Psychosocial Predictors of Ventilator weaning Outcomes among patients in intensive care units.

Background: Ventilator weaning is a process of discontinuing mechanical ventilation and transitioning patients to independent breathing after a period of mechanical support. Weaning outcomes among the critically ill in intensive care units (ICUs) vary significantly among individuals, leading to considerable variation in healthcare costs, length of hospital stay, morbidity and mortality. Addressing psychosocial aspects of care can improve weaning outcomes. Objective: This study aimed to determine the effect of psychosocial factors (social support, family/significant other support, ability to communicate) on weaning outcome within intensive care patients. This research hypothesized that psychological and social factors play a role in determining ventilator weaning outcomes among ICU patients. Methods: This study used a longitudinal, retrospective research design to analyze positive and negative psychosocial predictors of ventilator weaning outcomes. Data collection methods include interviews and questionnaires with patients and their families, as well as clinical data from the patient's medical records. Results: presence of anxiety, depression, and hallucinations, have a negative relationship with weaning outcomes regarding a patient's psychological characteristics (rs = -0.207, -0.163, -0.158), while communication with a patient during mechanical ventilation have a positive relationship with weaning outcomes regarding a patient's psychological characteristics (rs = 0.152; p ≤ 0.05). Moreover patients who have fear during weaning trials, feeling neglected, and feeling insecurity have a negative relationship with weaning outcomes while gaining family support during mechanical ventilation have a positive relationship with weaning outcomes (rs = 0.144; p ≤ 0.05).Significance of results, the findings suggests that psychosocial factors, such as anxiety, depression, patient's perception of their illness, motivation to wean, and family involvement can influence the success of ventilator weaning among patients in ICUs.

Nurses' knowledge, attitudes and practices towards palliative care provided to patients diagnosed with cancer.

AIM AND OBJECTIVES: This study aimed to explore the levels of knowledge, attitudes, and practices toward palliative care (PC) among nurses working with patients diagnosed with cancer in Jordan. BACKGROUND: PC is a growing specialty in healthcare and nursing in Jordan with an increased need to expand its scope, develop policies to govern it, and increase the awareness of its importance especially for patients diagnosed with cancer. DESIGN: Cross sectional design was used in the current study. METHODS: Using an online self-report questionnaire data was collected from 228 nurses working at four hospitals in Amman. The four hospitals were from three different healthcare sectors: one public, one educational, and two private hospitals. A convenience sampling method was employed. RESULTS: Results showed a low level of PC knowledge (M = 8.8), a moderate level of attitudes (M = 80.9) toward dying patients, and a moderate level of PC practices (M = 52.7). Differences in PC knowledge, attitudes, and practices were found in regard to nurses' gender, level of education, PC training, years of experience, and working sector. Significant correlations were found between PC practices with both PC knowledge and attitudes toward dying patients. No significant relationship between PC knowledge and attitudes toward dying patients. CONCLUSION: Low level of PC knowledge and moderate level of attitudes toward dying patients. Differences in PC knowledge, attitudes, and practices were found in regard to some participants' demographics.

Oral Candidiasis of Tobacco Smokers: A Literature Review.

The mouth is a vital point of entry into the human body, the health of the mouth entails mental, physical as well as social well-being. Studying diseases, microbiota and environmental conditions of the mouth is important to maintain oral health and all body. The smoke of tobacco cigarettes is one of the worst habits that affect the health of the mouth and the body. Therefore, this review has been conducted to study the effect of smoking on the balance of the oral microbiota and the opportunistic organisms, one of the most important of them <i>Candida</i>. Although a few studies have found that cigarette smoking does not influence carriage by <i>Candida</i> significantly. However, most of the studies had results completely contrary to that, smoking cigarettes affect <i>Candida</i> pathogenic characteristics such as a transition from yeast to hyphal form, biofilm formation and, virulence-related gene expressions. Tobacco is not only an inducer of the transition process but it considers an excellent medium for this process. Furthermore, smoking was significantly associated with <i>Candida</i> pathogenicity in patients with clinically suspected oral leukoplakia and smoking worsens oral candidiasis and dampens epithelial cell defense response. Nicotine significantly altered the composition and proportion of yeast cells, as well as the extracellular polysaccharide amounts which increase biofilm matrix and thickness which could promote oral candidiasis. Smoking has the potential to alter the oral condition and cause severe oxidative stress, thereby damaging the epithelial barrier of the mouth. These oxidative molecules during smoking activate epithelial cells proteins called oxidative stress-sensing proteins. If some of these proteins induced, widely thought to have anti-inflammatory properties, inhibit the secretion of pro-inflammatory cytokines and are linked to inflammation and oxidative stress is thought to be a possible therapeutic objective and a crucial regulator for smoking-related oral diseases and mouth candidiasis for instance leukoplakia. Also, it is transported into the cell nucleus in the existence of additional electrophilic chemicals to activate antioxidant enzyme gene expression. Therefore, smoking cigarettes destroys oral health and consequently destroys the health of the whole body.

Saudi Nursing Students' Knowledge and Perception of Testicular Cancer Assessment and Management: A Cross-Sectional Study.

INTRODUCTION: Testicular cancer (TC) incidence is increasing worldwide. This study aimed to investigate Saudi nursing students' knowledge and perception about TC. METHOD: This cross-sectional study was done using convenience sampling method. In this study, 280 nursing students from different nursing schools in six cities of Saudi Arabia were recruited. A structured self-report questionnaire was used to collect data. RESULT: About 49.2% of the participants received education about TC in their nursing schools. The findings showed lack of enough knowledge about TC among Saudi nursing students. Mostly, the participants reported that heredity factor and having family history of TC (48.9%) and age between 56 and 70 years (41.8%) were the most common risk factors of TC. According to the participants, physical examination was the most common diagnostic test usually used for early detection of TC (40.4%) and biopsy test was the most accurate test to confirm TC diagnosis (45.4%). Only one third of the participants (34.6%) knew that between 75% and 100% of TC cases can be cured in case of early detection. About half of the participants (51.8%) reported that surgical procedure was the most common treatment for TC. The nursing students who had high GPA (r=0.86, p<0.001), were unwilling to get more information on TC (r=0.24, p=0.04), had family history of TC (r= 0.53, p=0.02), medical problems with testicles (r= 0.69, p=0.01), received education about TC in their school of nursing (r=0.65, p=0.02), and were more self-confident in assessing and managing TC (r=0.38, p=0.03) had higher level knowledge about TC.  Conclusion: Despite the importance of nurses' roles in assessing and managing TC, nursing students in Saudi Arabia still did not have enough knowledge about TC. Improving nursing programs' curricula and conducting health education programs are recommended.

The Knowledge of Palliative Care among Geriatric Home Staff in Jordan.

Background: Palliative care in nursing homes (NHS) is a major challenge, because it gives the demands of the knowledge and skills of nursing staff to provide high-quality care. Purpose: The purpose of this study was to assess the knowledge of palliative care among nursing home staff. Methods: A descriptive study design was used, 124 nurses, aged over 30 years and most of them were male working in the nursing home in Jordan. Around 109 participants were responded to the questionnaire. All licensed nurses were included in the study, except of that will be excluded. The knowledge of palliative care was measured via the palliative care survey. knowledge scores were ranged 0-1, with higher scores indicate greater knowledge. Results: Descriptive statistics was used. The Knowledge of palliative care issues is 0.21 in Jordan (95% confidence interval (CI) 0.19-0.24). Knowledge of physical aspects that can contribute to pain is 0.22 (95% CI 0.2-0.25), and knowledge of psychological aspects that can contribute to pain is 0.21 (95% CI 0.2-0.22). Conclusion: Education for nursing staff needs to be enhanced to address the specific knowledge gaps. Additional studies with large sample size recommended to explore the effect of educational programs in regard of palliative care in nursing homes.

Hand hygiene practices among Jordanian nurses in Amman.

Background: Hand hygiene is a simple and effective practice that helps to reduce the spread of hospital-acquired infections. However, health care professionals' adherence to hand hygiene guidelines is low. The purpose of this study is to evaluate hand hygiene practices among Jordanian nurses working in hospitals. Methodology: The standardized version of the World Health Organization (WHO) questionnaire was given to Jordanian nurses from two hospitals in Amman. Result: The response rate was 76 percent, with 173 nurses contacted to enroll 226 participants. According to the study, 65.5 percent (113) of the participants have a good practice hand hygiene, while 11 percent (19) practiced poor hand hygiene. The percentage of female participants who practiced good hand hygiene was found to be significantly higher (70 percent) than the percentage of male participants (30 percent). Conclusion: To improve compliance with hand hygiene practices, male nurses and nurses working in the department of internal medicine and pediatrics need in-service educational intervention. Posters and other visual aids emphasizing the importance of hand hygiene should be displayed in all departments to raise awareness of the importance of hand hygiene among nurses.

Prostate Cancer-based Interventions' Efficacy on Knowledge and Adherence Intention to Healthy Lifestyle among Men.

BACKGROUND: Previous Literature has supported educational program efficacy, but no studies have been found to examine Prostate Cancer-based interventions' Efficacy on knowledge and adherence intention to a healthy lifestyle among Men in Jordan. PURPOSE: The purpose of the current study was to assess Prostate Cancer-based interventions' efficacy on knowledge and adherence intention to a healthy lifestyle among Men in Jordan. METHODS: A quasi-experimental research with one group pretest-posttest design was used and the study was conducted in Masjids (praying place), Amman, Jordan. The population consists of Jordanian Men aged 40 years and above. The sample size was 76 men, who fulfilled the inclusion criteria. The tool used for data collection was a structured questionnaire. RESULTS: Paired sample t-test showed that the change in the mean knowledge scores (9.5), p < .001 was statistically significant 1 month after the application of the program. In addition, the change in the mean adherence to healthy lifestyle scores (4.7), p < .05 was statistically significant 1 month after the application of the structured teaching program. CONCLUSION: Jordanian men had gained knowledge and Adherence Intention to Healthy Lifestyle regarding prostate cancer after the implementation of a structured teaching program. IMPLICATIONS FOR PRACTICE: Educational program aimed at motivating men to increase their knowledge of prostate cancer and having adherence intention to a healthy lifestyle.
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The Effect of Prostate Cancer Educational Program on the level of Knowledge and Intention to Screen among Jordanian Men in Amman.

PURPOSE: The purpose of this study was to examine the effect of prostate cancer educational program on the level of knowledge and intention to screen for prostate cancer among Jordanian men in Amman. METHODS: A quasi-experimental, with nonequivalent control group design was used. 154 participants were randomly assigned to the intervention and control groups.  Level of Knowledge and intention to screen were measured at baseline and at 1 month after the application of the prostate cancer educational program. Independent sample t-test was used to analyze the data. RESULTS: The results showed statistically significant change in the mean knowledge scores (8.7), p < 0.001 and the mean of intention to screen scores (3.71), p < 0.001, after 1 month from the application of the educational program in the experimental group compared to the control group. CONCLUSION: Implementing prostate cancer educational programs help enhance knowledge and intention to screen among Jordanian men.

Enhancing Knowledge, Beliefs, and Intention to Screen for Prostate Cancer via Different Health Educational Interventions: a Literature Review.

BACKGROUND: Prostate cancer is one of the most common cancers affecting men globally, constituting the sixth leading cause of cancer related death in males, and the eleventh leading cause of death from cancer in all age groups. In Jordan, prostate cancer is the third most common cancer in the male population, accounting for one third (6.2%) of cancer related deaths and in 2010 alone, 218 (9.4%) new cases were identified. OBJECTIVE: To assess the effectiveness of different health education interventions aimed at enhancing knowledge, beliefs and intention to screen for prostate cancer. MATERIALS AND METHODS: A literature search from January 2000 to April 2015 was conducted using the key words "prostate disease," "educational program," "knowledge," "prostate cancer," "demographic factors and prostate cancer," "knowledge and prostate cancer," "education for patients with prostate cancer," "factors that affect intention to screen," "knowledge, beliefs, and intention to screen for prostate cancer," "impact of prostate educational program on beliefs," and "impact of educational program on intention to screen." RESULTS: Majority of studies reviewed indicated that men had low levels of knowledge regarding prostate cancer, and mild to moderate beliefs with good intention to screen for prostate cancer. CONCLUSIONS: Most studies indicated that men's knowledge levels about prostate cancer were poor and they had mild to moderate beliefs and intentions to screen for prostate cancer. Therefore, development of an assessment strategy based on the Health Belief Model seems essential. An effectively designed and implemented educational program can help identify the needs and priorities of the target population.

Calcium-sensing receptor 20 years later.

The calcium-sensing receptor (CaSR) has played an important role as a target in the treatment of a variety of disease states over the past 20 plus years. In this review, we give an overview of the receptor at the cellular level and then provide details as to how this receptor has been targeted to modulate cellular ion transport mechanisms. As a member of the G protein-coupled receptor (GPCR) family, it has a high degree of homology with a variety of other members in this class, which could explain why this receptor has been identified in so many different tissues throughout the body. This diversity of locations sets it apart from other members of the family and may explain how the receptor interacts with so many different organ systems in the body to modulate the physiology and pathophysiology. The receptor is unique in that it has two large exofacial lobes that sit in the extracellular environment and sense changes in a wide variety of environmental cues including salinity, pH, amino acid concentration, and polyamines to name just a few. It is for this reason that there has been a great deal of research associated with normal receptor physiology over the past 20 years. With the ongoing research, in more recent years a focus on the pathophysiology has emerged and the effects of receptor mutations on cellular and organ physiology have been identified. We hope that this review will enhance and update the knowledge about the importance of this receptor and stimulate future potential investigations focused around this receptor in cellular, organ, and systemic physiology and pathophysiology.

Effect of NSAIDs on Na⁺/H⁺ exchanger activity in rat colonic crypts.

Nonsteroidal anti-inflammatory drugs (NSAIDs; 1) are widely recommended for several acute and chronic conditions. For example, both indomethacin and aspirin are taken for pain relief. Aspirin is also used for prevention of myocardial infarction, and indomethacin can be administered orally or as a suppository for patients with rheumatoid disease and other chronic inflammatory states. However, use of NSAIDs can cause damage to the mucosal barrier surrounding the gastrointestinal (GI) tract, increasing the risk of ulcer formation. While microencapsulation of NSAIDs has been shown to reduce upper GI injury, sustained release in the lower GI tract and colon may cause epithelial erosion due to increased acidification. The use of suppositories has also been linked to rectal and lower GI bleeding. In this study, we investigated the role of NSAIDs aspirin and indomethacin on Na⁺/H⁺ exchanger (NHE) activity in rat colonic crypts. By comparing average rates of pH recovery between control and NSAID perfusion runs, we were able to determine that both aspirin and indomethacin increase hydrogen extrusion into the colonic lumen. Through treatment with 5-ethylisopropyl amiloride (EIPA), amiloride, and zoniporide dihydrochloride, we further demonstrated that indomethacin specifically enhances proton excretion through regulation of apical NHE-3 and NHE-2 and to a lesser extent on basolateral NHE-1 and NHE-4. Our results suggest that clinical exposure to NSAIDs may affect colonic tissue at the site of selected NHE isoforms, resulting in modulation of transport and barrier function.