Assessing pressure injury knowledge among Jordanian and Turkish nursing students: A cross-cultural comparison.

AIM: Pressure injuries, a prevalent issue in healthcare settings, have profound physical and emotional implications for patients and healthcare providers. However, further evidence is needed regarding the level of nursing students' knowledge of pressure injuries in the Middle East, a region where healthcare is rapidly evolving. This study examines the knowledge levels regarding pressure injuries among nursing students in Jordan and Turkey. MATERIALS AND METHODS: This cross-sectional study collected data from a randomly selected sample of 282 nursing students studying in two private and two Public Universities in Turkey and Jordan. Data was collected using a demographic survey and the Pressure Ulcer Knowledge Assessment Tool (PUKAT 2.0). RESULTS: The overall knowledge scores among students were alarmingly low, with significant differences between Jordanian and Turkish cohorts, with Turkish students scoring higher. Moreover, a significant difference was observed between students' knowledge levels from public and private universities in Jordan, but no difference was found between students of the two Turkish universities. CONCLUSION: The knowledge gap among nursing students regarding pressure ulcers is a critical issue that needs immediate attention. These findings highlight the urgent need for improved educational strategies and standardized competencies in this aspect. This study strongly advocates for changing teaching strategies and incorporating evidence-based pressure injury prevention education into nursing curricula, interprofessional education initiatives, and continuous professional development for faculty. These measures can significantly enhance nursing students' knowledge and improve patient care.

AWARENESS AND PRACTICES TOWARDS PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV AMONG MARRIED MEN ATTENDING THE ANTIRETROVIRAL CLINIC IN AMINU KANO TEACHING HOSPITAL, KANO, NIGERIA.

Background: The prevention of mother-to-child transmission (PMTCT) of HIV programme was introduced as a comprehensive package of interventions with the aim of reducing mother-to-child transmission (MTCT) of HIV. The programme offers an opportunity to capture pregnant women and their partners in order to prevent the transmission of HIV to the baby. This study is aimed at assessing the awareness and practices of married HIV-positive male partners towards PMTCT. Methodology: A descriptive cross-sectional study that interviewed 220 HIV-positive male partners using an interviewer-administered questionnaire. Results: The study revealed that more of the respondents 145 (65.9%) were between the age group of 31 to 40 years. More than half 130 (59%) of the respondents were aware of PMTCT while 135 (61.4%) of the respondents had good practice of PMTCT. Respondents with formal education were 1.5 times more likely to be aware of the PMTCT programme than those having informal education [p=0.03, AOR=1.53, 95%CI=(1.98-4.54)]. Similarly, respondents with formal education were 2.5 times more likely to practice PMTCT programme than those having informal education [p=0.03, AOR=2.53, 95%CI= (1.63-4.54)].In addition, Male partners who were above 30 years of age were 3 times more likely to participate in PMTCT activities compared to those who were less than 30 years [p=0.02, AOR=2.17, 95%CI=(0.01-4.12)]. Conclusion: Raising awareness about the need for male partners' involvement in the PMTCT programme as well as encouraging male partners to partake in PMTCT activities will further increase its uptake.

Postoperative cognitive recovery and prevention of postoperative cognitive complications in the elderly patient.

Elderly patients undergoing surgery are at higher risk of life-altering and costly complications. This challenge is increasingly recognized with the growing geriatric surgical population. Advanced age and comorbid conditions, such as disability and frailty that often develop with age, are all independent risk factors of postoperative morbidity and mortality. A common factor in this age group is cognitive impairment, which poses a challenge for the patient and clinician in the perioperative setting. It affects the capacity for informed consent and limits optimization before surgery; furthermore, an existing impairment may progress in severity during the perioperative period, and new onset of signs of delirium or postoperative cognitive dysfunction may arise during postoperative recovery. In this article, we aim to review the current literature examining the latest definitions, diagnostic criteria, and preventive strategies that may ameliorate postoperative cognitive complications.

The elderly in the post-anesthesia care unit.

It is increasingly conceivable that elderly patients will be treated in perioperative settings as the world's population shifts toward an older age distribution. They are more prone to a variety of unfavorable outcomes as a consequence of the physiological changes that accompany aging and the coexistence of multiple medical conditions. Postoperative complications in elderly patients are linked to a large increase in morbidity and mortality and the burden placed on the healthcare system. Our goal is to determine how elderly patients' recovery after anesthesia differs from that of younger patients. In addition, we will discuss the main postoperative complications experienced by elderly patients and the measures that are utilized to limit the risk of these complications developing.

Generalized Concept and MATLAB Code for Modeling and Analyzing Wideband 90° Stub-Loaded Phase Shifters with Simulation and Experimental Verifications.

In the design of phase shifters, the modeling equations are too complicated and require some approximations to be derived correctly by hand. In response to this problem, this paper presents a generalized concept, algorithm, and MATLAB code that provide the exact modeling equations of the transmission parameters and the scattering parameters of any 90° wideband stub-loaded phase shifter. The proposed code gives the modeling equations in term of variables for any number of stubs and characteristic impedance value by utilizing the symbol-based analysis of the MATLAB code. It also illustrates the results as a function of normalized frequency relative to the center frequency fo, and can be and can be tailored to any user-defined frequency range. As a matter of comparison, a three-stub wideband 90° stub-loaded phase shifter is simulated using CST Microwave Studio and experimentally fabricated on Rogers RT5880 dielectric substrate with dimensions of 30 × 40 × 0.8 mm3. The comparison reveals the accuracy of the proposed computerized modeling with -10 dB impedance bandwidth equal to 90% (0.55fo-1.45fo), (90°∓5°) phase difference bandwidth equal to 100% (0.5fo-1.5fo), and negligible insertion loss. The novelty of this work is that the proposed code provides the exact modeling equations of the stub-loaded phase shifter for any number of stubs regardless the complexity of the mathematical derivations.

Repositioning Practice of Bedridden Patients: An Evolutionary Concept Analysis.

Introduction: Repositioning practice is an essential pressure ulcer prevention intervention that has emerged in the history of nursing. Numerous terms are employed to indicate its meaning, such as turning, positioning, or posturing. However, there is no available analysis that distinguishes these terms or analyzes repositioning practice attributes. Objective: To analyze repositioning practice as a concept of bedridden patients in hospitals by combining methods from Foucault's archeology of knowledge and Rodger's concept analysis. Concept Description: Repositioning practice passes through three eras: classical, modern, and research. The repositioning practice is "turn a bedridden patient in a harmonized way and ends with anchor and documentation." The analysis concludes seven attributes for the repositioning practice: pre-turn, assessment, turn, harmonization, anchor, documentation, and time. The analysis assumes bedridden patients, and assigned nurses on duty are the antecedents. Moreover, the main consequence is pressure ulcer prevention, while patient safety and quality of care are the secondary consequences. Discussion: Repositioning practice understanding has grown with time. Each era has added to or removed from nursing's understanding for repositioning practice until it appears as it now. The current analysis expects further development in repositioning practice understanding and applications. Conclusion: Repositioning practice is an important nursing intervention and has shown a dynamic movement over history. It is expected that this dynamic will continue in the future.

Novel Permanent Magnetic Surface Work Hardening Process for 60/40 Brass.

Surface work hardening is a process of deforming a material surface using a thin layer. It hardens and strengthens the surface while keeping the core relatively soft and ductile to absorb stresses. This study introduces a permanent magnate surface work hardening under two opposite permanent poles of a magnet to investigate its influence on a brass surface. The gap between the brass and the north magnet pole-fixed in the spindle of a vertical machine-was filled with martensitic stainless steel balls. The rotational speed and feed rates were 500-1250 rpm and 6-14 mm min-1, respectively. The novel method improved the surface hardness for all parameters by up to 112%, in favor of high speed, and also increased yield by approximately 10% compared to ground samples. Surface roughness showed higher values for all speed-feed rate combinations compared to the ground sample. Nevertheless, it showed better roughness than other treated conditions with high and low feed rates. The ultimate tensile strength and ductility remained unchanged for all conditions other than the untreated brass. A factorial design and nonlinear regression analysis were performed to predict the microhardness equation and effectiveness of the independent variable-speed and feed rate-for the proposed process.

Nursing Development in Indonesia: Colonialism, After Independence and Nursing act.

INTRODUCTION: Stereotyping of nurses still occurs nowadays in Indonesia. Society and healthcare think nursing is a doctor helper service. The public image of a nurse as a doctor's helper is hard to erase. Thus, the nursing development in Indonesia needs to be explored in describing the stereotyping and the nursing conditions in the current situation. METHODS: The study used a narrative review with 45 sources analyzed and extracted. RESULTS: Nursing education has been developed since colonialism. The first time the Netherland Indies built the hospital and they used Babu or a helper as a nurse. The result showed it had a negative impact, which showed as they started to train nurses. They trained male nurses to be Mantri nurses as hulpgeneesheeren (ancillary doctors). After independence, the project HOPE influenced the development of nursing in Indonesia. Indonesian nurses focused on technical aspects and added the nursing process to the education curricula in 1986. However, nurses' practice culture did not change for a long time because of a lack of research and literature being evaluated during 1990-2010. Indonesia nursing started to increase the education, practice, and research afterward, with specifically the declaration of the Indonesian Nursing Act. It brought nurses into the professionalism of healthcare which the Indonesian government recognized. Then, nurses have faced new problems, including practice and education gaps. CONCLUSION: The development of nurses will increase autonomy and dignity. Increasing education curricula, practice competency, and research impact will change the perspective of society with the support of recognition and education from the nursing organization. In addition, the nursing organization has an essential role in nursing development in each country.

Surface Evaluation of a Multi-Pass Flexible Magnetic Burnishing Brush for Rough and Soft Ground 60/40 Brass.

Burnishing is an advanced finishing process that produces higher-quality surfaces with better hardness and roughness than conventional finishing processes. Herein, a flexible magnetic burnishing brush comprising stainless steel pins under permanent magnet poles was used to investigate the influence of multiple passes and directions on the produced surface of soft and rough ground prepared brass. In total, five different samples were burnished on each of the two brass samples prepared. Four samples were processed in the same direction for up to four passes and the fifth sample was processed with two passes in the opposite direction. Results indicate that there was approximately a 30% increase in hardness and an 83% increase in microroughness for rougher-surface brass samples. For smoothly prepared surfaces, there was approximately a 14% increase in hardness and a 35% increase in microroughness. In the same direction of multi-pass burnishing, increasing the number of passes negatively affected surface roughness; for rougher surfaces, the surface hardness reduced and process uniformity increased owing to surface over-hardening and flaking mechanisms, and for smoother surfaces, the hardness, roughness, and process non-uniformity increased with the number of passes owing to repeated surface deformation at some locations and high flaking at other locations. Compared to single-pass burnishing, wherein the surface roughness and microhardness showed almost no change with high process uniformity, in burnishing with two opposite-direction passes, the produced surface exhibited better surface roughness, process uniformity, and microhardness improvements owing to a reverse strain mechanism. Hence, opposite burnishing passes are recommended.

The role of kaolin and kaolin/ZnO nanoadsorbents in adsorption studies for tannery wastewater treatment.

In the present study, comparative studies of kaolin and kaolin/ZnO nanocomposites for the adsorption of Cr(VI), Fe(III), COD, BOD, and chloride from tannery wastewater were investigated. ZnO nanoparticles and kaolin/ZnO nanocomposites were prepared by sol-gel followed by wet-impregnation methods. The prepared adsorbents were characterized using different analytical tools such as X-ray diffraction, Fourier transforms infrared, high-resolution transmission electron microscopy, energy dispersive spectroscopy, selective area electron diffraction and Brunauer Emmett-Teller (BET) and X-ray Photoelectron Spectroscopy (XPS). The HRSEM/EDS/XPS analysis confirmed successful immobilization of clay structural network on the lattice layers of zincite hexagonal structure of ZnO nanoparticles. BET measurement showed an increase in the surface area of kaolin/ZnO nanocomposites (31.8 m2/g) when compared to kaolin (17 m2/g). Batch adsorption studies were carried out by varying the parameters such as contact time, adsorbent dosage and temperature. The maximum removal of Cr(VI) (100%), Fe(III) (98%), COD (95%), BOD (94%) and Chloride (78%) was obtained at 15 min by kaolin/ZnO composites. While 78% Cr(VI), 91% Fe(III), 91% COD, 89% BOD and 73% Chloride were removed by kaolin under the same conditions. The kaolin/ZnO nanocomposites exhibited better adsorption performance than kaolin due to higher surface area of the former than the latter. It was found that the Jovanovic isotherm model fitted the adsorption experimental data most with the highest correlation (R2 > 0.99) for both nanoadsorbents and indicate the occurrence of adsorption on monolayer and heterogeneous surfaces. The mechanism for the adsorption of metal ions in tannery wastewater onto the nano-adsorbents was examined using Weber Morris intra-particle diffusion model and Boyd plot which showed that the adsorption process was both intra-particle and film diffusion controlled. The thermodynamic parameters such as enthalpy change showed that that adsorption of metal ions and other parameters was feasible, spontaneous and endothermic. The ZnO/clay nanocomposites exhibited excellent recyclable and re-useable properties even after six repeated applications and can, therefore, be applied in wastewater treatment for removal of heavy metals and other physicochemical parameters.

The incidence and predictors of pneumothorax among trauma patients in Saudi Arabia. Findings from a level-I trauma center.

OBJECTIVES: To investigate the incidence and predictors of traumatic pneumothorax using data from a Level-I trauma center in Riyadh, Saudi Arabia. METHODS: This is a retrospective chart-review study carried out in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Data were extracted from the hospital's trauma registry (2016-2018). A total of 2,109 trauma patients were included. Inclusion criteria were patients ≥16 years  old admitted for a traumatic injury. Variables included patient demographics, transport mode, trauma team activation, mechanism of injury, mortality rate, Glasgow Coma Scale and Injury Severity Scores. A logistic regression analysis was constructed to evaluate potential predictors of pneumothorax. Results: Of 2,109 patients included from the trauma registry, 236 (11.2%) were diagnosed with pneumothorax. The majority of the study population was young (19-49 years) (60.7%) and male (79.4%.) Injury mechanism was significantly associated with the presence of pneumothorax (p greater than 0.001). Regression analysis indicated that the odds of having pneumothorax among intentional injury victims was 15 times higher than fall injury victims (OR=15.3, 95% CI= 7.2-32.9). Participants who sustained motor vehicle collision injuries had 3 times higher odds of developing pneumothorax than those who suffered fall injuries (OR=3.1, 95% CI= 1.5-6.1). Conclusion: The incidence of traumatic pneumothorax is sizable and highly associated with the mechanism of injury. Efforts to reduce motor vehicle collision burden should be directly associated with decreasing the burden of traumatic pneumothorax.

The challenges of working in underserved areas: a qualitative exploratory study of views of policy makers and professionals.

BACKGROUND: The inadequate number of health care providers, particularly nurses, in underserved areas is one of the biggest challenges for health policymakers. There is a scarcity of research in Jordan about factors that affect nurse staffing and retention in underserved areas. PURPOSE: To elucidate the views of staff nurses working in underserved areas, directors of health facilities in underserved areas and key informants from the policy and education arena on issues of staffing and retention of nurses in underserved areas. METHODS: An exploratory study using a qualitative approach with semi-structured interviews was utilized to elucidate the views of 22 key informants from the policy and education arena, 11 directors of health centers, and 19 staff nurses on issues that contribute to low staffing and retention of nurses in underserved areas. The five stage 'framework approach' proposed by Bryman et al. (1993) was utilized for data analysis. RESULTS: Nursing shortage in underserved areas in Jordan are exacerbated by a lack of financial incentives, poor transportation and remoteness of these areas, bad working conditions, and lack of health education institutions in these areas, as well as by opportunities for internal and external migration. Young Jordanian male nurses usually grab any opportunity to migrate and work outside the country to improve their financial conditions; whereas, female nurses are more restricted and not encouraged to travel abroad to work. Several strategies are suggested to enhance retention in these areas, such as promoting financial incentives for staff to work there, enhancing the transportation system, and promoting continuous and academic education. CONCLUSION: Nurses' administrators and health care policy makers could utilize the findings of the present study to design and implement comprehensive interventions to enhance retention of staff in underserved areas.

Prevalence and predictors of diabetic foot syndrome in type 2 diabetes mellitus in Jordan.

OBJECTIVE: To detect feet changes and to identify risk factors leading to amputation among type 2 diabetics. METHODS: A total of 1142 patients with type 2 diabetes mellitus; 595 males (52%), and 547 females (48%) were seen between January and December 2001 at the National Center for Diabetes, Endocrinology, and Genetics (NCDG) Amman, Jordan. The mean age was 56.1 years (SD=10.2) and the mean duration of diabetes was 9 years (SD=7.1). All patients had a complete medical assessment including history, physical examination, glycosylated hemoglobin (HbA1c) (the mean of the last 4 readings) and microalbuminuria. Statistical analysis were performed to identify significant risk factors leading to amputation using Epi info, version 6 software. RESULTS: Mean HbA1c was 7.4% (SD=1.4). The prevalence of hypertension was 52%, retinopathy 45% and microalbuminuria 33%. Impaired vibration, position and protective sense were found in 19%, 13%, and 18%. The prevalence of all amputations was 5%. The following were strong predictors of amputation; duration of diabetes (P= 0.04), smoking (P=0.01), microalbuminuria (P=0.02), retinopathy (P=0.008), legs hair loss (P=0.003), neurological deficit (P=0.0001), ulceration (P=0.00001) absent dorsalis pedis (P=0.0006) and insulin therapy (P=0.0001). The rate of amputation was directly proportional to high HbA1c >= 8% (P=0.01). Age and gender were not found to have an impact on prevalence of amputation. CONCLUSION: Prevalence of amputation correlates with duration of diabetes, poor glycemic control, smoking, neurological impairment, peripheral vascular disease and microalbuminuria.