Relationship Between Waiting Time, Anxiety and Sleep Disturbances Among Saudi Parents of Children Admitted to Pediatric Intensive Care Unit

Parents of children admitted to PICU experience extreme level of anxiety. It is an extremely difficult process for parents to make a transition from parents of well-child to parents of acutely ill child. Aim: To identify the relationship between waiting time, anxiety and sleep disturbances among saudi parents of children admitted to pediatric intensive care unit. Methods: A cross sectional descriptive correlational study design was employed to conduct this study on a convienience sample of 115 adult parents of children admitted to the PICU. Participants were asked to complete three questionnaire survey including participant’s demographic background, Spielberger State-Trait Anxiety Inventory, and a parental sleep disturbance questionnaire. An explanation about the purpose and the nature of the study was offered for each individual potential participant. Subjects were assured about the confidentiality of the collected data and that it will be only used by the researcher for the purpose of the current study. Data were analyzed using SPSS version 22. Results: More than half of the participants (62.6%) scored 12 and above reflecting considerable levels of anxiety. A very significant precentage (92.7%) of the parents reported sleep problems. Three quarters of the participants (73.2%) mentioned that sleep problems affected them negatively. There was a highly statistically significant difference between groups with different educational background in relation to anxiety, as well Unemployed participants experienced significantly higher anxiety. Conclusion: The findings of this exploratory study indicate considerable levels of anxiety and changes in sleep pattern of parents of children admitted to paediatric intensive care unit. During this period, identifying the parental needs and the causes of anxiety might contribute to parents' mental health. Keywords: PICU, Parental Anxiety, waiting time, sleep disturbances DOI: 10.7176/JHMN/71-11 Publication date: February 29th 202

Save Environment by Replace Plastic, The Case of PepsiCola

Pepsi-Cola is one of the largest multinational food and beverage brand in the world. In 1902 Pepsi-Cola Company was founded in the United State. It has continuously developed during the past 118 years. Our Report is about replacing Plastic bottle to Reusable Plastic to develop and change the company product to be better. The issue of environmental pollution especially plastic pollution is becoming serious; it is damaging the ecological environment. This had triggered the attention of organization on the environment and some of them take their responsibility to work hard on sustainability a strong environmental profile

The Effect of Coronal Pre-flaring and Type of Root Canal Irrigation on Working Length Accuracy Using Electronic Apex Locators [version 3; peer review: 2 approved]

Background: Successful root canal treatment is influenced by the apical extent of root canal preparation and the eventual root canal filling. Achieving the full working length until the apical constriction, which is usually 0.5 – 1 mm shorter than the anatomical apex, is crucial. Electronic apex locators were used to detect the working length more accurately. There are six generations of electronic apex locators in the market. The selection of the appropriate irrigation with each apex locator for accurate working length determination is not fully investigated. Methods: The actual working lengths of 120 freshly extracted human single-rooted teeth were measured and compared with their working lengths using 3rd generation (Root ZX) followed by 6th generation (Raypex 6) apex locators in dry medium, presence of 5.25% sodium hypochlorite, and 2% chlorhexidine, without coronal pre-flaring and after coronal pre-flaring using the same irrigating media. Data were collected, tabulated, and afterward analyzed using one-way ANOVA with post-hoc to evaluate the significant difference in average working length between actual working length, Root ZX, and Raypex 6 apex locator working lengths accuracy. Results: The significant results were shown in roots that were coronally pre-flared and their working lengths were measured in a dry medium using Raypex 6 apex locator. While using the Root ZX apex locator, the most accurate results were shown in roots that were coronally pre-flared and their working lengths were measured while using a chlorhexidine irrigating solution. Conclusions: It is concluded that it is very important to know the specific irrigating medium to be used with each specific electronic apex locator to achieve the most accurate working length results

Perceived Risk of falls among Acute Care Patients

Purpose: In an effort to lower the number of falls that occur among hospitalized patients, several facilities have begun introducing various fall prevention programs. However, the efficacy of fall prevention programs is diminished if patients do not consider themselves to be at risk for falls and do not follow recommended procedures. The goal of this study was to characterize how patients in four different acute care specialist services felt about their risk of falling while in the hospital. Methods: One hundred patients admitted to the study hospital with a Morse Fall Scale score of 45 or higher were given the Patient Perception Questionnaire, a tool designed to assess a patient's perception of their own fall risk, fear of falling, and motivation to take part in fall prevention efforts. Scores on the Morse Fall Scale were gathered through a historical assessment of medical records. Descriptive statistics, Pearson's correlation coefficients, and independent sample t tests were used to examine the data. Results: The average age was 65, and around half (52%) were men and half (48%) were women. Based on their ratings on the Morse Fall Scale, all 100 participants were classified as being at high risk for falls. However, only 55.5% of the individuals agreed with this assessment. The likelihood that a patient would seek assistance and the degree to which they feared falling both declined as their faith in their mobility improved. Patients hospitalized after a fall exhibited considerably lower confidence scores and greater fear scores than patients who had not been injured in a fall. Conclusions: Patients who have a high fall risk assessment score may not believe they are at risk for falls and may not take any steps to reduce their risk. The prevalence of falls in hospitals might be mitigated by the creation of a fall risk assessment technique that takes into account both objective and subjective factors

From stock to seat: Shareholder activism as an internal corporate governance mechanism: The case of Kuwait with reference to Malaysia

Within Kuwaiti corporate governance as an internal system, this thesis provides a practical solution to mitigate the inherited agency problem between major and minority shareholders in Kuwaiti companies. The solution concerns forming a minority watchdog group to encourage shareholder activism, promoting the efficiency of corporate governance practices in Kuwait. The examination of shareholder activism in Kuwait illuminates five standpoints. First, it addresses the obstacles to shareholder activism in Kuwait from different viewpoints. Most importantly, the viewpoint concerns the socio-cultural situation in Kuwait. This discussion illuminated that the culture of shareholder apathy is the product of different circumstances and cultures in Kuwait, such as the limitations of litigation culture in the region, free-riding problems, shareholders’ investment approach and social norms. Second, the examination of shareholder activism in Kuwait considers the concentrated ownership structure and the classification of Kuwait CG as an insider system. Consequently, it raises the possibility that shareholder activism can function as an internal mechanism. This is believed to give a wider perspective to studies about shareholder activism. Third, it empirically evaluates the role of shareholder passivity in contributing to the low standards of corporate governance in Kuwait and suggests that promoting shareholder engagement can prevent companies from delisting from the market. Thus, it argues that shareholder activism can mitigate the agency problem in Kuwaiti companies. Fourth, this thesis claims the necessity of adopting shareholder activism in Kuwait based on the deficiency of the current internal mechanisms, which are non-executive directors, non-executive independent directors and the company’s auditor. Evaluating these mechanisms requires adopting an empirical approach because this thesis agrees with the view that evaluating the practice can only be done by an empirical approach. v Fifth, this thesis examines the extent to which shareholder activism exists in Kuwaiti-listed companies. This requires scrutinising the AGM minutes of Kuwaiti-listed companies across three financial years. This captures the genuine contemporary practices of shareholder engagements in Kuwait and suggests a threshold to classify the prevalence of shareholder activism in Kuwait based on the AGM minutes. Shareholder activism was found to be low in Kuwaiti publicly listed companies because only 10 per cent of the minutes showed some form of activism. However, the examination of the quality of the AGM minutes raises the concern that the minutes are not reliable enough to reflect the genuine level of shareholder activism in Kuwait. This will require regulators to enhance companies' disclosure in Kuwait and encourage shareholder engagement by establishing a minority shareholder watchdog group similar to the Malaysian model

The Effects of Different Pediatric Drugs and Brushing on the Color Stability of Esthetic Restorative Materials Used in Pediatric Dentistry: An In Vitro Study

The aim of the current study is to observe how different pediatric drugs and tooth brushing affect the color stability of different esthetic restorative materials. Three restorative materials (composite, compomer, and glass ionomer cement (GIC)) were each used to produce 72 specimens (10 mm × 2 mm). The specimens were divided into six groups and immersed in distilled water and five different pediatric drugs (amoxicillin, ibuprofen, ventolin, paracetamol, and multivitamins). Each group was divided into two subgroups (brushed and non-brushed). Over the course of two weeks, the specimens were agitated for one minute every eight hours. Color changes in all the specimens were evaluated using a spectrophotometer at 1 and 2 weeks. GIC showed a change in color that was significantly greater than that in all the other materials in each solution, except for those in amoxicillin. After a period of 1 to 2 weeks, the most noticeable change in color was detected in the amoxicillin composite and amoxicillin GIC unbrushed groups, and after 2 weeks, a significant difference was found in the ventolin GIC unbrushed group. The color stability of the restorative materials used in pediatric dentistry can be influenced by using popular liquid pediatric medications. GIC was the least color-stable material when subjected to liquid medications

Assessment of tear film parameters in females with refractive errors using a single device: an observational study

This observational study aimed to evaluate the use of a single portable device to assess the non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer patterns (LLP) in young females with refractive errors (REs). The study was conducted at the College of Applied Medical Science (Female campus), Riyadh, Saudi Arabia between January 5, 2021 to May 15, 2021. Forty young females, with mean age of 23.0± 4.3 years with REs (2.53 ± 2.05 D) and 40 females, mean age 23.8± 4.5 years with healthy eyes were recruited. The tests were administered in the following order: Ocular Surface Disease Index (OSDI), followed by NITBUT, TMH, and LLP. Significant differences (via Mann–Whitney U test) were noted in the median ocular surface disease index (OSDI; p<0.001), NITBUT (p = 0.035), TMH (p = 0.009), and LLP (p<0.001) scores between the study and control groups. ---Continu

Correlation between Subclinical Hypothyroidism and Metabolic Syndrome: A Retrospective Study

Background: Several studies worldwide have studied the correlation between subclinical hypothyroidism (SCH), and metabolic syndrome (MetS), but have reported inconsistent findings. Objectives: To assess the correlation between SCH and MetS in a population from Saudi Arabia. Methods: This retrospective study was conducted at King Abdulaziz University Hospital and analyzed all thyroid function tests conducted between January 1, 2019, to December 31, 2021. A predesigned checklist was used to collect data about patients' characteristics such as age, gender, nationality, TSH, FT4 level, and MetS components. Results: A total of 41,519 thyroid function tests were conducted during the study period. From this, 1303 (3.1%) patients were found to have SCH, with the majority being females (74.4%). The prevalence did not differ according to gender but increased to 3.5% among those aged >60 years. MetS components between mildly and markedly elevated TSH were significant for total cholesterol (P < 0.001) and high-density lipoprotein cholesterol (P < 0.05). Male patients with SCH were at a higher risk of developing diabetes (P < 0.001) and hypertension (P < 0.02), than female patients with SCH. After adjusting for age, in the multiple stepwise linear regression analysis, a significant association was found between TSH levels and ALT (odds ratio: 0.77) and SBP (odds ratio: 0.35). Conclusion: The study demonstrated that the prevalence of SCH is similar between both genders but increases with age. MetS components were abnormal in patients aged >50 years and in males with SCH. SCH and MetS components were found to be correlated, and thus monitoring these variables in patients with SCH is advisable

Physicians’ knowledge, attitude and perceptions towards vaccine-hesitant parents: a cross-sectional study

Abstract Objectives Research has shown that physicians are encountering an increase in vaccine-hesitant parents (VHPs) numbers. This study examined physicians' vaccination knowledge, vaccine-related discussions with VHPs, beliefs about and responses to vaccine hesitancy, and challenges faced while discussing immunization with VHPs. Methods This cross-sectional, descriptive study was performed at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia, in September 2020. The data were collected through a questionnaire distributed via email. The sample comprised 90 physicians who routinely treat children and reported they frequently have appropriate vaccine discussions when encountering VHPs. Results Ninety participants (59% were females) completed the questionnaire. Of these, 37.8% were from family medicine, 7.8% from primary care, and 54.4% from paediatrics. The most discussed topics were vaccine necessity, reasons for vaccine refusal, and vaccine safety. Seventeen participants (18.8%) reported being extremely confident, and (42.2%) were confident in their vaccine-specific knowledge. Regarding confidence in communication skills, 22.2% reported being extremely confident and (45.6%) were confident. Determinants of higher confidence in the knowledge and communication skills were physician age (p = 0.001 and p = 0.0001, respectively), years of practice (p = 0.002 and (p = 0.005), and patients seen per workday (p = 0.0001 and p = 0.024). Other factors such as physician sex (p = 0.062), the field of practice (p = 0.329), and hours of work per week (p = 0.061) were not significantly different. Forty-six (51%) physicians sometimes find it challenging to conduct appropriate vaccine-related discussions because of having too many other issues to discuss during the consultation. Furthermore, 53 (59%) participants agreed/strongly agreed that parental refusal to vaccinate would raise suspicions of negligence. On the other hand, 59 (65%) disagreed/strongly disagreed that parental refusal of vaccines is a parental right. Participants expressed the need to refer VHPs to a specialised advisory clinic with excellent experience and negotiation skills to overcome the challenges. Conclusion Vaccine safety and necessity are the topics of most concern to VHPs, and a knowledgeable physician with competent communication skills is critical in responding to such situations. This study highlights the most reported barriers to successful vaccine-related discussions. It raises underlying ethical principles such as parental autonomy and the need to train physicians in VHPs. To train physians for succucful vaccine counceling of VHPs

Silane-Containing Universal Adhesives Influence Resin-Ceramic Microtensile Bond Strength

Background: Silane-containing universal adhesives (UAs) are marketed as adhesion promotors for glass-ceramics. Objectives: This study aimed to evaluate the priming capacity of γ-methacryloxypropyltrimethoxysilane (γMPTS)-containing and γ-methacryloxypropyltriethoxysilane (γMPTES)/3-(aminopropyl)triethoxysilane (APTES)-containing universal adhesives (UAs) for lithium disilicate ceramic (LDC). Materials and Methods: Etched LDC discs were distributed into four groups according to the priming material used: (control), no priming; (MBN), LDC was primed with a universal primer (Monobond N); (SBU), γMPTS-containing UA (Single Bond Universal Adhesive) was used as a primer; and (SBP), γMPTES/APTES-containing UA (Scotchbond Universal Plus Adhesive) was used as a primer. LDC discs were cemented using a dual-cure resin cement, then sectioned into microbeams for microtensile bond strength (μTBS) evaluation. Failure modes were assessed. Results: MBN application showed the highest μTBS among all groups. γMPTES/APTES-containing UA (SBP) resulted in considerably higher μTBS compared with γMPTS-containing UA (SBU) or the control group. The mixed failures were the most predominant among all groups. Conclusions: The effect of silane-containing UAs on resin-ceramic μTBS is material dependent. Although γMPTES/APTES-containing UA improved bonding to LDC, the priming of LDC with either of the UAs tested cannot be considered as an alternative to a separate silanization (priming) step using a universal primer