Factors Influencing Nursing Preceptors' Role in Saudi Arabia: A Mixed Methods Study

The global shortage of nurses is a significant issue of concern. There is a need to increase the number of registered nurses to cover this shortage and maintain the quality of care and safety required to deal with unexpected crises. Clinical education equips nursing students to integrate theory into real-world practice. Registered nurses, who act as preceptors, play a vital role through formal assessment and feedback in teaching novice nurses how to provide safe, high-quality patient care. The increase in nursing students enrolled in nursing colleges places more responsibility on preceptors as they train a new generation of nurses alongside their daily roles in the hospital. There is limited research on preceptorship in Saudi Arabia, especially in relation to its multicultural workforce. Because of staff shortages in Saudi Arabia, nurses are often recruited from other countries; thus, expatriate nurses play a significant role in the education of Saudi nursing students. The value of preceptorship in terms of preparing nurses in the clinical practice environment should not be underestimated. Preceptorship provides important opportunities for novice nurses to be prepared for the nursing profession by developing their confidence and competence. Despite its importance, there is a lack of detail and insight into the way Saudi and expatriate preceptors undertake the critical role of preceptorship. his aim of this study was to investigate factors influencing preceptors’ experiences in performing their role of training intern nurses in the Saudi Arabian context. An explanatory sequential mixed methods design was conducted, consisting of three phases. In Phase 1, a quantitative study of 285 preceptors identified their backgrounds and perceptions, and investigated the factors influencing their role. The findings indicated that most preceptors were not formally prepared for their role. Organisational factors negatively affected preceptors regardless of their nationality, and cultural factors significantly hindered the expatriate preceptor role. In Phase 2, a qualitative study was conducted to obtain an in-depth understanding of preceptors’ lived experiences through semi-structured interviews with eight participants. The interviews were analysed using Interpretive Phenomenological Analysis framework. Three superordinate categories with nine subordinate themes described the participants’ journeys from uncertainty to satisfaction as well as the challenges and obstacles they experienced. After the data from the two phases were separately collected, analysed and reported, the findings were integrated in Phase 3 to understand the complete picture and achieve the aim of employing a mixed methods approach. Joint display and contiguous integration methods were employed to bring the data together, and the results of the integration revealed two main categories of factors influencing preceptors in Saudi Arabia. The first was organisational factors, which covered several issues related to a lack of clarity in the preceptors’ responsibilities, inadequate preparation, excessive workload, lack of appreciation and lack of communication. The second, individual factors, included concerns related to precepting across cultures, interns who are uninterested in learning and preceptors maintaining their own motivation. The key results from this project provide evidence that will inform nursing education leaders specifically in Saudi Arabia to consider these factors and incorporate them to develop well-structured guidelines and policy imperatives that will ensure the sustainability of the preceptor role. The study offers insights for an international readership that may inform the development of cultural training content in curricula, to prepare preceptors to competently teach new nurses from a variety of nationalities, ethnicities and backgrounds. Investment in preparing preceptors could help ensure that the new generation of nurses cultivates the knowledge, skills and confidence needed to retain them in the profession. This may further ease the staff shortages that threaten the provision of safe and quality care to patients.Thesis (Ph.D.) -- University of Adelaide, Adelaide Nursing School, 202

Effect of nitrogen fertilization levels and plant density on dry weight, yield components and bulb quality of onion plant

A field experiment was carried out during the two successive winter seasons of 2020/2021 and 2021/2022 to study the effect of mineral nitrogen levels and plant density on dry weight, yield and its components, as well as bulb quality of onions (cv. ‘Ahmar Tanawy’). This experiment included 12 treatments, which were combinations between four levels of mineral nitrogen (0, 192, 240 and 288 kg N/ha) and three plant densities (4, 5 and 6 rows/ridge equal 33.33, 41.67 and 50 plants/m2, respectively). These treatments were arranged in a split-plot design with three replications. Nitrogen levels were randomly arranged in the main plots, and plant densities were randomly distributed in the subplots. Nitrogen application at 192,244 and 288 kg N/ha led to increase dry weight/plant compared to control (zero N) and 288 kg N/ha gave the highest values of dry weight of leaves, dry weight of bulbs, and total dry weight per plant at 100 days in both seasons. The increases in total dry weight per plant were about 4.84 and 4.80 g per plant for 192 kg N/ha, 4.76 and 3.87 g per plant for 244 kg N/ha, and 6.86 and 5.74 g per plant for 288 kg N/ha over the control at 100 days in the 1st and 2nd seasons, respectively. The interaction between N at 288 kg/ha and low plant density (4 rows/ridge) gave the highest values of dry weight of leaves, bulb, and total dry weight/plant and increased yield of grade 1, exportable yield, average bulb weight, as well as nitrate and sulphur contents in bulbs, whereas the interaction between N at 244 kg/ha and high plant density (6 rows/ridge) increased grades 2, 3, and 4, marketable yield, and total yield/ha

Sub-micron moulding topological mass transport regimes in angled vortex fluidic flow

Shear stress in dynamic thin films, as in vortex fluidics, can be harnessed for generating non-equilibrium conditions, but the nature of the fluid flow is not understood. A rapidly rotating inclined tube in the vortex fluidic device (VFD) imparts shear stress (mechanical energy) into a thin film of liquid, depending on the physical characteristics of the liquid and rotational speed,ω, tilt angle,θ, and diameter of the tube. Through understanding that the fluid exhibits resonance behaviours from the confining boundaries of the glass surface and the meniscus that determines the liquid film thickness, we have established specific topological mass transport regimes. These topologies have been established through materials processing, as spinning top flow normal to the surface of the tube, double-helical flow across the thin film, and spicular flow, a transitional region where both effects contribute. The manifestation of mass transport patterns within the film have been observed by monitoring the mixing time, temperature profile, and film thickness against increasing rotational speed,ω. In addition, these flow patterns have unique signatures that enable the morphology of nanomaterials processed in the VFD to be predicted, for example in reversible scrolling and crumbling graphene oxide sheets. Shear-stress induced recrystallisation, crystallisation and polymerisation, at different rotational speeds, provide moulds of high-shear topologies, as ‘positive’ and ‘negative’ spicular flow behaviour. ‘Molecular drilling’ of holes in a thin film of polysulfone demonstrate spatial arrangement of double-helices. The grand sum of the different behavioural regimes is a general fluid flow model that accounts for all processing in the VFD at an optimal tilt angle of 45°, and provides a new concept in the fabrication of novel nanomaterials and controlling the organisation of matter

Evaluation of inhaled nitric oxide (iNO) treatment for moderate-to-severe ARDS in critically ill patients with COVID-19: A multicenter cohort study

Background: Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS. Methods: This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria. Results: A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO2, FiO2 requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001). Conclusion: In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs

Bio-nanotechnology application in wastewater treatment

The nanoparticles have received high interest in the field of medicine and water purification, however, the nanomaterials produced by chemical and physical methods are considered hazardous, expensive, and leave behind harmful substances to the environment. This chapter aimed to focus on green-synthesized nanoparticles and their medical applications. Moreover, the chapter highlighted the applicability of the metallic nanoparticles (MNPs) in the inactivation of microbial cells due to their high surface and small particle size. Modifying nanomaterials produced by green-methods is safe, inexpensive, and easy. Therefore, the control and modification of nanoparticles and their properties were also discussed

Antimicrobial activity of sesquiterpene lactones isolated from traditional medicinal plant, Costus speciosus (Koen ex.Retz.) Sm

<p>Abstract</p> <p>Background</p> <p><it>Costus speciosus </it>(Koen ex.Retz.) Sm (Costaceae) is an Indian ornamental plant which has long been used medicinally in traditional systems of medicine. The plant has been found to possess diverse pharmacological activities. Rhizomes are used to treat pneumonia, rheumatism, dropsy, urinary diseases, jaundice, skin diseases and leaves are used<b/>to treat mental disorders.</p> <p>Method</p> <p>Antibacterial and antifungal activities were tested using Disc diffusion method and Minimum Inhibitory <b>Concentration </b>(MIC). Column chromatography was used to isolate compounds from hexane extract. X-ray crystallography technique and GC-MS analysis were used to identify the compounds</p> <p>Results</p> <p>Antibacterial and antifungal activities were observed in hexane, chloroform, ethyl acetate and methanol extracts. Hexane extract of <it>C.speciosus </it>showed good activity against tested fungi also. Two sesquiterpenoid compounds were isolated (costunolide and eremanthin) from the hexane extract. Both the compounds did not inhibit the growth of tested bacteria. But, both the compounds inhibited the tested fungi. The compound costunolide showed significant antifungal activity. The MIC values of costunolide were; 62.5 μg/ml against <it>Trichophyton mentagrophytes</it>, 62. μg/ml against <it>T. simii</it>, 31.25 μg/ml against <it>T. rubrum </it>296, 62.5 μg/ml against <it>T. rubrum </it>57, 125 μg/ml against <it>Epidermophyton floccosum</it>, 250 μg/ml against <it>Scopulariopsis </it>sp, 250 μg/ml against <it>Aspergillus niger</it>, 125 μg/ml against <it>Curvulari lunata</it>, 250 μg/ml against <it>Magnaporthe grisea</it>.</p> <p>Conclusion</p> <p>Hexane extract showed promising antibacterial and antifungal activity. The isolated compound costunolide showed good antifungal activity.</p

Preventing AVF thrombosis: the rationale and design of the Omega-3 fatty acids (Fish Oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) study

Background: Haemodialysis (HD) is critically dependent on the availability of adequate access to the systemic circulation, ideally via a native arteriovenous fistula (AVF). The Primary failure rate of an AVF ranges between 20-54%, due to thrombosis or failure of maturation. There remains limited evidence for the use of anti-platelet agents and uncertainty as to choice of agent(s) for the prevention of AVF thrombosis. We present the study protocol for a randomised, double-blind, placebo-controlled, clinical trial examining whether the use of the anti-platelet agents, aspirin and omega-3 fatty acids, either alone or in combination, will effectively reduce the risk of early thrombosis in de novo AVF