Impact of A designed Eye Care Protocol on Nurses Knowledge, Practices and on Eye Health Status of Unconscious Mechanically Ventilated Patients at North Palestine Hospitals.\n\n*1 Imad H. Fashafsheh, 2 WardaYousef and 2 Manal Sayed\n\n1 Dean Assistant-Faculty of Allied Medical Sciences, AAUJ- Palestine.\n2 Critical Care& Emergency Nursing, Cairo University, Cairo, Egypt.\[email protected]; [email protected]; [email protected]\n\nAbstract: Patients on intensive care units are at high risk of eye problems due to the loss of normal physiologic defense mechanisms of the eye. Mechanical ventilation is one of the therapeutic measurements used for some of such patients which leads to a lot of health problems and eye problems is good example, sedation to facilitate mechanical ventilation also leads to loss of physiologic actions of decrease tear production and increase evaporation due to eye lid opening. Care of the eyes is least to be considered from the nurses because it’s not life threading and infection control measures also regarding eye hygiene is not routine practice. Eye complications prevalence in many studies quantifies more than 40 percent even it is difficult to quantify this problem because there is no documentation in these departments. The aim of the present study research was to examine the impact of utilization of a designed eye care protocol on reducing the incidence of eye complications of ventilated sedated or unconscious patients; to fulfill the aim three research hypothesis were formulated. Quasi experimental design was used. The study sample constitute from 35 nurses working in the ICU departments in three main governmental hospitals in north Palestine and 70 patients whom fulfill the inclusion criteria to be a part of this research sample. Data were obtained through three tools; knowledge assessment questionnaire, an observational check list, and eye health assessment form with grading of the severity. The educational, instructional, and demonstrational programs designed based on nurses assessment needs. Method the educational booklet distributed for all participants nurses that included brief information with images about anatomy and physiology of the eye and complications of mechanical ventilation and at the end assessment and prevention of eye problems, small educational and demonstration sessions with an average of 2 to 3 nurses in the work field done. Results; all research hypothesis were supported, in which nurses knowledge and practices and eye health showed sustainable improvements regarding eye care in the critical care departments. Conclusion; nurses were lacking some knowledge and practices competences regarding eye care in critical care departments, the educational handout , demonstrations and the designed protocol showed a positive impact in improving nurses knowledge, practices and lower the percent of eye health complications. Recommendations; the study recommended establishing a written updated protocol for assessment and implementation the management needed for eye care by continuous education appraisal to ensure enough knowledge, and complete safe practices, which leads for sure in minimizing the incidence of eye complications. \nKey words: Designed Eye Care Protocol, Nurses Knowledge, Nurses Practices, Eye Care.

Study of clinical biomechanic of injured instrument vertebral column is restricted to qualitative consideration. Recently with helping Finite Element Method studies are done. Quantitative instrument evaluation injured instrument vertebral column have got new shape. At most of the biomechanical studies are done on the evaluation stability of implants and vertebral column (instrument), so for determining any stress distribution, in this research five pieces of posterior spinal implants system evaluated stress distribution,maximum von mises stress and displacement with using Finite Element Method and ANSYS software which including: Cotrel Dubousset Horizon, pedicular screw, made of medical titanium, pedicular screw, made of medical stainless steel, Cotrel Dubousset Horizon, laminar hook, pedicular hook, device for transvers traction, DTT hook and connecting rod , that all of them were made from medical titanium , in conditions without vertebra and in all loading conditions similar to biomechanic loading include: axial compression, flexion, lateral bending and axial rotation. In this research, quasi static safety factor of fixation devices determined between 3 to 6, so results of this study show that maximum Von Mises stress, at all loading conditions happen on the neck of the pedicular screws, in the blade of the hook and in the middle of the rod.

In his work, „Nation, State, and Economy” (1919), Ludwig von Mises claims that the idea of liberalism starts with the freedom of the individual and it rejects all rules of some persons over others. This paper aims to illustrate an opposite direction, deprecating the 18 century colonial practices which have gradually tainted the pacifistic principle of liberalism with the oppressive, imperialistic goals, of the most powerful states. We focus on the British East India Company, which dominated East Indies. We find that, under the cover of free trading, the British Superpower has often used military intrusion to acquire territories, to rule resources and, through this, to exercise power over the native population.

The companies providing procurement and support or so called logistic services play an important role in developing export but it is often disregarded. The purpose of the present study is to investigate the effect of the performance of companies providing logistic services in export development since the export amount of productive companies will be reduced if they are not provided by proper logistic services. Based on the findings of the study, the future export behavior can be predicted through selecting the export market development approach if the role of the performance of the companies providing logistic services is recognized properly. On the other hand, the logistic limitations are the factors associated with the export performance in the strategic group of the market focus. Followings are the other hypotheses proved n the present paper: the variable of transportation and delay cost in payments has an internal relation with the export performance at the confidence level of 99% and the variable of transportation barriers has also a relation with the export performance at the confidence level of 95%. There is a significant relation between the companies` and organizations` logistic performance improvement and the more share in the export market. There is also a significant relation between recognizing the logistic limitations and the export performance. Finally, there is a significant relation between the performance effect of the companies providing logistic services and providing the opportunity to obtain a positive intensification in integration and inter-company and intra-company management.

Curbing and reducing flood damages has a special status in exhaustive management of watershed areas. Thus, precisely identifying flood-prone regions on field level is of paramount importance; because we can reduce flood-proneness level of the field by proper watershed procedures, whether constructional or non-constructional, or a combination of both. The field which is studied here is a flood-prone field in Golestan province. In the present research, in order to determine the hydrograph of the runoff resulting from precipitation under the fields, HEC- HMS mathematical model, in which precipitation’s change into runoff is done based on hydrological methods, has been used.\nIn this research the results of calibration and validation of model HEC- HMS indicated that in case of presence of dry condition, initial damages coefficient in this field would be 15.0 , A coefficient for calculating the concentration time under the fields based on relation in Tamar field would be 4.0, and B coefficient for all subfields would be 3.0 and the ratio of saving coefficient to concentration coefficient in Tamar field would be 4.0 , based on which we can see that the observed and simulated hydrograph had high correlation. \nAfter calibrating and validating the model, prioritization of the subfields from the viewpoint of their participation in output flood (flood-proneness analysis) was examined. Based on flood-proneness studies in Tamar field we can say that upper subfields have had the biggest effect on flood-proneness level according to selected floods in the field.

The author in a historical context showed the role of evolution of geopolitical roots in the formation of mentality of Russian mass consciousness. Regarding the Russian nation natural and geographical factor includes country’s location, climate and soil peculiarities, and territorial size of the state. That is why the factor of geopolitical location of Russia among other world countries played a significant role in formation of mass consciousness of the Russian nation. The Russian nation is forced by historical circumstances to settle down on a great plain located at the joint of Europe and Asia

Introduction: \nUnusual menstrual bleeding is a most common adverse effects of IUD users, leading to discontinuation of usage or iron deficiency anemia in consumers. Considering intensive tendency to the use of herbal preparations, this study aimed to investigate the effect of cumin on menstrual bleeding in IUD users.\n\nMaterials and Methods:\nA randomized, triple blind and crossover clinical trial study performed on 100 women with IUD who have passed Inclusion criteria to enter the study, comming to the 6 selected health centers in the Karaj city (west of Tehran), Iran. The study was conducted in three phases: At first, during one cycle, menstrual bleeding of all participants were measured by using Hygam table, in the second phase, individuals were randomly divided into two groups: mefenamic acid group and cumin group. Each group received relevant capsules during two consecutive menstrual cycles. In the third step, for each of the individuals, in two other consecutive cycles, the opposite group treatment method were repeated, by replaceing drugs with the same specifications. \nThe amount and duration of menstrual bleeding during this five cycles, measured by using Hygam chart and eventually, statistical data were analyzed and compared.\n \nResults:\n After 2 cycles of intervention, The average amount of menstrual bleeding in both groups (cumin and mefenamic acid) decreased (P<0.001).\nAfter two cycles of treatment, comparing the two groups, there was no statistically significant difference, in the average of Hygam score, (P=0.62).\n \nConclusion:\nThis study showed that the Cumin capsule can effectively reduce the amount and duration of menstrual bleeding,so it seems that it could be recommended to decrease menstrual bleeding in IUD users.