92 research outputs found
Prediction Model of Elastic Modulus for Granular Road Bases
The estimation of elastic modulus for road bases is the primary objective of this research which is implemented a significant role in transmitting the vertical loading to the pavement foundation layers. In this study, the effect of weathering conditions on the stiffness of base course is investigated and implied the durability test by subjecting the prepared samples to a different numbers of wet-dry cycles (0,2, 4, 6, 8 and 10). A conventional base materials of local natural gravel aggregate and treated base materials with recycled concrete aggregate RCA at different percentages (0%, 25%, 50% 75% and 100%) is adopted in this research.
The elastic characteristics are estimated in terms of elastic modulus. Elastic modulus are estimated by passing the ultrasonic pulse velocity through the untreated and treated base materials laboratory specimens. This test can be used to study the elastic modulus properties of base materials. A multiple linear regression analysis is used for prediction the elastic modulus using the SPSS (software ver.21). Elastic Modulus (kPa) is the dependent variable whereas the independent variable are; No. of wet- dry cycle and Percent (%) of RCA stabilizer. The obtained results for elastic modulus (Es) of granular base material layer showed increasing in elastic modulus with percentage of RCA%., results revealed that the (Es) values reached a maximum value of (6927kPa) for 100%.
For the OMC’s values increases due to the percentage increment of RCA in granular base material mixture, this increment in water contents is refer to high absorption capacity of the paste clinging to the RCA. On other side the dry density decrease gradually with adding percentage of (RCA) in granular base material mixture
The Experience of Mothers and Teachers of Attention Deficit / Hyperactivity Disorder Children, and Their Management Practices for the Behaviors of the Child: A Descriptive Phenomenological Study
Introduction: ADHD (attention deficit hyperactivity disorder) is a childhood disorder affecting children worldwide and has a major burden on the child, family and other caregivers. Aim: The aim of this study is to investigate and describe the experience of the adults that interact on a daily basis with school-aged children with Attention Deficit Hyperactivity Disorder, which are mothers and teachers. This study aims also to understand management practices that are used by mothers and teachers to deal with the most prominent signs of ADHD, which are hyperactivity, impulsivity, and inattention in order to formulate a care plan. Design: The study used a qualitative descriptive phenomenological method to explore the experiences of primary caregivers of ADHD children to capture as much as possible the way in which the phenomenon is experienced. Data collection: Face to face, in-depth, semi-structured interviews were conducted with participants – the mothers and teachers of ADHD children. The interview guide allowed mothers and teachers to express their experiences with the ADHD child. Sample: Purposive sampling was used; four children diagnosed with ADHD were chosen. The sample was 4 mothers and 12 teachers (3 teachers for each child). Setting: Interviews were conducted in schools and homes of children with ADHD. Data Analysis: The data was analyzed by using Giorgi’s phenomenological psychology method (1985). Results: Three major themes emerged from the mothers’ interviews and ten sub-themes; (1) the burden of caring (academic track burden, activities of daily living burden, psychological and emotional burden); (2) inadequate support (lack of support from spouses and relatives, lack of support from schools, lack of support from community); (3)disturbances of the child's behavior (hyper activity, inattention, impulsivity, hostility). Five major themes also emerged from the teachers interviews and thirteen sub-themes; (1) lack of information (the nature of the disease, student health and follow-up, the ideal method for dealing with child); (2) child´s behaviors disruptive (inability to follow class rules, inattention and impulsivity, using verbal and physical abuse); (3) the lack of resources (lack of time, lack of materials and experts); (4) lack of support (lack of Ministry of Education support and school team, lack of parental support); (5) the burden of having the child in the class (burden of managing the safety of the child, burden to calm the child and the other students, emotional burden). Conclusion: The findings of the study demonstrate the importance of understanding the experience of the mothers and teachers of ADHD children. It reflected the difficulties and issues of dealing and caring with ADHD children. There were clear defects in the knowledge, understanding, services provided for the children, and available support for the care givers. Improving services in terms of family and school care should be a major concern. The recommendations made on the basis of the results of this study can be used as a guide to improve the delivery of care services for people who have children with ADHD. Keywords: ADHD, experience, descriptive phenomenology
Nurses’ Attitudes and Practices towards Inpatient Aggression in a Palestinian Mental Health Hospital
Background: Inpatient aggression can occur for many reasons and there are many factors that contribute to this occurrence such as patient factors, staff factors and environmental factors. There are strategies to prevent and manage aggression. Aims: The aims of this study are to explore nurse's practices and attitudes of inpatient psychiatric aggression to identify the way the nurses handle aggression by patients and exploring the effects of patients, staff and environmental factors on the occurrence of aggression. Participants and methods: The study was conducted at a Mental Health Hospital in Palestine. All nursing staff in the mental health hospital who had worked for at least one year at the time of the study was recruited (67 nurses). The participants ranged in age from 20-50 years with a mean age of (35.1) (±SD = ±7.8) and included 30 females and 37 males. A questionnaire was used which has three scales: Attitude Toward Aggression Scale (ATAS), Management Of Aggression and Violence Scale (MAVAS) and Demographic Scale.Results: Nurses were inclined to perceive patient aggression as destructive, violent, intrusive and functional reactions. They were less inclined to view aggression as protective, communicative or acceptable normal reactions. Female nurses in this study were more likely to view aggression as having an intrusive role whereas, on the contrary, male nurses were more likely to view aggression as having a communicative role and they believed that the aggression could be managed in general. Longer professional experience was significantly associated with a higher frequency of the management of aggression in general. Nurses from the admission ward (male and female) were in less agreement with the Protective and Communicative Attitudes scales than the nurses from the other inpatient wards. On the other hand, nurses from admission ward (particularly female) and recovery ward (male and female) had a higher rate of violent and offensive reaction to aggression than nurses from the other wards. The nurses from the chronic female ward had a higher intrusive scale than nurses from the other wards. The highest level of the scientific grade group is a Master of Mental Health with a high level mean regarding the attitudes to the acceptable normal reaction scale, violent reaction scale, functional reaction scale, offensive scale, communicative scale, destructive scale, external causative factors scale, situational/interactional causative factors scale, Management: general, and Management: use of medication. The nurses agree that there are internal, external and interactional factors to inpatient aggression. Nurses believe that patients may be aggressive because of the environment of the psychiatric hospital. Nurses believe that aggression develops because staff does not listen to the patients, there is poor interaction between staff and patients and other people make patients aggressive. Nurses believe in the use of medications, restraint and seclusion widely, on the contrary, they believe in the use of non-physical methods like negotiation and expression of anger. Conclusion: This study demonstrates that there are different attitudes of nurses toward patient aggression in psychiatric inpatient settings. This study found that aggression is negatively viewed by Palestinian psychiatric nurses. These attitudes are reflective of the opinions of lay persons in our society. There is a need for training programs to reorient the opinions of nurses in relation to inpatient aggression. These programs should contribute to improved patient care and reduction in the frequency of aggressive acts within inpatient units. Keywords: Aggression; mental health, nurses; ATAS; MAVAS
Acupressure for Chemotherapy Induced Nausea and Vomiting in Breast-Cancer Patients: A Randomized, Placebo-Controlled Clinical Trial
Introduction: Chemotherapy is an important treatment in cancer (CA) care and is associated with numerous side effects. Early studies reported that patients cited nausea and vomiting as the most distressing symptoms when receiving chemotherapy. Despite continuing improvements in antiemetic therapies, nausea and vomiting following chemotherapy treatment for CA remains a significant clinical problem for many patients and there is correlation between the intensity of anticipatory nausea in the clinic prior to their treatment infusion and subsequent post treatment of nausea and vomiting. Since pharmacological treatments have failed to completely manage nausea and vomiting, exploring the complementary, non-pharmacological, approaches that can be used in addition to pharmacological approaches becomes paramount. Acupressure at the P6 point is a value-added technique in addition to pharmaceutics; management for women undergoing treatment for breast cancer to reduce the incidence and intensity of delayed chemotherapy induced nausea and vomiting (CINV), since up to 60% of patients had been reported nausea despite the use of antiemetics Aims: The first aim is to examine the efficacy of P6-acupressure in preventing chemotherapy induced nausea and emesis associated with highly emetogenic chemotherapy (i.e. doxorubicin as adjuncts to standard 5-HT3 antiemetics (granisetron) and dexamethasone antiemetic given as part of routine care in reducing acute nausea (during the day of treatment) and delayed nausea (2-5 days) following the day of chemotherapy. The second aim is to examine the efficacy of the acupressure bands in reducing vomiting and in maintaining Quality of Life (QOL). Patients and methods: A randomised, double-blind, placebo controlled trial. One group received acupressure with bilateral stimulation of P6 (n=42), a second group received bilateral placebo stimulation, (n=42) and a third group received no acupressure wrist band and served as a control group, (n=42). Acupressure was applied using a Sea-Band (Sea- Band UK Ltd., Leicestershire, England) which had to wear for the 5 days following the chemotherapy administration. Assessments of acute and delayed nausea and emesis, OOL, patients' satisfaction, recommendation of treatment and requirement of rescue antiemetic were obtained. Results: No significant differences were found in the incidence of acute nausea or emesis 24- h following chemotherapy by treatment groups. Significant difference was found in the severity of early nausea (0-6 scale) in the acupressure group M (SD) 1.62 (2.04) as compared to placebo group 2.17 (2.09), p=, 0006. The acupressure group had a statistically significant reduction in the incidence of delayed nausea 40% (17/42) as compared to the control group 62% (26/42) (p= ,0495). Further analyses indicated that significant difference existed in the intensity of delayed nausea by acupressure group mean (SD) 1.45 (1.73), p=, 0002 as compared to control 2.03 (1.91). Significant difference also existed in the intensity of delayed nausea by placebo group 1.33 (1.66), p=, 0010 as compared to control 2.03 (1.91). Here we noted a placebo effect. The percentage of the patients who had delayed moderate to very severe nausea day 2-5 (≥3 on 0-6 scale) in the acupressure group is 55% (23/42 (p= 0206), in the placebo group 52% (22/42) (p= 0116), a statistically significant reduction existed as compared to control 79% (33/42). Here we noted a placebo effect. The incidence of delayed vomiting episodes day 2-5 was 48% (20/42), 64% (27/42), and 57% (24/42) in the acupressure, placebo and control group respectively. No significant differences were found between the groups. The mean of number of delayed emetic episodes day 2-5 was significantly less in the acupressure group 2.7 (1.87) as compared to placebo 3.3 (1.91), p=,0022 and control groups 2.07(1.20), P= ,0005. Requirement of rescue antiemetic was significantly lower in P6-acupressure (55%, 23/42), as compared to control group (76%, 32/42) (p= 0389). 81% (35/42)) of the patients in acupressure group were significantly satisfied with P6-acupressure as compared to placebo group 64% (27/42), p= 0.0471. 79% (34/42)) of the patients in acupressure group would recommend P6-acupressure to another patients as compared to placebo group 62% (26/42), p= 0,0533 . No statistically significant differences between groups were observed for the overall items response rate of the FACT-Scale which were 74/108, 67/108, 69/108 in the acupressure, placebo and control group respectively. Conclusion: P-6 Acupressure is efficacious for control of delayed chemotherapy related nausea and emesis and is a value-added method in addition to pharmaceutical management for women undergoing treatment for breast cancer. Placebo effect of acupressure decreased severity of delayed nausea day 2-5 but the mean of number of delayed emetic episodes and need of rescue antiemetics were reduced only by acupressure with the correct P6 point stimulation. Keywords: breast cancer, chemotherapy, nausea, vomiting, acupressure.
Prevalence and Severity of Depression among Mothers of Disabled Children in Palestine. A Descriptive, Aanalytical, Cross Sectional Study
Introduction: Mothers of children with disabilities often experience greater stress and emotional demands than other mothers do. Mothers of children with disabilities showed also more psychological distress than other member in their families, as they are the primary caregivers for their children. Childhood disability often imposes a social and emotional burden for children and their families. Aim: The aim of the study is to assess the prevalence and severity of depression among mothers of disabled children in the north of the West Bank in order to establish baseline data and suggest recommendations to policy makers and professional workers. Subjects and Methods: A descriptive, analytical kind (cross sectional) study. Two hundred mothers were included in the study divided in two groups, including 100 mothers of children with disabilities (age range, 2-16years) as a study group, and 100 mothers of normally developing children (age range, 2-16 years) as a control group. There were 47% girls and 53% boys of the children in the control group and there were 38% girls and 62% boys of the children in the study group. These children have different diagnoses with a 10% down syndrome, 18% hearing disabilities, 7 % physical disability, 11% speech disorders, 18% autism, 14% mental retardation, 12% cerebral palsy and 10 % other disorders. The mothers’ average ages in the study group and control group were 32.6 (SD±6.3) and 31(SD± 5.7) years, respectively. A demographic information form and Beck Depression Inventory were administered to mothers of these children who met the inclusion criteria. The assessments were performed during children´s treatment in rehabilitation centers. Results: The prevalence of depression was higher among mothers caring for disabled children than mothers of non-disabled children in the control group. Fifty four percent of mothers of disabled children had a mild to severe level of depression and 18% of them suffered from moderate to severe depression as derived from Beck Inventory score. When we compare between the study and control groups, the study reveals that there are many factors that increase the prevalence of depression among mothers in the study group compared to control group which include: child’s age <10 years, mother’s age <40 years, middle and low income, and un-employment. On the other hand there was no association in the study group between mothers´ depression score and mothers´ age, child age, educational level of the mothers, family style and family income. For the control group (mothers of normally developing children) 15% of them had a mild to severe level of depression and 2% had moderate to severe depression and there was a significant correlation between mothers´ depression score and mother´s age (p=0.010). There was a relation between mothers depression score and family income, but it was not statically significant (p=0.07).The result of this study indicates that there was a significant difference between mothers’ depression score with respect to having or not having disabled children (u=1911, p<0.01).The mothers of children with physical disabilities (mean rank was 60.36) and cerebral palsy (mean rank was 58.67) have a higher depression score than mothers with children of other kinds of disabilities, and the lowest level of depression score was for mothers whose children have down syndrome, which had a mean rank of 38.45. Conclusion: The results of this study indicate that 54% of the mothers of disabled children had various degrees of depression, with 18 % suffering from severe depression. For the mothers with non-disabled children, 18% had various degrees of depression, which is within the normal statistics (12-25%) (WHO, 1990). In study group the study reveals that the disability itself tend to be consider as a strong factor in the same group to increase the prevalence of depression, in contrary in control group the study reveals that there are many factors to increase the prevalence of depression among mothers which include: mothers age>40, child age >10, low family income and low educational level. When we compare between the study and control groups, the study reveals that there are many factors to increase the prevalence of depression among mothers in the study group compared to control group which include: child’s age <10 years, mother’s age <40 years, middle and low income, and un-employment. Recommendations: Early recognition of depression symptoms in mothers of disabled children should be of great concern for health care providers. The effective rehabilitation programs should provide ample opportunity for repeated follow-up interviews that not only offer information about children's disabilities but also psychological support for mothers. Shifting the rehabilitation services from child-centered to family-centered services through providing supportive services is recommended. Keywords: disabled children, depression, Beck depression inventory, extended family, nuclear family
Women and Suicide in Palestine: Victimization, Loss, Socio-Psychological Factors and Lack of Support - A Phenomenological Study
Background: Despite the protective factors of Islam suicide, female suicide attempts exists in Palestine. However there is little information about the causes, risks or protective factors regarding suicide for women in Palestine. Aims: This study investigates the history and experiences of Palestinian women who have attempted suicide in order to better inform policy makers, service providers and the international community about steps need to reduce this disturbing trend. Methods: Guided interviews were completed with 20 female suicide attempt survivors in Palestine using a qualitative phenomenological method to analyze the data. Results: Five themes emerged: victimization related to violence; Loss (family members, cultural identity, relationships, and security); psychological factors ; socio-cultural factors; and lack of support systems. Conclusion and Recommendation: The findings of the study demonstrate the importance of understanding the experience of suicide in the female population in Palestine, looking at risks related to victimization, loss, and lack of personal control. The findings reflect the need for a holistic national strategy for prevention including support for mental health and advocacy programs for women, demanding basic human rights, prohibiting cultural practices such as child marriage, providing economic and social support and promoting Islamic values rather than traditional customs. Keywords: Suicide, Women’s Issues, Palestine, Victimization, Socio-cultural factor
Association between Autism Spectrum Disorder and Iron Deficiency in Children Diagnosed Autism Spectrum Disorder in the Northern West Bank
Iron has an important role in cognitive, behavioral, and motor development. A high prevalence of iron deficiency (ID) has been reported in people with autism. Children with autism are at risk for ID and this condition may increase the severity of psychomotor and behavioral problems, some of which already inherently exist in these children. Aim of the study: The aim of this study is to investigate the association between autism and iron deficiency in autistic children in the Northern West Bank and to identify food selectivity and compare indices of food selectivity among children with autism, children with mental disorders and typically developing children (normal children).Background: Autism is a developmental disorder characterized by qualitative abnormalities of social interaction, impairments in communication, and unusual forms of repetitive behavior . Research shows that a high prevalence of iron deficiency has been reported in children with autism spectrum disorders. Inadequate dietary iron intake was considered as a cause of iron deficiency, and low iron intake was thought to be associated with food selectivity which is commonly seen in children with autistic disorders. Method: 90 children with an age range of 3 to 13 years participated in a case control study distributed into study group and two control groups. Thirty children diagnosed with autism according to DSMIV and ICD-10 criteria served as a study group, 30 children with mental disorders other than autism served as a control group, and 30 typically developing children taken from the public functioned as a second control group. The three groups were matched for age, gender and geographical area. Serum ferritin, hemoglobin, hematocrit, mean corpuscular volume, and red cell distribution width values were measured and analyzed with food habit survey and demographic data. Results: ID was detected in 20% (N = 6/30) of autistic children based on Serum ferritin level (SF< 10μ/l), compared with 0% for the two control groups (p= 0.0001). Anemia was defined as hemoglobin <110g/l for children under the age of 6 years and hemoglobin <120g/l for children between 6 and 13 years of age .When analysis done for HGB to these six children (children who have low serum ferritin); it was found that 66.6% (4/6) of the children two were pre-school male children (HGB is less than 110g/1), and the other two were one male and one female of school children (HGB is less than 120g/l) have iron deficiency anemia, and the iron deficiency anemia was 13.3% (4\30) for all autistic group. The results indicated that these differences were for males. It was found also that the frequency of low iron intake in these children was associated with feeding difficulties and food selectivity; there was a significant difference between children in the autistic group who chose foods with a red color as a favorite 23% (7/30) compared to the other two control groups: 0%, respectively (p= 0.0001). The results demonstrated also a significant difference in the frequency of snacks per day (≥ 4) in autistic children 40% (12/30) compared to both mental disorder 16.7 % (n = 5/30) (p = 0.006) and typically developing children 6.7% (n = 2/30) groups (p = 0.001).Conclusions: Results of this study indicated that there is an association between autism, iron deficiency and anemia. Low levels of serum ferritin in autistic children might be a sign of iron deficiency and an early precursor of iron deficiency anemia. These findings suggest that food selectivity is more common in children with autism than in typically developing children. These findings suggest that ferritin levels should be measured in children with autism as a part of routine investigation. Keywords: Child, Autism, Mental disorder, typically developing children, Iron deficiency, Iron deficiency anemia, Ferritin
Synthesis and Characterization of Some New Morpholine Derivatives
In this paper a new series of morpholine derivatives was prepared by reacting the morpholine with ethyl chloro acetate in the presence triethylamine as a catalyst in benzene gave morpholin-N-ethyl acetate(1) which reacted with hydrazine hydrate in ethanol, and gave morpholin-N-ethyl acetohydrazide (2) . Morpholin-N-aceto semithiocarbazide (3) were prepared by reacting compound(2) with ammonium thiocyanate , concentrated hydrochloric acid and ethanol as a solvent .Compound (3) reacted with sodium hydroxide and hydrochloric acid to give 5-(morpholin-N-methylene)-1H-1,2,4-triazole-3-thiol (4) .The new series of 1,2,4-triazol derivatives (5-8) was synthesized by reaction of compound(4) with formaldehyde , DMF as a solvent and different secondary amines. Preparation of new 1,2,4-triazoline derivatives (9) by reaction compound (4) with bromo acetic acid . Reaction of compound (9) with different aromatic aldehyde and dimethyl sulfoxide as a solvent obtained compounds (10-13)
The Effect of One-Way Urban Street on Traffic Operation Performance
Traffic congestion has become a serious problem affecting citizens' daily life. Many adopted strategies are studied and applied to alleviate this problem and reduce traffic pressure on street networks. Some are costly, and others are unsuccessful in solving the problem due to higher demand. The one-way traffic movement with circulation modification is adopted in this work which promotes the capacity of streets to sustain higher demand. The study area is identified with the most congested signalized intersection (Al-Nakhala, Al-Sakhara, and Beirut) along the urban corridor. The obtained results suggest using one-way traffic movement with a circulation network that significantly improves traffic operation and reduces congestion to a great extent. Control delays of selected signalized intersections are reduced from about 95%, and v/c is reduced to 0.69 (Al-Nakhala), 0.59 (Al-Sakhara), and 0.99 (Beirut) intersections. The results of modified traffic movement show excessive delays are not experienced, and the traffic movement modification ensures the sufficiency of the signalized corridor to accommodate the traffic demand. The traffic one-way movement can solve the problem of traffic congestion in the study area and improve the level of service from (F) to (A) and (B)
Stressors Affecting Baccalaureate Nursing Students in the Clinical Area in Palestinian Universities
Stress is one of the issues that nursing student face during their transition from theoretical education to clinical application and it can affect the psychosocial status; it may influence academic performance and student well-being. Aim of the study: This paper aims to identify sources of stress and the intensity of stressors facing baccalaureate nursing students in clinical training in governmental and private hospitals in Palestinian Universities. Background: Stress among nursing students is familiar especially in training as the student exposed to new area with different types of patients, professionals, equipment’s, instructors and hospitals; these stressors mostly affect the student’s ability to achieve good outcome. Method: This descriptive study use face-to-face questionnaire. Results: the mean total response degree about the stress factors due to the career, training environment, working with various kinds of patients, and the evaluation by supervisors were medium (2.52, 2.59, 2.81, 2.59) respectively. There is relationship between the degree of the stress factors towards the university, place of training, years of study, and training period, F= 3.858(0.002), 3.194( 0.042), 4.214 ( 0.015), 4.778( 0.009) respectively. Conclusions: stress that nursing students face must be consider as an important factor that affect their achievement and ability to have good experience, there are differences between the variables which needs more attention trying to decrease the number and intensity of these stressors. Keywords: clinical learning, Palestinian Universities, Stressors, Training settings
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