«ΑΝΑΠΤΥΞΗ ΕΚΠΑΙΔΕΥΤΙΚΗΣ ΕΦΑΡΜΟΓΗΣ ΠΟΛΥΜΕΣΩΝ, ΜΕ ΣΚΟΠΟ ΤΗΝ ΕΝΗΜΕΡΩΣΗ ΚΑΙ ΕΥΑΙΣΘΗΤΟΠΟΙΗΣΗ ΤΩΝ ΠΑΙΔΙΩΝ ΣΧΕΤΙΚΑ ΜΕ ΤΗΝ ΠΡΟΣΤΑΣΙΑ ΚΑΙ ΤΗ ΔΙΑΤΗΡΗΣΗ ΤΩΝ ΔΑΣΩΝ»

Η ραγδαία εξέλιξη της τεχνολογίας, των επιστημών και της οικονομίας έχει επιφέρει σημαντικές αλλαγές και επιπτώσεις στο περιβάλλον. Είναι πολύ σημαντικό η εκπαίδευση και ενημέρωση των μαθητών για θέματα σχετικά με το φυσικό περιβάλλον και τα δασικά οικοσυστήματα, να ξεκινάει από νωρίς. Η συνεχής υποβάθμιση των δασικών οικοσυστημάτων και το γεγονός των πολλαπλών πυρκαγιών που πλήττουν τον πλανήτη μας κάθε χρόνο, οδήγησε στην επιλογή του θέματος και στην επιθυμία εκπόνησης της συγκεκριμένης διπλωματικής εργασίας. Στα πλαίσια αυτής της εργασίας δημιουργήθηκε μια διαδραστική εφαρμογή πολυμέσων εκπαιδευτικού χαρακτήρα με θέμα τα δάση, για παιδιά 9-12 ετών. Σκοπός της εφαρμογής είναι η ενεργοποίηση των μαθητών και η ενημέρωσή τους για θέματα σχετικά με τα δάση, καθώς επίσης και η ανάδειξη και αναδόμηση της προϋπάρχουσας γνώσης τους. Επιπλέον, η συγκεκριμένη εφαρμογή πολυμέσων μπορεί να λειτουργήσει ως πρόσθετο βοηθητικό εργαλείο και σε συνδυασμό με άλλες δραστηριότητες να συμβάλλει στην ευαισθητοποίηση των παιδιών απέναντι στην προστασία των δασών και στην υιοθέτηση πρακτικών οι οποίες δεν θα βλάπτουν το περιβάλλον. Στις μέρες μας η ανάπτυξη των νέων τεχνολογικών μέσων και η εισαγωγή των Τεχνολογιών της Πληροφορίας και της Επικοινωνίας (ΤΠΕ) στην εκπαίδευση, εμπλουτίζει την εκπαιδευτική διαδικασία, την καθιστούν πιο ελκυστική και ενεργοποιούν τη μάθηση. Μέρος αυτών των νέων τεχνολογικών μέσων θεωρούνται και οι εφαρμογές πολυμέσων εκπαιδευτικού χαρακτήρα, οι οποίες μπορούν να χρησιμοποιηθούν ως εναλλακτικό εργαλείο μάθησης μέσα στην τάξη. Οι εφαρμογές αυτές έχουν τη δυνατότητα να παρέχουν μελλοντικές λύσεις για σύνθετα προβλήματα περιβαλλοντικού χαρακτήρα, αφού επιτρέπουν την εμπλοκή των συμμετεχόντων σε σενάρια πραγματικού κόσμου. Στο τελευταίο μέρος αυτής της εργασίας, περιγράφεται η διαδικασία της αξιολόγησης της διαδραστικής εφαρμογής πολυμέσων από εκπαιδευτικούς και παιδιά, η παράθεση των αποτελεσμάτων που προέκυψαν και επιχειρείται η εξαγωγή συμπερασμάτων.The rapid growth of technology, science, and the economy has led to significant changes and impacts on the environment. It is very important that education and information of students about the natural environment and forest ecosystems start at an early age. The progressive degradation of forest ecosystems and the numerous fires that ravage our planet every year, led to the choice of the topic and the desire to write this paper. As part of this paper, an interactive multimedia educational application on the topic of forests was developed for children aged 9-12. The aim of this application is to activate and inform students about forest-related topics, as well as to deepen and restructure their existing knowledge. Furthermore, this interactive multimedia application can serve as an additional tool and, in combination with other activities, help to raise children's awareness of forest conservation and the use of environmentally friendly practices. Nowadays, the development of new technological tools and Implementation of Information and Communication Technology (ICT) in education, can improve the educational process, make it more attractive and enable learning. Part of these new technological tools are the interactive multimedia educational applications, that can be used as alternative learning tools in the classroom. These applications have the potential to provide future solutions to complex environmental problems by enabling participants to engage in real-life scenarios. The final part of this paper describes the process of evaluation of the interactive multimedia application by teachers and children, presents the results and draws conclusions

Nurse-physician collaboration and associations with perceived autonomy in Cypriot critical care nurses

Background and aims: Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses' autonomy and pertinent nurses' characteristics in adult intensive care units (ICUs) in Cyprus. Design and Methods: Descriptive correlational study with sampling of the entire adult ICU nurses' population in Cyprus (five ICUs in four public hospitals, n = 163, response rate 88·58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. Results: The average CSACD score was 36·36 ± 13·30 (range: 7–70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores (t = 2·056, p = 0·04). CSACD correlated positively with years of ICU nursing experience (r = 0·332, p < 0·0001) and professional satisfaction (r = 0·455, p < 0·0001). The mean autonomy score was 76·15 ± 16·84 (range: 18–108). Higher degree of perceived collaboration (CSACD scores) associated with higher autonomy scores (r = 0·508, p <0·0001). Conclusions: Our findings imply low levels of nurse-physician collaboration and satisfaction with care decisions and moderate levels of autonomy in ICU nurses in Cyprus. Relevance to clinical practice: The results provide insight into the association between nurse-physician collaboration and nurses' autonomy and the correlating factors

Nurse-physician collaboration and associations with perceived nurse autonomy in critical care nurses in Cyprus

Background and aims: Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses’ autonomy and pertinent nurses’ characteristics in adult intensive care units (ICUs) in Cyprus. Design and Methods: Descriptive correlational study with sampling of the entire adult ICU nurses’ population in Cyprus (five ICUs in four public hospitals, n =163, response rate 88⋅58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. Results: The average CSACD score was 36⋅36 ±13⋅30 (range: 7 – 70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores (t =2⋅056, p =0⋅04). CSACD correlated positively with years of ICU nursing experience (r =0⋅332, p <0⋅0001) and professional satisfaction (r =0⋅455, p <0⋅0001). The mean autonomy score was 76⋅15 ±16⋅84 (range: 18 – 108). Higher degree of perceived collaboration (CSACD scores) associated with higher autonomy scores (r =0⋅508, p <0⋅0001). Conclusions: Our findings imply low levels of nurse-physician collaboration and satisfaction with care decisions and moderate levels of autonomy in ICU nurses in Cyprus. Relevance to clinical practice: The results provide insight into the association between nurse-physician collaboration and nurses’ autonomy and the correlating factors

The effectiveness of systematic pain assessment on critically ill patient outcomes: A randomised controlled trial

Background: Evidence suggests that critically ill patients’ pain may still be underestimated. Systematic approaches to pain assessment are of paramount importance for improving patients’ outcomes. Objectives: To investigate the effectiveness of a systematic approach to pain assessment on the incidence and intensity of pain and related clinical outcomes in critically ill patients. Methods: Randomized controlled study with consecutive critically ill patients allocated to either a standard care only or a systematic pain assessment group. The Behavioral Pain Scale (BPS) and the Critical Pain Observation Tool (C-POT) were completed twice daily for all participants. In the intervention group, clinicians were notified of pain scores. Linear Mixed Models (LMM) for the longitudinal effect of the intervention were employed. Results: A total of 117 patients were included (control: n=61; intervention: n2=56). The incidence of pain (C-POT >2) in the intervention group was significantly lower compared to the control group (p < .001). The intervention had a statistically significant effect on pain intensity (BPS, p = 0.01). The average total morphine equivalent dose in the intervention group was higher than in the control group (p = 0.045), as well as the average total dose of propofol (p = 0.027). There were no statistically significant differences in ICU mortality (23.4% vs 19.3%, p=0.38, odds ratio 0.82 [0.337-1.997]) and length of ICU stay (13.5, SD 11.1 vs 13.9, SD 9.5 days, p= 0.47). Conclusion: Systematic pain assessment may be associated with a decrease in the intensity and incidence of pain and influence the pharmacological management of pain and sedation of critically ill patients

The Impact of Pain Assessment on Critically Ill Patients' Outcomes: A Systematic Review

In critically ill patients, pain is a major problem. Efficient pain management depends on a systematic, comprehensive assessment of pain. We aimed to review and synthesize current evidence on the impact of a systematic approach to pain assessment on critically ill patients' outcomes. A systematic review of published studies (CINAHL, PUBMED, SCOPUS, EMBASE, and COCHRANE databases) with predetermined eligibility criteria was undertaken. Methodological quality was assessed by the EPHPP quality assessment tool. A total of 10 eligible studies were identified. Due to big heterogeneity, quantitative synthesis was not feasible. Most studies indicated the frequency, duration of pain assessment, and types of pain assessment tools. Methodological quality assessment yielded "strong" ratings for 5/10 and "weak" ratings for 3/10 studies. Implementation of systematic approaches to pain assessment appears to associate with more frequent documented reports of pain and more efficient decisions for pain management. There was evidence of favorable effects on pain intensity, duration of mechanical ventilation, length of ICU stay, mortality, adverse events, and complications. This systematic review demonstrates a link between systematic pain assessment and outcome in critical illness. However, the current level of evidence is insufficient to draw firm conclusions. More high quality randomized clinical studies are needed

The Impact of Pain Assessment on Critically Ill Patients’ Outcomes: A Systematic Review

In critically ill patients, pain is a major problem. Efficient pain management depends on a systematic, comprehensive assessment of pain. We aimed to review and synthesize current evidence on the impact of a systematic approach to pain assessment on critically ill patients’ outcomes. A systematic review of published studies (CINAHL, PUBMED, SCOPUS, EMBASE, and COCHRANE databases) with predetermined eligibility criteria was undertaken. Methodological quality was assessed by the EPHPP quality assessment tool. A total of 10 eligible studies were identified. Due to big heterogeneity, quantitative synthesis was not feasible. Most studies indicated the frequency, duration of pain assessment, and types of pain assessment tools. Methodological quality assessment yielded “strong” ratings for 5/10 and “weak” ratings for 3/10 studies. Implementation of systematic approaches to pain assessment appears to associate with more frequent documented reports of pain and more efficient decisions for pain management. There was evidence of favorable effects on pain intensity, duration of mechanical ventilation, length of ICU stay, mortality, adverse events, and complications. This systematic review demonstrates a link between systematic pain assessment and outcome in critical illness. However, the current level of evidence is insufficient to draw firm conclusions. More high quality randomized clinical studies are needed

Divided naevus of the eyelid, seven cases

Divided naevus of the upper and tower lids is an infrequent congenital naevus of the human eyelids. It is also known as kissing naevus or split ocular naevus. The histological types of divided naevi may be metanocytic, cellular or compound. Until now about 30 such cases have been reported in the literature. In our clinic, in the last 20 years we have seen seven patients with divided naevus, four female and three male. Three patients, two children of 10 and 11 years and a 77-year-old nun, did not accept any treatment. The remaining four patients, three female and one mate, accepted surgical, treatment. None of them had received any treatment in the past. Three of these divided naevi were cellular and one was metanocytic. Treatment included a two stage reconstruction in three cases and a single stage procedure in one case. The Lower eyelid was usually treated first, and upper eyelid full thickness grafts were mostly used. Lid shortening was common, particularly in the cellular naevi. The results were aesthetically and functionally good. No major complications were observed. (c) 2006 The British Association of Plastic Surgeons. Pubtished by Etsevier Ltd. All rights reserved

Development of an Instrument to Determine Competencies of Postgraduate ICU Nurses in Cyprus

Aims and objectives: The study sought to explore the expected competencies for postgraduate intensive care unit nurses aiming to develop a future competency-based curriculum. The aim of this part of the study is to develop a new instrument to determine what competencies are expected of postgraduate critical care nurses. Background: Despite existing competency frameworks that emerged from research in the area of critical care, globally and within countries there is diversity and an ongoing debate regarding level of critical care education, outcomes and competencies acquired. Design and methods: A combination of qualitative and quantitative approach was used. In first stage (qualitative), focus groups and interviews were used aiming to explore critical care nurses views concerning expected competencies of postgraduate critical care nurses. In second stage (quantitative), an 81 items Likert scale questionnaire, which was designed based on qualitative data and literature, was distributed among critical care nurses in Cyprus (n: 234, response rate 66%) aiming to receive feedback from clinical nurses and validate the instrument. Psychometric approaches such as internal consistency reliability using Cronbach's α and construct validity were used to validate the instrument. Results: The final questionnaire includes 72 items and has a four-dimensional structure. The four dimensions are (1) leadership/management and professional development, (2) decision-making and management of emergencies, (3) provision of care and professional practice and (4) ethical practice. All factors were highly reliable, with Cronbach's α ranging from 0·895 to 0·974. Conclusions: A new instrument to determine what competencies are expected of postgraduate critical care nurses was generated from this study. A new framework of competencies is grounded on this study that addresses the holistic, individualized and ethically informed quality care of critically ill and may inform educational strategies. Relevance to clinical practice: Critical care nurses competencies need to be determined for quality care and speciality development