Medical Device-Related Pressure Injury (MDRPI) Prevention in the Intensive Care Unit (ICU): An Evidence Based Practice Quality Improvement Project

Introduction: All intensive care unit (ICU) patients utilize various medical devices for care and treatment, placing them at high-risk for medical device-related pressure injuries (MDRPIs), which can lead to life-threatening infections, wounds/scars, and consumption of additional time and products to rectify these issues. Lack of appropriate decompression measures and improper bedside handoff report was recognized in the ICU at a hospital in Connecticut (CT). Method: A literature search using CINAHL, MEDLINE, and the Cochrane Database of Systematic Reviews was conducted, restricting the search to the period between 2018-2022. The keywords searched were: “pressure injuries,” “adult patients,” “intensive care unit,” “educational intervention,” “prevention,” and “identification.” From an initial library of eight articles, the selection resulted in four articles by adding the keywords “medical device-related pressure injuries.” The Plan-Do-Study-Act (PDSA) cycle was used to create/conduct an educational simulation training highlighting preventative and treatment measures carried out on three ICU competency days. The ICU nurses learned to take lead by understanding risk factors, tailored prevention to the device type, and collaborated with other team members to ensure continuity of care and brought these skills to their daily bedside routine. Results: A review of literature validated that staff education led to a positive impact on MDRPI prevention, decreased ICU stays pertaining to MDRPIs, and reduced costs and resources to correct these issues. The pre-survey, post-survey, and post-intervention results showed an increased perception on continuous skin assessments leading to an accurate account of MDRPI risk, and a drastic decrease in the number of MDRPIs in the ICU setting

Twenty years later: Family’s Continued Battle for Media Coverage of their Missing and Murdered Indigenous Women and Girls

Past research on media coverage of missing and murdered Indigenous women and girls (MMIWG) has focused mainly on stereotypical images of Indigenous femininity, with limited research on the family’s role and perspectives regarding such coverage. This study examines how family members conceptualise the media coverage of their missing and murdered loved ones, and the family’s role in shifting the dominant media narratives. Drawing on an intersectional feminist framework that pays close attention to decolonization, I reflect on the dominant media discourses about MMIWG. This research focuses on the cases of two Indigenous women – Rosianna Poucachiche, murdered in 2000, and Shannon Alexander, missing since 2008. The primary data was collected through an in-depth interview with a family member of the two young women. Articles were selected from mainstream media platforms, that include, CBC News, The Globe and Mail, Ottawa Citizen, Canada NewsWire and the Montreal Gazette. A qualitative content analysis was conducted to analyse data from the interview and news articles, which produced four main themes: impact of colonialism, police role in addressing MMIWG cases, media’s role and coverage of MMIWG, and the experiences and role of MMIWG families in pushing for media coverage. The findings of this research show that, although stereotyping and insensitive media coverage of MMIWG continues, there has been an identifiable change in media reporting in the past decade as narratives shift to more positive language and empathetic tones. I argue that this has been possible due to ongoing Indigenous family and community activism. The findings further reveal that families and activists have pushed media to not only place a greater emphasis on family narratives, but on issues of systemic and racist oppression as well, to acknowledge how these systems are implicated in the phenomenon of MMIWG. Recommendations from this research suggest that mainstream media platforms need to ensure that the families of MMIWG are not only consulted, but that their narratives be prioritised in public reporting on this issue

Prevalence of Xerostomia in Diabetes Mellitus at lower Sindh.

Introduction: Xerostomia is a common problem in apparently normal as well as in ill individuals. Diabetes mellitus is a common endocrine disorder in which Xerostomia is complained frequently. Xerostomia contributes to altered eating habits and increase risk of dental caries and oral infection if there is inadequate blood glucose control. Factors affecting Xerostomia includes socioeconomic and medical condition, includes uncontrolled diabetes mellitus, presence of peripheral neuropathy, use of medications, gender and age. Objective: To document the prevalence of Xerostomia among diabetic patients. Methodology: This prospective, cross sectional study was conducted on known cases of Diabetes mellitus attending medical OPD at Muhammad Medical College, Mirpurkhas Sindh from March 2017 to August 2017. During this period 100 patients were included according to inclusion criteria. Demographic details were recorded. Fox questionnaire was filled in, the data collected was analyzed by SPSS version 22, and presented as number and percentage. Result:  Among100 patients; 37% were xerostomic and 63% were non xerostomic, age range of xerostomic was 50 ±7years and non xerostomic was 35 ±11 years. 21 females had Xerostomia and 29 had no Xerostomia .16 males were xerostomic, and 34 males were non xerostomic. Among xerostomic patients 15 were insulin dependent and 21 were non-insulin dependent. Where as in non xerostomic 22 were insulin dependent and 42 were non-insulin dependent. The mean duration of diabetes mellitus was 10 ±5 years in Xerostomic and it was 8 ±3 years in non xerostomic diabetes mellitus. Conclusion: Xerostomia is common in elderly diabetics and in females and is dependent on glycemic control and duration of diabetes. Key words: Xerostomia, Diabetes mellitus, Elderly and Duration of Diabetes Mellitus.&nbsp

Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli.

BackgroundThe surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence.MethodsA cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale.ResultsThe respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008).ConclusionDiabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans

Synthesis and Characterization of Manganese Pyridazyl Complexes

Heterocyclic’s and their fused-ring derivatives have been of interest for their use in electronic materials due to their ease of production, synthetic versatility, and low cost compared to traditional inorganic materials like silicon. Pyridazines have been found to be useful in catalysis gas storage, polymeric sensors and biological mimetics. When a transition-metal is fused into a synthesized pyridazine, unique properties such as conductivity and optics are allowed. In this work, synthesized pyridazine complexes will be analyzed by mass spectroscopy, elemental analysis, nuclear magnetic resonance, imaging, x-ray crystallography, and infrared spectroscopy. We are interested in synthesizing organometallic pyridazines and manganese pyridazyl complex for polymer research. Off-metal synthesis and characterization of manganese pyridazyl complex required three intermediate steps. The research focuses on the synthesis and characterization of various manganese pyridazyl complexes

Political identities of Pakistani students in Lahore

Im Zentrum dieser Arbeit liegt die Präsentation einer Studie über politischen Identitäten von pakistanischen StudentInnen in Lahore. Die von Juli bis September 2007 selbst durchgeführte Studie im Rahmen einer Feldforschung vor Ort zeigt die unterschiedlichen Einstellungen und Meinungen von StudentInnen in Bezug auf pakistanische Politik und ihre eigene Identität auf und analysiert sie im Rahmen von Identitätsdiskursen in Pakistan. Der hermeneutische Teil der Arbeit identifiziert die pakistanische politische Kultur als zentrales Analyseelement und betrachtet sie anhand verschiedener politischer, historischer und psychologischer Parameter in der Auseinandersetzung der Debatte um eine pakistanische Identität, welche ausschlaggebend für die Erziehung junger Menschen in Pakistan ist. Das dreigliedrige Bildungssystem in Pakistan – ein Englisch geprägtes Bildungssystem, ein Urdu geprägtes Bildungssystem und ein Madrassah Bildungssystem - ist nicht nur Ursache sondern auch Problem einer Identitätsdebatte in Pakistan, welche die Ansichten und Weltanschauungen jener StudentInnen signifikant formt. An dieser Stelle setzt die Arbeit mit einem empirischen Teil fort: Die Analyse und Auswertung eines Fragebogens und zusätzliche semi-strukturierte Interviews mit StudentInnen von drei verschiedenen Universitäten, die alle unterschiedliche Schichten von StudentInnen unterrichten. Die Auswertung fokussiert vor allem auf drei spezifische Analyseeinheiten: 1) Identität, 2) Einstellungen gegenüber pakistanischer Regierung, Staatsbürgerschaft und Armee sowie 3) wahrgenommenen Bedrohungen. Die Ergebnisse der Studie zeichnen ein Bild von drei verschiedenen Studentenkörpern, die zwar ein jeweils unterschiedliches Mainstream-Denken in Bezug auf bestimmte Fragen aufzeigen, jedoch aufgrund unterschiedlicher sozialer Hintergründe und verschiedener Nuancen politischer Einstellungen von konservativ bis liberal keine konsolidierte politische Identität repräsentieren. Das politische Potenzial, das in dieser Gruppe steckt, findet sich nicht nur im empirischen Teil wieder, sondern ist erkennbar in dem politischem Aktivismus der StudentInnen, was vor allem in den letzten Jahren auf Grund der Absetzung des Richters des Obersten Gerichtshof im März 2007 sowie durch die Verhängung des Ausnahmezustandes in Pakistan durch Präsident Pervez Musharraf im November 2007 an hoher Relevanz gewonnen hat. Jenes politische Potenzial innerhalb der StudentInnen ist somit Teil der pakistanischen Zivilgesellschaft im Kampf für ein gerechtes Pakistan. Eine Konstellationsanalyse der politischen Landschaft Pakistans, ihrer wichtigsten Akteuren, sowie der größten politischen Problemfelder Pakistans wie etwa Korruption, bettet den politischen Aktivismus jener StudentInnen in die aktuelle Debatte um Pakistans politische Entwicklung ein.This paper presents a study on the political identities of Pakistani students in Lahore. Through a self-conducted study in a field research in Lahore from July to September 2007 the attitudes and opinions of three different student bodies in Lahore in regard of Pakistani politics and Pakistani identity were gathered and analysed in the light of the identity formation discourse in Pakistan. Thus, this paper starts with a hermeneutical approach analysing Pakistan’s political culture through a close look on the genesis of Pakistan’s creation and the following national identity discourse. This genesis is being looked at through different parameters such as political, historical and psychological components within this debate, which influences the education of young people in Pakistan. The education in Pakistan which is characterized by a threefold system: an English vernacular system, an Urdu vernacular system and a madrassah system, is the outcome and core of a big identity issue in Pakistan, which significantly shapes a student’s view on the world. This is where the empirical part of the paper connects. The study which was carried out through a questionnaire and with additional semi-structured interviews with students analyzes their responses and portrays the results of the survey along three different units of analysis: 1) identity 2) attitudes towards the Pakistani government, citizenship and army, and 3) perceived threats. The study shows that the students from different social backgrounds do show a core mainstream thinking towards specific issues, whereas one consolidated identity even within one student body cannot be made out, as all nuances from conservative to very liberal can be found in each institution. The political potential of students is not only remarkable through the presented study but shows itself within their political activism, which gathered high relevance during the events of the chief justice affair in march 2007 and the imposition of a state of emergency by president Pervez Musharraf in November 2007. The political potential located within this group finds its place within Pakistani civil society in the demand for a just Pakistan. A constellation analysis of the Pakistani political landscape, its major actors and its biggest problem fields, such as corruption, embed the student’s initiative in the current debate on Pakistan’s political development

The Impact of Advertisement on Mutual Funds Awareness: A Case Study of Arif Habib Investment Limited

The critical role of advertising is to generate awareness about organization offerings regardless of the industry in which it is operating. Advertising and its effectiveness on mutual funds products in terms of awareness is studied in this paper. Arif Habib Investment limited was taken as case to investigate the impact of advertising on its funds awareness. Employees were interviewed for this purpose. Due to the investigative nature of the research qualitative research technique is used by the researchers. The studied showed that advertisement has positive impact on the attentiveness of products offered by mutual funds among patrons. The significance of advertising in generating brand awareness in financial sector is revealed during the course of the study

PREVALENCE AND RISK FACTOR OF POLYCYSTIC OVARIAN SYNDROME

ABSTRACTPolycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. Its clinical manifestation varies from mild to severedisturbance of reproductive and metabolic functions. PCOS is clinical and public health importance because it is affecting up to one in five womenof reproductive age. It is an X-linked dominant condition and has diverse clinical implications such as psychological features (anxiety, depression),reproductive features (hirsutism and hyperandrogenism), and impaired glucose tolerance. It is widely dependent on environmental, genetic, ethnicityfactors including lifestyle and body weight. Weight loss improves the endocrine profile and increases chances of ovulation and pregnancy. It canbe treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, and gonadotrophins. The last option for fertilization isin vitro fertilization when other treatment fails. Its prevalence is estimated at 4-8% from studies performed in Spain and USA. Lifestyle including diet,exercise, and behavior therapy improves fertility. PCOS has unique interactions with the ever increasing obesity prevalence worldwide as obesityinducedinsulin resistancesignificantlyaggravatesall thefeaturesof PCOS.EducationabouthowPCOSaffectslong-termhealth shouldbe providedtowomenwith this disordertofeelphysicaland psychologicalbenefits so that theycould engagethemselvesmorewith their health careproviders.Keywords: Polycystic ovarian syndrome, Hyperinsulinemia, Hormone disbalance, Hirsutism, Ovarian cyst, Obesity, Sleep disorders

Maternal Care Disparities: Impact Of Pregnancy Profiles, Socioeconomic Factors, and Age on Maternal Outcomes

OBJECTIVES This study aimed to evaluate the impact of pregnancy profiles, socioeconomic factors, and age on maternal at teaching hospitals in Mardan, Khyber Pakhtunkhwa. METHODOLOGY This descriptive-exploratory/qualitative study was conducted at the genealogical outside-patient department of the Mardan Medical Complex, with the approval of the ethics committee. A total of 1187 patients attended the complex between January 2021 and January 2022. Informed consent was obtained, and a comprehensive history and physical examination were conducted using a pre-designed proforma. Patients meeting specific criteria, such as gestational age >36 weeks, singleton pregnancies, and absence of maternal co-morbidities, were included. Exclusion criteria encompassed conditions such as antepartum haemorrhage and fetal anomalies. Data analysis was performed using SPSS-24 version, ensuring the confidentiality and anonymity of participants. RESULTSOut % of 1187 patients, 48% had previous pregnancies (multiparous), while 52% were experiencing their first pregnancy (primiparous). Gestational age distribution showed that 45% of cases fell within the 36-38 week range, and 55% were between 39-40 weeks. Regarding booking status, 29% of patients were booked, while 71% were unbooked. Finally, the socioeconomic status analysis indicates that 61% of cases were above the poverty line, while 39% were below. These findings highlight important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status that can influence maternal care and outcomes. Among the different age groups, the <20 age group had the highest percentage of spontaneous deliveries (31%), while the >30 age group had the highest percentage of cesarean sections (25%). Induced labour rates were relatively consistent across age groups. Not being in labour was more prevalent in the 25-30 and >30 age groups. CONCLUSION The findings highlight that important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status can influence maternal care and outcomes

A forwarder based temperature aware routing protocol in wireless body area networks

© 2019 Taiwan Academic Network Management Committee. All rights reserved. A Wireless Body Area Network (WBAN) allows the seamless integration of miniaturized sensor nodes in or around a human body, which May cause damage to the surrounding body issue due to high temperature. Although various temperature aware routing protocols have been proposed to prevent temperature rise of sensor nodes, most of them accommodate single traffic transmission with no mobility support. We propose a Forwarder based Temperature Aware Routing Protocol (FTAR) that supports multiple traffic transmission for normal and critical data. Normal data is forwarded directly to the sink through forwarding nodes which are selected among mobile nodes attached to the arms and legs, while critical data is forwarded to the sink through static nodes attached to fixed body parts with no mobility. We conduct extensive simulations of FTAR, and conclude that FTAR has good performance in terms of hot spot generation ratio, hot spot duration time, and packet delivery ratio