[The effect of education on trauma critical care nurses attitudes towards and knowledge and practices from the viewpoint of their about application of physical restraint]

Introduction: physical restraints are commonly used in ICUs to manage patient agitation, ensure patient safety, and prevent patient fall and patient interruption in medical and nursing care interventions. But there are many physical and psychological negative outcomes related to their use. Nurses are the key decision makers in the application of physical restraints to patients. Thus, educational programs regarding physical restraints must be considered to enhance nurses' knowledge, correct their attitude and improve their practice and consequently improve the quality of patients' care. This study aimed at examining the effect of education program on critical care nurses' attitudes towards, knowledge about and practice regarding the application of physical restraint

Method: in this quasi experimental study 66 nurses working in traumatic ICUs in Kerman recruited using convenience sampling. Participants were randomly assigned in two control and intervention groups and each group included 33 persons. The study questionnaire consisted of four parts: 1] background information; 2] Selfdesigned questionnaire to assess nurses' knowledge about physical restraint; 3] Attitudes of Physical Restraint Use [APRU] to examine the nurses' attitude towards physical restraints. 4] Practice of Physical Restraint Use [PPRU] to evaluate nurses' practice regarding physical restraints. Prior to education program implementation, the questionnaire completed by all of the participants. Then an education program conducted for intervention group and after 2 weeks, that questionnaires completed by intervention group again. Data was analyzed using SPSS v.18 and paired t-test, independent t-test and Pearson correlation

Results: after the completion of the education program results showed a significant improvement in the intervention group in terms of knowledge [P<0.001], attitude [P<0.001] and practice [P<0.001] related to physical restraints

Conclusion: findings indicated the level of nurses' knowledge, attitude and practice that demonstrated the need to provide an education program on physical restraint. These programs can significantly improve the nurses' knowledge, attitude and practice

Attitude of primary health care nurses in Kuwait towards domestic violence against women

Domestic violence against women is an important public health problem. Battered women attend primary health care centers seeking for both medical treatment and support. Nurses with a positive attitude play a key role to deal with victimized women. The current study was formulated to reveal attitude of nurses towards domestic violence against women and factors affecting this attitude. All 1617 nurses registered in primary health care centers in Kuwait were the target population for this study. A total of 988 nurses were interviewed with an overall response rate of 61.1%. The results of the current study revealed that nurses tended to have a relatively low positive overall attitude score towards violence against women [58.3 +13.82%], with a mean percent score of 42.9 +15.99% for relationship between partners domain, 69.7 +21.03% for good reasons to hit wives domain, and 58.7 +20.59% for management of domestic violence domain. Female Kuwaiti nurses tended to have higher positive attitude score than male non-Kuwaiti nurses. Years spent at the current job negatively correlated with the total attitude score of nurses towards domestic violence against women. Training nurses about domestic violence, especially against women can improve their attitude and hence a better medical care and support of battered women

[Evaluating demographic factors influencing outcome of ACL reconstruction using patellar and medial hamstring tendons]

Background: since anterior cruciate ligament [ACL] reconstruction become more frequently carried out, expectation of less morbidity and earlier return to activities become higher; for this reason defining influencing factors on outcome for selecting patients is valuable. The aim of this study is to investigate demographic factors influencing outcome of ACL reconstruction

Materials and Methods: we evaluate the clinical results of 187 patients who underwent patellar and hamstring techniques for ACL reconstruction, considering height, weight, BMI, gender, and age as assessed by history, instability tests, KT 1000 knee arthrometer, Lysholm and IKDC score, and MRI and compare them. Majority of patients were followed and evaluated 6 months [92%] and 3 years [84%] after arthroscopic reconstruction

Results: there were no differences between the study groups considering these two surgical techniques and demographic factors preoperatively. Our comparison has shown less satisfaction in the results while BMI was increased, but there were no differences between male and female in the outcome. However, results of reconstruction in the patients over 40 years old were favorable, but there were more complications in the patellar tendon group

Conclusion: obesity was a factor resulted in more complications and unsatisfactory. Gender was not a reason for making any difference between patients, and outcomes of both male and female were the same. Results of patients over 40 years old were a good reason for performing reconstruction at these ages, but since complications of patellar technique were noticeable, it is a good reason for surgeons to prefer hamstring technique in elderly

[Assessment of genuvarum in above 60 year old military males referred to 501 Army hospital, 1385-86]

Background: Genuvarum is an essential health disturber in army soldiers. At present, above 10 cm of bicondylar distance exempt men from soldiering, but they have problems with much less degrees. Assessment of pain related to degrees of genuvarum in old cases seems to be a reliable method of predicting these young knee situations in future

Materials and Methods: This research was done according to the descriptive method by observation and measurement. 200 old male cases referred to 501 Army hospital, 100 military and 100 non military, with genuvarum also were examined for bicondylar distance, as mild [0-5 cm], moderate [5-10 cm] and severe [> 10 cm], their pain and other symptoms were recorded. Then we compair military group's data with that of non-military. Statistical analysis of the data was performed with SPSS

Results: The prevalence of mild, moderate, and sever genuvarum was equal in the military and non military persons, and so the prevalence of pain and discomfort in mild and sever genuvarum. But, in the moderate group, the symptomatic genuvarum was much more frequent in military persons than non military [53% versus 16%]

Conclusions: The severity of genuvarum is equact to increase in the severity of symptoms. Mild, moderate, and sever genuvarum is seen equally in military and non military persons. In the two groups, pain and discomfort is equal in mild and sever degrees in both groups, but the military ones with moderate genuvarum are more symptomatic. Thus, 7.5 cm [mean of moderate degrees] is offered to be considered for exempting soldiers of routine 10 cm

CT scan findings of occult sinus pathology in asymptomatic individuals

One hundred-fourteen computed tomographic [CT] scans of the skull region were revised for occult sinus pathology in asymptomatic individuals. The scans were conducted to investigate other skull regions. None of the patients had nasal or sinus symptoms. Twenty-nine percent of the ethmoid sinuses had occult pathology mostly in the form of thickened mucous membrane. Occult pathology occurred in 14% of maxillary sinuses, 4.8% of the frontal sinuses, and 4.6% of the sphenoid sinuses. As ethmoids carry a high incidence for possible occult pathology, isolated clouding of the ethmoids in CT scans should not be regarded as a cause for patients symptoms especially in headache investigation