Effects of Exercise on Physiologic and Psychologic Outcomes in Patients with End Stage Kidney Disease on Hemodialysis: A Quasi-Experimental Study.

End stage kidney disease (ESKD), a public health concern, has overwhelming effects on individuals' holistic wellbeing. Hemodialysis, albeit a life-saving treatment for patients with ESKD, can lead to muscle atrophy, weakness, and decreased quality of life mostly due to an inactive lifestyle. This quasi-experimental, pre-post design was used to study the effects of exercise on physiologic and psychologic outcomes of patients with ESKD at a hemodialysis unit in Lebanon.

Implementing a Rapid Response Team: A Quality Improvement Project in a Low- to Middle-Income Country.

Background: The benefits of rapid response teams (RRTs) have been controversial with few studies conducted in low- to middle-income countries.

Objective: The aim of this study was to investigate the effectiveness of implementing an RRT on 4 patient outcomes.

Methods: We conducted a quality improvement pre-and-post design using the Plan-Do-Study-Act model in a tertiary hospital in a low- to middle-income country.

The efficacy of honey or olive oil on the severity of oral mucositis and pain compared to placebo (standard care) in children with leukemia receiving intensive chemotherapy: A randomized controlled trial (RCT).

Background: Oral mucositis (OM) is a significant complication occurring in approximately 40 to 80% of patients receiving chemotherapy regimens. Although a wide variety of agents have been tested to prevent OM or reduce its severity, none have provided conclusive evidence.

Objectives: To determine the efficacy of honey or olive oil on the severity and OM pain in children with leukemia and suffering from OM compared to placebo (standard care) and, to assess which of the two interventions is more beneficial.

Moral and Professional Values of Nurses in Lebanon.

Background: Moral and professional values vary among cultures. The purpose of this study was to explore the moral and professional values of registered nurses at a university medical center in a Middle Eastern country and determine the relationship among formal ethics education, background variables (age, gender, nursing degree, regular daily prayer), and nurses' professional and moral values.

Method: A cross-sectional survey method with 123 nurses was used.

A Nonrandomized Pretest Posttest Study on the Impact of an Educational Pain Management Program on Nurses' Knowledge and Attitudes Regarding Pain in a Middle Eastern Country.

Background: Although nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries.

Aims: To examine nurses' knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge.

The Impact of Therapeutic Exercises on the Quality of Life and Shoulder Range of Motion in Women After a Mastectomy, an RCT.

Breast cancer ranks highest in incidence and mortality among females and second among both genders. Lebanon has the second highest rate of breast cancer worldwide for those 35-39 years old and the highest for those 40-49. Mastectomy often results in deceased shoulder and arm mobility and decreased quality of life.

Implementing NIDCAP training in a low-middle-income country: Comparing nurses and physicians' attitudes.

Background: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) provides developmentally supportive environment for preterm infants and their families. Few studies evaluated staff perceptions about NIDCAP implementation and its effect on infant and parents and working conditions.

Aims: To assess the perception and experience of NICU staff during the NIDCAP implementation.

Achieving a Zero Central Line-Associated Bloodstream Infection Rate in 4 Critical Care Units in Lebanon.

Every health care facility aims to achieve and maintain a zero central line-associated bloodstream infection (CLABSI) rate. Infections can be costly for institutions of any size and are often not covered by health insurance. The interventions put in place in this quality improvement project were implemented in 4 phases: (1) develop a new standard of care for central lines and give nurses full responsibility for the care and handling of these lines (including blood sampling); (2) revise policy and provide educational sessions to support nurses; (3) document compliance with the new policy; and (4) document CLABSI rates.

Translation, Cross-Cultural Adaptation, and Validation of the Adolescent Pediatric Pain Tool (APPT) for Multidimensional Measurement of Pain in Children and Adolescents.

Background: Pain is subjective and multidimensional in nature. Its assessment is very challenging especially in the pediatric population. Adequate assessment of pain in children is the keystone for effective management.

The psychometric properties of the Ages and Stages Questionnaires-3 in Arabic: Cross-sectional observational study.

Background: Screening for developmental delay is recommended for pediatricians, yet validated screening tools in Arabic are scarce.

Aims: Assess the reliability, validity, sensitivity and specificity of the Arabic ASQ-3 in detecting developmental delays in children aged 4-33 months.

Study Design: Cross-sectional observational study.

Does intervention improve the outcomes of patients after total knee replacement surgery?

Objective: To assess the effect of a one to one intervention by a nurse on the outcomes of patients undergoing Total Knee Replacement (TNR) surgery.

Methods: A quasi-experimental design was used with 60 participants, half of which received a one to one intervention including education and exercise training by a nurse prior to surgery. Follow up was at two and four weeks post-surgery to assess pain, knee function using the Hospital for Special Surgery (HSS) Knee Rating Sheet and activities of daily living measured on the Lower Extremity Functional Scale (LEFS).

Pragmatic Trial to Evaluate the Effect of a Promotora Telephone Intervention on the Duration of Breastfeeding.

Objective: To evaluate the effectiveness of a telephone intervention delivered by promotoras (lay health care workers) to increase the duration of exclusive breastfeeding (EBF) in Hispanic women at 12 weeks postpartum. Secondary objectives were to assess breastfeeding duration (BFD) and to evaluate background variables that may be associated with EBF and BFD.

Design: Pragmatic trial.

Breast Cancer Risk Factors: a Cross- Cultural Comparison between the West and the East.

Background: The incidence of breast cancer in Lebanon is higher than any other Middle –Eastern country, is diagnosed at a younger age than women in Western countries, and is more aggressive and fatal. Therefore addressing risk factors in this population is of paramount importance. Methods: A descriptive cross-sectional, comparative design evaluated the risk factors for breast cancer in a convenient sample of 105 Lebanese-American women with 250 Lebanese.

Evidence on Nurse Staffing Ratios and Patient Outcomes in a Low-Income Country: Implications for Future Research and Practice.

Background: Conclusive evidence on the effect of nurse staffing ratios on nurse-sensitive outcomes (NSOs) has not yet been achieved worldwide.

Aims: To describe the relationship between nurse staffing and NSOs at a Magnet designated, university hospital a low-income country.

Methods: A 48-month prospective study assessed the relationship between nurse staffing and six patient outcomes or NSOs in medical-surgical units and critical care units (CCUs).

Is the Effect of Postpartum Depression on Mother-Infant Bonding Universal?

Purpose: Although the negative consequences of maternal depression on infants has been documented in several Western societies, similar studies have not been conducted in Middle-Eastern countries where cultural norms and traditions may differ. The main objective of this study was to determine the risk factors for postpartum depression (PPD) and its relationship to mother -infant bonding in a Lebanese population.

Methods: One hundred and fifty participants were administered the Edinburgh Postpartum Depression Scale (EPDS), and the social support scale at 2-3 days postpartum.

Predictors of Pressure Injuries in a Critical Care Unit in Lebanon: Prevalence, Characteristics, and Associated Factors.

Purpose: The purpose of this study was to identify factors associated with pressure injury in a medical-surgical intensive care unit (MSICU).

Design: Retrospective review of medical records.

Subjects And Setting: We reviewed the medical records of 145 patients who developed a new pressure injury in the MSICU of a 420-bed university medical center in Lebanon.

Effect of a Quality Improvement Project to Reduce Noise in a Pediatric Unit.

Purpose: Noise levels remain high in clinical settings, which may result in stress and sleep disruption, and can lead to immunosuppression, delayed healing, confusion, disorientation, delusions, and increased length of hospital stay. The purpose of this quality improvement project was to assess effects of a multidisciplinary noise reduction program on a pediatric unit in an acute care hospital in a developing country.

Methods: A quality improvement project was carried out over 15 months in a pediatric unit.

Preterm infants exhibited less pain during a heel stick when they were played the same music their mothers listened to during pregnancy.

Aim: Playing music during painful procedures has shown inconsistent benefits for preterm infants. This study observed preterm infants during a heel stick procedure to assess whether listening to the music their mothers listened to during pregnancy had any impact on their pain and physiological and behavioural parameters.

Methods: We randomly exposed 42 preterm infants, with a mean gestational age of 31.

NeoSeal to Prevent Nasal Injury in Preterm Infants Receiving Oxygen Therapy.

Purpose: To determine if a foam septum protector prevents nasal injury in preterm infants receiving nasal heated humidified oxygen.

Design: A retrospective before and after comparative design was used.

Sample: Medical records of 101 preterm infants receiving either nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive pressure ventilation (NIPPV) were reviewed; 50 were in the control group and 51 were in the intervention group that had the NeoSeal septum protector applied.

Distraction Using the BUZZY for Children During an IV Insertion.

Unlabelled: Needle pricks are rated by children as their most feared medical event resulting in acute pain, anxiety and distress, which negatively affects both the child and his/her parents.

Objectives: To investigate the effects of external cold and vibration via the "BUZZY" on pain ratings of children, their parents and nurses during peripheral IV insertion, to measure the time to a successful IV insertion and to assess the factors that are associated with pain perception of children.

Methods: In this randomized control trial (RCT), children between the ages of 4 to 12years were assigned to either an intervention or a control group.

A Meta-Analysis of Preterm Infant Massage: An Ancient Practice With Contemporary Applications.

Objective: To evaluate the efficacy of massage on the short- and long-term outcomes of preterm infants.

Methods: A search was conducted using the PRISMA framework. Validity of included studies was assessed using criteria defined by the Cochrane Collaboration that was carried out independently by two reviewers with a third reviewer to resolve differences.

Psychometric Testing of a Comprehensive Patient Satisfaction Survey in Arabic.

Background And Purpose: Although patient satisfaction is an important indicator of the quality of care received in hospitals, no reliable and valid Arabic comprehensive inpatient satisfaction survey has been published. The purpose of this study was to evaluate the psychometric properties of an Arabic patient satisfaction survey.

Methods: A cross-sectional design was used where 1,339 randomly selected patients were interviewed by phone.

The satisfaction of families in the care of their loved ones in CCUs in Lebanon.

Background: The needs of family members vary among cultures and hospitals. Often, these needs remain unmet increasing their stress and anxiety and decreasing their satisfaction with care, which may negatively impact the quality of patient care.

Aims: To assess the satisfaction of families with the care of their loved ones in critical care units (CCUs) in a large university medical centre in Lebanon and to assess the predictors of satisfaction.