High Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Effect of an Intervention Program on Parenting Styles, Self Efficacy and Adherence among Diabetic Adolescents in Farwanyia Governorate, Kuwait4084232061210.21608/jhiph.2010.20612ENSherine HassanDepartment of Health Administration and Behavioral Sciences (Division of Health Education and Behavioral Sciences), High institute of public Health, Alexandria university, Alexandria, EgyptHatem MassoudPediatric Specialist, Farwanyia hospital, KuwaitAyman El-KobroslyPediatric Specialist, Farwanyia hospital, KuwaitJournal Article20181206Diabetes is a source of stress for patients of all ages, but particularly during adolescence. The transition into adolescence is frequently marked by declines in adherence and metabolic control due to decreased parental responsibility for diabetes care. Many factors affect parents' ability to deliver diabetic care including: knowledge, parental self-efficacy and parental style. The aim of the study was to find the correlation of parenting style, parents' self-efficacy and adherence with glucose level among early adolescents with type I diabetes through an interview questionnaire and the impact of an intervention program on those determinants. Results showed that 40.5% of parents had authoritative style, 39.7% had authoritarian style and 19.8% had permissive style. There was a positive correlation of adherence and metabolic control with knowledge, self-efficacy and authoritative behaviors of parents. Following the intervention, there was improvement in knowledge, self-efficacy, authoritative behaviors and adherence and no significant effect on metabolic control.https://jhiphalexu.journals.ekb.eg/article_20612_5bc4cba7bf65294fd7df7a87970629e8.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Comparison of Physical Activity Patterns among Diabetic and Non Diabetic Adults in Saudi Arabia4244352061310.21608/jhiph.2010.20613ENNasser Al-HamdanDepartment of Community Medicine, King Saud bin Abdulaziz University for Health Sciences, Faculty of Medicine, King Fahad Medical City, Saudi ArabiaAhmed BahnassyDepartment of Community Medicine, King Saud bin Abdulaziz University for Health Sciences, Faculty of Medicine, King Fahad Medical City, Saudi ArabiaAbdalla SaeedDepartment of Community Medicine, King Saud bin Abdulaziz University for Health Sciences, Faculty of Medicine, King Fahad Medical City, Saudi ArabiaMostafa AbbasFaculty of Medicine, Suez Canal University, Ismailia, EgyptLamiaa AbuzaidFaculty of Medicine, Suez Canal University, Ismailia, EgyptAbdelshakour AbdallaDepartment of Community Medicine, King Saud bin Abdulaziz University for Health Sciences, Faculty of Medicine, King Fahad Medical City, Saudi ArabiaJournal Article20181206<strong>Background and Objectives</strong>: Quantifying the magnitude and risk factors of Diabetes Mellitus in the community is essential for all intervention strategies. The objective of this study is to assess physical activity as a risk factor of diabetes mellitus by comparing physical activity patterns of diabetics and non diabetics.<strong> Methods:</strong> A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample. Data was collected using a questionnaire which included patterns and durations of physical activity, sociodemographics, and history of diabetes, biochemical and anthropometric measurements. <strong>Results:</strong> Of the total 4657 subjects, 712(15.3%) were diabetic (369(16%) for males and 343(14.6%) for females). Of all subjects only 12.1, 20.2 and 46.1% were physically active in recreational, work and transport respectively. Diabetes was significantly negatively associated with total level of physical activity. All lower levels of physical activity in leisure, transport and work were significantly associated with increased risk of diabetes .Physical activity at work and walking or cycling for 10 minutes continuously were significant predictors of diabetes. <strong>Conclusions</strong>: Diabetes mellitus among adults in associated with lower levels of all patterns of physical activity. Specifically tailored and culturally sensitive physical activity interventions, is necessary for preventing, controlling diabetes. Females, elderly and retired persons need special attention.https://jhiphalexu.journals.ekb.eg/article_20613_5e034e23c8c48489be5fcd570d8f15f9.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Nursing and Medical Students Views Regarding the Nurses’ Role in Tanta University4364512061410.21608/jhiph.2010.20614ENSafaa ZahranNursing Service Administration; Faculty of Nursing, Tanta University, Tanta, EgyptNahed MorsyPsychiatric and mental health Nursing, Faculty of Nursing, Tanta University, Tanta, EgyptJournal Article20181206<strong>Background: </strong>The role of the nurses is one of the challenges facing nursing and medical students entering the clinical phase of their education. <strong>Objective:</strong> This study designed to assess and compare between the views of nursing and medical students about the nursing’ roles. <strong>Methods:</strong> This study used descriptive and comparative design. The study carried out at Nursing and Medicine Faculties in Tanta University. The subjects constituted of 100 nursing students and 100 medical students, both of them were undergraduates belonging Tanta University. Data were collected randomly from the last year program of both nursing and medical students. One tool was used to collect necessary data to measure nursing and medical student’s views about nurses’ role. <strong>Results:</strong> The result indicated that, the majority of nursing and medical students have negative view about nurses’ roles. <strong>Conclusion and Recommendations:</strong> The study recommended that, there is need to identify the nursing faculty program and joint objectives that can be measured and evaluated to minimize the gap between the views of nurses and medical staff. https://jhiphalexu.journals.ekb.eg/article_20614_e2fa81859706660dd64187f9875e8014.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Improvement of Blood Utilization at a Governmental General Hospital in the State of Kuwait4524742061510.21608/jhiph.2010.20615ENTalal Al FadhalahQuality and Accreditation Directorate, Ministry of Health, State of KuwaitMoustafa Nour El-DinDepartment of Health Administration and Behavioural Sciences (Hospital Administration Division), High Institute of Public Health, Alexandria University, Alexandria, EgyptRana Al AbdulrazzakDonations Department and Hospital Liaison Department, Central Blood Bank of Kuwait, State of KuwaitJournal Article20181206<strong>Background</strong>: Red blood cells (RBCs) transfusions have saved lives and expedited the recovery of illnesses to millions of patients. However, RBCs transfusions carry high risk of life threatening complications and economic burden. <strong>Objective:</strong> The present study aimed at assessing the appropriateness of RBCs transfusion at one Ministry of Health hospital in Kuwait and to assess the effect of multiple interventions for improving the appropriateness of RBCs utilization. <strong>Methods</strong>: The present study used one group pre-test post-test quasi experimental design. To assess the appropriateness of RBCs transfusions, 185 records were reviewed in each of pre and post intervention phases. Improvement interventions included involvement of hospital administrators and heads of departments, development of the hospital transfusion guidelines, improvement of participant physicians’ knowledge, and improvement of blood transfusion documentation. <strong>Results: </strong>The present study revealed 22.4% reduction in the total number of RBCs transfusions in the post intervention phase as compared to pre intervention phase. However, low rate of appropriateness of RBCs transfusion in pre intervention phase (40.4%) was encountered which was minimally improved to 46.5% following implementation of multiple improvement interventions. Physicians showed very low compliance with completion of the newly introduced blood transfusion request and consent forms. <strong>Conclusion: </strong>The appropriateness of red blood cells transfusions at the study hospital is low before and after implementation of the improvement interventions. Documentation of blood transfusion is deficient at the study hospital. It is recommended to strengthen the blood transfusion interventions used in the present study and to implement these interventions in Ministry of Health Hospitals in Kuwait to improve the appropriateness of RBCs transfusions.https://jhiphalexu.journals.ekb.eg/article_20615_0e4452f3d994451ff251be2932b26dd3.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Nurses’ Compliance with Evidence-based Guidelines for Preventing Ventilator-Associated Pneumonia in Critical Care Units4754962061610.21608/jhiph.2010.20616ENMohannad AlhirishNursing Supervisor, Ministry of Health, Syrian Arab RepublicHayam AsfourDepartment of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria EgyptAzza El-SoussiDepartment of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria EgyptJournal Article20181206<strong>Background: </strong>Critically ill patients in critical care units (CCUs) are at high risk for infections associated with increased morbidity, mortality, and health care costs. The overall infection rate in critically ill patients approaches 40% and may be as high as 50% or 60% in patients who remain in the CCU for more than 5 days. Ventilator-associated pneumonia (VAP) in mechanically ventilated patients ranges from 8% to 28%. VAP refers to an infection that develops during mechanical ventilation after 48 hours of intubation. Nurses play a pivotal role in decreasing patients’ risk of acquiring VAP. Keeping pace, in this instance, is really about turning focus back to the more basic aspects of critical care nursing. Evidence now demonstrates how important basic nursing care is to the prevention of VAP by using strategies for the prevention of VAP. <strong>Objective:</strong> The aim of this study was to assess nurses’ compliance of evidence-based guidelines for preventing VAP in CCUs.<strong> Methods:</strong> The study was conducted at the CCUs of Alexandria Main University Hospital namely, Casualty Intensive Care Unit (unit I) and General Intensive Care Unit (unit III). The sample of this study consisted of 60 nurses working in the previously mentioned CCUs<strong>. </strong>Two tools were used for data collection VAP Preventive interventions Observation Checklist (VAPPIOC) and VAP knowledge questionnaire (VAPKQ). <strong>Results: </strong>Nurses had different levels of adherence for many non-pharmacologic strategies. All nurses responses to the questionnaire, rates and reasons for non adherence were addressed. <strong>Conclusion: </strong>The most important barriers to implementation were environment-related. Other reasons for non-adherence were patient-related barriers being significantly important for nurses. Overall, the most important barriers to adherence were unavailability of resources. Our findings suggest the need for development of guidelines to reduce variability and the need to include the nursing point of view in these guidelines.https://jhiphalexu.journals.ekb.eg/article_20616_46d10694e91d614ea33d30c3044aa344.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Compliance of General Surgeons with Safe Surgery in a General Navy Hospital, Alexandria, Egypt4975142061710.21608/jhiph.2010.20617ENNagwa Abou El EneinDepartment of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, EgyptAhmed FathiGeneral Surgeon, Egyptian Navy Medical ServicesJournal Article20181206<strong>Background</strong>: Surgical care is an integral part of health care throughout the world; and is gaining attention from the public health community worldwide.<strong> Objectives:</strong> This study was conducted to assess compliance and attitudes of the surgeons in the General Navy Hospital toward safe surgery. <strong>Methods</strong>: Fifty-five general surgical operations, performed in the 3 main operation rooms of the Anesthesia and Operations Department of study hospital were observed to assess the compliance of the operating 11 general surgeons to the WHO safe surgery checklist starting from 15 March 2010 and for three weeks. Five observations were done for each surgeon. WHO checklist divides the operation into three phases namely sign in, time out and sign out, each corresponding to a specific time period in the normal flow of a procedure. All safety practices and steps were weighted equally such that a team was given 1 point for compliance with a practice or process and 0 point for noncompliance and scores could range from 0% to 100%. In order to assess how the safe surgery checklist was perceived, the same 11 general surgeons were interviewed with a structured questionnaire. <strong>Results</strong>: The least aggregate surgeons' compliance was in completing the safety practices comprising 'time out' phase; 56.4% (31 times out of the 55 surgeries). The highest aggregate surgeons' compliance was in completing the safety practices comprising 'sign in' phase was 65.5% (36 times out of the 55 surgeries). While, the aggregate compliance score of the 'sign out' phase was 67.3% (37 times out of the 55 surgeries), and that the overall aggregate compliance score for completing the 19 safety practices comprising the safe surgery checklist was 52.7% (29 surgeries out of the 55 surgeries).Regarding surgeons' attitude to safety practices items, none of the items was rated to be definitely ‘of no importance. <strong>Conclusion and</strong> <strong>Recommendations</strong>: Hospitals should consider implementing operating room briefings as a strategy to improve operating room efficiency and clinical and economic outcomes in surgical patients. Surgeons must be committed to the common goals of patient safety to ensure safe surgery.<br /> <strong> </strong>https://jhiphalexu.journals.ekb.eg/article_20617_230d23b59fde8308d1b7f1771fbaa6a5.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Serum Levels of Angiopoietin-2 and C-Reactive Protein in Chronic Myeloid Leukaemia Patients: Relation to Different Phases of the Disease5155272061810.21608/jhiph.2010.20618ENAmel El NaggarHematology, Medical Research Institute; Alexandria University, Alexandria, EgyptGihane KhalilChemical Pathology Medical Research Institute; Alexandria University, Alexandria, EgyptHoda HamdyBiochemistry Department, Medical Research Institute, Alexandria University, Alexandria, EgyptJournal Article20181206Serum levels of Angiopoietin-2 (Ang-2) and C-reactive protein (CRP) were measured in 50 patients with chronic myeloid leukemia (CML) (30 patients in chronic phase (group A) and 20 patients in advanced phase (group B)) and 15 healthy age and sex matched subjects as a control group, to investigate their relation to different phases of the disease. Serum levels of both Ang-2 and CRP were significantly higher (<em>p</em><0.05) in patients group compared to controls, and in advanced stage compared to chronic phase. Furthermore a significant positive correlation was detected between Ang-2 and CRP in the whole patients group which could support the hypothesis that CRP might play a role in modulating angiogenesis. The present data suggest that both Ang-2 and CRP could play a role in the leukemic process. Understanding their roles may help in follow-up care and in designing new therapeutic strategies for CML. Furthermore the role of CRP in modulating angiogenesis should not be underestimated.https://jhiphalexu.journals.ekb.eg/article_20618_3818eaa4c2c3ef75b29764b2c45a8a3a.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Critical Care Nurses' Knowledge and Attitudes Regarding the "Do Not Resuscitate Status"5285622061910.21608/jhiph.2010.20619ENSaeer TahaNursing Supervisor, Ministry of Health, Syrian Arab Republic.
Department of Nursing, Faculty of Nursing, Alexandria University, Alexandria, EgyptHayam AsfourDepartment of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, EgyptAmal AttiaDepartment of Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University, Alexandria, EgyptJournal Article20181206<strong>Background: </strong>Patients in the critical care unit (CCU) are, by definition, the sickest patients in acute care hospitals and face higher risk of death than any other hospital population and usually require advanced life support such as mechanical ventilation, inotropes, or dialysis. Since every day critical care nurses encounter death and dying in the critical care units, Nurses are vital to end-of-life care as they are the ones present at the bedside, they have an opportunity to observe behaviours and actions that are barriers to a peaceful and dignified death while they provide end-of-life care. Do-not-resuscitate orders (DNR) are used in many countries to limit the use of cardiopulmonary resuscitation (CPR) in certain situations. There is still a continuing debate about the ethics, legalities and the appropriate medical indications for use of DNR. The status of DNR can raise many issues for nurses, including ethical dilemmas, conflict, and power struggles among members of the health care team. <strong>Objective:</strong> This study was carried out to describe critical care nurses' knowledge and attitudes regarding the Do not resuscitate (DNR) status in Critical Care Units. A descriptive design was used was conducted in the critical care units of Alexandria Main University Hospital, namely the: Casualty Care Unit (Unit I), General intensive Care Unit (Unit III), Chest intensive Care Unit, Coronary care unit, Neurosurgery intensive Care Unit, Triage and the Burn intensive care unit. <strong>Methods: </strong>A convenient sample consisting of one hundred and forty (140) critical care nurses working in the previously mentioned intensive care units were included.They were interviewed by using knowledge and attitudes regarding do not resuscitate (DNR) status structured interview schedule. <strong>Results:</strong> The majority of critical care nurses have knowledge about DNR status regarding the following: the meaning of DNR as withholding CPR, provided care as administering oxygen, the medical management as defibrillation / cardioversion and documentation. Regarding critical care nurses’ attitudes towards DNR status, most of them were of the opinion of continuing monitoring patients' vital signs, providing care as suctioning artificial airway.<strong> Conclusions:</strong> Clear policy and documentation for DNR statusare suggested to reduce confusion and promoting nurses’ involvement in decision making process of DNR and improving nursing practice.https://jhiphalexu.journals.ekb.eg/article_20619_adbaae00086ff947c76ea3d4b2c52779.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Hepatitis G Virus Infection in Patients with Hepatitis C5635722062010.21608/jhiph.2010.20620ENHeba SelimDepartment of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, EgyptMohamed El BarrawyDepartment of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, EgyptOsama MohamedDepartment of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, EgyptMarwa Gamal El-DinDepartment of Microbiology, High Institute of Public Health, Alexandria University, Alexandria, EgyptJournal Article20181206<strong>Background: </strong>Hepatitis G virus (HGV) infection is a worldwide health problem causing acute and chronic non A-E hepatitis. Because HGV and hepatitis C virus (HCV) share same modes of transmission, co-infection with the two viruses is not uncommon especially among people at high risk of parenteral infection. <strong>Objective: </strong>The aim of this study was to determine the prevalence of HGV among HCV virus cases, and to determine the degree of concurrent association between HGV and other prevalent infections in Egypt as <em>Schistosoma</em>, and hepatitis B virus (HBV) infections. <strong>Methods: </strong>This study included 100 blood donors attending Alexandria University Blood Bank in EL Shatby, proved to be positive for HCV antibodies by enzyme linked immunosorbant assay (ELISA) technique. Blood samples were collected and tested for the detection of HBV surface antigen (HBsAg) and <em>Schistosoma</em> antibodies by ELISA technique and HGV RNA by nested polymerase chain reaction (PCR) technique. <strong>Results: </strong>Out of 100 anti-HCV positive blood donors, 39(39%) had HGV RNA in their serum, of them 10 (25.6%) were positive for HBsAg, on the other hand 34(87.2%) were positive for <em>Schistosoma</em> antibodies. <strong>Conclusion and Recommendations: </strong>From this study it could be concluded that HGV is a common co-infection in HCV cases, however there was no significant statistical relation between the presence of HGV RNA and the presence of HBsAg and /or <em>Schistosoma</em> antibodies. Screening for HGV among blood donors in addition to the routinely screened HBV and HCV may have a beneficial effect in reducing its transmission among the population.https://jhiphalexu.journals.ekb.eg/article_20620_1bcf66bf013927a45b6effc0b4ff1354.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Knowledge and Attitude towards Smoking among Fayoum University Students5735852062110.21608/jhiph.2010.20621ENNaglaa El SherbinyDepartment of Public Health & Community Medicine; Faculty of Medicine; Fayoum University, Al Fayoum, EgyptAssem El EssawyDepartment of Chest Diseases, Faculty of Medicine, Fayoum University, Al Fayoum, EgyptEkram Abdel KhalekDepartment of Public Health & Community Medicine, Faculty of Medicine, Assiut Universit, Assiut, EgyptJournal Article20181206<strong>Background: </strong>Smoking is a behavioral cause of premature morbidity and mortality, resulting in approximately four million persons dying of smoking-related diseases annually worldwide. <strong>Objective:</strong> This study aims to investigate the extent of smoking habit, knowledge toward smoking among Fayoum University students. <strong>Methods: </strong>A cross sectional analytical study was conducted in Fayoum University during the academic year 2010. A total of 804 students were selected by using randomized multi-stage sampling using self-administered questionnaire for data collection. Data were analyzed using SPSS version 16. <strong>Results:</strong> The respondents age ranged from 18 to 26 years 20.36 ± (1.21) years. The males were 51% (n=410) and females were 49% (n=394). The prevalence of smoking among students was 13.4%. a large percentage of the smokers 82.4% used cigarettes while 8.3% smoked water pipe. Regarding knowledge about smoking related diseases, 97.3% of the students knew that smoking causes diseases; but only 5.6% of the sample had good/and satisfactory knowledge score about the causal role of tobacco in the development of specific diseases, and 66.7% of smoker students want to quit with a higher intention of for older group. <strong>Conclusion:</strong> Smoking is prevalent among the university students and their knowledge about the harmful effects of smoking is generally superficial. Definite counseling programs are greatly needed to help students quit smoking.https://jhiphalexu.journals.ekb.eg/article_20621_c7d1899a177a79261fcb04db8b0092b9.pdfHigh Institute of Public Health, Alexandria UniversityJournal of High Institute of Public Health2357-060140320100701Biological Monitoring of Fuel Stations Workers Occupationally Exposed to Petroleum Products5865952062210.21608/jhiph.2010.20622ENKhaled El-SaidDepartment of Occupational Health and Air pollution (Division of Occupational Hygiene and Air pollution), High Institute of Public Health, Alexandria University, Alexandria, EgyptAmr El-NoueamProfessor of Physiology, Physiology Department, Faculty of Medicine, Alexandria University, Alexandria, EgyptJournal Article20181206<strong>Background</strong>: The increased use of petroleum products in automobiles and industry has led to the deterioration in air quality and human health. Petrol (or gasoline) is a volatile and inflammable petroleum derived liquid mixture primarily used for internal combustion of engines. Occupational exposure to gasoline and air pollutant from vehicular sources are relatively unexplored. <strong>Objective</strong>: The main purpose of this study was conducting biological monitoring for petrol workers occupationally exposed to petroleum product and air pollutants. <strong>Methods</strong>: The study was conducted on fifty male workers employed in petrol filler stations and fifty subjects were recruited as a control group matched for age, sex and socio-economic status. <strong>Results</strong>: The results revealed that presence of high significant association in the levels of liver enzymes and some haematological changes among exposed workers. In addition to the significant decline in the lung function. A significant increase in urinary phenol as a biomarker of benzene exposure was found. Sulphur dioxide nitrogen dioxide, carbon dioxide and carbon monoxide did not exceed the standards indoor air quality guidelines. However, particulate matter exceeded the limits as indoor air quality guidelines. This study demonstrated that it is possible to detect human health risks at an early stage using sensitive techniques. <strong>Conclusion</strong>: Petrol pump workers should be carefully monitored and should take adequate protective measures to prevent long term effects.https://jhiphalexu.journals.ekb.eg/article_20622_a65133d3da702c28dfb205a02a387c5c.pdf