Search results for: nursing protocol

Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

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College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

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Authors: Abdullah Saeidi, Aydin Gülses, Christan Flörke

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Skin cancer of the face region is the most common type of malignancy and surgical excision is the preferred approach. However, the clinical long term results reported in the literature are still controversial. Objectives: To describe; 1. Demographical characteristics 2. Affected site, distribution and TNM classification regarding tumor type 3. Surgical aspects • Surgical removal: excision principles, safety margins, the need for secondary resection, primary reconstruction/ defect closure, anesthesia protocol, duration of hospital stay (if any) • Secondary intervention for defect closure/reconstruction: Flap technique, anesthesia protocol, duration of hospital stay (if any), postoperative wound management etc. 4. Tumor recurrences 5. Clinical outcomes 6. Studying the possible therapy approach throw Biostatistical relation and correlation between multiple Histological, diagnostics and clinical Faktors. following surgical ablation of the skin cancer of the head and neck region. Methods: Selection and statistical analysis of medical records of patients who had admitted to the Department of Oral and Maxillofacial Surgery, Universitätsklinikum Schleswig Holstein, Campus Kiel during the period of 2015-2019 will be retrospectively evaluated. Data will be collected via ORBIS Information-Management-System (ORBIS AG, Saarbrücken, Germany).

Keywords: non melanoma skin cancer, face skin cancer, skin reconstruction, non melanoma skin cancer recurrence, non melanoma skin cancer metastases

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Authors: Sue S. Feldman

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As clinical and nursing informatics mature, an area that has gotten a lot of attention is the value capstone projects. Capstones are meant to address authentic and complex domain-specific problems. While capstone projects have not always been essential in graduate clinical and nursing informatics education, employers are wanting to see evidence of the prospective employee's knowledge and skills as an indication of employability. Capstones can be organized in many ways: a single course over a single semester, multiple courses over multiple semesters, as a targeted demonstration of skills, as a synthesis of prior knowledge and skills, mentored by one single person or mentored by various people, submitted as an assignment or presented in front of a panel. Because of the potential for capstones to enhance the educational experience, and as a mechanism for application of knowledge and demonstration of skills, a rigorous capstone can accelerate a graduate's potential in the workforce. In 2016, the capstone at the University of Alabama at Birmingham (UAB) could feel the external forces of a maturing Clinical and Nursing Informatics discipline. While the program had a capstone course for many years, it was lacking the depth of knowledge and demonstration of skills being asked for by those hiring in a maturing Informatics field. Since the program is online, all capstones were always in the online environment. While this modality did not change, other contributors to instruction modality changed. Pre-2016, the instruction modality was self-guided. Students checked in with a single instructor, and that instructor monitored progress across all capstones toward a PowerPoint and written paper deliverable. At the time, the enrollment was few, and the maturity had not yet pushed hard enough. By 2017, doubling enrollment and the increased demand of a more rigorously trained workforce led to restructuring the capstone so that graduates would have and retain the skills learned in the capstone process. There were three major changes: the capstone was broken up into a 3-course sequence (meaning it lasted about 10 months instead of 14 weeks), there were many chunks of deliverables, and each faculty had a cadre of about 5 students to advise through the capstone process. Literature suggests that the chunking, breaking up complex projects (i.e., the capstone in one summer) into smaller, more manageable chunks (i.e., chunks of the capstone across 3 semesters), can increase and sustain learning while allowing for increased rigor. By doing this, the teaching responsibility was shared across faculty with each semester course being taught by a different faculty member. This change facilitated delving much deeper in instruction and produced a significantly more rigorous final deliverable. Having students advised across the faculty seemed like the right thing to do. It not only shared the load, but also shared the success of students. Furthermore, it meant that students could be placed with an academic advisor who had expertise in their capstone area, further increasing the rigor of the entire capstone process and project and increasing student knowledge and skills.

Keywords: capstones, clinical informatics, health informatics, informatics

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Authors: Mujahid Muhammad, Paul Kearney, Adel Aneiba

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The ability for vehicles to communicate with other vehicles (V2V), the physical (V2I) and network (V2N) infrastructures, pedestrians (V2P), etc. – collectively known as V2X (Vehicle to Everything) – will enable a broad and growing set of applications and services within the intelligent transport domain for improving road safety, alleviate traffic congestion and support autonomous driving. The telecommunication research and industry communities and standardization bodies (notably 3GPP) has finally approved in Release 14, cellular communications connectivity to support V2X communication (known as LTE – V2X). LTE – V2X system will combine simultaneous connectivity across existing LTE network infrastructures via LTE-Uu interface and direct device-to-device (D2D) communications. In order for V2X services to function effectively, a robust security mechanism is needed to ensure legal and safe interaction among authenticated V2X entities in the LTE-based V2X architecture. The characteristics of vehicular networks, and the nature of most V2X applications, which involve human safety makes it significant to protect V2X messages from attacks that can result in catastrophically wrong decisions/actions include ones affecting road safety. Attack vectors include impersonation attacks, modification, masquerading, replay, MiM attacks, and Sybil attacks. In this paper, we focus our attention on LTE-based V2X security and access control mechanisms. The current LTE-A security framework provides its own access authentication scheme, the AKA protocol for mutual authentication and other essential cryptographic operations between UEs and the network. V2N systems can leverage this protocol to achieve mutual authentication between vehicles and the mobile core network. However, this protocol experiences technical challenges, such as high signaling overhead, lack of synchronization, handover delay and potential control plane signaling overloads, as well as privacy preservation issues, which cannot satisfy the adequate security requirements for majority of LTE-based V2X services. This paper examines these challenges and points to possible ways by which they can be addressed. One possible solution, is the implementation of the distributed peer-to-peer LTE security mechanism based on the Bitcoin/Namecoin framework, to allow for security operations with minimal overhead cost, which is desirable for V2X services. The proposed architecture can ensure fast, secure and robust V2X services under LTE network while meeting V2X security requirements.

Keywords: authentication, long term evolution, security, vehicle-to-everything

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Authors: Elaine Wong Yee-Sing, Liaw Wee Tong

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Rapid transformations in demographic and socioeconomic shifts are leading to a growing global demand for health and beauty products and services that demands holistic concepts of well-being. In addition, technological breakthroughs such as internet of things make it convenient and offer innovative solutions for well-being and engage consumers to track their own health conditions and fitness goals. This 'new health economy' encompasses three key concepts: well-being, well-conditioned and well-shaped; which are shaped by wellness segments and goals that influence purchasing decisions of consumers. The research protocol aims to examine the feasibility, challenges, and capabilities in provision for each customer with an ecosystem, or platform, that organizes data and insights to create an individual health and fitness, nutrition, and beauty profile. Convenience sampling of 100 consumers residing in private housing within five major districts in Singapore will be selected to participate in the study. Statistical Package for Social Science 25 will be used to conduct descriptive statistics for quantitative data while qualitative data results using focus interviews, will be translated and transcribed to identify improvements in provision of these services. Rising income in emerging global markets is fuelling the demand for these general wellbeing products and services. Combined with technological advances, it is imperative to understand how these highly personalized services with integrated technology can be designed better to support consumer preferences; provide greater flexibility and high-quality service, and generate better health awareness among consumers.

Keywords: beauty, consumers, health, technology, wellness

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Authors: Prashansa Singh, Rohit Bajaj, Manjot Kaur

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In the modern agricultural landscape, precision farming has emerged as a pivotal strategy for enhancing crop yield and optimizing resource utilization. This paper introduces an innovative Crop Recommendation System (CRS) that leverages the Internet of Things (IoT) technology and the Message Queuing Telemetry Transport (MQTT) protocol to collect critical environmental and soil data via sensors deployed across agricultural fields. The system is designed to address the challenges of real-time data acquisition, efficient data transmission, and dynamic crop recommendation through the application of advanced Artificial Intelligence (AI) and Machine Learning (ML) models. The CRS architecture encompasses a network of sensors that continuously monitor environmental parameters such as temperature, humidity, soil moisture, and nutrient levels. This sensor data is then transmitted to a central MQTT server, ensuring reliable and low-latency communication even in bandwidth-constrained scenarios typical of rural agricultural settings. Upon reaching the server, the data is processed and analyzed by AI/ML models trained to correlate specific environmental conditions with optimal crop choices and cultivation practices. These models consider historical crop performance data, current agricultural research, and real-time field conditions to generate tailored crop recommendations. This implementation gets 99% accuracy.

Keywords: Iot, MQTT protocol, machine learning, sensor, publish, subscriber, agriculture, humidity

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Authors: Larissa M. Vargas, Julia M. Sacchi, Renata O. Pereira, Lucas S. Asano, Iara C. Araújo, Patricia Fiorino, Vera Farah

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The aim of this study was to evaluate the occurrence of subclinical organ injuries induced by high-fat diet. Male wistar rats (n=5/group) were divided in control diet group (CD), commercial rat chow, and hyperlipidic diet (30% lipids) group (HD) administrated during 8 weeks, starting after weaning. All the procedures followed the rules of the Committee of Research and Ethics of the Mackenzie University (CEUA Nº 077/03/2011). At the end of protocol the animals were euthanized by anesthesia overload and the left kidney was removed. Intrarenal lipid deposition was evaluated by histological analyses with oilred. Kidney slices were stained with picrosirius red to evaluate the area of the Bowman's capsule (AB) and space (SB), and glomerular tuft area (GT). The renal expression of sterol regulatory element–binding protein (SREBP-2) was performed by Western Blotting. Creatinine concentration (serum and urine) and lipid profile were determined by colorimetric kit (Labtest). At the end of the protocol there was no differences in body weight between the groups, however the HD showed a marked increase in lipid deposits, glomeruli and tubules, and biochemical analysis for cholesterol and triglycerides. Moreover, in the kidney, the high-fat diet induced a reduction in the AB (13%), GT (18%) and SB (17%) associated with a reduction in glomerular filtration rate (creatinine clearance). The renal SRBP2 expression was increased in HD group. These data suggests that consumption of high-fat diet starting in childhood is associated with subclinical renal damage and function.

Keywords: high-fat diet, kidney, intrarenal lipid deposition, SRBP2

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Authors: Mohammad Soltani, Sajad Ahmadizad, Fatemeh Hoseinzadeh, Atefe Sarvestan

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The exercise recovery is an important variable in designing resistance exercise training. This study determined the effects of passive and active recoveries on responses of platelet indices and hemodynamic variables to resistance exercise. Twelve healthy subjects (six men and six women, age, 25.4 ±2.5 yrs) performed two types of resistance exercise protocols (six exercises including upper- and lower-body parts) at two separate sessions with one-week intervening. First resistance protocol included three sets of six repetitions at 80% of 1RM with 2 min passive rest between sets and exercises; while, the second protocol included three sets of six repetitions at 60% of 1RM followed by active recovery included six repetitions of the same exercise at 20% of 1RM. The exercise volume was equalized. Three blood samples were taken before exercise, immediately after exercise and after 1-hour recovery, and analyzed for fibrinogen and platelet indices. Blood pressure (BP), heart rate (HR) and rate pressure product (RPP), were measured before, immediately after exercise and every 5 minutes during recovery. Data analyzes showed a significant increase in SBP (systolic blood pressure), HR, rate of pressure product (RPP) and PLT in response to resistance exercise (P<0.05) and that changes for HR and RPP were significantly different between two protocols (P<0.05). Furthermore, MPV and P_LCR did not change in response to resistance exercise, though significant reductions were observed after 1h recovery compared to before and after exercise (P<0.05). No significant changes in fibrinogen and PDW following two types of resistance exercise protocols were observed (P>0.05). On the other hand, no significant differences in platelet indices were found between the two protocols (P>0.05). Resistance exercise induces changes in platelet indices and hemodynamic variables, and that these changes are not related to the type of recovery and returned to normal levels after 1h recovery.

Keywords: hemodynamic variables, platelet indices, resistance exercise, recovery intensity

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Authors: Gülcan Taşkıran, Ülkü Tatar Baykal

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Aim: To identify nurses’ perceived competencies for disaster preparedness. Background: Recently, the number of disasters has increased worldwide. Since disasters often strike without warning, healthcare providers, especially nurses must be prepared with appropriate competencies for disaster procedures. Nurses’ perceptions of their own competencies for disaster preparedness need to be evaluated to aid in the creation of effective national plans and educational programs. Design: This study was conducted with a descriptive and cross-sectional design. Methods: Nurses’ perceptions were assessed using the 13-item Demographic Profile Questionnaire that is based on previous literature and the 45-item Nurses’ Perception of Core Competencies for Disaster Preparedness Scale (NPCDPS). Data were collected from June to September 2014 from 406 (79.9% return rate) Turkish nurses working in the western region of Turkey. Results: At the end of the study, it was found that out of the nurses whose mean age was 31.27 ± 5.86 and mean of working time was 8.07 ± 6.60 by the time vast majority of the nurses were women (85.7%), married (59.4%), bachelor’s degree holder (88.2%) and service nurses (56.2%). The most potential disaster that nurses think is an earthquake (70.9%) by the time majority of nurses consider having a role as a nurse at every stage of disasters. The mean total point score of nurses’ perception of disaster preparedness was 4.62. The mean total point score of the nurses from the Nurses’ Perception of Core Competencies for Disaster Preparedness Scale was 133.96. When the subscales’ mean scores are examined, the highest average of the mean score is for Technical Skills (44.52), and the lowest is for Critical Thinking Skills (10.47). When the subscales of Nurses’ Perception of Core Competencies for Disaster Preparedness Scale compared with sex, marital status and education level out of independent variable of nurses there is no significant difference (p > 0.05); compared with age group, working years, duty and being with a disaster out of independent variable of nurses there is a significant difference (p ≤ 0.05). Conclusion: Nurses generally perceive themselves as sufficient at a ‘medium level’ in terms of meeting the core competencies that are required for disaster preparedness. Nurses are not adequately prepared for disasters, but they are aware of the need for such preparation and disaster education. Disaster management training should be given to all nurses in their basic education.

Keywords: disaster competencies, disaster management, disaster nursing, disaster preparedness, nursing, nursing administration, Turkish nurses

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Authors: Hao-Wei Fu, Chung-Feng Kao

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In the era of rapid technological advancement, information technology (IT) has become integral to modern life, exerting significant influence across diverse sectors and serving as a catalyst for development in various industries. Within agriculture, the integration of IT offers substantial benefits, notably enhancing operational efficiency. Real-time monitoring systems, for instance, have been widely embraced in agriculture, effectively improving crop management practices. This study specifically addresses the management of rice panicle fertilizer, presenting the development of a web application tailored to handle data associated with rice panicle fertilizer management. Leveraging the normalized difference red edge index, this application optimizes the quantity of rice panicle fertilizer used, providing recommendations to agricultural stakeholders and service providers in the agricultural information sector. The overarching objective is to minimize costs while maximizing yields. Furthermore, a robust database system has been established to store and manage relevant data for future reference in rice cultivation management. Additionally, the study utilizes the Representational State Transfer software architectural style to construct an application programming interface (API), facilitating data creation, retrieval, updating, and deletion for users via the HyperText Transfer Protocol methods. Future plans involve integrating this API with third-party services to incorporate it into larger frameworks, thus catering to the diverse requirements of various third-party services.

Keywords: application programming interface, HyperText Transfer Protocol, nitrogen fertilizer intelligent management, web-based application

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Authors: S. Abed, S. O’Neill

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This research explored ward nurses’ views about the characteristics of effective nurse leaders in the context of Iraq as a developing country, where the delivery of health care continues to face disruption and change. It is well established that the provision of modern health care requires effective nurse leaders, but in countries such as Iraq the lack of effective nurse leaders is noted as a major challenge. In a descriptive quantitative study, a survey questionnaire was administered to 210 ward nurses working in two public hospitals in a major city in the north of Iraq. The participating nurses were of the opinion that the effectiveness of their nurse leaders was evident in their ability to demonstrate: good clinical knowledge, effective communication and managerial skills. They also viewed their leaders as needing to hold high-level nursing qualifications, though this was not necessarily the case in practice. Additionally, they viewed nurse leaders’ personal qualities as important, which included politeness, ethical behaviour, and trustworthiness. When considered against the issues raised in interviews with a smaller group (20) of senior nurse leaders, representative of the various occupational levels, implications identify the need for professional development that focuses on how the underpinning competencies relate to leadership and how transformational leadership is evidenced in practice.

Keywords: health care, nurse education, nursing in Iraq, nurse leadership

Procedia PDF Downloads 251

Authors: Nattanon Peerapen, Wanwisa Insang, Lanlalin Khumman, Wipada Juanprajak, Sikan Na Chiangmai, Wacharin Suksanan, Thanasak Tantinakom

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This research was intended to study guidelines from elderly care businesses that are continuously growing and rapidly benefitting because these businesses respond to the needs of those who cannot find time to in take care of their elderly people, including intimate care services from the caregivers, thus rapidly expanding elderly care businesses to have recently become interesting domestically and internationally. Chiang Mai is a popular choice for the businesses because of excellent weathers and simple and peaceful ways of living, thus making the businesses grow rapidly and continuously. The sample group consisted of 5 persons, executives and staff, from each of the 4 businesses that provide elderly cares chosen to interview by the researches, which were Vivo Bene Village, Baan Donsuk, PT Nursing Home, and PD Nursing Home. The interviews indicated that most elderly care businesses are located in rural areas with moving traffics, shady environments, and far from crowded urban areas since elderly people need peacefulness and clean environments that will affect their physical and mental health directly. The sections within the businesses are distinctly divided with definite duties assigned to each personnel, including welfares, remunerations, uniforms, accommodations, food and social occasions, such as birthdays or New Year festivities.

Keywords: elderly, elderly care, business strategy, success factors

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Authors: Raghava Dhanya, Shashank S.

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This paper delves into the intersection of chess and computer science, specifically focusing on the efficient representation of chess game states. We propose two methods: the Static Method and the Dynamic Method, each offering unique advantages in terms of space efficiency and computational complexity. The Static Method aims to represent the game state using a fixedlength encoding, allocating 192 bits to capture the positions of all pieces on the board. This method introduces a protocol for ordering and encoding piece positions, ensuring efficient storage and retrieval. However, it faces challenges in representing pieces no longer in play. In contrast, the Dynamic Method adapts to the evolving game state by dynamically adjusting the encoding length based on the number of pieces in play. By incorporating Alive Bits for each piece kind, this method achieves greater flexibility and space efficiency. Additionally, it includes provisions for encoding additional game state information such as castling rights and en passant squares. Our findings demonstrate that the Dynamic Method offers superior space efficiency compared to traditional Forsyth-Edwards Notation (FEN), particularly as the game progresses and pieces are captured. However, it comes with increased complexity in encoding and decoding processes. In conclusion, this study provides insights into optimizing the representation of chess game states, offering potential applications in chess engines, game databases, and artificial intelligence research. The proposed methods offer a balance between space efficiency and computational overhead, paving the way for further advancements in the field.

Keywords: chess, optimisation, encoding, bit manipulation

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Authors: Ivette Gonzalez-Rivera, Diana B. Paz-Trejo, Oscar Galicia-Castillo, David N. Velazquez-Martinez, Hugo Sanchez-Castillo

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Prolonged exposure to stress can cause disorders related with dysfunction in the prefrontal cortex such as generalized anxiety and depression. These disorders involve alterations in neurotransmitter systems; the serotonergic system—a target of the drugs that are commonly used as a treatment to these disorders—is one of them. Recent studies suggest that 5-HT1A receptors play a pivotal role in the serotonergic system regulation and in stress responses. In the same way, there is increasing evidence that astrocytes are involved in the pathophysiology of stress. The aim of this study was to examine the effects of 8-OH-DPAT, a selective agonist of 5-HT1A receptors, in the behavioral signs of anxiety and anhedonia as well as in the number of astrocytes in the medial prefrontal cortex (mPFC) after exposure to chronic stress. They used 50 male Wistar rats of 250-350 grams housed in standard laboratory conditions and treated in accordance with the ethical standards of use and care of laboratory animals. A protocol of chronic unpredictable stress was used for 10 consecutive days during which the presentation of stressors such as motion restriction, water deprivation, wet bed, among others, were used. 40 rats were subjected to the stress protocol and then were divided into 4 groups of 10 rats each, which were administered 8-OH-DPAT (Tocris, USA) intraperitoneally with saline as vehicle in doses 0.0, 0.3, 1.0 and 2.0 mg/kg respectively. Another 10 rats were not subjected to the stress protocol or the drug. Subsequently, all the rats were measured in an open field test, a forced swimming test, sucrose consume, and a cero maze test. At the end of this procedure, the animals were sacrificed, the brain was removed and the tissue of the mPFC (Bregma: 4.20, 3.70, 2.70, 2.20) was processed in immunofluorescence staining for astrocytes (Anti-GFAP antibody - astrocyte maker, ABCAM). Statistically significant differences were found in the behavioral tests of all groups, showing that the stress group with saline administration had more indicators of anxiety and anhedonia than the control group and the groups with administration of 8-OH-DPAT. Also, a dose dependent effect of 8-OH-DPAT was found on the number of astrocytes in the mPFC. The results show that 8-OH-DPAT can modulate the effect of stress in both behavioral and anatomical level. Also they indicate that 5-HT1A receptors and astrocytes play an important role in the stress response and may modulate the therapeutic effect of serotonergic drugs, so they should be explored as a fundamental part in the treatment of symptoms of stress and in the understanding of the mechanisms of stress responses.

Keywords: anxiety, prefrontal cortex, serotonergic system, stress

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Authors: Wanlapa Kunsongkeit

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When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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Authors: Parvin Malhami

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The purpose of the present study was to investigate the effects of two functional and functional stretching methods of the leg muscles on a selection of kinematical and kinetic indicators among women with ankle instability. Twenty-four persons were targeted and randomly divided into the functional exercise (8 persons), extra-functional exercise (8 persons) and control (8 persons) groups on the basis of inclusion and exclusion criteria. The experimental groups received stretching for eight weeks, 3 sessions each week, and the control group merely performed its daily activities. Then, in order to measure the pre -test and post -test variables, the dorsi flexion, Plantar flexion and ground reaction force were investigated and measured. Data were analyzed using paired T-test and independent T-tests at a significant level of 0.05. All statistical analyses were conducted using SPSS 25 software. The results of the T-test showed the significant effect of eight weeks of functional and Extra functional exercises on dorsi Flexion, Plantar Flexion and ground reaction force. (P≤ 0/001). The results of this study showed that the implementation of the functional and Extra-functional exercise protocol had an impact on the amount of Ankle dorsi Flexion and the Plantar felxion of women with an ankle instability. It was also found that muscle flexibility following the stretch ability of the gastrocnemius muscles facilitates the walking of the wrist installation by affecting the amount of wrist flexion, so these people are recommended to use the functional and extra-functional exercise protocol.

Keywords: functional stretching, extra functional stretching, dorsi flexion, plantar flexion

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Authors: Ruvaitha Banu, Amaladhithyan Krishnamoorthy

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IoT networks today solve various consumer problems, from home automation systems to aiding in driving autonomous vehicles with the exploration of multiple devices. For example, in an autonomous vehicle environment, multiple sensors are available on roads to monitor weather and road conditions and interact with each other to aid the vehicle in reaching its destination safely and timely. IoT systems are predominantly dependent on the cloud environment for data storage, and computing needs that result in latency problems. With the advent of Fog networks, some of this storage and computing is pushed to the edge/fog nodes, saving the network bandwidth and reducing the latency proportionally. Managing the data stored in these fog nodes becomes crucial as it might also store sensitive information required for a certain application. Data management in fog nodes is strenuous because Fog networks are dynamic in terms of their availability and hardware capability. It becomes more challenging when the nodes in the network also live a short span, detaching and joining frequently. When an end-user or Fog Node wants to access, read, or write data stored in another Fog Node, then a new protocol becomes necessary to access/manage the data stored in the fog devices as a conventional static way of managing the data doesn’t work in Fog Networks. The proposed solution discusses a protocol that acts by defining sensitivity levels for the data being written and read. Additionally, a distinct data distribution and replication model among the Fog nodes is established to decentralize the access mechanism. In this paper, the proposed model implements stewardship towards the data stored in the Fog node using the application of Reinforcement Learning so that access to the data is determined dynamically based on the requests.

Keywords: IoT, fog networks, data stewardship, dynamic access policy

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Authors: Hind Mohammed A. Asiri, Asia Mohammed Asiri, Hana Falah Alruwaili, Joseph Almazan

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With the rapid growth of the older adult population, an underlying growth of public health concern is also seen. Various technologies were developed to help mitigate the arising problems of older adults with cognitive impairment and the improvement of their cognitive functions. This scooping review used the Joanna Briggs Institute (JBI) and the PRISMA extension for scoping reviews. The eligibility criteria were defined using the Population, Concept, Context (PCC) framework, as described in the JBI’s Reviewers Manual (Peters et al.,2020). The population of interest for this review is older adults 65 years old or older. Studies involving monitoring technology devices utilized in caring with older adult with cognitive impairment. This scoping review has shown information that researchers are more focused on creating alternative and novel methods or technological devices and use these as a tool for designing interventions depending on the data of the patient. This study has shown the type of technologies that have been explored in terms of assessing, detecting, monitoring, and interventions for cognitive impairment. Thus, there is a need for this technology to be applied in the practical field to further strengthen the evidence that it could enhance the lives of older adults.

Keywords: technology devices, cognitive impairment, older adult, nursing care, caring

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Authors: Masih Nikgou

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ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

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Authors: Riza Adriyani, Tommy Apriantono, Suprijanto

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Objective: Several studies have revealed that flatfoot posture has some effect on altered lower limb muscle function, in comparison to normal foot posture. There were still limited studies to examine the effect of fatigue on flatfoot posture in children. Therefore, this study was aimed to find out jumping fatiguing effect on static balance and to compare lower limb muscle function between flatfoot and normal foot in school children. Methods: Thirty junior high school children aged 12 to 14 years took part in this study. Of these all children, 15 had the normal foot (8 males and 7 females) and 15 had flatfoot (6 males and 9 females). Foot posture was classified based on an arch index of the footprint by a foot scanner which calculated the data using AUTOCAD 2013 software. Surface electromyography (EMG) activity was recorded from tibialis anterior, gastrocnemius medialis, and peroneus longus muscles while those participants were standing on one leg barefoot with opened eyes. All participants completed the entire protocol (pre-fatigue data collection, fatigue protocol, and post fatigue data collection) in a single session. Static balance and electromyographic data were collected before and after a functional fatigue protocol. Results: School children with normal foot had arch index 0.25±0.01 whereas those with flatfoot had 0.36±0.01. In fact, there were no significant differences for anthropometric characteristics between children with flatfoot and normal foot. This statistical analysis showed that fatigue could influence static balance in flatfoot school children (p < 0.05), but not in normal foot school children. Based on electromyographic data, the statistical analysis showed that there were significant differences (p < 0.05) of the decreased median frequency on tibialis anterior in flatfoot compared to normal foot school children after fatigue. However, there were no significant differences on the median frequency of gastrocnemius medialis and peroneus longus between both groups. After fatigue, median frequency timing was significantly different (p < 0.05) on tibialis anterior in flatfoot compared to normal foot children and tended to appear earlier on tibialis anterior, gastrocnemius medialis and peroneus longus (at 7s, 8s, 9s) in flatfoot compared to normal foot (at 15s, 11s , 12s). Conclusion: Fatigue influenced static balance and tended to appear earlier on selected lower limb muscles while performing static balance in flatfoot school children. After fatigue, tremor (median frequency decreased) showed more significant differences on tibialis anterior in flatfoot rather than in normal foot school children.

Keywords: fatigue, foot postures, median frequency, static balance

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Authors: Seyed Reza Mirmahdi, Seyedeh Maryam Hashemi Jabali

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This research was conducted to evaluate the effects of group spiritual therapy on increasing the life expectancy and mental health among the elderlies. This was a quasi-experimental research using a pretest-posttest design with a control group conducted over a population including all the elderly people of Tehran in 2012-13. A randomized sampling method was used to select 30 elderly people living in Parham nursing home that were then randomly assigned into two control and experimental groups of 15 people each. The instruments used were Miller’s life expectancy and mental health test (SCL.90.R) standard questionnaires. Individuals in experimental group received 12 sessions of group spiritual therapy while those in control group did not receive any kind of therapy. The tests were performed again for all the subjects (30 individuals) at the end of the experiment. To test the hypotheses, the data collected by questionnaires were analyzed using descriptive methods through relevant tables and charts and also inferential methods through the analysis of covariance using the SPSS software. Results showed that group spiritual therapy leads to a significant increase in both mental health and life expectancy in the experimental group of elderlies living in Parham nursing home compared to those in the control group.

Keywords: spiritual therapy, life expectancy, mental health, elderlies

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Authors: Chia-Chi Chang, Chuan-Bi Lin, Chia-Min Chan

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Most ZigBee sensor networks to date make use of nodes with limited processing, communication, and energy capabilities. Energy consumption is of great importance in wireless sensor applications as their nodes are commonly battery-driven. Once ZigBee nodes are deployed outdoors, limited power may make a sensor network useless before its purpose is complete. At present, there are two strategies for long node and network lifetime. The first strategy is saving energy as much as possible. The energy consumption will be minimized through switching the node from active mode to sleep mode and routing protocol with ultra-low energy consumption. The second strategy is to evaluate the energy consumption of sensor applications as accurately as possible. Erroneous energy model may render a ZigBee sensor network useless before changing batteries. In this paper, we present a ZigBee wireless sensor node with four key modules: a processing and radio unit, an energy harvesting unit, an energy storage unit, and a sensor unit. The processing unit uses CC2530 for controlling the sensor, carrying out routing protocol, and performing wireless communication with other nodes. The harvesting unit uses a 2W solar panel to provide lasting energy for the node. The storage unit consists of a rechargeable 1200 mAh Li-ion battery and a battery charger using a constant-current/constant-voltage algorithm. Our solution to extend node lifetime is implemented. Finally, a long-term sensor network test is used to exhibit the functionality of the solar powered system.

Keywords: ZigBee, Li-ion battery, solar panel, CC2530

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Authors: Nguyen Quynh Trang, Nguyễn Thị Hông Nhung

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The study aimed to identify the effectiveness of using the mind map technique to enhance students’ medical vocabulary retention among a group of students at a higher education institution - Thai Nguyen University of Medicine and Pharmacy during the first semester of the school year 2022-2023. The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. Almost teachers and students showed high preferences for the implementation of the mind map technique in language teaching and learning. Furthermore, results from the pre-and-post tests between the experimental group and control one pointed out that this technique brought back positive academic performance in teaching and learning English. The research findings revealed that there should be more supportive policies to evoke the use of the mind map technique in a pedagogical context. Aim of the Study: The purpose of this research was to investigate whether using mind mapping can help students to enhance nursing students’ medical vocabulary retention and to assess the students’ attitudes toward using mind mapping as a tool to improve their vocabulary. The methodology of the study: The research employed a quasi-experimental method, exploring primary sources such as questionnaires and the analyzed results of pre-and-post tests. The contribution of the study: The research contributed to the innovation of teaching vocabulary methods for English teachers at a higher education institution. Moreover, the research helped the English teachers and the administrators at a university evoke and maintain the motivation of students not only in English classes but also in other subjects. The findings of this research were beneficial to teachers, students, and researchers interested in using mind mapping to teach and learn English vocabulary. The research explored and proved the effectiveness of applying mind mapping in teaching and learning English vocabulary. Therefore, teaching and learning activities were conducted more and more effectively and helped students overcome challenges in remembering vocabulary and creating motivation to learn English vocabulary.

Keywords: medical vocabulary retention, mind map technique, nursing students, medical vocabulary

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Authors: Asnakech Zekiwos

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Background: Stress in nursing refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone Public Hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs attention.

Keywords: stress, nurses, public hospitals, expanded stress scale

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Authors: M. Qorbani

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Neuromuscular control of posture as understood through studies of responses to mechanical sudden acceleration automatically has been previously demonstrated in individuals with chronic ankle instability (CAI), but the presence of acute condition has not been previously explored specially in a sudden acceleration. The aim of this study was to determine neuromuscular control pattern in those with and without unilateral acute ankle sprains. Design: Case - control. Setting: University research laboratory. The sinker–card protocol with surface translation was be used as a sudden acceleration protocol with study of EMG upon 4 posture stabilizer muscles in two sides of the body in response to sudden acceleration in forward and backward directions. 20 young adult women in two groups (10 LAS; 23.9 ± 2.03 yrs and 10 normal; 26.4 ± 3.2 yrs). The data of EMG were assessed by using multivariate test and one-way repeated measures 2×2×4 ANOVA (P< 0.05). The results showed a significant muscle by direction interaction. Higher TA activity of left and right side in LAS group than normal group in forward direction significantly be showed. Higher MGR activity in normal group than LAS group in backward direction significantly showed. These findings suggest that compared two sides of the body in two directions for 4 muscles EMG activities between and within group for neuromuscular control of posture in avoiding fall. EMG activations of two sides of the body in lateral ankle sprain (LAS) patients were symmetric significantly. Acute ankle instability following once ankle sprains caused to coordinated temporal spatial patterns and strategy selection.

Keywords: neuromuscular response, sEMG, lateral ankle sprain, posture.

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Authors: Judson P. LaGrone

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Simulation-based education in curricula was once a luxurious component of nursing programs but now serves as a vital element of an individual’s learning experience. A debriefing occurs after the simulation scenario or clinical experience is completed to allow the instructor(s) or trained professional(s) to act as a debriefer to guide a reflection with a purpose of acknowledging, assessing, and synthesizing the thought process, decision-making process, and actions/behaviors performed during the scenario or clinical experience. Debriefing is a vital component of the simulation process and educational experience to allow the learner(s) to progressively build upon past experiences and current scenarios within a safe and welcoming environment with a guided dialog to enhance future practice. The aim of this integrative review was to assess current practices of debriefing models in simulation-based education for health care professionals and students. The following databases were utilized for the search: CINAHL Plus, Cochrane Database of Systemic Reviews, EBSCO (ERIC), PsycINFO (Ovid), and Google Scholar. The advanced search option was useful to narrow down the search of articles (full text, Boolean operators, English language, peer-reviewed, published in the past five years). Key terms included debrief, debriefing, debriefing model, debriefing intervention, psychological debriefing, simulation, simulation-based education, simulation pedagogy, health care professional, nursing student, and learning process. Included studies focus on debriefing after clinical scenarios of nursing students, medical students, and interprofessional teams conducted between 2015 and 2020. Common themes were identified after the analysis of articles matching the search criteria. Several debriefing models are addressed in the literature with similarities of effectiveness for participants in clinical simulation-based pedagogy. Themes identified included (a) importance of debriefing in simulation-based pedagogy, (b) environment for which debriefing takes place is an important consideration, (c) individuals who should conduct the debrief, (d) length of debrief, and (e) methodology of the debrief. Debriefing models supported by theoretical frameworks and facilitated by trained staff are vital for a successful debriefing experience. Models differed from self-debriefing, facilitator-led debriefing, video-assisted debriefing, rapid cycle deliberate practice, and reflective debriefing. A reoccurring finding was centered around the emphasis of continued research for systematic tool development and analysis of the validity and effectiveness of current debriefing practices. There is a lack of consistency of debriefing models among nursing curriculum with an increasing rate of ill-prepared faculty to facilitate the debriefing phase of the simulation.

Keywords: debriefing model, debriefing intervention, health care professional, simulation-based education

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Authors: Rahy Farooq, Maria Ahmad Khan, Ayesha Isani Majeed

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Objective: The main aim of this research is to assess the knowledge, attitude and practices of female nursing staff and nursing students regarding breast cancer, to provide a baseline for monitoring trends of breast cancer awareness in them. Background: Healthcare professionals are a direct source of information for the patients and the general public as a whole. It is, therefore, essential that the information they convey be accurate and helps in building additional awareness. However, clinical experience does not influence the knowledge, attitude and practices regarding breast cancer. Nurses, being the prime part of the healthcare professionals, play a significant role and hence, their awareness regarding this pressing issue is pertinent. Lack of awareness regarding common presenting symptoms or breast cancer risk factors translates to poor breast cancer screening practices and late diagnosis. Methodology: A cross-sectional study of 280 female nurses was conducted at a tertiary care hospital in Islamabad, Pakistan. A pre-tested structured questionnaire with additional variables like cultural barriers to seeking medical help was used. The scores for outcome variables including knowledge, attitude and practices were pre-defined. Data was analyzed using SPSSv23. Results: Of the 280 participants with a mean age of 28.99±9.98 years, 142 (50.7%) were married, and 138 (49.3%) were unmarried. Mean scores were computed to be 6.14±2.93 (out of 12), 0.30±0.7 (out of 3) and 9.53±1.92 (out of 16) for knowledge, attitude and practice respectively. Using independent sample T-test, a statistically significant correlation was found when means for the score of Attitude was compared with age. With a p-value of 0.018, 117 nurses of age more than 30 years, faced more practical, financial, emotional and service barriers as compared to 163 women younger than 30 years of age. Knowledge of age-related lifetime risks was also significantly poor more in single women; with a p-value of 0.006 for identification of correct age as a risk factor and a p-value of 0.005 for correct identification of risk for development of breast cancer in the lifetime of women. By application of Chi-square test, there was a significant correlation between marital status and cultural barriers to seeking medical help, showing that single women (58.7%) shy away from talking about breast cancer considering it a taboo (p-value 0.028) whereas, more married nurses (59.2%) were apprehensive that they might be considered at fault by the society, as compared to 40.8% of single nurses. (p-value 0.038). Conclusion: Owing to the scarcity of awareness among nurses, this study recognizes the need for delivering effective information to the female nurses regarding breast cancer. Educating patients is likely to be effective if the female nurses play their part and have correct attitudes towards breast cancer practices. A better understanding of the knowledge and practices regarding breast cancer among the nursing population will enable high-risk patients to be recognized early. Therefore, we recommend arrangement of special courses and seminars for all healthcare professionals including the nursing staff.

Keywords: breast cancer, cultural barriers, kap, nurses

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Authors: Krzysztof Buczak, Sonia Lachowska, Pawel Kucharski, Agnieszka Antonczyk

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Tiletamine - zolazepam combination is increasingly used in veterinary anaesthesiology in wild animals, including snakes. The available literature shows a lack of information about anesthesia in this mixture in ovoviviparous snakes. The studies show the possibility of using the combination at a dose of 20 mg/kg or more for snake immobilization. This paper presents an anesthetic protocol with the use of a combination of tiletamine - zolazepam at the dose of 10 mg/kg intramuscularly and maintenance with inhalant anesthesia with isoflurane in pure oxygen. The objective of this study was to evaluate the usefulness of the anesthetic protocol to proceed with coeliotomy in Amazon Tree Boa. The patient was a five years old bicolor female Amazon Tree Boa (Corallus hortulanus) with dystocia. The clinical examination reveals significant emaciation (bodyweight 520g), high degree of dehydration, heart rate (HR = 60 / min), pale mucous membranes and poor reactivity. Meloxicam (1 mg/kg) and tramadol (10 mg/kg) were administered subcutaneously and the patient was placed in an incubator with access to fresh oxygen. Four hours later, the combination of tiletamine - zolazepam (10 mg/kg) was administered intramuscularly for induction of anesthesia. The snake was intubated and connected to inhalant anesthesia equipment. For maintenance, the anesthesia isoflurane in pure oxygen was used due to apnea, which occurs 30 minutes after the induction semi-closed system was attached and the ventilator was turned on (PCV system, four breaths per minute, 8 cm of H2O). Cardiopulmonary parameters (HR, RR, SPO2, ETCO2, ETISO) were assessed throughout the procedure. During the entire procedure, the operating room was heated to a temperature of 26 degrees Celsius. Additionally, the hose was placed on a heating mat, which maintained a temperature of 30 degrees Celsius. For 15 minutes after induction, the loss of muscle tone was observed from the head to the tail. Induction of general anesthesia was scored as good because of the possibility of intubation. During the whole procedure, the heart rate was at the rate of 58 beats per minute (bpm). Ventilation parameters were stable throughout the procedure. The recovery period lasts for about 4 hours after the end of general anesthesia. The muscle tension returned from tail to head. The snake started to breathe spontaneously within 1,5 hours after the end of general anesthesia. The protocol of general anesthesia with the combination of tiletamine- zolazepam with a dose of 10 mg/kg is useful for proceeding with the emergency coeliotomy in maintenance with isoflurane in oxygen. Further study about the impact of the combination of tiletamine- zolazepam for the recovery period is needed.

Keywords: anesthesia, corallus hortulanus, ovoviparous, snake, tiletamine, zolazepam

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Authors: Md. Ashikur Rahman

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Optimal breastfeeding practice is essential to reducing childhood morbidity and mortality and helps to achieve Millennium Development Goal (MDG). A cross-sectional study was conducted in a rural area in Dhaka district to explore the barrier to optimal breastfeeding practices. The population of this study constitutes all nursing mothers having children aged 0-6 months, and they were selected purposively. The study adopted a structured and in-depth interview procedure consisting of open and closed-ended questions. Four hundred rural nursing mothers constituted the sample of the structured interview, while 15 were involved in the in-depth interview. Among the respondent's majority (67%) were in the age group 17-25 years, with a mean age of 24.44 years. Most (39.5%) of the mothers were housewives with a secondary level of education (46.5%). About 32% of mothers started breastfeeding within one hour after birth. But delayed initiation was reported in 31.5% of mothers, whereas 36.8% of mothers forgot the exact time of initiation of breastfeeding. The main reason not to practice colostrum was mothers tried to breastfeed, but there was no milk, stated 13.8% of mothers. In addition, about one-third (34.3%) of the respondents practiced pre-lacteal feeding, and among them, 12.8% introduced sugar with water. Reasons given by the mothers for bottle-feeding was that baby was not satisfied with breast milk only; 22.0% of mothers indicated this cause. The main influence to take formula milk by their mother and mothers-in-law was stated by 18.8% of mothers. Some mothers stated that major constraints to EBF were the perception of not having enough milk (25.5 %) and babies crying seems to be hungry (8.8%). One-third of the mothers (31.5%) felt uncomfortable during breastfeeding. Access to antenatal and postnatal counseling in the study area also was a key obstacle to optimal breastfeeding practices. In a qualitative survey, some mothers believed that there was no difference between breast milk and formula milk. Colostrum feeding, pre-lacteal feeding, early initiation of breastfeeding, and exclusive breastfeeding were strongly associated with family type, family member, birth order, religion, husbands' occupation, delivery attendants and delivery type, postnatal care, and health care facilities. To reduce the barriers to the successful practice of exclusive breastfeeding, there is a need for a grass-roots approach to educating and counseling nursing mothers with identifying factors influencing or discouraging the optimal practice.

Keywords: exclusive, breast feeding, practices, Bangladesh

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Authors: Jung Yoon Kim

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Introduction: Wounds inevitably cause patients to experience discomfort, distress, and consequentially reduced quality of life due to entailed pain, maceration, and foul odor. The dressing has been a universal wound care method in which wounds are covered and protected, and an optimum environment for healing is provided. This study aimed to investigate Korean nurses’ level of awareness of pain and skin tearing in wound beds and/or peri-wound skin at dressing change. Methods: A descriptive study was performed. Convenience sampling was employed, and registered nurses were recruited from attendees of continuing education program. A total of 399 participants (RN) completed the questionnaire. Data were collected from September to November 2022. Results: Many of them perceived skin tearing and wound-related pain associated with dressing changes, but most of them did not assess and record pain and skin tearing at dressing change. More than half of the respondents reported that they did not provide nursing intervention to prevent pain and skin tearing. Many of them reported that a systematic educational program for preventing pain and skin tearing at dressing changes was needed. Discussion: Many of the respondents were aware of pain and skin tearing at dressing change but did not take any further necessary measures, including nursing intervention, for the most appropriate, systematic pain and skin tearing management. Therefore, this study suggested that a systematic and comprehensive educational program for Korean healthcare professionals needs to be developed and implemented in Korea’s hospital settings.

Keywords: skin tearing, pain, dressing change, nurses

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