Caring and Effective Teaching Behavior of Clinical Nursing Instructors in Clinical Area as Perceived by Their Students

Nursing is considered to be an applied science. Thus clinical teaching is central to nurse education. The quality of the student-teacher interaction in the clinical field can either facilitate or hinder the students' integration of theory to practice. It has been postulated that clinical instructors must possess caring behavior and effective clinical teacher characteristics if they want to facilitate students' entry and learning in a multifaceted world of clinical practice. So this study done to describe the clinical instructors’ caring and effective clinical teaching behaviors in clinical area as perceived by their students. A convenience sample of 113 nursing students affiliated to faculty of nursing, King Khalid University, Saudi Arabia was included. Two tools for data collection were used; the first on was developed by the researcher and it was concerned with measuring the effective teaching characteristics of the clinical nursing instructors and the second one was the Nursing Student Perceptions of Instructor Caring (NSPIC) which was concerned with measuring clinical instructor’s caring behaviors.  The participant nursing students has common and unique perspectives on the importance of a clinical instructor demonstrating effective teaching characteristics. In addition, caring behaviors demonstrated by clinical instructors were identified and they perceived their clinical instructors demonstrated the highest number of caring behaviors from the subscales of respectful sharing and appreciation of life’s meanings. Clinically, the results might be utilized to improve faculty awareness of students’ views on their teaching performance. On the other hand, the clinical faculty can be educated and provided with useful educational tools to assist them in providing effective clinical instructions. Keywords: effective clinical teaching characteristics, caring behavior, clinical teaching in nursin

Cell-mediated immunity in recent-onset type 1 diabetic children

Background: The ability to suppress an immune response makes regulatory T-cells (T-reg) an attractive candidate as a novel therapeutic agent for treating autoimmune diseases. The mechanisms involved in maintenance of peripheral tolerance include a specialized subset of regulatory-T-cells (Treg) within the T-cell population. The CD4+ CD25+ T-cells may be important in modulating the risk for autoimmunity. Auto-reactive cytotoxic T-cells recognize peptide epitopes displayed on the beta cells surface in the context of HLA class1 molecules. A population of CD8+ regulatory T-cells characterized by expression of CD25 and FOXP3 have been identified and induced in the human peripheral blood cells. The regulatory activity of these cells is on autologous, antigen-reactive CD4+ T-cells in a cell contactdependent manner. These findings provide an evidence for a new mechanism for induction of immune regulation in human. Objective: This study was aiming to assess the cellular immune parameters including the percentage of CD4+, CD8+, CD4+/CD8+ ratio,CD4+CD25+, CD8+ CD25+ lymphocytes, which may have its application in developing immune therapy based tools for halting disease progression. Methods: This study was conducted on 20 children of recent onset type 1 diabetes (disease duration 0.05) between the two groups. A significant inverse correlation was found between CD4+ CD25+ T-cells and HbA1c percentage among patients group (p < 0.05).Also a significant difference in the percentage of CD4+ CD25+ T-cells was found when patients with HbA1c8% (the latter group had significantly lower percentage of CD4+ CD8+ T-cells). Conclusion: Type 1diabetes is characterised at its onset by a lowered percentage of CD8+ and CD8+ CD25+ T-cells in peripheral blood, a normal percentage of CD4+ and CD4+ CD25+ T-cells. There may be an inverse correlation between percentage of CD4+ CD25+ T-cells at disease onset and HbA1c level after three months. These data support the hypothesis that a defect in function or deficiency in number of T- regulatory cells may affect the pathogenesis of type 1 diabetes.Keywords: Type 1 diabetes, cell-mediated immunity, childrenEgypt J Pediatr Allergy Immunol 2008; 6(2): 69-7

Sulphide pollutants elimination and degradation in petroleum wastewater by ozonation process

An efficient and robust chemical oxidation process using an OZ-3G ozone generator was developed and investigated to degrade and reduce sulphide toxicity in petrochemical wastewater. Different concentrations of sulphide in synthetic wastewater were prepared and evaluated using the Spectrophotometric technique. The values of Chemical Oxygen Demand (COD) and pH were also studied. The obtained results demonstrated that 100 minutes of ozone treatment removed 97.4 % for 40 mg/L concentration. The pH was decreased gradually with the increase along the time of oxidation. Based on the ozone method's significant results, ozonation can be considered a potential candidate method for wastewater treatment in petroleum refineries

Zaštitno djelovanje selenija protiv prekomjerne ekspresije apoptotskih gena povezanih s karcinomom u štakora izloženih o-krezolu

Cresols are monomethyl derivatives of phenol frequently used as solvents and intermediates in the production of disinfectants, fragrances, pesticides, dyes, and explosives, which is probably why they are widely distributed in the environment. General population may be exposed to cresols mainly through inhalation of contaminated air. In this study we evaluated the toxicological effects of o-cresol on differential gene expression profile of rat liver and prostate. Experiments were conducted on 80 male rats, 60 of which were exposed to o-cresol (1.5 g kg-1, 5 g kg-1, or 15 g kg-1) through feed for 8 weeks. Three groups of rats were supplemented with 0.1 mg kg-1 selenium (Se, in the form of, sodium selenite) in addition to o-cresol to evaluate its effectiveness against o-cresol toxicity. Control group received neither o-cresol nor Se, while one group received Se alone. Survival was similar between the exposed and control animals. Rats exposed to 15 g kg-1 of o-cresol showed a 16 % loss in body weight by the end of the study, which may have been related to o-cresol making feed unpalatable at this concentration. Liver and prostate tissue samples were collected at the end of the treatment. mRNA analysis revealed that apoptotic genes (CYP3A, COX-2, PPARγ, BAX, BCL2, AKT-1, and PKCα) related to cancer were up-regulated in liver and prostate tissues isolated from groups exposed to 5 g kg-1 and 15 g kg-1 o-cresol in comparison to control. Changes in gene expression profile were prevented when rats were supplemented with Se. The exact mechanisms underlying its protective effect remain to be clarified by future studies.Krezoli su monometilni derivati fenola koji se često rabe kao otapala te kao posrednici u proizvodnji dezinfekcijskih sredstava, mirisa, pesticida, boja i eksploziva. Otuda i njihova rasprostranjenost u okolišu. Opća je populacija izložena krezolima uglavnom putem zraka. U ovome se toksikološkom istraživanju ocijenilo djelovanje o-krezola, jednoga od tri krezolova izomera, na ekspresiju gena u tkivima jetre i prostate mužjaka štakora. Istraživanje je provedeno na 80 mužjaka, od kojih je 60 tijekom osam tjedana bilo izloženo o-krezolu (1,5 g kg-1, 5 g kg-1, odnosno 15 g kg-1) preko krmiva. Tri skupine štakora primale su uz o-krezol nadomjestak selenija u dozi od 0.1 mg kg-1 (Se, u obliku natrijeva selenita) radi ocjene njegove djelotvornosti protiv toksičnosti o-krezola. Kontrolna skupina nije primala ni o-krezol ni Se, dok je jedna skupina primala samo Se. Preživljenje je bilo podjednako u svih skupina životinja. Štakori izloženi najvišoj dozi o-krezola (15 g kg-1) imali su 16 % manju tjelesnu masu od kontrolne skupine na kraju ispitivanja, što može biti povezano s lošim okusom krmiva zbog primjese visoke doze o-krezola. S istekom osmotjednoga izlaganja o-krezolu životinje su eutanazirane te su prikupljeni uzorci tkiva jetre i prostate. Analiza m-RNA pokazala je značajno povišenu ekspresiju apoptotskih gena CYP3A, COX-2, PPARγ, BAX, BCL2, AKT-1 i PKCα, koji su povezani s nastankom karcinoma u skupinama štakora izloženim o-krezolu (5 g kg-1 i 15 g kg-1 u odnosu na kontrolu. Ova je prekomjerna ekspresija poništena u štakora koji su primali selenij. Još nisu jasni mehanizmi iza ovoga zaštitnog djelovanja, na što će odgovoriti buduća istraživanja

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Isolation of a Novel Reassortant Highly Pathogenic Avian Influenza (H5N2) Virus in Egypt

Highly pathogenic avian influenza (HPAI) H5N1 and H5N8 have become endemic among domestic poultry in Egypt since 2006 and 2016, respectively. In parallel, the low pathogenic avian influenza H9N2 virus has been endemic since 2010. Despite the continuous circulation of these subtypes for several years, no natural reassortant has been detected so far among the domestic poultry population in Egypt. In this study, the HPAI (H5N2) virus was isolated from a commercial duck farm, giving evidence of the emergence of the first natural reassortment event in domestic poultry in Egypt. The virus was derived as a result of genetic reassortment between avian influenza viruses of H5N8 and H9N2 subtypes circulating in Egypt. The exchange of the neuraminidase segment and high number of acquired mutations might be associated with an alteration in the biological propensities of this virus