Sleep Disturbance and Outcomes in Patients with Heart Failure and their Family Caregivers

Sleep disturbance is common in patients with heart failure (HF) and the family caregivers. Sleep disturbance is known as a predictor of poor quality of life (QoL) in individual level. The manner in which patients’ and caregivers’ sleep disturbances influence each other’s QoL has not been determined. The purpose of this dissertation was to investigate the associations of sleep disturbance and outcomes in patients with HF and their primary family caregivers. The specific aims were to: 1) examine whether sleep disturbance of patients and their family caregivers predict their own and their partners’ QoL; 2) examine the mediator effects of depressive symptoms on the association between sleep disturbance and QoL in patients and family caregivers; and 3) provide evidence of the psychometric priorities of the Zarit Burden Interview (ZBI) as a measure of caregiving burden in caregivers of patients with HF. The three specific aims were addressed using secondary analyses of cross-sectional data available from 143 patients with HF and their primary family caregivers. To accomplish Specific Aim One, multilevel dyadic analysis, actor-partner interdependence model was used for 78 patient- caregiver dyads. Individuals’ sleep disturbance predicted their own poor QoL. Caregivers’ sleep disturbance predicted patients’ mental aspect of QoL. For Specific Aim Two, a series of multiple regressions was used to examine the mediation effect in patients and caregivers separately. Depressive symptoms significantly mediated the relationship between sleep disturbance and mental aspect of QoL in patients. The mediation effect was similar in caregivers. For Specific Aim Three, the internal consistency and convergent and construct validity of the ZBI in 124 family caregivers of patients with HF were examined. The results showed that the ZBI is a reliable and valid measure of caregiving burden in this population. This dissertation has fulfilled important gaps in the evidence base for the QoL outcome in patients with HF and caregivers. The findings from this dissertation provided evidence of the importance of monitoring sleep disturbance for better QoL in both patients and caregivers and the importance of assessing caregivers’ sleep disturbance for improving patients’ QoL. It also provided evidence of the importance of managing depressive symptoms when targeting sleep disturbance to improve QoL in both patients and caregivers

Police Powers to Take and Retain DNA Samples in the Qatari Law: A Comparative Study

Chapter 1 of Pt 1 of the Protection of Freedoms Act 2012 introduces a new regime governing the destruction, retention and use of fingerprints, footwear impressions, and samples and the DNA profiles derived from such samples. The purpose of the article is to explain and examine the new regime in all its complexity and, in particular, to assess whether it is compliant with the European Convention on Human Rights (ECHR). The research shows that the 2012 Act does not afford adequate privacy protection to innocent individuals, adding pains to an already coercive process without due justification. In Qatar, the DNA Profiling Act regulates the police powers to take and retain DNA samples. The Act should be amended to comply with human rights requirements as enshrined in the Qatar Constitution 2004, in particular the right to privacy. Keywords: DNA, Privacy, Police Powers, The Protection of Freedoms Act 2012, The DNA Profiling Act 2013

Intention to get COVID-19 Vaccine and Trust in the Government: Policy Matters

Background: Building trust in the government and intention to get vaccinated against COVID-19 is as important as developing a safe vaccine to contain the pandemic. Purpose: The study aimed to examine the associations between the intention to vaccinate against COVID-19 and the people’s trust in the government, and compare both concepts based on the subject’s characteristics. Methods: This is a part of a large-scale cross-sectional study that employed a web-based survey conducted in 2021. The study utilized data collected on the main study variables using questionnaires from a convenient sample of 281 Jordanian subjects. Bivariate statistics were employed with .05 as a significance level. Results: Trust in the government scores were significantly different based on gender and marital status. As mistrust in the government increases, subjects tend to accept the vaccine. Female subjects tend to trust the government but have low intention to get vaccinated than male subjects. Married subjects tend to have higher mistrust of the government than single subjects. Subjects who agree with the statement “herd immunity would be beneficial for COVID-19 and this fact is covered up” and "the government restrictions are stronger than is needed" had a higher intention to get vaccinated scores than those who disagree with it. Conclusions: To build and maintain the trust of the public, the government needs to enhance its efforts in publicizing information on the pandemic and employ strategies for improved communication management to the public through social media and mainstream information sources and healthcare providers, especially those who are in the front lines healthcare providers. Policy-makers should employ strategies to improve communication management to the public and rebuild trust in the government during the COVID-19 pandemic. Longitudinal studies with more representative samples are recommended. &nbsp

Quality of Life and General Well-being in People Receiving Hemodialysis Treatment: A Cross-sectional Study

Background: End-stage renal disease (ESRD) and hemodialysis (HD) treatment are debilitating and progressive and can have a significant impact on patients’ general well-being and quality of life. Understanding the impact of ESRD and HD on Jordanian patients may help health care providers improve the type of care delivered. Objectives: this study aimed to examine quality of life (QOL) and general well-being (GWB) of patients undergoing HD treatment and to examine the associations between patients' demographic variables and QOL and GWB. Methods: this was a cross-sectional study in which 203 patients were recruited from different dialysis units across Jordan. Valid questionnaires were used to collect data on QOL and GWB along with demographic data sheet were used. Results:  participants scored moderately low on general well-being (GWB) with the highest means were for the Social Dysfunction and the Depression subscales, respectively. The highest reported score was on the Social Relationships domain of quality of life (QOL) and the lowest was for the Physical domain. Age groups significantly differed in their scores of GWB and in all domains of QOL apart from the Environmental domain. Female participants had a significantly higher (worse) difference than males in terms of the Somatic symptoms and Depression subscales of GWB. Conclusions and Implications to nursing: It was shown that HD treatment negatively influence patients QOL and GWB and interfere with their day-to-day lives. Dialysis nurses play a vital role in monitoring and supporting their patients and might provide an avenue by which they can optimize patients’ QOL and GWB. Hence, working with patients to find the best possible plan of care may have a positive impact on patients’ lives and health outcomes. &nbsp

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Is privacy brought home? : criminal justice and the right to privacy

This thesis is concerned with protection of the right to privacy in the English and Scottish criminal justice systems.  The aim of this research is to consider the extent to which privacy has been recognised in both criminal justice systems. It analyses the extent to which the right to privacy is protected by the substantive criminal law of those jurisdictions, as well as in their criminal procedural law. A part of the examination will address the question of whether there should be a criminal offence of violating the privacy of another. The thesis is mainly devoted to addressing whether the right to respect for private life has a place within criminal justice theory and practice. The protection of privacy in the criminal justice system is the predominant subject of this thesis for two main reasons. First, this is an important topic that has been neglected.  Prior to this thesis no one had yet addressed this topic at any length as a distinct subject.  The protection of privacy in the criminal justice system and the use of substantive criminal law to enforce the privacy rights of victims have received minimal attention in the English jurisprudence. No comprehensive legal and theoretical analysis of the topic could be found in English or Scottish law. Therefore, this topic was crying out for new insights and perspectives. Secondly, the Human Rights Act 1998 incorporates into the UK law certain rights and freedoms set out in the European Convention on Human Rights, including the right to respect for private life enshrined by Article 8. The aim of the Act is to “bring rights home” and give further effect to rights and freedoms guaranteed under the European Convention. The Act requires all public authorities to act in a way which is compatible with the Convention rights. Since the incorporation of the European Convention on Human Rights into United Kingdom law, it is particularly appropriate to ask whether English and Scottish criminal lawyers need to add privacy to their essential lexicon. The Human Rights Act 1998 could be expected to have a profound impact on the right to privacy within the criminal justice system.  The European Convention obliges the Contracting States to bring their criminal justice systems into line with the European Convention requirements to protect the fundamental human rights in it. The thesis has the following objectives.  First, to address the extent to which the right to privacy is protected by the substantive criminal law and whether privacy rights have been respected in criminal procedure laws. Secondly, to highlight the impact of the Human Rights Act of 1998 on the right to privacy in the criminal justice arena.  This thesis shows that although right to privacy has been recognised by the European Convention and incorporated by the Human Rights Act 1998, the criminal justice systems in England and Scotland display little respect for privacy rights. In other words, this study has demonstrated that, as far as privacy is concerned, it is misleading and inaccurate to say that rights have been brought home.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The Exclusionary Rule in Criminal Procedures: An Analytical Study in the European Court of Human Rights Jurisprudence

يتناول البحث منهج المحكمة الأوروبية في قاعدة "استبعاد الأدلة غير المشروعة في الإجراءات الجنائية"، من خلال التنقيب عن السوابق القضائية. وما إذا كانت تنظر في الأدلة غير المشروعة، أم تصرف النظر عنها. وفي حال ما إذا ثبت أنّها تنظر في تقييم مشروعية هذه الأدلة وتقدير قبولها؛ فإلى أيّ مدى تملك سلطة استبعاد تلك الأدلة؟ وتبرز أهمية البحث في بيان الضوابط القانونية التي تعتمدها المحكمة لتحديد نطاق صلاحياتها في هذه المسألة؛ سواء من حيث تقييم الدليل وتقدير قبوله، أم من حيث صلاحيات الحكم بعدم مشروعية الدليل، في حال ثبوت انتهاك حقّ من الحقوق المنصوص عليها في الاتفاقية الأوروبية لحقوق الإنسان، وخاصة الحق في محاكمة عادلة، والحق في احترام الحياة الخاصة. يجيب البحث عن الإشكالية، منطلقًا من المستوى النظري إلى المستوى العملي، ليخلص إلى نتيجة مفادها أنه وعلى الرغم من أنّ المحكمة راقبت مشروعية الأدلة وقبولها في أحوال كثيرة؛ إلاّ أنها لم تُؤسّس لمنهجية واضحة في التعامل مع الأدلة المشروعة. ورغم أنها اعتمدت عددًا من المعايير، إلاّ أنها لم تذهب لترجيح أحدها وبلورته كمنهج حقيقي في التعامل مع الأدلة. ومع ذلك فإن السوابق القضائية تستند إلى معايير وأسس تصلح لأنْ تكون بذرة لإنشاء قواعد واضحة بخصوص قاعدة الاستبعاد، لكنّ ذلك الأمر يحتاج وقفة جادة من المحكمة تحسم بها المسألة.This research deciphers the European Court’s standing on the dictum of excluding illegally obtained evidence in criminal procedures. It seeks to look into judicial precedents that reveal the methodology followed by the European Court in this regard to see whether the Court has inclined to actually assess the obtained illegal evidence, or even draws any attention to it. If it is proven that the Court actually evaluates the legitimacy of this evidence and assesses its acceptance, the next question would be to assess the extent to which it does so, and whether the Court has the authority to exclude the evidence all together.   The research seeks to clarify the legal controls adopted by the Court to determine the scope of its powers in this matter, whether in terms of evaluating the evidence and estimating its acceptance, or in terms of the powers to rule on the illegality of the evidence in the event of a violation of one of the rights stipulated in the European Convention on Human Rights, especially the right to a fair trial and the right to respect private life.   This study answers the problem from the theoretical level to the practical one. Although the Court monitored the legitimacy of evidence and its acceptance in many cases, it did not establish a clear methodology for dealing with legitimate evidence. Despite the fact that that Court has adopted a number of criteria, the Court did not go as far as to suggest any as the dominant one, and it did not go further to suggest one of them and formulate it as a real approach to dealing with evidence. However, the jurisprudence of the European Court is replete with judicial precedents that are based on criteria and foundations that are suitable to serve as the base for the establishment of clear detailed regulations regarding the exclusion rule, but that needs a serious pause from the Court and a bold step by which the Court proceeds to take an explicit position in this regard

In vitro cytotoxic and antioxidant activities of phenolic components of Algerian Achillea odorata leaves

In this study, methanol extract from Achillea odorata was evaluated for its phenolic contents using Folin–Ciocalteu reagent, and antioxidant activity using: 1,1-diphenyl-2-picrylhidrazyl (DPPH) radical scavenging activity, reducing activity of H2O2 and ferric reducing power assay. The total phenolic content was determined as gallic acid (GAE) equivalent. Flavonoids and flavonols contents were determined as quercetin (QE) equivalents. The cytotoxicity of the plant extract was tested against three tumor cell lines: MCF-7, Hep2 and WEHI using 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphynyl tetrazolium bromide (MTT) assay. Preliminary screening was concluded in the presence of substances with large therapeutic values. The total phenolic content confirmed the presence of total phenolics in the extract and showed strong association with antioxidant activity. An important content of flavonoids and flavonols was also detected. The results of the antioxidant activities obtained indicate that A. odorata recorded a good capacity. For the cytotoxic activity, the results showed the plant extract significantly inhibited tumor cell growth and colony formation at various concentrations

Competency in nursing practice: a concept analysis

Objective Competency denotes the ability to execute a certain task or action with the necessary knowledge. Competency definitions and measurements are challenging for nursing and other professions due to their multidimensional aspects. This study aimed to clarify the concept of competency in nursing practice and propose an accurate definition.Design Walker and Avant’s approach was used to elucidate the concept of competency in nursing practice.Data sources ScienceDirect, PubMed, ProQuest, Scopus and CINAHL were searched from 1 January 2000 to 31 December 2021.Eligibility criteria We included studies with the keywords: “concept analysis”, “competence”, “competency” and “nursing”. The search was limited to full-text studies written in English that used theoretical and empirical approaches.Data extraction and synthesis We extracted the concept’s uses, defining attributes, and the consequences and antecedents of the concept.Results 60 articles were identified from the search process; after excluding duplicates and works unrelated to the study aim and context following the full-text screening, 10 articles were included in this concept analysis. The common defining attributes of competency were knowledge, self-assessment and dynamic state. Competency in nursing practice had many reported positive consequences that include but are not limited to improved patient, nurse and organisational outcomes.Conclusions Nurses can benefit from the result of this analysis in practice to implement professional care, in particular clinical contexts and situations to enhance patients’ health

Breakfast skipping and associated factors among Jordanian university students

Background: Although breakfast skipping among university students is a significant concern, its prevalence and the contributing factors among university students have received little attention in the literature. This study aims to determine the prevalence of skipping breakfast among Jordanian university students and examine the associated factors and variations in rates of skipping breakfast by day of the week. Materials and Methods: A cross-sectional study was conducted among undergraduate students between March and May 2022 through a self-questionnaire. A convenience sample of 891 students was chosen at four Jordanian public universities. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of skipping breakfast among university students was 66%. The reasons for skipping breakfast were having no time due to oversleeping and having no feeling of hunger (59% for both), followed by having no energy to prepare the breakfast and making no difference (49% and 48%), and not being able to afford to eat or buy breakfast (19%). There is a strong correlation between eating fast food and skipping breakfast. With whom the student eats breakfast is significantly associated with breakfast skipping, revealing that the highest percentages of skipping occur with friends. About 63% of students skipped breakfast through university days compared with 37% on the weekend, while 37% of them had breakfast through university days compared with 67% on the weekend. Conclusions: A high percentage of university students in Jordan skip breakfast. More attention should be paid to correlating factors and developing interventions to help students adhere to the breakfast