6 research outputs found
Effect of Educational Intervention on Pediatric Diabetes self Care Practices
No full textAbstract: Background: Diabetes mellitus is among the most common chronic illnesses in childhood, it is a chronic metabolic condition affecting the child’s physical and physiological growth and development. Aim of the study: Study the effect of educational intervention on pediatric diabetes self care practices. Research design: A quasi experimental design (one group pre/post test) was used in the study. Settings: The present study was carried out at pediatric outpatient unit affiliated to Suez Canal University Hospitals and Health Insurance Hospital at Ismailia city. Sample: A non probability purposive sample (30) of diabetic children at the previously mentioned settings. Tools for data collection: The data were collected using two tools namely structured interview questionnaire and observational checklists to assess diabetes self care practices. Results: There was statistically significant difference in the total mean scores of satisfactory knowledge and self care practice pre/immediate post educational intervention. The total satisfactory knowledge was 100% immediate post educational intervention compared with 6.7% pre intervention. The total satisfactory level of self care practice was 100% immediate post educational intervention compared with 63.3% pre educational intervention. Conclusion: The educational intervention had a positive effect on children's diabetes self care practices. Recommendations: Periodic educational interventions are required to achieve positive change on diabetic children's self care practices.
Keywords: Diabetic children, educational intervention, Knowledge, Nursing, Practice.
Title: Effect of Educational Intervention on Pediatric Diabetes self Care Practices
Author: Hadeer Hussien Soliman, Wafaa El- Sayed Ouda, Manal Farouk Mohamed, Rehab Hassan Kafl
International Journal of Novel Research in Healthcare and Nursing
ISSN 2394-7330
Vol. 9, Issue 3, September 2022 - December 2022
Page No: 55-64
Novelty Journals
Website: www.noveltyjournals.com
Published Date: 27-September-2022
DOI: https://doi.org/10.5281/zenodo.7115915
Paper Download Link (Source)
https://www.noveltyjournals.com/upload/paper/Effect%20of%20Educational%20Intervention-27092022-1.pdfInternational Journal of Novel Research in Healthcare and Nursing, ISSN 2394-7330, Novelty Journals, Website: www.noveltyjournals.co
Physical model tests of the notional permeability on breakwaters
No full textBreakwaters are important objects to protect coastal- and harbour areas. To minimalize the probability of failure of breakwaters, a lot of research has been conducted concerning the stability of breakwaters. After Iribarren and Hudson, an influential research is conducted by Van der Meer. The literature research of this report will provide more background information concerning their researches on the stability of breakwaters. Van der Meer tested three sorts of breakwater constructions. The first breakwater structure contained a homogeneous construction (P=0.6) The second and third structure consisted of respectively a construction with impermeable core (P=0.1) and a structure with a filter layer and a permeable core (P=0.5). These variants of breakwaters were constructed with different slopes angles to require as much information possible concerning the stability of breakwaters. Van der Meer discovered two formulas for the stability of breakwaters. The first formula is used for plunging waves while the second formula is used for surging waves.Within these formulas, important factors as damage, wave height and notional permeability are included. The most important parameter of the formulas of Van der Meer is the notional permeability factor P. Van der Meer conducted his research on three different constructions and has designed a fourth construction based on the stability curves. This fourth construction has a value of permeability of 0.4. This value is estimated based on curve fitting. Following the research done by Van der Meer, Kik has subsequently researched the notional permeability of three breakwater constructions. Firstly, Kik repeated the test with a construction of impermeable core (model 1/P=0.08) and the test with the construction of filter layer and permeable core (model 2/ P=0.05) of Van der Meer. Lastly, Kik did a third test existing of a variant of the design of the fourth construction of Van der Meer (model 3 / P=0.35). Concluding from his research, Kik stated that the ‘Root mean square equation’ is a reliable method to determine the notional permeability P. During this research the influence of the thickness of the filter layer on the notional permeability P is studied. This research will also try to answer the question whether other relevant aspects might influence the notional permeability as well. The elaboration of this research is performed in a practical way in a wave flume in the water laboratory of the faculty of civil engineering of the TU Delft. Scale models of the breakwaters were constructed to test the notional permeability of the breakwaters. In the water laboratory three models were tested. Firstly, model 3 of Kik is repeated as model 3A, with a calculated value of notional permeability P 0.38. The construction of model 3A is build with a top layer, filter layer 1, filter layer 2 and a impermeable core. Second, another variant of model 3 of Kik is designed and tested (model 4). However, the measured damage figures were too low and therefore they could not be used to calculate a value for the notional permeability P. The construction of model four is build with a top layer, filter layer 1, filter layer 2 which is thicker as model 3A and an impermeable core. Finally, model 5 is tested with a calculated value of notional permeability of P 0.45. This model is designed from the fourth construction of Van der Meer. The construction of model 5 is build with a top layer, filter layer 1 and a permeable core with the same material of filter layer 2 of model 3A and model 4. The results of this research show that the influences of the notional permeability P exists of the ratio of the armour layer thickness and the thickness of the second filter layer. If the layer thicknesses are equal the value for notional permeability P is 0.38, which follows from model 3A. If the second layer has an infinite thickness (permeable core), the value for notional permeability P is 0.45, which follows from model 5. The value of the notional permeability P of model 5 corresponds to the design calculations of the computer model HADEER. Van der Meer discovered using this computer model that the ratio of dn50a/ dn50f = 5 has a value on the notional permeability P of 0.43 –0.44. During this research, while using two different methods, a value of the notional permeability P of 0.45 was calculated.coastal engineeringHydraulic EngineeringCivil Engineering and Geoscience
Late Neoproterozoic Rare-Metal Pegmatites with Mixed NYF-LCT Features: A Case Study from the Egyptian Nubian Shield
No full textThe current work records for the first time the rare-metal pegmatites with mixed NYF-LCT located at Wadi Sikait, south Eastern Desert of the Egyptian Nubian Shield. Most of the Sikait pegmatites are associated with sheared granite and are surrounded by an alteration zone cross-cutting through greisen bodies. Sikait pegmatites show zoned and complex types, where the outer wall zones are highly mineralized (Nb, Ta, Y, Th, Hf, REE, U) than the barren cores. They consist essentially of K-feldspar, quartz, micas (muscovite, lepidolite, and zinnwaldite), and less albite. They contain a wide range of accessory minerals, including garnet, columbite, fergusonite-(Y), cassiterite, allanite, monazite, bastnaesite (Y, Ce, Nd), thorite, zircon, beryl, topaz, apatite, and Fe-Ti oxides. In the present work, the discovery of Li-bearing minerals for the first time in the Wadi Sikait pegmatite is highly significant. Sikait pegmatites are highly mineralized and yield higher maximum concentrations of several metals than the associated sheared granite. They are strongly enriched in Li (900–1791 ppm), Nb (1181–1771 ppm), Ta (138–191 ppm), Y (626–998 ppm), Hf (201–303 ppm), Th (413–685 ppm), Zr (2592–4429 ppm), U (224–699 ppm), and ∑REE (830–1711 ppm). The pegmatites and associated sheared granite represent highly differentiated peraluminous rocks that are typical of post-collisional rare-metal bearing granites. They show parallel chondrite-normalized REE patterns, enriched in HREE relative to LREE [(La/Lu)n = 0.04–0.12] and strongly negative Eu anomalies [(Eu/Eu*) = 0.03–0.10]. The REE patterns show an M-type tetrad effect, usually observed in granites that are strongly differentiated and ascribed to hydrothermal fluid exchange. The pegmatite has mineralogical and geochemical characteristics of the mixed NYF-LCT family and shows non-CHARAC behavior due to a hydrothermal effect. Late-stage metasomatism processes caused redistribution, concentrated on the primary rare metals, and drove the development of greisen and quartz veins along the fracture systems. The genetic relationship between the Sikait pegmatite and the surrounding sheared granite was demonstrated by the similarities in their geochemical properties. The source magmas were mostly derived from the juvenile continental crust of the Nubian Shield through partial melting and subsequently subjected to a high fractional crystallization degree. During the late hydrothermal stage, the exsolution of F-rich fluids transported some elements and locally increased their concentrations to the economic grades. The investigated pegmatite and sheared granite should be considered as a potential resource to warrant exploration for REEs and other rare metals
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
No full text© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
No full text© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit
Positive communication for decreasing burnout in intensive-care-unit staff: a cluster-randomized trial.
No full textPurpose: Occupational burnout is common among intensive-care-unit (ICU) staff and adversely affects staff well-being and patient care. We hypothesized that a multicomponent intervention based on organizational support and workplace climate improvement would reduce burnout. Methods: The 1:1 cluster-randomized Hello trial involved 370 ICUs from sixty countries allocated to either the intervention or usual care. The four-week intervention designed to promote a positive workplace culture and within-team support used posters, email nudges, greetings during morning meetings, role modeling, and positive messages in boxes and on noticeboards. The primary endpoint was burnout prevalence, measured using the Maslach Burnout Inventory. Secondary outcomes included MBI subscale scores, well-being, job satisfaction, ethical climate, intention to leave, work safety, and professional conflicts. Results: Before the intervention, burnout prevalence was 59.4% (95% CI, 58.6-60.5), with no difference between arms. After the intervention, 4966 intervention-arm and 4602 control-arm healthcare professionals completed the MBI. Burnout prevalence was significantly lower in the intervention arm relative to controls (52.2% vs. 63.3%; adjusted odds ratio, 0.56; 95%CI 0.46-0.68; P < 0.001). Among MBI sub-scales scores, emotional exhaustion and depersonalization were lower, and personal accomplishment was higher in the intervention arm. Staff in the intervention arm reported better job satisfaction, workplace safety, ethical climate, and patient- and family-centered care; they were less often considering a job change. Conclusions: The Hello intervention reduced burnout and improved workplace culture among ICU staff. Given the pragmatic design, the intervention tested may have broad applicability. Trial registration: The trial was registered on ClinicalTrials.gov on June 18, 2024 (NCT06453616)
