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Background: Subcutaneous enoxaparin administration often causes problems such as pain; bruise and hematoma at the injection sites. In terms of these problems, cold application has been found to have various therapeutic benefits as relieve pain by produce localized anesthetic effect and controls bleeding by causing vasoconstriction. Aim of the study: To investigate the effect of cold application on local problems among patients receiving subcutaneous enoxaparin. Design: Self controlled trial design was utilized. Setting: The study was carried out in general surgery department, orthopedic surgery department, and chest Intensive Care Unit at Beni-seuf University Hospital. Study subjects: A purposive sample of 60 patients was included in the study. Data collection tools: Data were obtained through Patient assessment tool, Bruising Category Scale, Visual Analogue Scale for pain and Hematoma Formation Scale. Results: All studied patients had pain and more than half developed bruise at injection site when they received enoxaparin without cold application but more than three quarter of studied patients had pain and less than one quarter developed bruise when they received injection with cold application. Meanwhile, the majority of the studied patient did not develop hematoma whether cold applied at injection site or not. Conclusion: The pre-injection cold application at enoxaparin injection site was effective in reducing the occurrence of pain and bruising. Moreover, there was statistically significant relation between the patients’ pain intensity, the size of bruising and their demographic characteristics; age and gender. Recommendations: Cold application should be included in standard protocol for the administration of SC enoxaparin and providing on-going and regular in-service educational programs about it for nurses.

The Urban Management is the cornerstone on which development is based as well as the achievement of the development goals at all levels. The administrative efficiency index, which emphasizes the need for a self-assessment mechanism to evaluate the capacity of the management system at all levels to achieve these objectives. To identify the shortcomings of the management system of urbanization overlap and conflict in terms of competencies for the lack of clarity of functional descriptions of the organizational structures and bureaucracy and long and complex documentary courses and the resulting obstacles to achieve the strategic objectives of The study suggested the production of a model based on a set of basic criteria, which in turn were sub-criteria. The characteristics of each criterion were determined by the analysis of some of the global and regional experiences (such as the British, Egypt's Urban Management Department) to draw up these criteria and indicators for the management systems of urbanization related to the management of the urban management system in Egypt. In order for the proposed model to be effective and a tool for urban management, The relative weights of all the indicators are evaluated. This makes the assessment and quantitative measurement by calculating the frequency of each indicator in the global and regional experiments and the percentage of the total frequencies. Thus, the standard curve of the performance measurement model of the urbanization management was applied to the urban management system in Egypt, And points that need to be improved for future planning and periodic evaluation, which underlines the importance of the proposed model and the importance of research.

Context: Hepatocellular carcinoma (HCC) is considered one of the most challenging tumors with high incidence, prevalence, and mortality rates. Radiofrequency Ablation (RFA) is one of the emerging therapeutic modalities used for the minimally invasive treatment in the management of early-stage HCC. Aim: This study aimed to assess the effect of self-care guidelines on quality of life for patients with Hepatocellular Carcinoma undergoing Radio Frequency Ablation. Methods: A quasi-experimental design was used to achieve the aim of this study. This study was conducted at the Interventional Radiology Unit, affiliated to Ain Shams University Hospital, on a purposive sample of 50 patients with hepatocellular carcinoma; 25 randomly allocated to the study group, and 25 allocated to the control group. A structured interview questionnaire for patients with hepatocellular carcinoma undergoing radiofrequency ablation was used to collect the study data. It comprises three parts: Sociodemographic characteristic, assessment of patients' medical health, and knowledge about HCC and RFA. The second tool was the quality of life of cancer survivors questionnaire (pre /posttest), and finally, a patient-reported self-care practices assessment checklist (pre /posttests). Results: There were statistically significant differences between the study and control groups regarding their total knowledge about hepatocellular carcinoma and radiofrequency ablation therapy pre and post-implementation of self-care guidelines. There were highly statistically significant differences between both groups regarding the total quality of life, pre and post-implementation of self-care guidelines. In addition, there were highly statistically significant differences regarding total self-care practice, pre, and post-implementation of self-care guidelines. A positive correlation was revealed between total knowledge with total self-care practice and total quality of life (pre/posttest). Also, a significant correlation was revealed between the total quality of life and self-care practices post self-care guidelines implementation at (p

Background: Intensive Care Unit Acquired Muscle Weakness (ICU-AW) is one of the most important complications occurs in the ICU. ICU-AW is a multifactorial syndrome characterized by generalized muscle weakness. Critical care nurses (CCNs) have an important role in the prevention of ICU-AW through increase mobility and applying of range of motion. Design: A descriptive exploratory design was utilized to achieve aim of this study. Aim: This study aimed to assess factors contributing to acquired muscle weakness among critical ill patients. Setting: the study was carried out in intensive care units of Beni–Suef University Hospital. Subjects: A Purposive sample of seventy five patients admitted in the previous mentioned setting. Tools of data collection were consisted of Patient assessment tool, muscle strength scale and indicators to incidence of ICU-AW and factors contributing to ICU-AW assessment tool. Results: revealed that more than half of the studied patients had ICU-AW. The majority of studied patients who had muscle weakness were older than the Non ICU-AW patients. Application of positioning and range of motion exercises were not done in the ICU-AW patients. Administration of corticosteroid and incidence of malnutrition was higher in the ICU-AW patients than the Non ICU-AW patients. There were no statistically significant relation between incidence of ICU-AW and gender, admission medical diagnosis, administration of parenteral nutrition and application of positioning and walking exercises. Conclusion: More than half of studied patients developed ICU-AW. The contributing factors of ICU-AW are patient age, WBCs level, not applying range of motion and chair sitting exercise to ICU patients, administration of corticosteroid and malnutrition. Recommendations: Further researches are recommended to study extensively the effect of nutritional status on incidence of ICU-AW. Also, examine the incidence of ICU-AW in sedated and unconscious patients.

Background: Hospital acquired anemia (HAA) is one of the most common intensive care unit (ICU) acquired complications that associated with poor outcomes, increase morbidity and mortality for critically ill patients. Factors contribute to its development include profound loss of RBCs or insufficient RBCs production. Aim of the study: to assess factors contributing to HAA among critical ill patients. Design: A descriptive exploratory design was utilized. Setting: The study was carried in Beni –Suief university hospital inside the critical care units which include; general ICU, cardio care unit (CCU) and chest ICU. Study subjects: purposive sample of 75newly admitted adult critically ill patients to the above mentioned sitting was included in the study. Data collection tools: Data were obtained through patients assessment tool, factors contributing to HAA and indicators of HAA tool. Results: reveals that, nearly one third of studied patients their age were more than or equal fifty years. As regard to gender, the results revealed that, more than half of them were males, nearly one third of anemic patients had HAA in the 5th day from admission to hospital. As well more than three quarter of anemic patients were under feeding and more than one third of them had sepsis, in addition to mean amount of blood loss for anemic patients exceed amount of blood loss for non anemic patients. Conclusion: More than half of studied patients developed HAA during their ICU stay. Even, non-anemic patients were subjected to a decline in their Hb level. As well as, there were statistically significant relation between nutrition deficiency, sepsis, blood loss in ICU and drugs increase RBCs loss factors and occurrence of HAA. Also there were insignificant relation between demographic characteristic of studied patients, their diagnosis on admission to hospital, hemodilution, drugs affect RBCs production and occurrence of HAA. Recommendations: Designing in-service training and educational program for nurses about blood conversation strategies especially prevention of blood loss associated invasive procedure and phlebotomy practice.

Introduction: Cerebrovascular Background: Critical care nurses are expertly trained to care for critically ill patients; however, many critical care nurses feel inadequately prepared to provide end of life care to patients in the intensive care unit. The nurses attribute this to lack of support and training on end-of-life care. The study aim was to assess effect of self-learning package (SLP) on critical care nurses' performance regarding care for end of life patient. Methods, Design: To achieve this aim a quasi-experimental design was utilized. Subjects and setting: A convenient sample of 60 nurses was selected from surgical, medical and neurological ICU of Ain-Shams university hospitals. Study results: Regarding demographic characteristics. This study revealed that, 58.3% of the studied subjects were less than 30 years, 83.3% were female, 75.0% were diploma nurses, 46.7% of them had ten or more years of experience, and 81.7% had no training related to end of life care. Regarding knowledge and practice 15.0% & 23.3% respectively of the study subjects had satisfactory knowledge and practice related to care for end of life patient in pre phase, 80.0% & 81.7 % respectively in post implementation of self-learning package and 60.0% &45% had a satisfactory knowledge and practice in follow up phase. While regarding attitude, positive attitude was 5%, 80% and 55% respectively in pre, post and follow up phases Conclusion: The current study concluded that there was highly statistically significant increase of total score of nurses' knowledge, practice and total score of nurse’s attitude pre/post, pre/follow up and post/ follow up phases of SLP implementation. there was statistically significant positive effect for SLP on nurses' knowledge, practice and attitude. Recommendations; conduction of further researches in end of life care to enrich, improve, & update nurse's knowledge, practice and attitude. Periodic in-services education program regarding end of life care and self-learning package to be performed for patients are recommended.

Reduction of energy consumption is a major concern in vapor compression cooling systems, especially in areas with very hot weather conditions. In hot weather conditions, performance of these systems decrease sharply and electrical power consumption increases considerably. Evaporative condensers enhance the heat rejection process by using the cooling effect of evaporation and therefore improve energy-usage efficiency. This paper presents an extensive review of the state of the art of evaporative condensers used in residential cooling systems: refrigeration, air-conditioning, and heat pump systems. The paper primarily concentrates on the energy consumption of residential cooling systems worldwide and its related problems. In addition, the paper covers the operation principles of evaporative-condensers, theory of heat rejection, and water evaporation rate. Finally, comparison between different types of condensers is presented. It is found that by using evaporative-cooled condenser instead of air-cooled condenser, the power consumption can be reduced up to 58% and the coefficient of performance can be improved by about 113.4% with systems of different cooling capacities ranging from 3 to 3000 kW.

DOI: http://dx.doi.org/10.22197/rbdpp.v1i1.9 Submitted by Rafaella Monterei (rcarine@stj.jus.br) on 2016-09-09T12:05:00Z No. of bitstreams: 2 producao_analogica_verdade_khaled.pdf: 782967 bytes, checksum: e6f9934a4a70f431d333aea1424092f1 (MD5) license.txt: 1239 bytes, checksum: c9b4c351324448672315a00808efb725 (MD5) Approved for entry into archive by Roberta Marins (rmarins@stj.jus.br) on 2016-11-18T18:09:16Z (GMT) No. of bitstreams: 2 producao_analogica_verdade_khaled.pdf: 782967 bytes, checksum: e6f9934a4a70f431d333aea1424092f1 (MD5) license.txt: 1239 bytes, checksum: c9b4c351324448672315a00808efb725 (MD5) Made available in DSpace on 2016-11-18T18:09:16Z (GMT). No. of bitstreams: 2 producao_analogica_verdade_khaled.pdf: 782967 bytes, checksum: e6f9934a4a70f431d333aea1424092f1 (MD5) license.txt: 1239 bytes, checksum: c9b4c351324448672315a00808efb725 (MD5) Previous issue date: 2015

This article discusses the criminal procedural system and the preliminary investigation in the Brazilian criminal justice system, utilizing the contributions from the social sciences and the more progressive doctrine of the criminal procedure in relation to the subject. The intention is to add the approach of Michel Misse and Roberto Kant de Lima to a discussion that usually is strictly dogmatic, enriching it with other perspectives of interpretation. Regarding the criminal procedure, the authors employed in this article are Aury Lopes Jr., Salo de Carvalho and Jacinto Nelson de Miranda Coutinho. The methodology employed was the analysis of literature relevant to the problem at hand. The conclusion is that the Brazilian system is in reality an inquisitorial system, as the legal provisions are, in practice, suffering from deformation.

O presente artigo explora a célebre polêmica entre Windscheid e Muther, na segunda metade do século XIX, valendo-se de uma abordagem que procura inovar ao tratar do tema a partir dos referenciais teóricos da história das ideias. Embora a polêmica instaurada entre os autores tenha sido objeto de inúmeras análises em função de sua importância para o desenvolvimento da autonomia do direito processual, a história das ideias preocupa-se com a difusão das ideias e, em especial, tem a proposta de narrar a biografia de uma ideia. Nesse sentido, o debate instaurado a partir do ataque de Muther às teses de Windscheid é reconhecidamente um dos marcos do pensamento jurídico contemporâneo, uma vez que a discussão protagonizada por ambos acabou promovendo avanços inegáveis no que se refere ao estabelecimento de um novo panorama, em que a ação processual deixou de ser considerada como dependente do direito material. This article explores the famous controversy between Windscheid and Muther in the second half of the nineteenth century. The article seeks to innovate by addressing the issue from the theoretical framework of the history of ideas. Although the controversy established between the authors has been the subject of numerous reviews because of its importance for the development of the autonomy of procedural law, the history of ideas is concerned with the dissemination of ideas and, in particular, has proposed to narrate the biography of an idea. In this sense, the debate initiated from Muther’s attack of the theses of Windscheid is recognized as a hallmark of contemporary legal thought, as the discussion ended up promoting undeniable progress regarding the establishment of a new landscape in which the procedural action was no longer considered as dependent of the material law.

Background: Invasive ventilation is a common practice in intensive care units (ICUs). Once a patient is intubated, maintenance of the endotracheal tube placement is essential. When the ETT is not secured effectively, even basic nursing management can cause tube slippage which is a major factor in causing airway trauma. Aim of the study: This study was aimed at comparing the effectiveness of three endotracheal tube securement techniques (Twill, Adhesive and Simple bow) on endotracheal tube slippage, external jugular venous pressure measurement, oral mucosa and facial skin integrity, pain intensity and on patient satisfaction after the fixation method. Subjects and methods: A randomized clinical trial was conducted at the intensive care units in Ain Shams University Specialized Hospital. It included a sample of 90 patients, randomly allocated to the three equal groups: Twill, Adhesive and Simple bow groups, 30 subjects for each. The tools used for data collection included demographic and clinical data sheet, the time profile of ETT fixation method sheet and scales for endotracheal tube (ETT) slippage, external jugular venous pressure (EJVP) measurement, oral assessment guide (OAG) for oral mucosa, Facial Skin Integrity, pain intensity and patient satisfaction procedure scale. The study maneuvers were applied according to the group. Results: Both ETT slippage and EJVP were measured at 15, 30, 60 and 120 min post fixation method. At 120 min, 73% of patients in the Twill group had no slippage compared to Simple bow (50%) and (36%) in Adhesive groups. However, at 30 min post fixation method 90% of patients in the Twill group had normal EJVP measurement compared to Simple bow and Adhesive groups (70% and 57%, respectively), with a statistically significant difference between the three groups. At 60 min, only 10% of patients in the Twill group had high EJVP compared to Simple bow (37%) and Adhesive groups (47%) with a statistically significant difference among them. As well, at 120 min post fixation method, most patients in the Twill group (97%) had normal EJVP measurement, compared to the Adhesive (60%) and Simple bow (57%) groups. Oral mucosa and facial skin integrity assessment was done for all patients in the three study groups at 2, 6, 12, and at 24 h post fixation method. For oral mucosa at 24 h post fixation method, 80% of patients in the Twill group had healthy oral mucosa compared to Simple bow and Adhesive groups (47% and 37%, respectively), with a statistically significant difference between the three groups (P = 0.07). For facial skin integrity, at 6 h, no one of patients in the Twill and Simple bow groups had severe facial skin reaction compared to patients in the Adhesive group (7%) and the difference was statistically significant, (P = 0.01). As well, a statistically significant difference was revealed among the three groups, at 12 and 24 h post fixation method, (P = 0.04 and 0.02, respectively). The Twill technique had the shortest time taken for application and removal of securement method than other groups. Additionally, the Twill group had the lowest scores of pain at all three assessment times (5, 10 and 20 min), whereas those in the Adhesive group had the highest scores. All these differences were statistically significant, (P

Bacterial strains were isolated form root nodules of various legumes, mainly trees, from different places in Africa. Polyphasic taxonomy, including numerical analysis of comparative whole-cell protein patterns obtained by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), 168 rRNA gene sequencing, auxanographic tests (API 50), and DNA:DNA hybridizations indicated that these strains belonged to #Agrobacterium$ biovar 1. These strains were not capable of inducing any nodule or tumor formulation on plants. No PCR amplification was observed using nif H primers, suggesting that they do not carry symbiotic genes. Biological implications of the presence of #Agrobacterium$ in nodules are discussed. (Résumé d'auteur)