Oral medications administration through enteral feeding tube: Clinical pharmacist-led educational intervention to improve knowledge of Intensive care units' nurses at Jordan University Hospital.

INTRODUCTION: Medication administration through enteral feeding tubes is a practice that is commonly encountered in hospital settings, particularly in critically ill patients. This study aims to evaluate the knowledge of intensive care unit nurses regarding enteral medication administration and evaluate the effect of an educational intervention led by a clinical pharmacist that would improve nurses' knowledge regarding the subject. METHODS: A pre/post interventional study was conducted. Improvement in nurses' knowledge regarding medication administration through an enteral feeding tube was assessed using a validated questionnaire. RESULTS: Data were coded, entered, and analyzed using the Statistical Package for Social Sciences (IBM SPSS statistics 22). Independent samples t-test and paired t-test were used to detect any statistically significant differences in the mean total knowledge scores both between and within each group respectively. A P-value of <0.05 was considered statistically significant. The mean total knowledge score for nurses in the intervention and control group at the pre-interventional phase of the study was inadequate. There was a statistically significant improvement in the mean total knowledge score for the interventional group at the post-interventional phase of the study, while that of the control group remained inadequate (Intervention group total mean knowledge score at baseline 12.11 ± 3.75, post-intervention 21.50 ± 2.36, p-value <0.001; Control group total mean knowledge score at baseline 12.05 ± 3.12, post-intervention 12.60 ± 3.76, p-value 0.96). CONCLUSION: Incorrect drug preparation and administration for patients with feeding tubes can affect patients. The knowledge of nurses regarding the subject can be improved significantly via an educational intervention. The activation of clinical pharmacists' role and collaboration between pharmacists, physicians, and nurses is highly recommended in this clinical setting.

Physicians' knowledge, attitude and practices regarding management of medications in Ramadan.

To evaluate knowledge, attitude and practices (KAP) of physicians regarding the management of medications in Ramadan we used a self-administered questionnaire on a target sample of 381 physicians at Jordan University Hospital, King Abdulla University Hospital and a number of private clinics in Amman, during September and October of 2008. A total of 297 questionnaires were returned. Physicians' KAP about management of medications in Ramadan was generally insufficient. The main factors that affected KAP were age, nationality, specialty, and country and year of last qualification (P < 0.05). Female physicians scored better than males, and fellows scored better than other groups for knowledge. Most physicians' attitudes and practices were in line with religious opinion in regard to which routes of drug administration can nullify fasting, indicating that physicians have adequate knowledge in this area.

Physicians' knowledge, attitude and practices regarding management of medications in Ramadan

To evaluate knowledge, attitude and practices [KAP] of physicians regarding the management of medications in Ramadan we used a self-administered questionnaire on a target sample of 381 physicians at Jordan University Hospital, King Abdulla University Hospital and a number of private clinics in Amman, during September and October of 2008. A total of 297 questionnaires were returned. Physicians' KAP about management of medications in Ramadan was generally insufficient. The main factors that affected KAP were age, nationality, specialty, and country and year of last qualification [P < 0.05]. Female physicians scored better than males, and fellows scored better than other groups for knowledge. Most physicians' attitudes and practices were in line with religious opinion in regard to which routes of drug administration can nullify fasting, indicating that physicians have adequate knowledge in this area

Knowledge and attitude of school children in Amman/Jordan toward the appropriate use of medicines: A cross-sectional study.

OBJECTIVES: The aim of this study is to examine the knowledge, practice, and attitude toward medications of different primary school children at age group (7-9) years. METHODS: This cross sectional study adopted the form of structured interviewing technique using a validated and pre-piloted questionnaire. The questionnaire consisted of a mixture of multiple choice and open-ended questions, 15 USP pictograms and six dosage form demos. A randomized stratified target sample of 200 students (n = 100 of each gender), of the first, second and third grades from the four Amman Education Directorates was recruited. School children were interviewed regarding their knowledge, attitude and the way they think medicines should be used. RESULTS: The mean score value achieved by children in all the knowledge questions was 23.26 ± 0.25 out of 32, which was considered as satisfactory knowledge by the research team. The most significant factors affecting children's knowledge (including: multiple choice questions, pictograms and dosage forms) were: age, school/area of residency, and the presence of a first-degree relative working in a medical job. The majority of participants (79%) stated that the taste of the medication was the main factor to prevent them from taking their medication. CONCLUSION: In general, school children in our sample have satisfactory knowledge and a generally positive attitude toward medicines. However, school curricula in Jordan should include more education regarding the effective and safe use of medicines.

Perception of efficacy and safety as determinants for use and discontinuation of birth control methods in Muslim Jordanian women.

OBJECTIVE: This study was conducted to identify the perceptions of working Muslim Jordanian women regarding the efficacy and safety of their contraceptive methods, and whether these perceptions affected method choice or discontinuation. METHODS: A prospective study on 207 married working women of reproductive age was conducted between March and June 2002. RESULTS: The majority of women were using an intrauterine device (IUD), fewer were using traditional methods and oral contraceptive pills. Effectiveness was the main reason for choosing IUD and pill methods, while concerns about safety were the main reason for discontinuation. Safety was the main reason for choosing traditional methods and poor efficacy was the reason for discontinuation. CONCLUSION: Health-care professionals need to increase the use of proper contraceptive methods and compliance by providing counseling services and correcting any misperceptions regarding birth control methods before and during use.

Two different inward rectifier K+ channels are effectors for transmitter-induced slow excitation in brain neurons.

Substance P (SP) excites large neurons of the nucleus basalis (NB) by inhibiting an inward rectifier K(+) channel (Kir). The properties of the Kir in NB (KirNB) in comparison with the G protein-coupled Kir (GIRK) were investigated. Single-channel recordings with the cell-attached mode showed constitutively active KirNB channels, which were inhibited by SP. When the recording method was changed from the on-cell to the inside-out mode, the channel activity of KirNB remained intact with its constitutive activity unaltered. Application of Gbeta(1gamma2) to inside-out patches induced activity of a second type of Kir (GIRK). Application of Gbeta(1gamma2), however, did not change the KirNB activity. Sequestering Gbeta(1gamma2) with Galpha(i2) abolished the GIRK activity, whereas the KirNB activity was not affected. The mean open time of KirNB channels (1.1 ms) was almost the same as that of GIRKs. The unitary conductance of KirNB was 23 pS (155 mM [K(+)](o)), whereas that of the GIRK was larger (32-39 pS). The results indicate that KirNB is different from GIRKs and from any of the classical Kirs (IRKs). Whole-cell current recordings revealed that application of muscarine to NB neurons induced a GIRK current, and this GIRK current was also inhibited by SP. Thus, SP inhibits both KirNB and GIRKs. We conclude that the excitatory transmitter SP has two types of Kirs as its effectors: the constitutively active, Gbetagamma-independent KirNB channel and the Gbetagamma-dependent GIRK.

Interaction sites of the G protein beta subunit with brain G protein-coupled inward rectifier K+ channel.

G protein-coupled inward rectifier K(+) channels (GIRK channels) are activated directly by the G protein betagamma subunit. The crystal structure of the G protein betagamma subunits reveals that the beta subunit consists of an N-terminal alpha helix followed by a symmetrical seven-bladed propeller structure. Each blade is made up of four antiparallel beta strands. The top surface of the propeller structure interacts with the Galpha subunit. The outer surface of the betagamma torus is largely made from outer beta strands of the propeller. We analyzed the interaction between the beta subunit and brain GIRK channels by mutating the outer surface of the betagamma torus. Mutants of the outer surface of the beta(1) subunit were generated by replacing the sequences at the outer beta strands of each blade with corresponding sequences of the yeast beta subunit, STE4. The mutant beta(1)gamma(2) subunits were expressed in and purified from Sf9 cells. They were applied to inside-out patches of cultured locus coeruleus neurons. The wild type beta(1)gamma(2) induced robust GIRK channel activity with an EC(50) of about 4 nm. Among the eight outer surface mutants tested, blade 1 and blade 2 mutants (D1 and CD2) were far less active than the wild type in stimulating GIRK channels. However, the ability of D1 and CD2 to regulate type I and type II adenylyl cyclases was not very different from that of the wild type beta(1)gamma(2). As to the activities to stimulate phospholipase Cbeta(2), D1 was more potent and CD2 was less potent than the wild type beta(1)gamma(2). Additionally we tested four beta(1) mutants in which mutated residues are located in the top Galpha/beta interacting surface. Among them, mutant W332A showed far less ability than the wild type to activate GIRK channels. These results suggest that the outer surface of blade 1 and blade 2 of the beta subunit might specifically interact with GIRK and that the beta subunit interacts with GIRK both over the outer surface and over the top Galpha interacting surface.

Calcium phosphate-mediated transfection of primary cultured brain neurons using GFP expression as a marker: application for single neuron electrophysiology.

We investigated the efficiency of transfecting primary cultured rat postnatal brain neurons (substantia nigra pars compacta neurons and locus coeruleus neurons) with cDNA encoding GFP (jellyfish green fluorescent protein) using a calcium phosphate method. The proportion of transfected neurons (transfection efficiency) was approximately 5%, when cultures from the substantia nigra pars compacta were transfected 3 days after plating. The transfection efficiency decreased when cultures were transfected 10 days after plating (1.7%). Neurons were cotransfected at a very high probability ( > 78%) with the muscarinic m2-receptor cDNAs together with GFP plasmids. Transfected neurons were very healthy as indicated by the zero-current potential and the microscopical appearance. Because the transfection efficiency is low, this method cannot be used for experiments involving the whole cell population. The transfection efficiency of 1.7% corresponded to approximately 20 transfected cells per dish in our culture conditions and these cells are sufficient in number for electrophysiological studies. Therefore, this is an excellent method for studying the influence of exogenous genes on single neurons using electrophysiological techniques.