Nurses' perception of obstacles and supportive behaviors in providing end of life care to critically ill pediatric patients

Pediatric critical care nurses care for dying children daily. The process of dying in an intensive care unit is complicated, and research on specific obstacles that impede delivery of end-of-life care and/or supportive behaviors that help in delivery of end-of-life care in pediatric intensive care units is limited. So, this descriptive research design aimed to describe pediatric critical care nurses’ perceptions of obstacles to provide end-of-life care and supportive behaviors that help in providing end-of life care in the intensive care units. The study concluded that the most supportive behaviors in providing end- of- life care to critically ill pediatric patients that perceived by nurses were, nurses scheduled so that child receives continuity of care and physicians agreeing about direction of child care while the most obstacles behaviors in providing end- of- life care were, child having pain that is difficult to control or alleviate, nurse too busy offering life saving measures to provide quality end of life care and family continually calls the nurse for update rather than the designated contact person. The study recommended that future researches are needed to identify and implement ways to decrease highly perceived obstacles and to continue to support highly perceived supportive behaviors. Furthermore, differences between ICU and non-ICU staff members’ perceptions of end-of-life care are needed to be studied. Key Wards: Perception, obstacles, supportive behaviors, end of life care, critically ill, childre

Coping Strategies of Mothers having Children with Special Needs

Families with a child who has special health care needs experience life differently than other families. Mothers appear to carry the larger burden of care and may feel a need to be with their child at all times and experience stress related to coping with the heavy load of care giving. the current descriptive research design is aimed to identify existing coping strategies of mothers who have children with special needs and determine whether there is a relationship between the coping strategies and the mothers’ demographic variables. Mother's coping strategies were assessed using the Family Crisis Oriented Personal Evaluation Scale (F-COPES). The study concluded that there is significance relationship between age and both reframing and passive appraisal, as well as between birth order and mobilizing family to acquire and accept help. The study recommended that future research should be done on larger populations and additional research might address the coping strategies of other family members, such as siblings and the extended family. Key Wards : Coping strategies, mothers, children, special needs, Family Crisis Oriented Personal Evaluation Scale (F-COPES).

Recent Drifts in pH-Sensitive Reverse Osmosis

Preparation of some smart PAm-ZTS pH-responsive membranes, via reactions between ZTS and PAm under different conditions, was conducted for testing pressure-driven reverse osmosis membranes (PDROMs) in active rejection of Ce4+, Pr3+, Sm3+, Gd3+, Dy3+, and Ho3+ ionic lanthanide species in their 3+ and 4+ states. Recent theoretical models to designate the membrane operations were mathematically itemized, after selective characterization of the PDROMs. The pH scale response of the membrane was confirmed using static adsorption and hydraulic pervasion result estimations. The flux across the PAm-ZTS membrane decreased with the lowering pH value, with drastic decreases between pH 4 and 7, and was both reversible and durable with pH shifts between ~3 and ~8. At lower pH 3, the individual pores were in a closed-state due to the prolonged structure of the amide chains on the porous surfaces. In contrast, at pH 8, the higher pH value, the membrane pores were in an open-state format, because of the collapsed structures of the amide chains. This grants a clear possible approach for manufacturing some pH-responsive composite membranes and inspires further design for their stimuli-responsive actions by incorporating molecularly designed macromolecules, synthesized by controlled polymerization

Prevalence of Pressure Ulcers with the Study of the Impact of Pressure Ulcer Educational Program on Registered Nurses’ Knowledge and Practice in Prince Miteb Bin Abdulaziz Hospital, Sakaka City, Saudi Arabia

Critically ill patients are at high risk for pressure ulcers. Prevalence differs based on settings but is 25% on the average. Cost of its treatment is two and a half times the cost of preventing them. Its development is an index of poor Nursing care. Nursing remains at the forefront of protecting and safeguarding the patient from pressure ulcers. Successful prevention of pressure ulcers requires that caregivers have adequate knowledge of this complication and preventive practice measures. This study describe the prevalence of pressure ulcers among inpatients of ICU and CCU departments, assess intensive care nurses’ knowledge and practice about pressure ulcers management and the impact of an educational program on knowledge and practice. An experimental research design was adopted to conduct the study on (39) nurses working in Intensive Care Units  of Prince Miteb Bin Abdulaziz  Hospital, Sakaka City, Saudi Arabia. Two tools were used for data collection: Knowledge questionnaire sheet and observation checklist. Completion of the educational program resulted in improved levels of nurses' knowledge  and practice regarding PU management. Findings of the present study suggest continued nursing education for the enrichment of nurses' knowledge and augmenting their practices about identification, prevention and management of pressure ulcer is effective in minimizing pressure ulcer for immobilized patients. Keywords: key words, Nurses’ Knowledge, Nurses’ Practice, Pressure Ulcer Prevention, educational programs

Knowledge of Pediatric Critical Care Nurses Regarding Evidence Based Guidelines for Prevention of Ventilator Associated Pneumonia (VAP)

ventilator associated pneumonia (VAP) is a costly, preventable, and often fatal consequence of medical therapy that increases hospital and intensive care stays in mechanically ventilated patients. The prevention of VAP is primarily the responsibility of the bedside nurse whose knowledge, beliefs, and practices influence the health outcome of ICU patients. Unfortunately little is known about the degree of nursing knowledge on evidence based guidelines for  the  prevention  of  VAP. This descriptive study aimed to assess knowledge of pediatric critical care nurses regarding evidence based guidelines for prevention of VAP in both pediatric and neonatal  intensive care units. The current study revealed inadequate knowledge of pediatric critical care nurses regarding evidence based guidelines for prevention of ventilator associated. There is strong correlation between years of experiences, previous training on guidelines of prevention of VAP  and knowledge of nurses on the evidence based guidelines for prevention of VAP. Moreover, there is no correlation  between  age and knowledge of nurses on evidence based guidelines for prevention of VAP. The study concluded that written unit protocols should be present and reviewed regularly as updates and new evidence for best practice are constantly emerging and staff should be educated on the updated protocols. Keywords: Knowledge, pediatric critical care nurses, evidence based guidelines, Ventilator Associated      Pneumonia (VAP

The Relationship between use of Technology and Parent- Adolescents Social Relationship

Today’s adolescents have unprecedented access to modern technology and use them in expected and unexpected ways. Adolescents spend many hours a day using the technology, and the vast majority of them have access to Internet, cell phones, smart phone, video games and many other forms of modern technology. With the increased role of modern technology in the adolescents’ lives has come the increased concern about how adolescents might be affected. This may take them away from important social interactions that develop in-person relationships. A good parent-teen relationship is important for adolescent health and development. The more time spent on television, computers, cell phone and video games leads to a lower quality of attachment to parents. This descriptive correlation study was aimed to investigate the relationship between adolescents' use of technology and their parent' social relationship. The study was conducted on randomly selected Preparatory and Secondary Schools from two governorates, Egypt. The data was collected during the first term of academic year 2015/2016. The participants for this study were 230 students (92 boys and 138 girls), with their ages ranging from 12 to 18 years. The self-report questionnaire sheet was developed by the researchers. The study concluded that there was a highly statistical correlation between adolescents' technology usage and social interaction with their parents. The study recommended that Parents need to educate themselves about social media and the ways their teens may use it, as well as the common risks, to help them understand and navigate the technologies. Moreover, parents' discussions are positive for teens and can result in less risky online behaviors. Future researches are needed to consider interviewing both parent and child together at the same time to get both parties’ perspectives on the same issues discussed. Key Wards: Technology, Parent, Adolescents, Teen age, Youth, Social Relationship

Prevalence and Molecular Characterization of Anisakidosis in both European (Merluccius merluccius) and Lizard Head (Saurida undosquamis) Hakes

This study focuses on Anisakidosis as a disease caused by a number of Anisakid larvae including Anisakis simplex, Pseudoterranova decipiens, Hysterothylacium spp. and Contracaecum spp., through assessing the clinical signs and the clinical examination of the disease in 170 Lizard head (Saurida undosquamis) and 160 European hakes (Merluccius merluccius) during the period from April 2011 to July 2012. In addition, identification of the recovered larvae morphologically and using random modified polymorphic DNA (RAPD-PCR) technique. No obvious clinical signs were observed in the examined fish. The post mortem examination revealed the presence of free or encapsulated larvae within the body cavity, on the visceral organs and in the musculature. The seasonal prevalence of Anisakid larvae was the highest in spring and summer and its lowest level was in autumn in both examined fish spp. The highest intensity of larvae was observed in the organs and viscera rather than in the musculature. RAPD technique identified the recovered larvae using four arbitrary primers. It could be concluded that Anisakid larvae can be easily identified using molecular tools by its well characterized genetic finger print and that in turn will help in its diagnosis in parallel with the traditional tools

Early versus Late Trophic Feeding: Effect on Health Status of Low Birth Weight Neonates

This study aimed to compare the effect of early versus late trophic feeding on the health status of low birth weight neonates. A comparative descriptive design was utilized on a convenience sample of one hundred low birth weight neonates, fifty of them for early group trophic feeding and the other fifty for late feeding. Sample was collected from two NICUs in Cairo University Hospitals from May 2013 till February 2014 to answer the research question” Does health status of low birth weight (LBW) neonates who start early trophic feeding better than those who started late trophic feeding?” Three tools were developed by researchers: socio-demographic data, nutritional recording sheet and observational check list for feeding tolerance signs and it filled by researchers daily for every neonate from admission till discharge. Results revealed that there were no statistically significant differences in the clinical and maternal characteristics of neonates in the two groups. The birth weight was increased significantly for early group than late in the 1st, 2nd and 3rd week. Amount of parenteral nutrition, hospital stay significantly less in early compared to late feeding group; late group experienced a highly significance incidence of milk intolerance and infection signs in the first week only. The benefits of early trophic feeding shown by this study strongly support its use for the LBW neonates. Early trophic feeding must be encouraged for all low birth weight neonates were recommended. Keywords: Early, Late Trophic Feeding, Health Status, Low Birth Weight Neonate