Over the last 50 years, the rapid population growth and significant expansion of health care services in Saudi Arabia have greatly challenged the Saudi Kingdom’s ability to provide an adequate supply of nurses to meet the staffing needs of its hospitals. Today, Saudi nurses comprise less than 30% of the total nursing workforce despite recent reports on nursing education showing a significant increase in the number of Saudi nursing graduates. Based on Saudi workforce recent studies reporting rates of retention/attrition, the high turnover rate and early career attrition rate are the main reasons for shortage. Yet, there are no available studies exploring the experience of currently working Saudi nurses in their workplace and the challenges they face.

OBJECTIVES

This study aimed to exploring how Saudi registered nurses experience the workplace and its associated challenges.

METHODS/ CONTENTS

Constructivist Grounded Theory, with its emphasis on participants as individuals, has been used to construct a shared understanding that is reflective of the experiences of both the participants and the researcher. The analysis was informed by detailed readings of Symbolic interactionism (Mead), and understandings were extended by Stryker’s articulation of identity as a larger sense of self.

Twenty-six semi-structured interviews were conducted with junior and senior Saudi female registered nurses working in a major governmental hospital in Jeddah, Saudi Arabia. Participants were recruited using a snowball technique. The final sample demonstrated a considerable and informative variation in characteristics such as marital status, age, length of nursing experience, and number of children. The initial round of data collection and its preliminary analysis revealed some important issues that needed further exploration, and a theoretical sampling approach was used for the second stage of data collection. The interviews were conducted and initially transcribed in Arabic and then translated into English to facilitate further analysis.

FINDING/ RESULTS

Symbolic interactionism has been used to assist in developing an understanding of how the participants perceive themselves as Saudi female nurses in the workplace and how they create a place for themselves as “me” at work. The following three categories have emerged from this analysis and reflect a developing conceptual understanding of the constituent subcategories:

•          Creating a place at work

•          Accommodating conditions of work

•          Verifying identity

Workplace was identified as social contexts where participants were interacting daily so as to maintain their nursing roles. In this category, participants interacted as socialised “selves” with generalised and significant others such as co-workers. As socialised selves they were trying to make it possible to work, by negotiating multiple ways to be within social contexts that determined and required different sets of obligations and responsibilities.

CONCLUSION

“Workplace”, as described here, is the second social context that participants have to interact with to pursue their work as nurses. The participants are therefore influenced by the cultural structure of the Saudi community in bringing their identity as Saudi nurses to this workplace, and being a Saudi nurse is an important component of each participant’s identity as it includes the norms and traditions that direct the behaviour of all Saudi nurses. In other words, “me” in the social context of “workplace” is actively constructed by the demands of including the participant’s Saudi identity within their construction of a nurse identity within their workplace. In this government hospital, they are not only “nurse” (as they would be if working in a Ministry of Health hospital) but also “Saudi nurses” whenever they engage with their work or their workplace.

Data has described how participants see themselves, through their understanding of patients’ language, religion and culture, as contributing to improving the care of Saudi patients. Their understanding of themselves as role models for other Saudi nurses and their high level of commitment to nursing and to being Saudi nurses within this workplace is also clear along with the difficulties they experience in attempting to develop their clinical confidence and a strong nursing identity when working with foreign “expert” clinical nurses, who are not always supportive of their efforts. The challenges experienced as they attempt to accommodate the conditions of their work and the frequent and constant difficulties of their relationship with their foreign colleagues.

The present study was carried out to assess the effectiveness of physical activity among 14 participants who are undergoing hemodialysis in a tertiary care teaching hospital, South India. The study was approved by the institutional human ethical committee of Saveetha University, Chennai (020/08/2016/IEC/SU Dated 11^th August 2016). The participants who are undergoing 2 to 3 times of hemodialysis in a week were selected. The participants were selected using the simple random technique. The patients receiving dialysis in morning hours were allotted for the experimental group( 7) and evening hours were allotted for the control group(7). The physical activity was given for 15 minutes duration for the period of 2 months in the experimental group. But there is no intervention

given for the control group. The demographic variables, clinical variables, biochemical values such as serum values of sodium, potassium, urea, creatinine, albumin, calcium, phosphate and post urea and quality of life were assessed before and after the intervention. The quality of life was assessed by using Modified Kidney Disease Quality of Life (KDQOL) scale and DASS 21 (Depression, Anxiety Stress 21 ) Scale. There is a significant difference between the pretest and post-test  Hemoglobin (p = 0.04) and Sodium (p = 0.05) in the experimental group. But there is no significant difference in potassium, urea, creatinine, albumin, calcium, phosphate and post urea levels. There is a significant difference (p = 0.008) between the pretest and post-test symptoms of patients in the experimental group. There is no significant difference in the general health, physical activity, social activity, pain, the effect of kidney disease, sexual function, sleep, social support and patient satisfaction.

Patient satisfaction is a major indicator of quality care. Patients are the best source of information about a hospital system’s communication, education and pain-management process, and they are the only source of information about whether they were treated with dignity and respect. The descriptive study was done using quantitative, explorative approach with the objective to assess the level of patients satisfaction with nursing care provided in selected wards in the tertiary care teaching hospital. The study participants were selected from the General wards such as Medical wards, Surgical wards, and OBG wards. The sample size was 120. The study was carried out after getting approval from the Institutional Review Board (IRB No. 1609). Adult patients from 18 years and above, both Male and Female patients, patients admitted in selected wards for > 2 days were selected as participants using Systematic random sampling technique. The study participants were informed about the nature and purpose of the study and written informed consent was obtained from them. The socio-demographic variables and Modified Newcastle Satisfaction with Nursing Scales tool were used to collect the data. The data was collected using the interview method. According to the level of patient satisfaction on nursing care provided in the selected hospital; majority 99 ( 83%) participants had good satisfaction, 15 (12%) had moderate and 6 ( 5%) had poor satisfaction on the nursing care provided in the hospital. This study helps to evaluate the quality of nursing care provided for the patient in the hospital and as well as to identify the areas for better improvement of nursing care.

The objective of this study is to develop a set of criteria and indicators to assess the standard of quality of development centres for early childhood. The combined learning system of the Child Development Centre is examined using mixed methods in order to fulfil the following three aims: (1) identification and establishment of elements to be used as a framework for the development of indicators for assessment through review literature from relevant and related agencies; (2) development of indicators for quality assessment using data obtained from comprehensive, formal, and informal interviews of participants involved in nineteen study areas, covering the North, North-east, South, East, and Central regions, and reviewed through content analysis; (3) establishment of indicators to be used as criteria for standard of quality assessment of Child Development Centres, with evaluation of content validity and accuracy conducted by experts (Cronbach Alpha coefficient of reliability).

Development of standard of quality criteria for Child Development Centres must encompass all five internal key management systems: the Child Development Centre Management System, Environmental Management

System, Curriculum Management System, Healthcare System, and Family and Community Participation System. The process consists of three stages: (1) evaluation of operational methods and processes of the Child Development Centre (total 52 reliability measures at 0.93); (2) evaluation of performance (total 30 reliability measures at 0.95), and; (3) general assessment (27 indicators). These tools lay the foundation for benchmarking and performance profiling of Child Development Centres. Results of comparisons can be utilized for planned, systematic improvements. 

Eosinophilic otitis media (EOM) is an intractable otitis media often associated with bronchial asthma and is characterized by eosinophil dominant, highly viscous middle ear effusion (MEE). EOM is not a fatal disease, but carries a high risk disease of progressive hearing loss. Therefore, it is important early diagnosis and management of appropriate treatment with understanding of the pathology of EOM.

In the present study, we investigated the expression of various substances related to allergic/eosinophilic inflammation such as major basic protein (MBP; cytotoxic protein derived from eosinophils), periostin (PN; extracellular matrix protein secreted by fibroblasts in response to IL-4 and/or IL-13), and thymic stromal lymphopoietin (TSLP; key trigger of Th2-type allergic disease) in the middle ear mucosa of EOM patients and animal models which we newly constructed. TSLP immunoreactivities were observed in the eustachian tube epithelium, MBP was shown on the eosinophils in middle ear mucosa and outer side of epithelial cells, and PN is observed in the subepithelial layer of granulated middle ear mucosa. These results indicate that TSLP secreted from the epithelial cells of eustachian tube induces Th2-type inflammation involved in eosinophilic infiltration and formation of granulation via PN.

Our concept of treatment for EOM is as follows: the removal of the MEE infiltrated with numerous eosinophils, and the suppression of the local and systemic eosinophilic inflammation. Regarding the management of the acute phase, topical and/or systemic steroids are effective. Regarding long-term management, a combination of several kinds of anti-allergic drugs is beneficial for cessation of steroids.

Proteomic treatment utilizes Chaperone Proteins (CP) to enhance the body’s ability to move toward a harmonized, homeostatic level of intra cellular protein production.

As we age and in certain disease states, our cellular ability to translate a transcribed mRNA code into a functional protein is impaired. Although the genesis of this clinical condition can be somewhat complex, it is characterized by intra-cellular protein accumulation. This accumulation not only decreases cellular function, but also impedes the translational capacity of the cell.

This “flows backwards” to decrease both primary transcription as well as “forward” to decrease translation of this message into a protein, hence the need for Proteomic Therapy.

Our fundamental hypothesis is that the primary etiology of this is a decrease in CP function inside the cell. To find treatment strategies, our group has utilized exogenous CP (Chaperonze®) and have demonstrated significant disease alleviation in renal insufficiency (Cat and Human). We have demonstrated that this treatment strategy alters the Chaperone Protein Axis (CPA) as measured by Heat Shock Protein 70 (HSP70) and have also recently concluded that this effect is coupled with cell membrane stabilization as measured by cell free DNA (cfDNA).

In the current study we report that cellular aging is marked by an increase in both circulating HSP70 and cfDNA, which are significantly correlated to each other. We also report that treatment with Chaperonze® can significantly decrease these 2 biomarkers which in turn leads to enhanced cellular stability.

Results of this study substantiate that proteomic treatment of cells with Chaperonze® not only harmonizes translational dynamics within the cell but also leads to stabilization of the cellular membrane. 

BACKGROUND: Umbilical cord blood (UCB) has become an alternative source of hematopoietic progenitor cells for transplantation. The aim of this study was to test the effectiveness of some modifications of human hematopoietic stem cells isolation protocols with the intention of improving the output and viability of CD34⁺ cells and progenitor subpopulations progeny that can be obtained from a sample of human umbilical cord blood and keeping the ability of long-term self-renewal and the capacity to give rise to one or more types of differentiated progeny.

METHODS: Human cord blood samples were transformed to buffy coat prior to the isolation of HSCs which was performed by two steps involving CD34 pre-enrichment using human cord blood CD34 positive selection kit and an immunomagnetic cell separation, targeting CD34 surface antigen. CD34+ cells were immunophenotyped by four-color fluorescence, using a large panel of monoclonal antibodies (CD34/PE, CD45/FITC, CD38/APC, CD33/Per-Cy, HLA-DR/PE, CD117/APC, CD123/Per-Cy, CD105-FITC, CD56/PE, CD14/Per-Cy, CD19/Per-Cy and CD3/APC) recognizing different lineage or activation antigens. The isolated CD34+ cells were also studied for proliferation and differentiation in liquid cultures in the presence of Flt3L, SCF, IL-3, IL-6 and M-CSF. Using differing combinations of growth factors the effect on cell proliferation and differentiation was determined. The macrophage-like phenotype was confirmed by analyses of surface markers, histo-morphology and phagocytosis.

RESULTS: Our results showed that the percentage of CD34⁺ cells in whole human cord blood samples was 0.02% of total cells. After isolation by two-step, combining CD34 pre-enrichment and immunomagnetic isolation, the frequency of CD34⁺ stem cells represented 0.65% among total MNCs and 83.53% among total isolated cells. This isolation leaded to a purity of over 95% and viability of 98.60%. In addition, we found that the percentage of CD34⁺ cells which are CD45⁺ was 83.53%, whereas CD34⁺CD38^- cells comprised 21.70%. About 70.85% of isolated CD34⁺ cells were characterized by the absence of human leukocyte antigen-DR (HLA-DR). Concerning the CD117, CD33, CD123 and CD105 antigens which characterize true stem cells, we found a high expression percentage among isolated HUCB CD34⁺ cells (81.26%, 57.14% 47.45%, 58.52% for CD117, CD33, CD123 and CD105, respectively), while a very small number displayed markers of advanced myeloid commitment, such as CD14 (Myeloid lineage, 0.7%) and CD56 (NK-cell lineage, 4.48%), or those of lymphoid differentiation: CD3 (T-cell lineage, 5.22%), and CD19 (B-cell lineage, 1.76%). We also demonstrated that these isolated CD34+ cells can be expanded and differentiate; a homogeneous population of CD14-positive monocytes is produced. These hES monocytes have a distinct myeloid signature and are capable of differentiating into functional macrophages. These macrophages are phagocytic; they respond to leishmanial infection and express phenotypic markers of mature macrophages.

CONCLUSIONS: We conclude that our modified technique enabled us to obtain an important proportion of primitive hematopoietic progenitors, as suggested by the absence of HLA-DR and CD38, as well as the presence of CD117, CD33, CD123, and CD105 on their surface. These cells are recognized as having long-term reconstitution capacity within the human CD34+ cell population. Therefore, the production of fully functional Human CD34- hematopoietic stem cells has been successfully achieved.  

Retinitis pigmentosa is a typical mark for a heterogeneous gathering of heritable retinal degenerative infections that outcome in dynamic visual misfortune optional to photoreceptor cell death. Of the 2 photoreceptor cell types in retina (Rods and cones), these diseases primarily affect rods. This is reflected in the regular clinical course of retinitis pigmentosa, which more often than not starts with loss of bar intervened night vision and Advances throughout the years with the dynamic loss of the fringe visual field and, at last, the loss of focal, cone-interceded vision. There is concomitant attenuation of the retinal vasculature. It is thought that vascular loss follows decreased metabolic demand by the photoreceptors. Currently, no definitive treatment for retinitis pigmentosa exists, although nutritional approaches may slow some forms of this disease. Mesenchymal stem cells (MSCs) are progenitors of all connective tissue cells. A number of studies have shown that bone-marrow-derived MSCs can differentiate into cells expressing photoreceptor proteins. Induced pluripotent stem cells are ES-like pluripotent cells capable of differentiating into most, if not all, body cells. This potential promises an unlimited source of differentiated cells to replace those lost in many human degenerative diseases.In this study we compare between two types of stem cells to restore vision in RP patients . Results are compared according to visual outcome, investigations and complications. Finally the use of stem cell is useful in cases of retinitis pigmentosa and may be other retinal dystrophies.

Cell-based therapy is not a new concept; it is considered as one of the most promising approaches for treating diseases and for regenerative medicine. In addition, effective cell therapy can greatly benefit from the ability to monitor transplanted stem cells post-intervention. Mesenchymal stem cells (MSCs) represent one of the leading candidate population for regenerative medicine. Superparamagnetic iron oxide nanoparticles (SPIONs) represent contrast agents offering a possible way to track labelled cells after administration using MRI. Moreover, we have demonstrated that these magnetic particles (MPs) do not affect cell viability, proliferation, differentiation or migration. The aim of the present study was to determine the ability to use these iron particles to label MSCs and test their potential to control cell migration when exposed to a magnet. This aim was achieved by culturing labelled and unlabelled cells in 2D and 3D models, in presence or absence of magnet. Significant response to magnet exposure was observed in the 2D culture where is 76% of labelled cells moved to the magnet side when compared to unlabelled cells. There was only 45% of unlabelled cells found to have moved to the magnet side. Additionally, 64% of labelled cells moved to the magnet side in a 3D culture model, while the unlabelled cells showed around 50% cells moving to the magnet side. Briefly, we have shown that MSCs can be labelled with MPs in vitro, and this strategy can contribute to improving the spatial tracking of transplanted stem cell, and therefore improve their efficiency for therapeutic applications.