Quality of Nursing Courses as Perceived by Students: Relationship with Their Academic Achievement in Palestine College of Nursing

The purpose of this study was to determine the Bachelor Science of Nursing (BSN), student’s perceptions of the quality of nursing courses taught at Palestine College of Nursing (PCN), which were fundamentals of nursing course, adult nursing course, pediatric nursing course, maternity nursing course, community nursing course, mental health and psychiatric nursing course and nursing management and leadership course, and its relationship with their academic achievement. The Palestine College of Nursing is governmental and Ministry of Health (MOH) affiliated. The sample included 467 nursing students registered in the college who studied the previously mentioned nursing courses. Data were collected using a self-administered questionnaire developed by the researcher, and guided by literature. That was to assess the included nine quality dimensions of the nursing courses as perceived by the students. Content validity and reliability tests were done for the tool. The study revealed that the total students’ perceptions of the quality of all nurses courses were within average quality level (80.42%). The nursing management course and community health nursing course were of the first two ranks of high quality level (84.54%, and 84.48%, respectively), where mental health and psychiatric nursing course, fundamentals of nursing course, adult health nursing course, pediatric nursing course and maternity health nursing course were the next ranks of average quality level. The study revealed that students’ perceptions of seven dimensions from nine were with average quality level (80.50%). The first rank was the “teacher/instructor characteristics and attributes”, dimension of high quality level (84.44%), while the last rank was “teaching methodology” dimension of average quality level (77.54%). There was a positive relationship between students’ achievement and the courses’ quality dimensions, pertaining objectives of the course, contents of the course, teacher/instructor competencies, teacher characteristics, teaching methodology, students/teacher interaction and course evaluation. The study recommended improving the quality of nursing courses for better level and to improve the quality of some dimensions like using different teaching strategies, the quality of clinical settings, and improve the quality of nursing instructors in some clinical areas. Finally the researcher recommend for further studies about concerning quality in nursing education.

Vitamin D Status, C-Reactive Protein and Risk of Coronary Artery Disease—A Hospital-Based Study

Coronary artery disease (CAD) is a leading cause of deaths of women and men worldwide. In this study we tried to assess the relationship between Vitamin D status and CAD. Vitamin D has a big role in the body and debate on its effect on the heart and coronary arteries still exits. C-reactive protein (CRP) is an inflammatory marker which may rise in CHD. Aim: To determine the relationship between Vitamin D status and CRP and CAD risk among patients at middle zone of the Gaza Strip. Methodology: A retrospective case-control, hospital-based study was conducted at Al-Aqsa Martyr’s Hospital in Dier El-Balah City from August 2014 to October 2014. Patients (n = 100) aged above 40 years with confirmed CAD history were recruited using a purposeful, non-random sampling. Vitamin D status assessed by food frequency questionnaire of dietary Vitamin D and serum Vitamin D. Serum Vitamin D was measured using Calbiotech’s 25-OH Vitamin D ELISA and serum CRP was measured by the latex agglutination. SPSS V.19 used for data analysis. Results: Mean of age among cases was (68.28 ± 8.01) higher than controls (57.82 ± 9.61) (P = 0.01);percent of males (54%) was higher than females (46.0%) among cases. Sun exposure and mean duration of daily exposure to sunlight were higher in cases (P > 0.05). Cases were consumed less servings of Vitamin D rich food than controls (P > 0.05). Percent of Vitamin D deficiency among cases (42%) was higher than controls (16.0%) (P = 0.002). Mean of serum Vitamin D in association with positive CRP was (79.95 ± 70.6) lower than those with negative CRP (106.06 ± 68.966) (P = 0.13). Percent of positive serum CRP among cases 30% was higher than controls 10% (P = 0.01). Conclusion: Vitamin D deficiency was associated with positive CRP in patients with CAD. Vitamin D may have an anti-inflammatory effect regarding to our results.

Effect of Intervention Educational Programs on Improving Quality of Life among Overweight/Obese University Students in Gaza Strip

Background: Overweight and obesity are among the most frequently encountered multi-factorial disorders in most populations of the world. In addition, to its health impacts, overweight/obesity leads to many health problems which reflect on the university students’ physical, psychological, social and environmental aspects of their quality of life. The study aim was to evaluate the effect of an educational program on improving quality of life of overweight/obese university students in Gaza strip. Materials and Methods: quasi-experimental nonequivalent pretest-posttest control group design utilized in this study 74 and 69 students in the intervention and control group respectively. The study conducted at Islamic university of Gaza and data were collected in two stages before and after five months from the application of the educational program, using interviewing questionnaire and world health organization quality of life-BREF instrument;pre-post test and body mass index were calculated. Results: the study results revealed that overall students’ knowledge for posttest was significantly higher than pretest (p-value ≤ 0.05). Overall, mean score of quality of life after the program was significantly (p-value = 0.001) greater than before and greater than control group for all domains. Conclusion: The study concluded that the health educational intervention program had positive effects on knowledge, practices and attitudes regarding overweight/obesity with improving university students’ mean score of quality of life.

Relationship of Serum Leptin, BMI, Waist Circumference and Cholesterol Level among Teenagers in the Gaza Strip

Leptin is one of the best known hormone markers for obesity. There is a limited anthropometric data in the Gaza Strip that reveals and arouses the nutritional status among all age groups especially adolescents aged 15 - 19 years old. The study aimed to assess the effect of Leptin hormone, lipid profiles, Body Mass Index (BMI) and waist circumference among secondary school age students in the Gaza Strip. Methodology: A cross sectional study included 442 cases of teenagers aged 15 - 19 years old from governmental and private schools in the Gaza strip. Blood samples were collected for analysis of Leptin hormone and lipid profile and measuring waist circumference for the teenager. Results: The mean of serum Leptin was (28.7) higher among cases than controls (28.1), but it was statistically insignificant (P = 0.85). It was found that there is a significant correlation between Leptin hormone and total cholesterol (Chol) (r = 0.24), high density cholesterol (HDL) (r = 0.27) and low density cholesterol (LDL) (r = 0.16). There was no relationship between Leptin hormone and triglycerides (TG) (r = -0.02). There was relationship between Leptin hormone and waist circumference in both males and females (r = 0.519, 0.544), respectively. There was no statistical significant deference noticed between Leptin hormone of obese objects and Leptin hormone of normal BMI objects of the same age (t-test = 0.93, P = 0.85). Conclusion: There are significant correlations between Leptin hormone and total Chol, HDL and LDL except for TG, and there were significant relationships between Leptin hormone and waist circumference which reflect the central obesity among males and females. There is no association between Leptin level and BMI.

The Effect of Atorvastatin on Liver Function among Patients with Coronary Heart Disease in Gaza Strip

Statins, which are inhibitors of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase, are considered as one of the most important drugs and the drug of choice for reducing an abnormal cholesterol level. Statins are normally used to decrease the risk of coronary heart disease (CHD), but they tend to be associated with liver adverse effects. The objective of this prospective study was to investigate the effect of atorvastatin therapy on the liver function in patients with CHD. Study comprised of 66 newly diagnosed CHD patients who were selected from UNRWA clinics in the Gaza Strip. The patients were clinically examined and treated with atorvastatin (10 - 40 mg/day). A questionnaire was used to collect the data concerning patient’s characteristics. Total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), liver enzymes tests such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and total and direct blood bilirubin were measured before starting treatment and after 3 and 6 months of treatment. The results showed a significant increase in the mean values of ALT, AST, total bilirubin and direct bilirubin levels after 3 months then decreased after the next 3 months, but they were higher than the baseline with insignificant association.

Dietary Magnesium Intake Related to C-Reactive Protein in Newly Diagnosed Coronary Heart Disease Patients at Middle Zone, Gaza Strip. A Hospital Based Study

Coronary Heart Disease (CHD) is a highly prevalent disease all over the world. Magnesium (Mg) plays a role in CHD but it is still unclear. C-Reactive Protein (CRP) is an inflammatory marker which may rise in CHD. Aim of study: To assess the impact of dietary Mg intake and its level in relation to CRP among newly diagnosed CHD at middle zone of Gaza Strip. Methodology: Patients (n = 140) with confirmed CHD, 50 ± 10 years, presented in the cardiac care unit at Aqsa Martyr’s Hospital between 1 April 2012 and 30 December 2012, were enrolled in this cross-sectional study after taking consent. ECG, clinical status, and cardiac markers were used to confirm diagnosis by cardiologist. Food frequency questionnaire was used to assess Mg intake and calcium intake in addition to measurement of its level in serum. CRP latex slide was used for measurement of CRP. Results: Mg intake and serum Mg were?inversely associated with risk?of CHD. Mean of serum Mg among cases (1.80) was lower than controls (2.41) (P = 0.001). Percent of positive CRP was higher in cases (32.9%) than controls (12.9%) (P = 0.005). Mean of serum Mg was (1.96 ± 0.47) for positive CRP which was lower than the mean of serum Mg (2.15 ± 0.44) for negative CRP. Conclusion: Newly diagnosed patients with CHD have a positive CRP, low serum and low?Mg intake, and low serum Mg was associated with elevated CRP.

Polypharmacy in Primary Care Practices among Chronic Elderly Patients in Gaza Strip

Introduction: The increasing number of elderly, and drug use among the elderly, emphasizes the need for continuous monitoring of drug utilization. Chronic diseases are frequent among the older population;the rate of drug related problems and drug-drug interactions (DDIs) with the medical and financial consequences are enormous. Polypharmacy (PP) is defined as the concomitant use of 5 or more medications. We studied PP among chronic elderly patients in Gaza Strip and its distri- bution among primary health care clinics in different areas. Materials and Methods: This study is a descriptive analytical study, analyzing prescription data from general practices during a 3-month time period, to measure the prevalence of PP and medication errors among chronic elderly pa- tients. Data were collected directly from the prescriptions and medical records, which contain per- sonal data for patients like patient age and gender, included the current illness, drug treatment for the current illness, chronic disease/s and drug treatment for chronic disease/s. SPSS software was used to analyze the obtained data. Results: Percent of major PP was the highest among patients aged 60 - 69 years when compared with other ages categories of study population but not reached to be statisticaly significant (0.012). Major PP was higher in female patients than that in male patients but difference wasn’t statistically significant (0.5). The average number of drug per prescription was 3.4 drug;and the minimum value per prescription was 1 meanwhile maximum value was 9 (SD + 1.7). Conclusion: PP (use of five drugs or more) is more prevalent among elderly patients with multiple diseases. Female patients consume more drugs than male do. There were some regional differences in drug utilization not explained by morbidity, suggesting some varia- tions in prescribing behaviors.