Nurses’ knowledge of heart failure self-management education principles

Heart failure is considered as a chronic disease and the management of such condition is complex and challenging. Nurses play a significant role in managing heart failure by enhancing self-care practices among patients. This paper aims to evaluate evidence from the literature regarding nurses level of knowledge about the educational principles in heart failure. The nine selected studies included a total number of 1181 patients. These studies were conducted in the USA and Europe from 2002 until 2019.the uniqueness of those selected studies that all the authors use the same instrument titled “nurses knowledge of heart failure education principles”. The results revealed that there was an inconsistency in the level of knowledge among nurses in hospital-based, ambulatory, primary care or home care settings. More randomized studies are needed to solve this discrepancy. The level of knowledge ranged from (60.4-79.85%). Six topics have been identified as areas of weakness in which education is needed. Educating nurses in different settings is the gold stander to raise their level of knowledge which in turn will be in a better position to provide a high level of education for patients in order to alleviate their suffering, improve the quality of life and reduce the frequent hospitalization

The faunal remains from Tell el-Mafjer, a Chalcolithic site in the Lower Jordan Valley, Palestine

Altogether 1925 animal bones, teeth, and mollusc shells were recovered during the first excavation season at Tell el-Mafjer in 2002. This faunal assemblage came from the Chalcolithic levels. Various animal species could be identified: cattle (domestic and wild), goats (domestic and wild), sheep (domestic and probably wild sheep), dogs, pigs and deer. No equine remains (horses and donkeys) were found. However, a certain number of marine, freshwater and terrestrial shells were present and identified. The relatively sedentary mode of life of the inhabitants of the site was based primarily on raising the main domestic species, sheep, goats, pigs, and probably cattle. The trade relations, the ecological conditions, and the economy of the site during the Chalcolithic period will be discussed in this article.Près de deux mille vestiges de faune ont été récoltés à Tell el-Mafjer au cours de la première campagne de fouille en 2002. Cet ensemble faunique provient de niveaux chalcolithiques. Des espèces variées d’animaux ont pu être déterminées : des bovins, des caprins et des ovins domestiques et probablement aussi des ovins sauvages ainsi que des chiens, des cochons et des cervidés. Aucun reste osseux d’équidés, ânes ou chevaux, n’a été identifié. Par ailleurs, un certain nombre de coquilles de mollusques marins, fluviatiles et terrestres sont présentes et ont été déterminées. Le mode de vie relativement sédentaire des occupants du site était basé sur l’élevage des principales espèces domestiques, les moutons, les chèvres, les cochons et également les bœufs. Les relations de commerce ou d’échange, les conditions écologiques et l’économie du site durant la période chalcolithique sont analysées dans cet article.Al-Zawahra Mohammed. The faunal remains from Tell el-Mafjer, a Chalcolithic site in the Lower Jordan Valley, Palestine. In: Archaeozoology of the Near East VIII. Actes des huitièmes Rencontres internationales d'Archéozoologie de l'Asie du Sud-Ouest et des régions adjacentes. Lyon : Maison de l'Orient et de la Méditerranée Jean Pouilloux, 2008. pp. 431-449. (Travaux de la Maison de l'Orient et de la Méditerranée, 49

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies