Incidence and prevalence of pressure ulcers in intensive care patients

Dissertation AnlagenZusammenfassung Dekubitalgeschwüre stellen eine potentielle Komplikation für Intensivpflegepatienten dar und ihre Prävention ist somit ein wichtiges Thema der Pflege. Daher ist das Ziel dieser Studie, Erkenntnisse über die Prävalenz und Inzidenz von Dekubitus auf Intensivstationen zu gewinnen. Die Studie gliedert sich in drei Teile: Der erste Teil ist ein Literaturreview. Hier wurden Studien innerhalb einer Zeitspanne von 2000 bis 2005 auf ihre Ergebnisse hinsichtlich der Prävalenz und Inzidenz von Dekubitus sowie damit zusammenhängender Faktoren unter-sucht. Außerdem wurde die methodische Qualität der Studien überprüft. Die Ergebnisse zeigten Variationen in der Prävalenz von Dekubitus auf Intensivstationen zwischen 4% bis 38% und in der Inzidenz zwischen 3,8% bis 12,3%. Alter, Inkontinenz, medizinische Diagnosen und Immobilität wiesen signifikante Zusammenhänge mit der Entwicklung eines Dekubitus auf. Mehrere Faktoren beeinträchtigten die methodische Genauigkeit der untersuchten Studien. In einem zweiten Schritt wurde eine Literaturstudie vorgenommen, um die prognostische Validität von Instrumenten zur Einschätzung des Dekubitusrisikos bei Intensivpflegepatienten zu untersuchen. Die Ergebnisse zeigten, dass nur ein Instrument, die Cubbin und Jackson-Skala , speziell für die Einschätzung des Dekubitusrisikos von Intensivpflegepatienten entwickelt wurde. Sensitivitäts- und Spezifitätstests zeigten sich als unzureichend, um die prognostische Validität von Risikoeinschätzungsinstrumenten zu demonstrieren. Den dritten Teil bildet die von der Abteilung Pflegewissenschaft, Charité Universitätsmedizin Berlin durchgeführte Prävalenzerhebung. Ihre Ziele waren die Ein-schätzung der Prävalenz von Dekubitus bei Intensivpflegepatienten und der damit verbun-denen Faktoren sowie die Ermittlung der Körperregionen, die am häufigsten betroffen sind. Die Querschnittsstudie wurde an 1760 Patienten von chirurgischen (N=402), internistischen (N=629) und interdisziplinären (N=729) Intensivstationen durchgeführt. Die Ergebnisse zeigten eine mittlere Prävalenzrate von ±30% zwischen 2002 bis 2005, während die Prävalenz in 2006 16,2% betrug.Abstract Pressure ulcers are a potential complication for intensive care patients and their prevention is a major issue in nursing care. Therefore, this study aims to give an insight into pressure ulcer prevalence and incidence in intensive care settings. This study consists of three parts: The first part is a literature review and aims to assess pressure ulcer prevalence and incidence in intensive care patients in the period from 2000 to 2005, the related factors, and the methodological rigour of these studies. The results revealed variations in the prevalence rate ranging from 4% to 38%, while the incidence rate ranged from 3.8% to 12.3% in intensive care settings. Age, incontinence, medical diagnoses and immobility were also significantly related to pressure ulcer development. In addition, more than one factor threatens the methodological rigour of the assessed studies. The second part reviews literature and aims to assess the predictive validity of pressure ulcer risk assessment tools in intensive care patients. The results revealed that only one pressure ulcer risk assessment scale was developed specially for intensive care patients called Cubbin and Jackson s scale . Sensitivity and specificity tests were not suitable for establishing the predictive validity of the risk assessment scales. The third part is a prevalence study conducted by the Department of Nursing Science, Charité-Universitätsmedizin Berlin in Germany. It aims to assess pressure ulcer prevalence in intensive care patients, the factors related to pressure ulcer prevalence in intensive care patients and the most common body sites of pressure ulcers. The results obtained from this study are based on a cross-sectional design carried out on 1760 patients from surgical (402), medical (629), and interdisciplinary intensive care (729). They revealed that the mean prevalence rate was ± 30% from 2002 to 2005 while it was 16.2% in 2006

Measuring the service quality factors of perspective international students to improve their satisfaction and loyalty towards University Tun Hussein Onn Malaysia (UTHM)

Student satisfaction and quality of education are of compelling interest to students, academic staff, policymakers and higher education researchers internationally. Students’ expectations can influence levels of student satisfaction before their study and their pre-conceived beliefs regarding the value of their education. It concerns that with less emphasis on the quality of services that provided by the Higher Education Institution (HEI) to the students may pose a threat regarding the satisfaction, retention and recruitment of the students which reduces the competitiveness of the institution. This study seeks to measure the service quality success factors through the perspective of international students to improve their satisfaction and loyalty towards University Tun Hussein Onn Malaysia. A questionnaire survey was carried out among international students in UTHM. A total of 246 questionnaires were collected and found valid. Analysis of Moment Structures Equation Modelling (AMOS-SEM) model was developed and found that seven groups of factors for service quality influences the satisfaction and loyalty towards UTHM, these factors are namely teaching, course content and supervision; administrative services; academic facilities; campus infrastructure; support services; student’s satisfaction and student’s loyalty. The findings from the critical factors of service quality through path analysis using structural model indicated that administrative services; academic facilities and support services have a significant effect on student's satisfaction, and student's satisfaction has a significant impact on student's loyalty while teaching, course content and supervision; and campus infrastructure groups were not supported. The implication of this research could enhance and further strengthen UTHM structures and creating new output as an adaptable strategy and education management tool

The Influence of Teacher’s Gender on the Implementation of English Language Curricula in Public Schools in Aqaba Governorate, Jordan

Purpose: This study examined the influence of teacher’s gender on the implementation of English language curricula in public schools in Aqaba governorate. Methods: Employing a descriptive survey design, 167 male and female English language teachers were selected purposively and participated from 240 English language teachers in public schools in Aqaba governorate. A 36- item questionnaire, which was used for collecting data, was validated by twenty one jurors. Its reliability was ensured by using a test- retest technique which was piloted sample of twenty male and female English language teachers who were not included the main sample. To analyze data, a descriptive statistics was employed. Findings: The findings of the study showed that there are not statistically significant differences at (α≤0.05) in the implementation of English language curricula due to the teacher’s gender. This implies that the implementation of English language curricula by male and female teachers in Aqaba governorate is not impacted by the gender of the teacher. Therefore, the study recommends carrying out more studies to ascertain the influence of teacher’s gender on the implementation of English language curricula and other curricula. Practical Implications: The results of the study might be of practical value for ministry of education since there is no gender effect on implementing the English curriculum. Originality/Value: The gender of the teacher does not have a statistical effect on   the implementation of English language curricula in public schools in Aqaba governorate

Sustainable Neighborhoods in the State of Qatar: Msheireb Downtown Doha

Over the past three decades, rapid urban sprawl, a changing economy, and shifting demographics have caused rapid developments, which included the urban regeneration of existing neighborhoods. In the 1940s, after oil and natural gas discoveries in the State of Qatar, Doha experienced massive transformations on social, economic, cultural and environmental levels. These transformations have created (A) the need for creating sustainable neighborhoods and (B) raised questions related to how existing neighborhoods can be more sustainable in the future. This study investigates the neighborhood of Msheireb Downtown Doha and the reasons which have caused its urban regeneration. The study investigates (1) practical forms of sustainable urbanism principles by analyzing the Msheireb project and (2) how this urban project can be enhanced according to these principles. The research design encompasses a summary of the literature, the site analysis, structured interviews and a resultant vision of a sustainable concept for Msheireb to define the actions needed to implement the sustainable neighborhood concept. The findings reveal that, comparing the image of old Msheireb with the current regenerated one, the later neighborhood is compact, pedestrian-friendly and mixed use, which in turn encourage people to engage and promote a higher level of social interaction and therefore, contribute to enhancing the urban livability of the neighborhood

Cytokines Profile in Newly Diagnosed Children with Type 1 Diabetes Mellitus

Background: Cytokines have long been implicated in the pathogenesis of autoimmune diabetes in a number of studies, and playing a role in the initiation of β-cell damaging process. The objective of this study is to gain more understanding about the role of cytokines in initiation of T1DM, through assessment of IFN-γ, IL-10 and IL-6 in diabetic patients. Patients and methods: A total of 60 patients who were newly diagnosed as having T1DM (diagnosed less than five months) were included in the present study. Fifty apparently healthy control subjects were underwent the measurement of serum IFN-γ, IL-10 and IL-6 by ELISA. Results: Higher serum levels of IFN-γ, IL-10, and Il-6 were observed in the investigated patients ≤10 years (75.60, 104.92, 147.6 pg/ml respectively) compared to controls (42.66, 57.01, 80.4 pg/ml respectively). The statistical analysis revealed a significant difference between patients and controls (P1= 0.005, 0.003, 0.036 respectively). The mean levels of serum IFN-γ, IL-10, and Il-6 were also significantly elevated in >10 years old patients (70.78, 84.22, 171.8 pg/ml respectively) than controls (40.39, 59.50, 81.6 pg/ml respectively), (P1= 0.006, 0.037, 0.04 respectively). A statistically difference of mean IL-10 concentration appears between patients in both age groups (P2= 0.04). No significant differences appear in the mean serum concentrations of IFN-γ, and IL-6 between the two age groups (P2=0.73, 0.07 respectively). Conclusions: In children with diabetes, a significant elevation of serum levels of IFN-γ, IL-10 and IL-6 were observed

GIS and RS Integrated Framework for Supporting Planners and Decision Makers

The power of integrations planning supports decision makers to take the right decision in the right time. In order to have good plan, we should gather different kind of information with different perspectives and sources. The integration between all kinds of information supports decision makers to set the right plans and logic strategies in order to achieve their expected goals.Decision makers may suffer from information leakage, un-integrated information from different sources; information which does not represent the current status of reality and ability to represent information geographically. Decision makers should use modern technologies and tools in order to overcome the obstacles which they may face.Remote sensing and Geographic information system can provide realistic source of data and logic solutions which can support the decision makers to take the right decision in the right time. Decision makers should use remote sensing technology  in order to set their future planning and select their right strategies because remote sensing is the science to obtain the date remotely either phenomena like temperature, humidity or even satellite images which provides a realistic representation for the land which may enable the decision maker to track changes which may happened on specific feature  or even extract a specific feature and get the different statistics  or measurements which  definitely important to set the right plans Geographic information system support decision makers by realistic solutions and excellent geographic  data representation  and even the ability to join and migrate different sources of data to be liked geographically with the related features. Keywords: Planning, Decision Making, Remote Sensing, Geographical Information Syste

Factors Facilitating the Implementation of the EFL Student’s Portfolio

The study examines the factors that facilitate the implementation of the student’s portfolio as viewed by EFL students and teachers. Gender differences in the factors were also investigated. To collect the data needed for answering the research questions, two instruments were developed, validated, and checked for reliability. The study sample included 953 students and 258 teachers. The main findings rregarding factors that facilitate the implementation of the student’s portfolio, both teachers and students agreed on the list of the given factors in the research instrument. Teachers considered the availability of materials and resources as the most important factor for better implementation of the student’s portfolio. Students viewed teachers’ support as the most important factor that would lead for better implementation of the student’s portfolio. Moreover, gender differences were reported with regard to the factors for both teachers and students

Investigation of Iodonium Salts: Synthesis, Stability and Reactivity

This thesis describes several approaches to the synthesis of novel iodonium salts. Firstly, attempts to synthesise a variety of novel alkynyl(aryl)iodonium salts (i-iii) is discussed. Most of these attempts were unsuccessful, however, useful information for future work was obtaine. The synthesis of iodonium salt (iii) was successful and this compound displayed some unusual reactivity. Several alkynyl(phenyl)iodonium trifluoroacetates were synthesised directly from commercially available iodobenzene diacetate and terminal acetylenes precursors with a range of substitution patterns in one step in excellent yields. These species were converted into alkenyl(arylsulfonyl)iodonium tetrafluoroborates in excellent yields by stereoselective Michael-type addition of arylsulfinic acids under protic conditions. Secondly, new reactivity of alkenyl(arylsulfonyl)iodonium tetrafluoroborates was investigated. Specially, the conversion of these selectively into aldehydes and vinyl chlorides using aqueous DMSO was achieved. Thirdly, two examples of stable enynyl(phenyl)iodonium trifluoroacetates were synthesised in excellent yields. These were converted into a new range of dienyl(aryl)iodonium salts. Finally, a computational study of alkynyl(aryl)iodonium salts was undertaken in an attempt to rationalise our experimental data on reactivity and stability

A Comparison of Text-Driven and Coursebook Materials: Investigating their Potential Learning Effects on EFL Learners’ Perceptions and Communicative Performance Using Multiple Research Methods

This study compared the potential effects of Text-Driven (TD) and Coursebook (CB) materials on learners' perceptions and interactions in EFL classrooms. It also explored which teaching materials are more likely to facilitate learners’ communicative competence through theoretical and empirical evaluations. 82 EFL female students at A2 (CEFR) level were selected in this study from the English Language Institute (ELI) at the University of Jeddah in KSA and divided into two comparable intact classes taught by the researcher. The first group was taught the developed Text-Driven materials, whereas the second group was taught the Coursebook materials. The study adopted a multiple-method research design. Data were collected through six methods: questionnaires, individual interviews, classroom interaction analysis, teachers’ observations, virtual forums, and pre-post communicative tests. The data revealed that while both TD and CB materials were viewed positively by the participants, Text-Driven showed a number of advantages over coursebook materials in developing learners’ engagement and classroom interactions. The findings demonstrated that the frequencies of learners' turns using L1 or L2 are higher in the TD group than in CB and that the observed interactional patterns differ considerably among the groups. The TD interactional patterns involved more open than closed responses, and their interaction was meaningful, personally engaging, and focused on both content and forms compared to their counterpart. Similarly, the two ELI instructors who observed the researcher’s TD and CB video-recoded classes commented that TD materials seemed more effective than the CB in developing classroom interaction, resulting in meaningful interactional patterns among TD learners. The pre-post communicative test results supported the previous data and showed that the TD materials are more likely to accelerate the learners’ overall English “communicative competence” than the CB materials. The theoretical content analysis of the coursebook unit provided further evidence that most of the tasks are controlled and aimed at practising language points and thus may not facilitate L2 communicative competence. The findings of this study would benefit TESOL/Applied linguistics stakeholders as a flexible communicative teaching model was proposed. It reflects the findings of language learning studies that explore how second language competence can be developed. Furthermore, these iii results may assist the ELI and other contexts in considering the significance of L2 materials development and its potential impact on learners’ engagement and communicative performance. In light of these findings, several recommendations are proposed

Antioxidant And Anti-Mycotoxin Activities, And Cytotoxicity Properties In Vitro Of Propolis Extracts

Abstract: The present study aims to determine the antioxidant activity and cytotoxic activity of propolis and evaluate the anti-mycotoxin activity of different propolis extracts. The three extracts of propolis (ethyl acetate, ethanol (75%), and water) were subjected to testing of the antioxidant potential, and total phenolic and flavonoid contents. determination of the cytotoxicity activity by standard cell culture method against colon and liver and the ability of propolis extracts to control aflatoxin (AF) production. The results revealed that the highest value of antioxidant activities was found for propolis ethyl acetate extract with an average % inhibition of 63.42%. the highest amount of propolis's total phenolic and flavonoid contents using ethyl acetate extract were 149.5 µg gallic acid equivalent/mg extract and 218.1 µg quercetin equivalent/mg extract, respectively. The three propolis extracts affect liver and colon human cell cancer. Ethyl acetate extract of propolis showed the lowest IC50 with the highest anti-cancer activity on the liver cancer cell line. In comparison, water extract showed the lowest IC50 with the greatest anticancer activity on the colon cancer cell line (50 and 54 µg/ml, respectively). Using different concentrations of propolis to reduce AF levels led to the complete disappearance of AF production at 100, 200, and 400 mg/ml concentrations of Ethyl acetate extract against AF production. In conclusion, these obtained findings indicated that propolis extracts exhibited substantial antioxidant and anti-cancer activities