of age, and able to read and speak English. Participants received a $10 gift card as compensation for their participation. SPSS macros were used to investigate the proposed relationships among study variables. Results: Perceived control mediated the effect of impulsivity on self-care maintenance only at low levels of stress. Backward regression showed that the best fit model for predicting self-care maintenance included impulsivity, perceived control, and functional status. A follow up mediation analysis showed that perceived control partially mediated the relationship between impulsivity and self-care maintenance. However, the results did not show any significant effect of those potential predictors on self-care management. Conclusion: The current study added new insights and filled a gap in the literature. Further research is needed since this study is the first to introduce impulsivity and Hot Cool System Model to the nursing literature, and it is the first to study this combination of variables in persons with heart failure Keyword: Heart failure, self-care, impulsivity, perceived control, perceived stress, Hot/Cool System Model, moderated mediatio

Large calculi within malpositioned and malformed kidneys, is percutaneous nephrolithotomy (PCNL) feasible? A Single Center’s Experience over 10 Years

Background and Purpose: Percutaneous nephrolithotomy (PCNL) for large calculi within malpositioned and malformed kidneys is a challenging problem for urologist because of the abnormal anatomy. The aim of this study was to evaluate and to review our experience with PCNLin malpositioned and malformed kidneys with large calculi.Patients and Methods: Between January 2000 and December 2009, we performed PCNL in 36 patients with large calculi in malpositioned and malformed kidneys, including 16 patients with horseshoe kidneys, 11 patients with rotational anomalous, three patients with transplanted kidneyand six patients with ectopic pelvic kidneys. After appropriate preoperative evaluation, the procedure was performed by choosing anterior,posterior or laparoscopic assisted approaches under fluoroscopic and ultrasound guidance. PCNL access was made in the upper pole of the kidney in 21 (58.3%) patients, in the midpole in 14 (38.9%) patients, and in the lower pole in one patient (2.8%).Results: The mean age of the patients was 37.5 years (range 21- 57) with male: female ratio 2.7: 1, the mean stone size was 2.9 cm (range 2.1- 4.9). Complete stone removal was achieved in 26 (72.2%) patients. A second-look procedure for residual stone removal was required in nine patients (25%), five of them via the same tract and three patients required another access, four of them became stone free, four patients required adjuvant ESWL sessions for the residual stones, and onepatient converted to open surgery due to difficulty in creating an access.The mean operating time for PCNL was 95 minutes (range 45-120), and the mean hospital stay was 3.7 days (range 3-8 days). Blood transfusion was required for three (8.3%) patients, transient postoperativepyrexia encountered in six (16.7%) patients and one patient had persistent urine leak (2.8%). Serious complications were encountered, small bowel perforation was occurred in two (5.6%) patients, and both were treated by laparatomy with primary repair of injury with uneventfuloutcome.Conclusion: Patients with malposition and malformed kidneys and large calculi can be managed safely and effectively with PCNL when they are properly selected and appropriately assessed before operation. Stone management in malformed and malposition kidneys is challenging, andestablishing percutaneous renal access is the most crucial step in the procedure

THE ROLE OF COMMERCIAL BANKS TOWARDS MONEY LAUNDERING AN EMPIRICAL STUDY

Money laundering phenomenon is considered one of the criminal phenomena that has a negative consequences on the local or international level because its strong relation with the arranged crimes especially that is related to the drugs and weapons trade and contraband ….etc. The technological advancement has a clear influence on money laundering process where the money launderers use the technological advancement to legalize the money they gain from illegal resources. This study aimed to the way that the banks follow to deal with money laundering process and the ways of detecting it and here we choose the commercial banks because they are the target of the most of money laundering process and that supervision of the commercial banks on money laundering process is considered one of the most factors in combating this phenomenon. This study found that banks use ways and techniques to limit and detect this phenomenon , however , the results of this study don’t indicate that banks don’t participate in the conferences that concern money laundering. Most of the countries try to limit this phenomenon throughout enacting the lows , using the supervision method on the financial and banking systems and supervising the entrances and borders of countries throughout the customs supervision enabling these countries to active combating money laundering processes on local level and incorporating with the other countries through regional and international channels. Some countries enact a punitive laws in order to pursue those practice money laundering . Jordan isn’t isolated from the world and will never be safe from this phenomenon and its negative effects on the society as whole and despite that there is no law concern with this phenomenon in specific , the central bank enacted the instructions about combating money laundering phenomenon

Teaching French civilization and culture through a multicultural perspective in the classrooms of French language students in Jordanian universities

With the advent of the communicative methodology, the goal of learning and teaching foreign languages is to acquire a communicative skill aimed at making students able to behave appropriately when communicating with speakers of these languages. This communicative skill is not limited to grammatical or linguistic aspects, but also includes cultural elements that seem to be of great importance. Through our experience, it seems to us that the practices of learning and teaching French as a foreign language, in the Jordanian university context, do not give an important place to cultural elements. This study aims to encourage teachers to focus more on the cultural aspects in the French as a foreign language class, and to think about the educational potential of this skill. To achieve this, we will first shed light on the relationship between the concept of social perceptions and the teaching and learning of French as a foreign language in the Jordanian university context, with a focus on cultural concepts. I will then present a number of educational proposals related to intercultural knowledge in learning and teaching French as a foreign language, in the Jordanian university context

Predictors of Depression in Older Adults with Heart Failure: An Acceptance and Commitment Therapy-derived Linear Regression Model

Background Depression is a frequently reported phenomenon that negatively affects self-care and the healthcare provided to older adults with heart failure. However, the literature is mixed about predictors of depression in older adults with heart failure. Objectives To examine newly introduced variables derived from the acceptance and commitment therapy model and selected demographics as predictors of depression in older adults with heart failure. Method A cross-sectional design was used. Participants with heart failure (N = 272) were recruited from major regional hospitals during their regular visits to the heart failure clinics. Descriptive analysis was run for the recruited sample. Pearson’s correlation was used to examine bivariate correlations between study variables. Finally, multiple linear regression was used to examine the model that contained the study variables to predict depression in older adults with heart failure. Results The results showed that time since diagnosis, impulsivity, stress, psychological flexibility, and heart failure knowledge significantly predicted depression in older adults with heart failure. The model explained 49.5% of the variance in depression. Conclusion An array of psychological and sociodemographic variables explained approximately half of depression in older adults with heart failure. The acceptance and commitment therapy model has been shown to be beneficial in incorporating new variables contributing to depression in older adults with heart failure. Implications The current study offers preliminary evidence of the potential benefit of the acceptance and commitment therapy model-based interventions. Future research should be conducted to minimize the impact of depression in persons with heart failure

Accuracy of Ex-vivo Fluorescence Confocal Microscopy in Margin Assessment of Solid Tumors: A Systematic Review

Fluorescence confocal microscopy (FCM) is a novel technology that enables rapid high-resolution digital imaging of non-formalin-fixed tissue specimens and offers real-time positive surgical margin identification. In this systematic review, we evaluated the accuracy metrics of ex vivo FCM for intraoperative margin assessment of different tumor types. A systematic search of MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus was performed for relevant papers (PROSPERO ID: CRD42022372558). We included 14 studies evaluating four types of microscopes in six different tumor types, including breast, prostate, central nervous system, kidney, bladder, and conjunctival tumors. Using the Quality Assessment of Diagnostic Accuracy Studies tool, we identified a high risk of bias in patient selection (21%) and index test (36%) of the included studies. Overall, we found that FCM has good accuracy metrics in all tumor types, with high sensitivity and specificity (>80%) and almost perfect concordance (>90%) against final pathology results. Despite these promising findings, the quality of the available evidence and bias concerns highlight the need for adequately designed studies to further define the role of ex vivo FCM in replacing the frozen section as the tool of choice for intraoperative margin assessment

Implementation of streamlining measures in selecting and prioritising complex cases for the cancer multidisciplinary team meeting: a mini review of the recent developments

In January 2020, NHS England and NHS Improvement, in the United Kingdom, issued a permissive framework for streamlining cancer multidisciplinary (MDT) meetings. Streamlining is defined as a process whereby complex cases are prioritized for full discussion by an MDT in an MDT meeting (MDM), while the management of straightforward cases is expedited using Standards of Care (SoC). SoC are points in the pathway of patient management where there are recognized guidelines and clear clinical consensus on the options for management and should be regionally agreed and uniformly applied by regional Cancer Alliances. While this report marks the first major change in cancer MDT management since the Calman-Hine report in 1995, its implementation, nationally, has been slow with now nearly four years since its publication. It is argued however that streamlining is a necessary step in ensuring the viability of MDT processes, and therefore maintaining patient care in the current socioeconomic context of rising workload and cancer incidence, financial pressures, and workforce shortages. In this mini review, we offer a succinct summary of the recent developments around the implementation of the 2020 streamlining framework, including challenges and barriers to its implementation, and the potential future directions in this field, which we propose should increase utilisation of implementation science. We conclude that ensuring successful implementation of the framework and the SOC requires securing a buy-in from key stakeholders, including MDTs and hospital management teams, with clearly defined (a) management approaches that include triage (e.g. through a mini MDT meeting), (b) assessment of case complexity (something that directly feeds into the SOC), and (c) roles of the MDT lead and the members, while acknowledging that the SOC cannot be universally applied without the consideration of individual variations across teams and hospital Trusts

The ​Role of ​Psychological ​Flexibility in ​Heart ​Failure: Structural ​Equation ​Model ​Analysis

Background With psychological flexibility as a central concept, the Acceptance and Commitment Therapy Model has gained empirical support with a broad range of behavioral and emotional issues across various populations. The role of psychological flexibility in health-related behavioral and emotional problems in heart failure is still limited.  Objectives  To examine the role of psychological flexibility in persons with heart failure. Methods Observational, cross‐sectional study. A total of 172 persons with heart failure aged 31 to 87 years from three major referral hospitals. To achieve the current study goal, a proposed model guide by the acceptance and commitment therapy model was tested using structural equation modeling using AMOS. Results The results showed that the path between psychological flexibility and emotional outcomes is statistically significant. The R2 value of the emotional outcomes construct was .52, meaning that psychological flexibility explains 52% of the predicted variance. On the other hand, the path between psychological flexibility and behavioral outcomes was not significant. Psychological flexibility explained half of the variance of stress and depression combined.  Conclusion This study suggests that psychological flexibility plays a significant role in determining emotional outcomes (i.e., stress and depression levels) in persons with heart failure. It also suggests that emotional outcomes may be improved by targeting psychological flexibility.  Implications to Nursing Nurses need to assess persons with compromised psychological flexibility as a predictor of adverse emotional outcomes, which inturn has been associated with various negative health outcomes. Nurses need to target these persons through specific interventions to promote psychological flexibility

Implications of the Node of Loss in Contemporary Arab Art

This study examines the contemporary artistic work and sheds light on the most important implications of the node of loss of the Arab artist after the Arab Spring. In this period, the artist attempted to use new color techniques and methods to cope with the loss and deprivation of the Arab community, and it falls within the context of chaos and insecurity, which has created new grants in contemporary Arab art, on all aspects and aesthetic and technical levels, and even in the emotional and impressionistic aspects of the artistic product. Keywords: Art, lost art, Plastic art, Contemporary art. DOI: 10.7176/JTHS/42-04 Publication date:July 31st 201