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Presenteeizm İşte Var Olma(Ma)
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Introduction:
Stoma surgery may reduce the quality of life, including sex life. A literature review was undertaken to explore what factors impact on the sexual health and sexuality of people with a stoma.
Methodology:
A review of the literature was undertaken using the online databases Cochrane, PsychInfo, Embase and Pubmed. The search was limited to articles on colostomates and ileostomates in the English language that were peer-reviewed and written in the past 5 years.
Results:
Intestinal stoma surgery affects many aspects of a patient's life, including body image, relationship with a partner and quality of sex life. The introduction of perioperative educational programmes for patients qualified for ostomy surgery and their relatives will provide the necessary support in the face of physical and mental difficulties that may be associated with the procedure.
Bu çalışma hemşirelik öğrencilerinin klinik öğretimde yaşadıkları etik sorunları belirlemek amacıyla yapılmıştır. Araştırmada nicel araştırma desenlerinden tarama deseni kullanılmıştır. Çalışmanın ulaşılabilir evrenini bir şehirde bulunan tek devlet üniversitesinin sağlık bilimleri fakültesi son sınıf hemşirelik bölümü öğrencileri oluşturmuştur. Bu çalışmada evrenin tamamına ulaşılmaya çalışılmış ve örneklem seçimine gidilmeden 229 öğrenci ile çalışma tamamlanmıştır. Çalışmada veriler öğrenci tanıtım formu ve “Hemşirelikte Klinik Öğretimde Etik Sorunlar Ölçeği” kullanılarak toplanmıştır. Çalışmadan elde edilen veriler ilk olarak betimsel, daha sonra çıkarıma dayalı istatistik yoluyla analiz edilmiştir. Hemşirelik intörn öğrencilerinin %50,7’si klinik öğretimde etik sorun yaşadığını belirtmiştir. Öğrencilerin etik sorun yaşama durumlarına yönelik ölçek toplam puanları ile yaş, cinsiyet, klinik uygulama alanı ve etik sorun yaşama durumları karşılaştırıldığında yaş grupları ve klinik uygulama alanı açısından anlamlı sonuç bulunamazken, cinsiyet ve etik sorun yaşama durumuna göre ölçek puanlarının istatistiksel olarak anlamlı (p
İnsanlık 18. yüzyılda tarihsel bir kırılma noktası olarak ele alınabilecek bir dönemi geride bırakmıştır. Bu dönem literatürde Sanayi Devrimi olarak adlandırılmaktadır. Sanayi Devrimi'yle birlikteki işyeri mekân anlamında ciddi bir ayrıma tabi tutulmuş ve iş-ev arasına kalın duvarlar örülmüştür. Yine bu dönem işgücünün profilinin ciddi anlamda değiştiği bir süreç olarak bilinmektedir. Özellikle zanaatkârların yeni dönemde kurulan fabrikalarda işçi olması bu durumun en temel göstergelerindendir. Tarımsal hayattan kopuşla işin sadece fabrika olarak adlandırılan bir ortamda yapılmaya başlanmasıyla birlikte çalışma hayatına ve sorunlarına yönelik olarak adlandırılan tüm parametrelerin yeniden tanımlanması ihtiyacı ortaya çıkmıştır. Dolayısıyla tarım hayatından farklı olarak sanayileşmeyle birlikte çalışanların problemlerinde ve bu problemlere dönük olarak ortaya atılan çözüm önerilerinde de değişiklikler meydana gelmiştir. Ayrıca bu dönemde kendi emeğini başkalarının tekeline bırakan işçi, çalışma sürelerinin uzamasına paralel olarak iş konusunda beklentilerini karşılayamamış tam aksine hayal kırıklığına uğramıştır. Kısacası, sanayileşmeyle birlikte işçiler, psikolojik anlamda her gün çalışma hayatının vebası olarak nitelendirilebilecek stres ve stres faktörlerine maruz kalmış; sonuç olarak da işçi devir hızı, işten ayrılma gibi tepkisel davranışlar ortaya koymaya başlamışlardır. Tüm bunlardan hareketle çalışmanın temel amacı işgörenlerin çalışma hayatında karşılaştıkları ve işten ayrılmalarıyla son bulan stres kavramını sebep ve sonuçlarıyla birlikte detaylı bir analize tabi tutmaktadır.
Hemşirelikte uzmanlık, sorunları bağımsız olarak çözebilme ve sonuçları değerlendirmek için mesleki bilgi ve becerileri kullanma becerisi olarak tanımlanmaktadır. Teknolojik gelişmeler ile sağlık sisteminin değişmesi, bakımın karmaşıklığının ve sorumlulukların artması sonucunda hemşireler bilgiye dayalı olarak hareket etmek istemekte, bu durum uzmanlaşmayı getirmektedir. Akademik uzmanlık, yüksek lisans ve doktora gibi lisansüstü programların veya sertifika programlarının tamamlanmasıyla elde edilen bir unvan olarak ifade edilirken, Benner uzmanlığı klinik deneyime dayandırmaktadır. Benner’e göre uzman hemşire, yararlı olmayan tanı ve çözümler için gereksiz yere düşünmeden ve zaman kaybetmeden durumu kavrayan, doğru tanı ve çözümü üretebilmek için sezgisel bir anlayışa sahip olan kişidir. Uzman hemşire, hız, esneklik, deneyim, sezgisellik ve önemli unsurları belirleyebilme özelliklerine sahiptir. Hemşirelikte uzmanlık, akademik ve klinik uzmanlık olmak üzere iki boyutta karşımıza çıkmaktadır. Hemşireliğin daha bağımsız bir disiplin haline gelebilmesi için bu iki uzmanlık seviyesi birbirinden ayrı düşünülmemelidir. Bu derlemenin amacı, hemşirelikte uzmanlık kavramlarının ele alınması ve ülkemizdeki uzman hemşirelerin mevcut durumunun incelenmesidir.
Introduction Postoperative surgical site infection (SSI) forms the major burden of nosocomial infections in surgical patients. There is prevalent practice of surgical site hair shaving as a part of preoperative preparation. There is uncertainty regarding the benefit versus harm of shaving for SSIs. Hairs at surgical sites are removed prior to surgery most often by shaving. We performed this study to look for what impact preoperative hair removal by shaving has on postoperative SSI.
Methods We performed prospective comparative cohort study in patients undergoing elective abdominal surgeries. We included clean and clean-contaminated surgeries in immunocompetent patients of which half were shaved and other half not shaved prior to surgery. Other confounding factors like skin cleaning, aseptic technique of surgery, antibiotic prophylaxis and treatment, and postoperative wound care were as per care. Patients were assessed for presence and grade of SSI postoperatively on day 7, 14, and 30. Results were analyzed statistically using chi-square and Fischer's exact tests for significance in entire sample as well as in demographic subgroups.
Results Overall SSI rate was 11.42%. There was no statistically significant difference in SSI rates between patients who underwent preoperative surgical site hair removal by shaving (232) and who did not have shaving (232) on all the three different assessment timelines in postoperative period, namely, day 7, 14, and 30. Although the absolute number of patients who had SSI was more in those who underwent preoperative surgical site hair removal by shaving, the difference was not statistically significant ( p > 0.05). But on subgroup analysis patients with clean-contaminated surgeries ( p = 0.037) and patients with surgeries lasting for less than 2 hours (Fischer's exact = 0.034) had significantly higher SSI in the shaved group compared with unshaved on day 14.
Conclusion As per our results, preoperative shaving did not significantly increase overall SSI except in subgroup of clean-contaminated surgeries and in surgeries of less than 2 hours' duration. So especially in these patients avoiding preoperative surgical site hair shaving may be used as one of the infection control measures.
Osteoporosis is a common skeletal disease with marked bone loss, deterioration of the bone microstructure and bone fragility. An abnormal bone remodelling cycle with relatively increased bone resorption is the crucial pathophysiological mechanism. Bone remodelling is predominantly controlled by osteoblasts and osteoclasts, which are specialized cell types that are regulated by a variety of osteogenic and osteoclastic factors, including cytokines expressed within the bone microenvironment under local or systemic inflammatory conditions. Signal transducer and activator of transcription 3 (STAT3) plays a prominent role in the communication between cytokines and kinases by binding downstream gene promotors and is involved in a wide range of biological or pathological processes. Emerging evidence suggests that STAT3 and its network participate in bone remodelling and the development of osteoporosis, and this factor may be a potent target for osteoporosis treatment. This review focuses on the role and molecular mechanism of the STAT3 signalling pathway in osteogenesis, osteoclastogenesis and osteoporosis, particularly the bone-related cytokines that regulate the osteoblastic differentiation of bone marrow stromal cells and the osteoclastic differentiation of bone marrow macrophages by initiating STAT3 signalling. This review also examines the cellular interactions among immune cells, haematopoietic cells and osteoblastic/osteoclastic cells.
Medical gas cylinders have been used for the
treatment of millions of patients at healthcare
centers and at homes. They comprise oxygen,
nitrous oxide, carbon dioxide, air, entonox,
and helium. These are compressed and
stored in cylinders in liquid or gaseous
form. These gases are predominantly used
in medical procedures, some for inducing
anesthesia and others for driving devices like
ventilators, cryoprobe, etc. Improper storage,
handling, and use of gas cylinders can pose
a physical and chemical threat to both staff
and patients. Many patients with diseases like
chronic obstructive pulmonary disease with
respiratory failure were already on domiciliary
oxygen. The recent COVID-19 pandemic left
many patients fighting for their lives and in
those who survived, the residual pulmonary
damage led to increased prescription of
domiciliary oxygen therapy.
Reckless use of cylinders is associated with
high chances of accidents. We must be aware
and also impart knowledge regarding the
handling of cylinders to our patients. In this
chapter, the basics of medical gas cylinders will
be dealt with and we will also learn how to store
these cylinders safely at hospitals and home.
Aim: This study was conducted to evaluate the general self-efficacy and professional readiness of intern nurses during the Covid-19 epidemic. Method: As a descriptive study, the study was completed with 173 students who took the fall and spring semester Intern Practice courses of the Faculty of Health Sciences of Erciyes University in the 2021-2022 academic year. Students Descriptive Form, General Self-Efficacy Scale and Professional Readiness Perception Scale in Nursing were used in the study. Ethical permission was obtained from Erciyes University Social and Human Ethics Committee (Date: 26.04.2022; no: 174). Results: Students' General Self-Efficacy Scale total median value was 32.0; The Occupational Fit sub-dimension median value of 4.0; Communication cooperation sub-dimension median value was 4.5; The median value of the professional competence sub-dimension was determined as 4.0. It has been determined that there is a statistically significant difference between professional adaptation, communication cooperation and professional competence, choosing the profession, his thoughts about his profession, and the effects of the epidemic on working life (p≤0.05). A positive, weak and significant relationship was found between the students' general self-efficacy scale scores, professional adjustment (rho= 0.39), communication cooperation (rho= 0.34) and professional competence (rho= 0.37) (p≤0.05). Conclusion and recommendations: It is recommended to increase the professional readiness of students by increasing their self-efficacy levels in acute processes such as epidemics. Keywords: Covid-19, Intern Nurse, Self-efficacy, Professional Readiness, Epidemic
Aim:
The study aimed to examine pain behavior during nursing interventions in patients who were on mechanical ventilation.
Method:
The study was carried out in patients who were under treatment at a university hospital during the 2017-2018 period and who were connected to a mechanical ventilator and were unable to communicate verbally. In two intensive cares (n = 165), 568 pain assessments were made before and during nursing interventions (aspirating the respiratory tract, wound care, injection applications, bed bath, perineal care, mouth care, etc.). Patients' sedation levels were determined according to the "Ramsay Sedation Scale" and their pain and physiological parameter were determined according to the "Behavioral Pain Scale." The Wilcoxon-signed rank test was used to evaluate the difference between the pain scores and physiological parameters before and during the procedure. A p-value of < .05 was accepted as statistically significant.
Results:
Totally 45.4% of the patients are over age 65, 59.4% were males and 66.1% had chronic diseases. The interventions causing pain score difference was nasogastric intubation, tracheal expiration, nasotracheal expiratory, oropharyngeal expiration, dressing change, perineum care, position change, bed bath, oral care, intravenous catheter application, tracheostomy cannula care, urethral catheter application, and eye care while a significant increase was seen in all physiological parameters during bed bath, perineal care, and nasogastric intubation.
Conclusion:
It is concluded that nurses should take some precautions before painful procedures.
The aim of this study is to develop a valid and reliable attitude scale that helps to reveal the nursing students’ attitudes towards
clinical practices. In the study; which was designed in a methodological type, firstly 34 draft items were created which measured
the attitude towards clinical applications that were in line with the literature. The scale, which was submitted to expert opinion
and reduced to 32 items accordingly to the recommendations, was applied to 365 students who were studying in the nursing
department. In the Explanatory Factor Analysis (EFA), the scale was reduced to 26 items, based on item factor loads. Factor
loadings of the items in the scale ranged between 0.347-0.745. Comparative fit indices Root Mean Square of Approximate Errors
(RMSAE)= 0.097 and Square Root of Residual Means (RMR)= 0.09 as a result of the Confirmatory Factor Analysis (CFA) performed
by collecting data from 127 students, excluding the students participating for EFA. The Cronbach Alpha value of the scale was
0.93. As a result, the developed scale proved to be a valid and reliable measurement tool in terms of measuring the attitudes of
nursing students towards clinical practice. It is thought that the developed scale can be used in research regarding the factors
affecting the emotions, achievements, values and skills of nursing students concerning clinical practice. It is recommended
that research on the reliability of the scale should also be conducted with different reliability tests such as test-retest.
Kanser, dünyada ölüm nedenleri arasında ikinci sırada yer alan, mortalite ve morbidite oranı yüksek, gelecek ve belirsizlik kaygısına yol açan ve yaşamı tehdit eden ciddi bir sağlık sorunudur. Kanser ve tedavisi istenmeyen pek çok semptoma neden olmakta ve bu semptomlar yaşam kalitesini azaltmaktadır. Kanser hastaları sıklıkla bu semptomların yönetiminde tamamlayıcı terapi yöntemlerine başvurmaktadır. Günümüzde tamamlayıcı terapi yöntemleri ciddi yan etkilerinin olmaması, kolay ulaşılabilir, ucuz ve kolay uygulanabilir olması nedenleri ile kanser hastaları tarafından bir tedavi yöntemi olarak kabul görmektedir. Bu yöntemlerden biri olan aromaterapi, esansiyel yağların destekleyici amaçla kullanıldığı bir yöntemdir. Aromaterapi, kanser ve tedavisine bağlı gelişen semptomların yönetiminde ve yaşam kalitesinin artırılmasında olumlu etkiler sağlamaktadır. Bu derleme makale, kanser hastalarının semptom yönetiminde aromaterapi kullanımı hakkında sağlık profesyonellerinin bilgilendirilmesi amacıyla yazılmıştır.
Objective
We conducted a systematic review and meta-analysis to clarify the effects of different exercise modes (resistance training [RT], whole body vibration training [WBVT], and mixed training [MT, resistance training combined with other exercises such as balance, endurance and aerobic training]) on muscle strength (knee extension strength [KES]) and physical performance (Timed Up and Go [TUG], gait speed [GS] and the Chair Stand [CS]) in older people with sarcopenia.
Method
All studies published from January 2010 to March 2021 on the effects of exercise training in older people with sarcopenia were retrieved from 6 electronic databases: Pubmed, Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure (CNKI), and Wanfang Database. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Pooled analyses for pre- and post- outcome measurements were performed using Review Manager 5.4 with standardized mean differences (SMDs) and fixed-effect models.
Result
Twenty-six studies (25 randomized controlled trails [RCTs] and one non-randomized controlled trail) were included in this study with 1191 older people with sarcopenia (mean age 60.6 ± 2.3 to 89.5 ± 4.4). Compared with a control group, RT and MT significantly improved KES (RT, SMD = 1.36, 95% confidence intervals [95% CI]: 0.71 to 2.02, p < 0.0001, I ² = 72%; MT, SMD = 0.62, 95% CI: 0.29 to 0.95, p = 0.0002, I ² = 56%) and GS (RT, SMD = 2.01, 95% CI: 1.04 to 2.97, p < 0.0001, I ² = 84%; MT, SMD = 0.69, 95% CI: 0.29 to 1.09, p = 0.008, I ² = 81%). WBVT showed no changes in KES (SMD = 0.65, 95% CI: − 0.02 to 1.31, p = 0.06, I ² = 80%) or GS (SMD = 0.12, 95% CI: − 0.15 to 0.39, p = 0.38, I ² = 0%). TUG times were significantly improved with all exercise training modes (SMD = -0.66, 95% CI: − 0.94 to − 0.38, p < 0.00001, I ² = 60%). There were no changes in CS times with any of the exercise training modes (SMD = 0.11, 95% CI: − 0.36 to 0.57, p = 0.65, I ² = 87%).
Conclusions
In older people with sarcopenia, KES and GS can be improved by RT and MT, but not by WBVT. All three training modes improved TUG times, but not improved CS times.
İnsanlar yaşadıkları coğrafyaya ilişkin edinmiş oldukları bilgi ve deneyimleri ile kendi yaşamsal hafızlarını, afet bilinçlerini, toplumsal afet kültürünü ve coğrafyanın da tarihçesini oluştururlar. Bu çalışmanın amacı, yetişkinlerin yaşadıkları coğrafyadaki afetlere ilişkin yaşamsal hafızalarında oluşturdukları bilgi ve deneyimlerini ortaya koymaktır. Çalışma nitel araştırma desenlerinden biri olan temel nitel araştırma deseni kullanılarak gerçekleştirilmiştir. Çalışma grubu bir devlet üniversitesinde 2019-2020 yılında öğrenim gören Sosyal Bilgiler Eğitimi Anabilim Dalı öğrencilerinin ebeveynlerinden biri olmak şartıyla 154 katılımcıdan oluşmaktadır. Çalışmanın verileri afet öncesi, afet anı ve afet sonrasını kapsayan açık uçlu sorulardan oluşan anket ile toplanmıştır. Katılımcılardan elde edilen veriler içerik analizi ile çözümlenmiş ve 6 farklı kategori altında sınıflandırılmıştır. Çalışma sonucunda katılımcıların yaşadıkları coğrafya ilişkin en çok bildikleri ile en çok yaşadıkları afetlerin deprem, sel ve heyelan olduğu belirlenmiştir. Katılımcıların afet anında dışarı çıktıkları, çok korktukları ve duygularını kontrol edemedikleri sonucuna varılmıştır. Katılımcılar afet sonrasında ise daha çok bir şey yapamadıklarını ifade etmişlerdir. Afet konusundaki önerilerinde ise afet bilincine sahip bireylerin yetiştirilmesini için eğitime vurgu yaptıkları sonucuna ulaşılmıştır.
Aim
This review aims to examine nurses’ perceived barriers to and facilitators of pain assessment and management in adult critical care patients.
Background
Pain is one of the worst memories among critically ill patients. However, pain among those patients is still undertreated due to several barriers that impede effective management. Therefore, addressing the perceived barriers and facilitators to pain assessment management among critical care nurses is crucial.
Methods
A systematic search of pain assessment and management in critical care patient-relevant literature from four databases was done, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Results
The barriers and facilitators were categorized into four groups: nurse-related, patient-related, physician-related, and system-related. The most frequently reported barriers in this study included nurses’ lack of knowledge regarding the use of pain assessment tools, patients’ inability to communicate, physicians’ prescription of analgesics being independent of pain scores evaluation, and absence of standardized guidelines and protocols for pain evaluation and control. For the facilitators, the most reported ones include ongoing education and professional training related to pain assessment and management, patients’ ability to self-report pain, effective collaboration between physicians and nurses, and productive discussion of patients’ pain scores during nurse-to-nurse handovers.
Conclusion
Various barriers and facilitators to pain assessment and management were identified and examined in this review. However, future research is still needed to further investigate these barriers and facilitators and examine any other potential associated factors among critical care nurses.
Relevance to Clinical Practice
The findings of our study could help hospital managers in developing continuous education and staff development training programs on assessing and managing pain for critical care patients. Also, our findings could be used to develop an evidence-based standard pain management protocol tailored to effectively assess and promptly treat pain in critical care patients.
İş sağlığı ve güvenliği sadece çalışma hayatında değil hayatın tüm aşamalarında dikkate alınması gereken bir kavramdır. Kazalar sadece iş hayatında değil ayrıca normal yaşam süreçlerinde de meydana gelmektedir. İş sağlığı ve güvenliğinin bir yaşam felsefesi hâline gelmesi ve bu alandaki eğitimlerin erken dönemde başlanması gerektiği aşikârdır. “Bana ve onlara birşey olmaz.” düşüncesinden uzaklaşarak işverenlerin, uzman ve çalışanların kendilerine düşen gerekli sorumlulukları yerine getirmeleri gerekir. Kitap; saha örnekleri, yönetmelik ve mevzuatlar, makaleler, raporlar, kitaplar, bildiriler, internet kaynakları vb. dikkate alınarak hazırlanmıştır. Konular; tablolar, grafikler, şekiller ve görsellerden faydalanılarak daha iyi anlaşılabilmeleri için detaylı anlatılmıştır. Her bir bölümün içeriği iş sağlığı ve güvenliğine kaynak olacak şekilde sektörler ile ilgili yönetmelikler, iş kazası istatistikleri, tehlikeler ve riskler, meslek hastalıkları, risk değerlendirmeleri ve alınması gereken önlemler ve önerilerden oluşmaktadır.
Bu kitap; iş sağlığı ve güvenliği genel bilgileri ve maden sektörü, inşaat ve kazı işleri, kamu sektörü ve belediyeler, elektrik işleri, sağlık sektörü, tekstil sektörü, tarım sektörü, gıda sektörü, üretim sektörü, kimya ve ilaç sektörü, hizmet sektörü ve işveren-alt işveren hukuki ilişkisi bölümlerinden oluşmaktadır. Bu konular, iş sağlığı ve güvenliği eğitimlerini destekleyerek sahadaki uygulamaların kavranmasını sağlayacak şekilde iş sağlığı ve güvenliği ile ilgilenen herkes için yardımcı kaynak olması amacıyla hazırlanmıştır.
Link: https://www.nobelyayin.com/is-sagligi-ve-guvenligi-sektorel-yonetimi_17505.html
This study aimed to examine the relationship between Hb A1c levels and the clinical course of coronavirus-19 (COVID-19) patients. Sixty-six COVID-19(+) patients with high Hb A1c and 46 with average Hb A1c and 30 COVID-19(–) patients with average Hb A1c were included. Hb A1c levels and parameters examined in COVID-19(+) patients were compared between groups, and correlation analysis was performed between these parameters and Hb A1c levels. The effect of Hb A1c levels on intensive care unit (ICU) admission and mortality rate in COVID-19 patients was analyzed with the χ² test. It was observed that hemoglobin (Hb) and arterial oxygen saturation (SaO2) levels of the COVID-19 (+) groups was lower than the COVID-19 (–) group, while ferritin, D-dimer, procalcitonin (PCT), and C-reactive protein (CRP) levels were higher. The COVID-19 (+) group with high Hb A1c had higher lactate dehydrogenase (LDH), PCT and D-dimer levels than the other two groups, while Hb, partial arterial oxygen pressure (PaO2) levels were lower. The Hb A1c levels of the COVID-19 (+) groups were positively correlated with absolute neutrophil count (ANC), LDH, PCT and (K⁺) levels, while negatively correlated with Hb and PaO2 levels. Hb A1c was found to be associated with the inflammation process, coagulation disorders and low PaO2 in COVID-19 patients. The COVID-19 patients with high Hb A1c levels had a higher mortality rate than other COVID-19 patients. Using Hb A1c measurements with other prognostic markers would contribute to the patient’s risk of death assessment.
Critical illness is often painful, both from the underlying source of illness, as well as necessary procedures performed for the monitoring and care of these patients. Pain is often under-recognized in the critically ill, especially among those who cannot self-report, so accurate assessment and management continue to be major consideration in their care. Pain management in the intensive care unit (ICU) is an evolving practice, with a focus on accurate and frequent pain assessment, and targeted pharmacologic and non-pharmacologic treatment methods to maximize analgesia and minimize sedation. In this review, we will evaluate several validated methods of pain assessment in the ICU and present management options. We will review the evidence-based recommendations put forth by the largest critical care societies and several high-quality studies related to both the in-hospital approach to pain, as well as the short- and long-term consequences of untreated pain in ICU patients. We conclude with future directions.
At present, diseases of bones and joints stand third after cardiovascular and oncological pathologies which demands the necessity of searching for new etiological factors and pathogenetical mechanisms of these illnesses. The accumulating data show the association between the impairment of bone tissue development and regeneration and endocrine disruptor impact.
Endocrine disruptors are chemical substances, mainly of anthropogenic origin, capable of affecting endocrine system functioning and interfering with organ morphogenesis and physiological functions. The development and regeneration of bone tissues have a complex hormonal regulation and therefore bone tissue cells, osteoblasts, and osteoclasts can be considered as potential targets for endocrine disruptors. Endocrine disruptors have been established to be able to impair calcium metabolism which also contributes to the development of musculoskeletal system pathology.
Data on histogenesis of bone tissue and regeneration, calcium metabolism as well as on hormonal regulation of bone growth and remodeling processes are presented in this work. Recent information on the effect of the main endocrine disruptor classes (diethylstilbestrol, organochlorine pesticides, alkylphenols, bisphenol A, dioxins, polychlorinated biphenyls, and phthalic acid esters) on the development and remodeling of bone tissues and calcium metabolism has been summarized. The established physiological and molecular mechanisms of their action have been also considered.
Bu araştırma, 2005-2020 yıllarında yayınlanmış afet eğitimi konulu
yerli ve yabancı akademik çalışmaların eğilimlerini belirlemeyi
amaçlamaktadır. Araştırma kapsamında afet eğitimi ile ilgili literatür
taranmış, yerli ve yabancı olmak üzere toplamda 67 akademik
çalışmaya ulaşılmıştır. Ulaşılan çalışmalar konu başlıkları, ele alınan
afet türü, çalışmanın yayın yılı, çalışmada yararlanılan araştırma
deseni, çalışmanın veri toplama aracı ve çalışmanın veri analiz
yöntemine göre genel ve alt kategorilere ayrılarak sınıflandırılmıştır.
Konularına göre ele alınan akademik çalışmaların ağırlıklı olarak,
afetlere yönelik bilgi düzeyini ve görüşleri belirleme, afetlerin
programa yansımasını saptama ve afet eğitiminin önemine vurgu
yapma eğiliminde oldukları sonucuna ulaşılmıştır. Araştırma
kapsamında incelenen akademik çalışmalarda okul öncesi ve özel
bireylerle yürütülen çalışma sayısının nispeten az olduğu
saptanmıştır. Ele alınan çalışmalar yöntemlerine göre incelendiğinde;
çalışmalarda en çok “Tarama” ve “Doküman İnceleme” yöntemlerinin
kullanıldığı sonucuna ulaşılmıştır. Ele alınan çalışmalarda karma
yöntemli bir çalışmaya rastlanmamıştır. En sık kullanılan veri toplama
araçlarının anket, literatür tarama ve ölçekler olduğu; en az kullanılan
veri toplama araçlarının ise kelime ilişkilendirme testi ve başarı testleri
olduğu görülmüştür. Veri analizinde yüzde ve frekans değeri
belirleme yöntemlerinin sıklıkla tercih edildiği de bu araştırmanın
bulguları arasında yer almaktadır. Elde edilen veriler ışığında, afet
eğitimi çalışmalarının mevcut hali göz önünde bulundurularak tespit
edilen eksikliklerin giderilmesi yönünde birtakım öneriler
sunulmuştur.
Amaç: Bu araştırma, son sınıf hemşirelik öğrencilerinin mesleki hazır oluşluk algılarının belirlenmesinde
geçerli ve güvenilir bir ölçüm aracı geliştirilmesi amacıyla yapıldı.
Yöntem: Metodolojik tasarımlı araştırma, Ocak-Mart 2018 tarihleri arasında İstanbul’da iki
üniversitenin hemşirelik bölümündeki 362 son sınıf öğrencisiyle yapıldı. “Kişisel Özellikler Formu
ve Hemşirelikte Mesleki Hazır Oluşluk Algısı Ölçeği” ile veriler toplandı. Veriler, tanımlayıcı
istatistikler, açıklayıcı ve doğrulayıcı faktör analizi, Pearson korelasyon analizi, bağımlı gruplarda
t-testi ve Cronbach alfa iç tutarlılık katsayısı ile değerlendirildi.
Bulgular: Faktör analizinin uygulanabilirliği, madde analizi, açıklayıcı ve doğrulayıcı faktör analizi
sonucunda 38 madde ölçekten çıkarıldı. Ölçeğin uyum iyiliği istatistiklerinin 15 madde ve
üç alt boyut ile kabul edilebilir/kusursuz uyum gösterdiği saptandı. Cronbach alfa iç tutarlılık
katsayısı ,90 olarak belirlendi. Test-tekrar test puan ortalamaları arasında istatistiksel açıdan
fark olmadığı (p>,05) ve anlamlı pozitif ilişkinin olduğu saptandı (r=,87; p<,001).
Sonuç: Ölçeğin geçerli ve güvenilir bir araç olduğu ve hemşirelik son sınıf öğrencilerinin mesleki
hazır oluşluk algılarının belirlenmesinde kullanılabileceği sonucuna varıldı.
Anahtar sözcükler: Hemşirenin rolü, hemşirenin uygulama kapsamı, hemşirelik öğrencileri,
mesleki yeterlilik
Background
Ethics stimulation in nursing education focuses on human, non-technical factors in a clinical reality. Simulation as a teaching method began in the 1930s with flight simulators. In the beginning of the 1990s, simulations developed further in tandem with other technological and digital inventions, including touchscreen and three-dimensional anatomical models. Medical science first used simulation as a pedagogical teaching tool. In nursing education, simulation has been used for approximately a hundred years. Teaching has mainly focused on medical-technical, patient-specific interventions and their management.
Objective
The objective of this study was, from a caring science didactic perspective, to deepen the understanding of ethics simulation in nursing education.
Design
Qualitative design and explorative, descriptive and hermeneutic approach of an inductive character.
Methods
Semi-structured face-to-face interviews in 2016–2017 with six Norwegian nursing students who were encouraged to narrate about their experiences of ethics simulation in nursing education.
Ethical considerations
Informed consent was obtained from the participants. Anonymity and confidentiality regarding data material were guaranteed.
Results
Interpretation of the nursing students’ narratives resulted in the following meaning units: ethical being and ethos, nursing students’ formation process, bridge-building between theory and clinical practice, and teacher and ethics simulation.
Conclusion
Through ethics simulation, nursing students can obtain an increased knowledge and a sense of being able to handle difficult ethical situations. Nursing students’ values, moral actions and ethical value base offer a positive point of departure, for both theoretical and practical ethics teaching, and an awareness of the unique human being, the patient, in clinical reality. The implementation of ethics simulation needs more attention in nursing education.
Hasta/sağlıklı bireyin fiziksel olduğu kadar, emosyonel yönden de anlaşılması sağlık profesyonellerinin etik duyarlılığının bir göstergesidir. Çünkü duyarlılık, ahlaki yanıtın ayrılmaz bir parçasıdır. Etik sorunu belirleme yeteneği olan “Etik Duyarlılık” etik ilkeler doğrultusunda savunulabilir olmalıdır. Etik duyarlılık etik sorunu çözmek, açıklık getirmek ya da eylemi haklı çıkartmanın yanı sıra etik ikilemi önleme noktasında da son derece önemlidir. Hemşirelik, mesleki felsefe ve bilimsel bir etik yapı üzerine temellendirilmiştir. Etik duyarlılık değer ve mesleki performansın doğasında yer alan alturism ile açıklanabilir. Bu noktada hemşirenin objektif gözlem yeteneği ve empatik yaklaşımı etkilidir. Etik ikilem ya da sorunlar karşısında karar verme sürecinde etik ilkeler doğrultusunda hareket etme, etik duyarlılığın gelişimine bağlıdır. Bu derlemede klinik uygulamada karşılaşılan etik sorunların giderilmesinde etik duyarlılık kavramının hemşireler için önemini vurgulamak amaçlanmıştır.
Abstract
Purpose:
Needle procedures are one of the most distressing practices for pediatric oncology patients. Virtual reality (VR) is a distraction method which offers an extremely realistic and interactive virtual environment and helps reduce needle-related pain and distress. The aim of this study was to evaluate the effects of VR method on pain during venous port access in pediatric oncology patients aged 7 to 18 years.
Method:
Children who had cancer and were between the ages of 7 and 18 years and undergoing a port-a-cath access were randomly assigned through blocked randomization to either the VR intervention group or control group. A commercially available VR headset was fitted to children in the intervention group. Immediately after the port access, pain scores were obtained from children’s self-reports and parents’ proxy reports, using the Wong–Baker FACES Pain Rating Scale.
Results:
Descriptive characteristics of the children (n = 71) showed a homogeneous distribution between groups. During the procedure, children in the control group (n = 36; 5.03 ± 3.35) experienced more pain than the children in VR group (n = 35; 2.34 ± 2.76; p < .001). Proxy reports of the parents in the experimental group (1.77 ± 2.46) were found to be lower than those in the control group (4.67 ± 2.56; p < .001).
Conclusions/Implications for Practice:
VR method is effective for reducing pain during venous port access in pediatric oncology patients. VR should be used as a distraction method during venous port access.
Keywords virtual reality, distraction, pain, venous port access
Teaching with real patients in the clinical setting lies at the heart of health professional education, providing an essential component to clinical training. This is true of all the health disciplines – particularly medicine, nursing, dentistry, physiotherapy, and dietetics. Clinical tutorials orientate students to the culture and social aspects of the healthcare environment, and shape their professional values as they prepare for practice. These patient-based tutorials introduce students to the clinical environment in a supervised and structured manner, providing opportunities to participate in communication skills, history taking, physical examination, clinical reasoning, diagnosis and management. It is only through participation that new practices are learnt, and progressively, new tasks are undertaken. The aim of this paper is to provide health professional students and early career health professionals involved in peer and near peer teaching, with an overview of approaches and key tips for teaching in the clinical setting. Although there are many competencies developed by students in the clinical setting, our tips for teaching focus on the domains of medical knowledge, interpersonal and communication skills, and professionalism.
Aim
To assess occurrence of pain during the first 6 days of intensive care unit (ICU) stay and evaluate associations between occurrence of pain and selected patient‐related variables.
Design
A longitudinal study.
Methods
Adult ICU patients from three units were included. Patients' pain was assessed with valid pain assessment tools every 8 hr during their first 6 days in ICU. Possible associations between occurrence of pain and selected patient‐related variables were modelled using multiple logistic regression.
Results
When pain was assessed regularly with pain assessment tools, 10% of patients were in pain at rest and 27% were in pain during turning. The proportions of patients who were in pain were significantly higher for patients able to self‐report pain, compared with patients not able to self‐report (p < .001). Several predictors were associated with being in pain. It is important to be aware of these predictors in order to improve pain management.
Background:
Cancer survivors (CS) with ostomies may face challenges in sustaining physical activity (PA) levels and maintaining healthy diets. This analysis describes lifestyle behaviors and their relationships with health-related quality of life (HRQOL) in CS with ostomies.
Methods:
This is a cross-sectional, secondary analysis of a multisite randomized self-management education trial for CS with ostomies. The baseline self-reported measures were queried on aerobic PA and diet using the City of Hope Quality of Life Ostomy measure, and the Self-Efficacy to Perform Self-Management Behaviors questionnaire (SE). PA was compared against the American Cancer Society PA guidelines for CS. Relationships between PA and HRQOL were evaluated using multiple linear regression, stratified by BMI.
Results:
Among 200 responders, fewer than 20% met or exceeded the PA guideline for cancer survivors; overall, confidence in the ability to perform gentle or aerobic PA was moderate (6/10 on the SE). Overall HRQOL (p = 0.038), psychological well-being (p = 0.017), and physical strength (p = 0.025) were associated with increased PA. Almost half (48.7%) of CS reported a special diet. CS with urostomies were less likely to report diet adjustments after their ostomy surgeries (OR: 0.16, 95% CI [0.08-0.38]) than CS with fecal ostomies.
Conclusions:
Better HRQOL is associated with PA guideline achievement among CS with ostomies. Additionally, diet adjustments were reported more frequently in CS with fecal ostomies. Our findings bear clinical relevance for designing ostomy self-management and lifestyle recommendations for CS with ostomies.
Implications for cancer survivors:
The evaluation of lifestyle behaviors may be an especially important focus for CS with ostomies.
Background:
Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated.
Aims:
This study sought to determine if preoperative chemical depilation reduces the risk of surgical site infection (SSI).
Methodology:
Two methods of preoperative hair removal: razor shaving and depilatory cream were compared. The eligible patients were randomized into two groups and the presence of postoperative wound infection was evaluated using the Southampton wound grading system. Data were analyzed using SPSS version 21 Chicago-Illinois, statistical significance was inferred at Pvalue ≤ 0.05.
Results:
In total 100 patients were analyzed with 20 patients excluded due to co-morbidities and noncompletion of the study. The overall prevalence of SSI was 18.0% (7 (14.0%) and 11 (22.0%) in the depilatory cream and razor shaving groups, respectively). The difference in the rate of SSI was not statistically significant (P = 0.436). Hair was completely removed in 47 (94.0%) compared to 38 (76.0%) patients in the razor shaving group (P = 0.012) while skin injuries were noted in 21 (42.0%) vs 1 (2.0%) patients who had razor shaving and chemical depilation(P = <0.0001), respectively.
Conclusion:
There was no significant difference in SSI rates in patients that had preoperative chemical depilation when compared with razor shaving.
Lactic acid bacteria (LAB) are the most frequently used probiotics in fermented foods and beverages and as food supplements for humans or animals, owing to their multiple beneficial features, which appear to be partially associated with their antioxidant properties. LAB can help improve food quality and flavor and prevent numerous disorders caused by oxidation in the host. In this review, we discuss the oxidative stress tolerance, the antioxidant capacity related herewith, and the underlying mechanisms and signaling pathways in probiotic LAB. In addition, we discuss appropriate methods used to evaluate the antioxidant capacity of probiotic LAB. The aim of the present review is to provide an overview of the current state of the research associated with the oxidative stress tolerance and antioxidant capacity of LAB.
Personal care and consumer products are extensively used and contain various chemicals that are recognized as endocrine disrupting chemicals. Few epidemiological studies measured the associations of these chemicals and metabolites, especially phenols, with bone health. We measured the associations between nine urinary phenol biomarkers and BMD and the subsequent prevalence of osteopenia/osteoporosis. National representative data from US adults aged over 20 years who participated in the National Health and Nutrition Examination Survey from 2005 to 2010 were used. 2,267 men, 1,145 premenopausal women and 1,033 postmenopausal women were included in the final analyses. Bisphenol A, benzophenone-3, triclosan, butylparaben, ethylparaben, methylparaben, propylparaben, 2,5-dichlorophenol and 2,4-dichlorophenol were measured by high-performance liquid chromatography-isotope dilution tandem mass spectrometry. Paraben concentrations, especially ethyl-, methyl- and propylparabens, were related to greater BMD in the femoral neck and intertrochanter and lumbar spine in men and premenopausal women. 2,4-dichlorophenol concentrations was associated with lower BMD and a higher prevalence of osteopenia + osteoporosis in men. Bisphenol A was associated with a higher prevalence of osteopenia + osteoporosis in the lumbar spine in postmenopausal women. Benzophenone-3 tended to be associated with a higher BMD of femur in men and premenopausal women. In conclusion, certain urinary personal care and consumer product chemicals and metabolites were significantly associated with BMD or osteopenia + osteoporosis. These results further indicate that, in future research, determination of the causal relationships and detection of undelying mechanism could be next important directions.
Amaç: Araştırma 2. ve 3. basamak yoğun bakım ünitesinde yatan, mekanik ventilatore bağlı entübe ya da trakeostomili ve hafif düzeyde sedatize hastaların intravasküler girişimler (arteriyel, santral ve periferik) sırasında yaşadığı ağrı deneyimlerine yönelik davranışsal ve fizyolojik tepkilerini belirlemek amacı ile yapıldı.Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırmaya Türkiye’nin batı bölgesindeki bir Eğitim ve Araştırma Hastanesi Anestezi Yoğun Bakım Ünitesinde yatan 70 hasta alındı. Veriler kişisel bilgi formu, Davranışsal Ağrı Ölçeği (DAÖ), Ramsey Sedasyon Ölçeği (RSÖ) ve fizyolojik ağrı göstergeleri formu kullanılarak toplandı. Verilerin analizinde tanımlayıcı istatistikler ve Wilcoxon işaretli sıra testi kullanıldı.Bulgular: Araştırma kapsamında alınan hastaların yaş ortalaması 64,53±13,54 yıl, %55,7’si 65 ve üzeri yaş grubunda ve %54,3’ünün erkek hastalardan oluştuğu saptandı. Hastaların %98,6’sının mekanik ventilatöre bağlı olduğu, %87,1’ine sedasyon uygulandığı, RSÖ ortalamasının 2,93±1,12 ve %57,1’inin uyanık olduğu belirlendi. Hastaların intravasküler girişimler sırasında işlem öncesine göre DAÖ puanlarının, ortalama arter basıncı (OAB), nabız ve solunum değerlerinin arttığı gözlendi.Sonuç: Araştırma sonucunda; hastaların intravasküler girişimler sırasında farklı düzeylerde ağrı yaşadığı ve bu ağrının fizyololojik parametre (OAB, solunum ve nabız) değerlerini arttırdığı saptandı. Yoğun bakım ünitesinde yatan hastaların intravasküler girişimler sırasında ağrıları değerlendirilmeli ve etkili ağrı yönetimi yapılmalıdır.
Objective: The aim of this study is to determine the ethical sensitivity level of nursing students and to determine the factors that affect them. Material and Methods: In our study which has a descriptive and analytical design, the data were collected from 211 nursing students in the 2,3 and 4 th grade of nursing faculty between November-December 2019. In the study, the participant identification form and the Modified Moral Sensitivity Questionnaire for Student Nurses (MMSQSN) were used as data collection form. The findings of the study were evaluated with SPSS 22.00 package program and the significance level was accepted as p <0.05 in all analyzes. Results: The mean age of the students participating in the study was 21.15 ± 1.26 years. 88.2% of the students are women and 50.2% are in the second year. There was a statistically significant difference between class and referring to expert information (0.010), gender and modified autonomy (0.027), benevolence (0.026), experiencing ethical dilemma (0.002), the place of residence and the interpersonal orientation (0.003), modified autonomy (0.015), benevolence (0.049), MMSQSN scale total score (0.019). Conclusion: In this study, we evaluated the level of ethical sensitivity of nursing students and found that ethical sensitivity was significant and affected by variables such as gender, class and place of residence.
Background
Surgical site infections are one of the commonest types of healthcare-associated infections. Up to 60% of these infections are estimated to be preventable by using evidence-based guidelines. As a front line caregiver, nurses are responsible for the majority of preventive activities. Hence, the enhanced practical skill of nurses is an essential component in preventive actions.
Objective
The aim of this study was to assess the practice of nurses and identify factors associated with it regarding prevention of surgical site infections in Addis Ababa city public hospitals.
Methods
An institution-based cross-sectional study was carried out from March 01–30, 2018. An adapted and pretested, self-administered questionnaire was utilized as a data collection tool. A stratified random sampling technique was employed by considering the level of hospitals as a stratum. Data were entered into a computer using Epi-data 3.1 statistical package. Then, it was exported to SPSS Version 23 for further analysis. Descriptive statistics were computed for the study variables. Bivariate regression analysis was also run to assess the association between independent variables and the level of nurse’s practice. To see the relative effect of independent variables on the nurse’s practice, a multivariable regression analysis was carried out.
Result
A total of 409 nurses returned the questionnaire with a response rate of 98%. Majority (60.4%) of the participants were females and 84.1% were BSc holders. Less than half, (48.9%) of the participants were found to have good practice regarding prevention of surgical site infection. Being male, having more work experience, higher educational level and using available infection prevention guidelines were significantly associated with practice at p <0.05.
Conclusion
More than half of the participants have inadequate practice regarding prevention of surgical site infection. Training nurses, making surgical site infection prevention guidelines easily accessible and ensuring possessed knowledge by nurses is potent enough and can be translated into desirable actions are recommended.
Surgical site infections (SSIs) can be costly and result in prolonged hospital stays; readmissions; and additional diagnostic tests, therapeutic antibiotic treatments, and surgical procedures. Evidence-based practices for preventing SSIs include environmental cleaning; instrument cleaning, decontamination, and sterilization; preoperative bathing; preoperative Staphylococcus aureus decolonization; intraoperative antimicrobial prophylaxis; hand hygiene; and surgical hand antisepsis. Strong partnerships among infection prevention personnel, perioperative nurses, surgeons, and anesthesia professionals may enhance perioperative infection prevention. Facility and physician-specific SSI rates should be reported to physicians and frontline personnel in a timely, accessible manner. Together with costs associated with SSIs, these data help determine the success of an infection prevention program. Leaders can develop a comprehensive business case proposal for perioperative infection prevention programs. The proposal should describe the need for the program and anticipated return on investment; it also should focus on the goal of decreasing SSIs by establishing metrics for assessing outcomes and addressing barriers.
Disasters increase the psychological and physiological vulnerability of individuals. Restriction of food resources, restriction of access to food resources by armed forces, deterioration of transportation and marketing systems, and increasing economic damage cause serious food shortages in disaster areas. In disasters, it is very difficult for individuals to plant or collect crops. In addition, there is serious pressure on the supply of seeds, pesticides, fertilizers, and irrigation systems in the disaster area. In disasters, inadequate nutrition of the individual under the recommended amount of energy increases the susceptibility to infection. As a result of this situation, both the frequency and severity of infectious diseases increase in society and the recovery period of individuals is prolonged. It is very important to prepare a disaster nutrition plan in order to protect and maintain the health of the disaster survivor society and the vulnerable groups within the society. In this study, the nutrition of the population in disasters and the nutrition plan for vulnerable groups were examined.
Phenols and parabens widely exist in personal care and consumer products and have been proved to be endocrine disrupting chemicals that could disturb bone metabolism. The current studies focusing on the associations between phenols and parabens with bone mineral density (BMD) drew contradictory conclusions. Considering the bias might be due to not considering the effects of mixed exposure, we conducted the first cross-sectional study to investigate the associations of both single and mixed metabolites of phenols and parabens with BMD in three populations by setting up four models: generalized linear regression model (GLM), weighted quantile sum (WQS) regression model, quantile g-computation (qgcomp) model and Bayesian kernel machine regression (BKMR) model, based on the US National Health and Nutrition Examination Survey (NHANES) database. We found that the association between the mixtures and total femur BMD in men was significantly negative. Bisphenol A (BPA) was shown to play the most important role in this negative association in the BKMR model, and this negative association was also confirmed in the GLM model with β coefficient (95% CI) being −0.02 (−0.04, −0.01). The relationships between the mixtures and femoral neck and trochanter BMD in postmenopausal women were significantly positive. Benzophenone-3 (BP-3) played the most significant role in the positive association with trochanter BMD, as confirmed by the WQS, qgcomp and BKMR models, and this positive association was also verified by the GLM model with β coefficient (95% CI) being 0.01 (0.00, 0.02). In conclusion, the association between the mixed phenols and parabens and BMD was negative in men while was positive in postmenopausal women, which was gender-specific. This study might provide new ideas for the prevention and treatment of osteoporosis and the control of personal care and consumer products containing phenols and parabens in the future.
Health care ethics education has focused on the four principles approach. Although relevant and important, this dimension is insufficient on its own. Emotional, cultural, spiritual, and relational aspects of ethics must also be addressed. Ethics cases are important in ethics education but should include everyday ethics scenarios that can be messy and emotional. Such situations occur regularly in nursing practice, making microethics particularly relevant to nurses. Art, songs, film, and literature provide stories that allow exploration of everyday ethics. Technology can facilitate this and promote ethics comportment, but more work is needed to demonstrate how best to do this.
The coronavirus pandemic, which is a serious health problem that causes many people to get sick and many people to die, and causes high levels of fear and anxiety, has caused eyes to turn to health professionals in the world and in our country, especially nurses who take an active role in the care of each patient. In the literature review, no research was found on the effects of this destructive process on the image of the nursing profession. With this study, the effect of the coronavirus epidemic on the image of nursing in the society will be determined. The aim of this study is to determine the purpose of applying the coronavirus pandemic to the image of nursing in Turkish society. This research is designed as descriptive. The data were collected online between 05-19/03/2021 with a questionnaire prepared by the researchers from 398 Turkish citizens. When the Nursing Image mean scores of the individuals participating in the research are examined; While the mean total score was 43.6±8.1 before the pandemic, the recommended score was 43.4±8.7 during the coronavirus pandemic. It was determined that the image of nurses in the society decreased during the pandemic compared to the pre-pandemic period.
Background
Professional nursing identity formation requires alignment with the values and moral norms of the nursing profession.
Purpose
This study sought to explore professional nursing identity formation by comparing differences in nursing values and moral identity between students enrolled in generic Bachelor of Science in nursing (BS) programs and Accelerated Second-degree Bachelor of Science in nursing (ASBS) programs who were nearing graduation. Secondary aims were 1) to explore the relationship between nursing values and moral identity and, 2) to analyze the influence of moral identity and being in an ASBS program on nursing values in baccalaureate students.”
Methods
The descriptive, correlative study used a 42-item survey that included the Nursing Professional Values Scale-3 (NPVS-3), the Moral Identity Scale (MIS), and four demographic questions. An emailed invitation to take the online survey was distributed to senior students enrolled at four universities in California.
Results
No significant differences in NPV-3 scores or MIS scores between BS students and ASBS students were found. Overall, students scored lowest in the NPV-3 activism subfactor. A positive, statistically significant relationship between nursing values and moral identity was revealed. Regression modeling detected that every 1-point increase on the MIS significantly corresponded to an increase of 1.26 points on the NPVS-3 after adjusting for age and gender. Enrollment in an ASBS program did not have a statistically significant influence on nursing values.
Conclusions
Findings suggest that students in both BS and ASBS programs who are nearing graduation are fully engaging with being a nurse. Overall, students ascribe more importance to the NPVS-3 subfactor of caring, and less importance on the NPVS-3 subfactors of activism and professionalism. Nursing values as measured by the NPVS-3 and moral identity as measured by the MIS are distinct concepts that together provide a salient measure of Professional Nursing Identity Formation in baccalaureate students.
Abstrak Abstract [Title: Design of Manifold with Pressure Controller for Automatic Exchange of Oxygen Gas Cylinders in Hospital] The regulation and supply of oxygen as one of the medical gases in the hospital is important to ensure the availability of these gases for the survival of patients. The regulation of oxygen gas in hospitals usually uses a piping system with manifolds. The manifold will monitor the oxygen gas pressure on each tube. Manifold systems that are widely used in general can only monitor pressure but cannot perform an automatic exchange on gas cylinders if the pressure is under the permissible conditions. The manifold system design developed is equipped with pressure monitoring for automatic exchange of oxygen gas cylinders using pressure sensors and microprocessors. The test results of the system using regulator and barometer comparisons showed the percentage value of sensor pressure accuracy of 96.92 percent and 97.16 percent. At pressure below the limit of 285 KPa manifold can perform the exchange of active gas cylinders automatically. These results show the manifold design built can work quite well. 1. Pendahuluan Oksigen adalah salah satu jenis gas medis yang sangat penting ketersediaannya di rumah sakit. Banyak pasien yang keberlangsungan hidupnya bergantung pada gas ini. Karena itu sistem pengaturan dan suplai oksigen di rumah sakit menjadi sangat penting. Menurut World Health Organization setidaknya ada empat sumber dan cara penyimpanan gas oksigen yang berbeda di rumah sakit, yaitu: tabung atau cylinder gas, oxygen concentrator, oxygen plant, dan liquid oxygen. Liquid oxygen membutuhkan sebuah sistem pemipaan agar dapat didistribusikan ke seluruh bagian yang membutuhkan. Bagian utama yang harus
Aim:
The aim of this national study was to explore student and faculty personal experiences of ethical dilemmas in nursing education and clinical practice.
Background:
Nurses encounter complex ethical dilemmas in practice that can lead to moral distress when they cannot "do the right thing" because of external constraints.
Method:
A mixed-methods study via online survey was conducted on senior nursing student members and faculty advisors of the National Student Nurses Association. Over 1,600 students and 600 faculty answered a "two-minute survey" with the question: "Please describe an ethical dilemma you have experienced."
Results:
Descriptive statistics demonstrated a difference in student and faculty reports about the ethics content they received. The qualitative results from constant comparison of open-ended questions also supported differences in themes from student and faculty perspectives.
Conclusion:
This study supports that students and faculty voice their concerns with different ethical dilemmas in their nursing education experiences.
Objective
Natural disasters have the potential to cause health problems both of environmental changes and access to health services. Sanitation is one aspect that lead to health problems in post-disaster areas. Diarrhea is a common disease sanitation related disasters. This study aims to determine the risk factors for post-disaster diarrhea.
Method
This study is an observational analytical study with Cross Sectional. The sampling was a non-probability technique based on inclusion and exclusion criteria. The research data were analyzed using univariate, bivariate and multivariate.
Results
The factors associated with the incidence of diarrhea include the provision of latrines (p = 0.599), provision of clean water (p = 0.003), waste management (p = 0.035) and personal hygiene (p = 0.004). The results of logistic regression analysis showed that the factor of water supply was p = 0.002, waste management factor p = 0.007 and obtained R² value of 0.399 that clean water supply, waste management and personal hygiene contributed 39.9% in influencing the prevalence of diarrhea.
Conclusion
There is a relationship between the provision of latrines, clean water supply, waste management, waste water disposal facilities and personal hygiene with the incidence of diarrhea in the affected areas.
Surgical site infection is associated with prolonged hospital stay and increased morbidity, mortality and healthcare costs, as well as a poorer patient quality of life. Many hospitals have adopted scientifically-validated guidelines for the prevention of surgical site infection. Most of these protocols have resulted in improved postoperative results. The Surgical Infection Division of the Spanish Association of Surgery conducted a critical review of the scientific evidence and the most recent international guidelines in order to select measures with the highest degree of evidence to be applied in Spanish surgical services. The best measures are: no removal or clipping of hair from the surgical field, skin decontamination with alcohol solutions, adequate systemic antibiotic prophylaxis (administration within 30–60 min before the incision in a single preoperative dose; intraoperative re-dosing when indicated), maintenance of normothermia and perioperative maintenance of glucose levels.
Background
The European Working Group on Sarcopenia in Older People (EWGSOP2) recently updated the definition of sarcopenia in order to reflect scientific and clinical evidences.
Objective
The aim is to explore the prevalence of sarcopenia (according to the new EWGSOP2 definition) and related risk factors among an unselected sample of subjects living in community.
Setting and Participants
The Longevity Check-up 7+ project is an ongoing cross-sectional study started in June 2015 and conducted in unconventional settings (ie, exhibitions, malls, and health promotion campaigns). Candidate participants are eligible for enrollment if they are at least 18 years of age.
Methods
Muscle strength was assessed by handgrip strength and physical performance was evaluated by chair stand test.
Results
The mean age of 11,253 subjects was 55.6 (standard deviation 11.5, from 18 to 98 years) years, and 6356 (56%) were women. Using the EWGSOP2 algorithm, 973 participants (8.6%) were identified as affected by sarcopenia, and the prevalence of sarcopenia significantly increased with age. Sarcopenia was associated with diabetes prevalence ratio (PR) 1.42, 95% confidence interval (CI) 1.06-1.89, impairment in 400-m walking performance (PR 2.16, 95% CI 1.74-2.17), and self-reported unhealthy status (PR 1.77, 95% CI 1.45-2.17). Conversely, a decreased probability of being sarcopenic was detected among subjects following a healthy diet (PR 0.79, 95% CI 0.63-0.98) and involved in regular physical activity (PR 0.79, 95% CI 0.64-0.99).
Conclusions and Implications
Muscle strength and physical performance assessment should be considered as the recommended methods for the early detection of individuals at risk of probable sarcopenia.