Midwifery Students’ Acquisition and Retention of Essential Newborn Care Competencies: An Experimental Study

@#Introduction: Annually, over two million newborns die worldwide immediately after birth, mostly because of failure to initiate and sustain breathing. A significant decline in newborn deaths can be achieved by using proper essential newborn care (ENC) techniques. Competency-based education (CBE) could successfully build ENC skills. The purpose of the present study was to investigate the effect of applying CBE on Midwifery students’ knowledge and skills acquisition and retention of ENC. Methods: This quasi-experimental study recruited third-year under-graduate midwifery students (n=54). They were equally assigned to the interventional and control group. The interventional group was taught ENC by using CBE, whereas the control group was taught by using traditional methods. Students’ ENC knowledge was assessed three times using a multiple-choice question exam. The ENC skills were measured twice by using the Essential Neonatal Care Performance Checklist. Results: The intervention group exhibited significant ENC knowledge and skills, performance acquisition, and retention (p<0.001). Conclusion: CBE is a useful educational model for the acquisition and retention of ENC.

role of advanced techniques of MRI in evaluation of pediatric bone tumors

Background: Functional magnetic resonance imaging [MRI] improves tissue characterization and staging of bone tumors compared to the information usually supplied by structural imaging. Dynamic MRI and diffusion MRI can be performed in everyday practice. Tumour characterization can benefit from perfusion MRI with dynamic gadolinium injection and enhancement time-intensity curve analysis combined with quantitative and qualitative diffusion MRI

Aim of the Work: is to elucidate the role of advanced MRI techniques in diagnosis of pediatric bone tumors and to assess the diagnostic potential of Dynamic contrast enhancement [DCE] in conjunction with Diffusion weighted imaging [DWI] in differentiating benign from malignant bone tumors

Patients and Methods: a prospective study conducted on thirty pediatric patients with clinically suspected and radiologically proven bone tumor or tumor like lesion. The patients were referred from the Department of Orthopedics, Ain Shams University. The patients were investigated using 1.5 Tesla magnetic resonance device. They were subjected to conventional MRI and DCMI

Results: DWI with measurement of Apparent diffusion coefficient [ADC] values helped in the differentiation of benign and malignant bone tumors, and that the best cut-off criterion is ADC of 0.9 is defined as benign results with overall sensitivity 100% and specificity 100%. A type II curve was seen in 23 cases [one malignant and twenty two benign], type IV was seen in 5 cases [all are malignant] and type V curve was seen in two malignant cases [after chemotherapeutic treatment]. ROC analysis for the Dynamic contrast enhancement [DCE] showed a sensitivity of 75 % and specificity of 100%

Conclusion: DWI and DCE-MRI had been proven to be highly useful in the differentiation of benign and malignant bone tumors. Measurement of ADC values improved the accuracy of the diagnosis of bone tumors. Moreover; they could be used in the follow up of tumors and their response to therapy

protective effect of lemon grass and its oil on hepatotoxicity in rats caused by CCL4

The present work was conducted to study the effect of lemon grass and its oil on the nutritional value, percent of organs weight/body weight, lipid parameters, glucose, iron status, kidney and liver functions of rats suffering from hepato-toxicity caused by CC1[4]. Six experimental groups [n = 6 for each group] were established. Groups [1 and 2] were fed on basal diets [used as a negative and positive control groups, respectively]. Groups [3- 4] received basal diets containing two levels of lemon grass [2.5 and 5g lemon grass/l00g diet, respectively]. Groups [5-6] received basal diets containing two levels of lemon grass oil [2.5 and 5g lemon grass/l00g diet, respectively]. Before 2 days from the end of the experiment period [28 days], all treated and positive control groups were injected with CC1[4], in paraffin oil [20% at dose 5 ml/kg] subcutaneous injection to induced hepatotoxicity in rats. Addition of lemon grass or its oil to the diets improved the nutritional value, in addition to the percent organs weight/ body weight. The mean values of serum cholesterol, triglycerides, low-density lipoprotein cholesterol [LDL-c], very low-density lipoprotein [VLDL-c], uric acid, urea nitrogen, creatinine, glucose, aspartate amino transferase [AST] and alanine amino transferase [ALT] decreased in all treated groups with lemon grass or its oil, as compared to the positive control groups, while high-density lipoprotein [HDL-c] increased. Histopathological examination of liver in group treated with CC1[4] revealed degenerative and necrotic changes, however, treated groups with lemon grass or its oil showed marked amelioration of the severity of these changes. It was concluded that high level of lemon grass or its oil [5g /l00g diet] realized the best effect on lipid profile, kidney and liver functions, glucose level and iron status

Histological, immunohistochemical and electron microscopic studies on the effect of melatonin on pituitary-testicular axis in aged male albino rat

Aging is a biological process affecting mammalian tissues and organs at different rates. The present work was done to study the effect of melatonin as anti-aging therapy on the structure of the testis and the pars distalis. A total number of 25 male albino rats were used. The animals were divided into three groups: group [I] served as a control adult group [6 months age], group [II] was the control aged group [20-months age] and group [III] was treated with melatonin. The specimens of the testis and pituitary glands were prepared for light and electron microscopy. Histological and immunohistochemical techniques were used to examine these organs. It was found that age-related changes occur in the histological immunohistochemistry and ultrastructure of the testis and pituitary gland. Also, treatment with melatonin as anti-oxidant and free radical scavenger caused improvement of these changes in the pituitary gland as well as the testis. The age-related changes that occurred in the testis included progressive involution and germ cells depletion in the seminiferous tubules which contained only Sertoli cells. Ultrastructural apoptotic changes of germ cells increased with aging and abnormal morphology of the resulting sperms were found. This might result in decapacitating sperm function increase in interstitial tissue. Leydig cells exhibited ultrastructural changes which might lead to a decrease in their activity and testosterone production. As regard the pituitary gland; different utrastructural changes occurred in the somatotrophs or GH cells. The ultrastructrual and immunohistochemical studies of gonadotrophs or LH/FSH cells showed marked deterioration with progression of age. Treatment with melatonin from the adult state improved the morphological and ultrastructural changes that occurred with aging

Violence behavior among patients and nurses in mental health hospital

Violent behavior is a complex phenomenon of great importance in society as well in clinical psychiatry. Violence in patients with mental disorder has always been an important area of concern. High stress jobs such as nursing tend to generate pressures that are often vented when additional stressors are added. The venting of the intolerable stress can result in violence behavior so that this study was aimed to: assess the violence behavior among patients and nurses in El Abbassia mental health hospital. Subjects of this study were representing two different groups. The first group was [122] psychiatric patients [male and female]. The second group was [113] nurses working in El Abbassia mental health hospital [male and female]. Two tools are used to assess the violence behavior among patients: sheet to collect patients socio demographic data and observation check list to assess patient violence behavior. Three tools are used to assess the violence behavior among nurses: sheet to collect nurses socio demographic data, observation check list to assess nurses violence behavior and questionnaire to assess nurse's attitude toward violence behavior. The study revealed that the most violent behavior among patient [male and female] was in second degree moderate. Target of violent behavior among patient were against other patients. Nurses were dealing with patient with violent behavior according to their personal experience without clear guidelines. A few percentages of them had a mild violent behavior against object. A very few percentage of nurses had mild degree of violent toward others. Nurses had a negative attitude toward violent behavior. There were no significant relation between degree of violence among nurses and patient. It was recommended that, develop an educational program are recommended for psychiatric nurses to develop a comprehensive skills about managing patients with violent behavior. Implementation of counseling service at El Abbassia mental health hospital for nurses about how to manage psychosocial and occupational stressors facing them

Students' feedback on objective structured clinical examinations [OSCEs] experience in emergency nursing course

Objective Structured Clinical Examinations [OSCEs] are an effective assessment strategy for assessing clinical skills and for highlighting curriculum problem areas Since its inception, the OSCE has been increasingly used to provide formative and summative assessment in various medical disciplines. The study was conducted at Critical Care Nursing and emergency Department, the Faculty of Nursing, Alexandria University, Specifically in emergency nursing course. Data were collected using questionnaire comprised 26 items to determine students' feedback in relation to OSCE as an assessment method in acute care. The majority of students agreed that the OSCE was comprehensive and covered a wide range of knowledge and clinical skills taught and in addition the exam was less stressful than other exams and the students felt the OSCE exam highlighting their strengths and weaknesses. Also, the exam increase their self confidence to face real situations. OSCE as an assessment method is an effective method to test students' competencies and teachers can diagnose the teaching defects and OSCE provides opportunities for students to learn from mistakes and increase their self confidence .OSCE can be implemented in different nursing specialties

Dispositions to think critically among nurse educators

Nurse Educators' critical thinking dispositions have a direct influence on the educational process and its outcome. In fact, the external measure of nurse educators' effectiveness is their graduates'abilities to think critically [6, 13]. Hence, they should demonstrate competence related to critical thinking in order to be role model, open doors to new perspectives of the world for their students, as well as foster self-confidence and encourage lifelong learning. The aim of this study is to determine the critical thinking dispositions among nurse educators. This study was carried out in all scientific nursing departments at the Faculty of Nursing, University of Alexandria, included all nurse educators who were available at the time of data collection in the above mentioned settings and willing to participate [n=151]. The data was collected using California Critical Thinking Disposition Inventory [CCTDI]. the current study revealed that 70.9% of nurse educators had positive disposition toward critical thinking, while less than one quarter of them [21.2%] had ambivalence disposition and only 7.9% strong positive disposition toward critical thinking disposition. It can be seen that the critical thinking self-confidence and analyticity subscale had higher mean scores, whereas the truth seeking subscale had the lowest mean score. There was a significant difference between nurse educators' academic degree and truth seeking, systematicity and total critical thinking disposition scores. The findings of this study revealed that the highest scores in self-confidence and analyticity and the lowest score in truth seeking. So, Studies should be conducted to examine the relationship between critical thinking dispositions and other variables such as critical thinking skills, thinking styles, leadership styles, personality type, teaching styles, burnout, and nurse educators' roles and core competencies

Changes of serum oxidized low density lipoproteins, iron and ferritin in chronic liver disease

We investigated the changes in and the correlations between serum oxidized low density lipoproteins [OX-LDL], iron, ferritin, uric acid and albumin in children and adolescents had autoimmune hepatitis [AIH], a chronic liver disease. Patients group had higher activities of serum transaminases and higher level of serum total bilirubin than normal values. Also, all of them gave positive results for antismooth muscle antibody test. In addition, results revealed that the concentration of oxidized low density lipoproteins antibodies [OX-LDL Ab] a marker for OX-LDL concent-ration in patients was significantly increased [P =/< 0.001] when compared with that of healthy controls. Moreover, serum ferritin, iron, and uric acid levels showed higher values in patients with different significant levels [P =/< 0.001, 0.025 and 0.001] respectively from those of the control subjects. Correlation study demonstrated that patient’s serum ferritin level had significant positive correlation with serum uric acid [r 0.406, p =/< 0.05]. Also, a positive correlation was found between serum uric acid and albumin [r 0.428, P =/< 0.05]. In healthy control group, a positive correlation [r 0.671, P =/< 0.05] was found between serum uric acid and albumin. Patients suffered from AIH for =/< 5 years showed significant increase in each of serum iron, ferritin, uric acid levels [P =/< 0.001] and in OX-LDL-Ab concentration [P =/< 0.05] as compared with those of control group. Furthermore, in other patients’ group [AIH for =/> 5 years], serum OX-LDL ab, ferritin and uric acid levels significantly increased [P =/< 0.001,0.005 and 0.001 respectively] as compared with those of the controls. On the other hand, comparison of these parameters between both groups of patients showed no significant changes. In conclusion, OX-LDL and ferritin increased in all patients regardless the duration of the disease. Increase the intake of natural antioxidants and decrease the intake of iron are recommended for those patients

correlation between the immunohistochemical expression of mutant P53 protein and HER-2/neu with clinical behaviour of infiltrating duct carcinoma of breast

A series of 40 females complaining of infiltrating duct carcinoma was included in this study. Clinicopathological background, histological grade and immunohistochemical staining for p53, HER-2/neu as well as estrogen and progesterone receptors were analyzed. The results showed that 14 cases were positive to p53, 12 were positive to HER-2/neu, 30 were positive to estrogen receptor and 22 were positive to progesterone receptors. The statistical analysis showed a positive correlation between p53 protein staining with tumor grade and an invasive relation to the hormonal status; whereas, HER-2/neu showed a significant correlation to the lymph node status. No correlation was detected between p53 protein, HER-2/neu protein expression and progression free survival. HER-2/neu protein-positive patients showed an improved response to anthracycline-containing regimen. A complete response was attained in 5% of the cases, partial response in 25%, stationary disease in 60% and 10% of the cases had progressive course