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BACKGROUND AND OBJECTIVE Sessiline ciliates live as eco commensals (low numbers) and parasites (high numbers) on different hosts, like mollusks copepods, mysids and fish. Riboscyphidia ecto-protozoan is moderately pathogenic but high numbers of it on the gills can physically prevent gas exchange. The present study aimed to describe the epizoic ciliates Riboscyphidia found on the Red Sea cultured Asian sea bass and obtain more information on the Epidemiology of the parasite with special references to control and histopathological examination of naturally infected sea bass. MATERIALS AND METHODS The occurrence of epizoic ciliates on the adult Asian Sea bass. About 100 Asian sea bass were collected by the fishing net at a private marine fish farm at Ismailia governorate and transferred to the hydrobiology laboratory at National Research Centre. A parasitological and histopathological study of epizoic sessile ciliate species was done. ANOVA test was used for Statistical analysis. RESULTS Riboscyphidia sp. was found and isolated after parasitological examination of investigated adult's Asian sea bass. The prevalence of Riboscyphidiosis was 64%. Sessile ciliates were found on gills, skin and fins. The clinical signs of Riboscyphidiosis were respiratory distress, flashing and off food. Histopathological alterations in naturally infested Asian sea bass were investigated. CONCLUSION The treatment of choice of Riboscyphidiosis was prolonged immersion by Copper citrate with a dose of 0.56 mg mL-1 for 7 days.

Background: Adverse nursing job and organizational outcomes are contributing factors to the shortage of nursing staff and the deterioration of the quality of nursing care in healthcare settings. The patient care delivery conceptual model has been developed to explore the relationship between structure, process, and outcomes of nursing work. Objective: The study aimed to examine the impact of the structure and process of nursing work on the nursing job and its organizational outcomes. Methods: A cross-sectional correlation survey was implemented in this research. Self-administered questionnaires of structure, process, and outcomes of nursing work were used to collect the study data from 565 nurses. Attendance nursing records were reviewed to collect absenteeism data. Results: The structure and process elements of nursing work were insufficient. Therefore, nurses reported a lack of enjoyment in their work environment and high psychological distress. Thereby, the absenteeism rate was 15.5 % among nurses. Nurses engaged in their work at a moderate level. The level of quality of care and patient safety was below the satisfactory level. R - Square results indicated that the nursing work structure and process were significant predictors of adverse nursing job and organizational outcomes. The structural equation model explained the direct and indirect effects of the study variables. Conclusion: Adverse nursing job and organizational outcomes in this study were related to the nursing work structure and process shortage.

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BackgroundWorkplace silence behavior is a social collective phenomenon. It refers to nurses choosing to withhold their ideas, opinions and concerns about critical issues in their workplace. Workplace silence behavior poses a threat to organizational ethics and success. It also has adverse effects on the performance of nurses in health organizations. Underlying nursing causes of silence behaviors could be related to individual, social and organizational attributes in health care settings.ObjectivesThe study aimed to develop a new Egyptian validation scale for measuring nursing motives of workplace silence behavior and identify consequences of workplace silence behavior on nurses.MethodsA cross-sectional correlational study was implemented using questionnaires on workplace silence behavior, nursing motives and nurses' consequences, collected from 332 nurses working in critical and toxicology care settings of Alexandria Main University Hospital.ResultsEgyptian scale was shown to be a good fit model of exploratory (36 nursing motives emerged in six dimensions with total variance of 73.3%) and confirmatory factor analysis tests (X2 = 1381.47, NNFI =0. 90, CFI = 0.91, RMSEA = 0.057). It also had high reliability tests with coefficient of alpha (0.85), Pearson (0.75) and Kendall coefficient of 0.72. High level of workplace silence behaviors showed a negative association with organizational dis-identification, fair citizenship behavior, and fair nurses' performance and declined reporting of patient adverse events. It also appeared to be in a positive association with higher levels of cynicism.ConclusionThe Egyptian scale was proved to be reliable and valid for measuring the underlying nursing causes of silence behaviors in the hospital workplace. Measuring nursing motives of workplace silence behaviors will help nurse managers to reduce negative outcomes of workplace silence behaviors and improve organizational outcomes.

Background The nursing profession requires ethical and legal regulations to guide nurses’ performance. Ethical climate plays a part in shaping nurses’ ethical practice. Therefore, ethico-legal aspects and ethical climate contribute to improving nurses’ ethical practice and competencies with reducing medical errors in hospital settings. Objective This study examined the effect of ethico-legal aspects and ethical climate on managing safe patient care and medical errors among nurses. Materials and methods A cross-sectional correlational study was carried out on 548 nurses. Data were collected through self-administered questionnaires about nurses’ knowledge in both ethical and legal aspects, ethical practice, competencies, ethical climate and experience with medical error. Results The main sources of nurses’ knowledge of ethical and legal aspects were undergraduate lectures, job experience and colleagues. Nurses’ knowledge in both ethical and legal aspects, nurses’ ethical practice and competencies were insufficient. Nurses fairly perceived their ethical climate. Also, nurses experienced medical errors about 22.6% in their units. Nurses’ knowledge of ethical and legal aspects, as well as the ethical climate were positive predictors of inadequate nurses’ ethical practice and competencies. Additionally, nurses’ knowledge in both ethical and legal aspects, ethical climate and practice had a negative influence on the occurrence of medical errors. Conclusion Enhancing nurses’ knowledge in both ethical and legal aspects as well as ethical climate could significantly influence improving nurses’ ethical practice, competencies and reducing medical errors in the study units. Therefore, planning for enhancing the nurses’ ethico-legal learning and ethical climate seems to be mandatory.

Background Functional disturbances of the gastrointestinal tract is caused by a number of neurodysplastic conditions including other diseases, rarer than the Hirschsprung’s disease dysganglionosis, such as ganglion cells immaturity including Intestinal Neuronal Dysplasia (IND). Bcl-2 shows positive immunoreactivity in the degenerative and immature ganglion cells . Aim This work evaluates the role of immunohistochemical expression of Bcl-2 in pediatric functional bowel obstruction cases with ganglionated specimens. Material and Methods Twenty one cases of functional bowel obstruction were enrolled in our study including the Hirschsprung Allied Disorders (HAD) and operated cases of Hirschsprung’s Disease (HD) with adequate ganglionated resection margins and presented by obstructive symptoms following surgery. All cases underwent histologic examination of ganglion cells and nerve bundles as well as evaluation for Bcl-2 immunohistochemical expression. Results 57.1% of the cases were strongly positive for Bcl-2 protein, 19% were weakly positive and 23.8 % were negative. A highly significant correlation was demonstrated between Bcl-2 expression and ganglion cell number ( P Conclusion Bcl-2 immunohistochemistry can be used as a valuable tool in the diagnosis of Hirschsprung’s disease allied disorders through its expression in the immature ganglion cells which are difficult to be identified by conventional H & E staining.

Background Working in hospitals entails several risks to nurses. A better nursing workplace can help in improving physical activity and reducing adverse occupational health outcomes among nurses. Aim This study aimed to investigate the relationships of the nursing workplace with occupational health outcomes and physical activity. Methods A cross-sectional correlation study was conducted with 623 nurses. Data were collected through report self-administered questionnaires that included employment and occupational conditions, hospital workplace environment, and adverse occupational health outcomes as well as physical activity pattern. Results The current study showed that the nursing workplace environment and conditions had a negative effect on occupational health outcomes and physical activity among nurses in the study units. Nurses in this study reported a high prevalence of low back pain (82.7%), burnout (78.3%), and occupational injuries (70.5%). They also reported insufficient physical activities (90.6%). High prevalence of burnout and low back pain were associated with low levels of physical activities among nurses. Conclusion A fair working environment and conditions have been implicated as a causative factor of negative occupational health outcomes and limitations of physical activity among nurses. Adverse occupational health outcomes also affect the nurses engaging in physical activity.

Background and objective Amyloodinium ocellatum infects the gills and skin of both marine and brackish water fishes. The aim of the present study was to examine pathogenesis, prevalence, trials for treatment and histopathological alterations of Amyloodinosis in naturally infested Asian Seabass Barramundi Lates calcarifer and Hamour Epinephelus polyphekadion in Ismailia Governorate, Egypt. Materials and methods A total number of 1447 Red Sea cultured Seabass (Lates calcarifer) broadstock and a total number of 53 Red Sea cultured Hamour, Epinephelus polyphekadion broadstock were collected and subjected for the study. Fishes showed symptoms of sudden death and respiratory distress besides Amyloodiniosis on gills and skin. All fishes were treated with various treatment protocols while gills of naturally infected fishes were examined histopathologically. Results The clinical signs of infested fishes were flashing, surfacing, off food and respiratory distress. The intensity of infestation of Amyloodiniosis was more sever in Asian Seabass than Epinephelus polyphekadion while treatment of choice was copper sulphate (prolonged bath), freshwater bath and formalin consequently. Conclusion Treatment of choice for Amyloodinium ocellatum infestation in Asian Seabass was copper sulphate (prolonged bath) followed by freshwater bath then formalin.

Background and PurposeManagers have diverted their attention to developing strategies for managing nursing work. Develop an Egyptian tool for evaluating rationing of nursing care in critical units and its association with nursing organization attributes and six nurse-sensitive patient outcomes.MethodsRationing of the nursing care questionnaire and concurrent record review were conducted to collect data.ResultsDeveloped Egyptian tool of rationing of nursing care contained 36 items in six components. Adverse patient outcomes were detected as medication administration errors (27.9%), pulmonary infection (24.5%), pressure ulcer (20.3%), bloodstream infections (12.6%), urinary tract infections (10.3%), and patient falls (4.7%). The mild level of rationing of nursing care was positively associated with negative patient outcomes and negatively correlated with fair nursing organization attributes.ConclusionThe valid and reliable Egyptian tool for evaluating the rationing of nursing care was developed.

Background Blood administration failures and errors have been a crucial issue in health care settings. Failure mode and effects analysis is an effective tool for the analysis of failures and errors in such lifesaving procedures. These failures or errors would lead to adverse outcomes for patients during blood administration. Objectives The study aimed to: use health care failure mode and effect analysis (HFMEA) for assessing potential failure modes associated with blood administration processes among nurses; develop a categorization of blood administration errors; and identify underlying reasons, proactive measures for identified failure modes, and corrective actions for identified high-risk failures. Methods A cross-sectional descriptive study was conducted in surgical care units by using observation, HFMEA, and brainstorming techniques. Prioritization of detected potential failures was performed by Pareto analysis. Results Eleven practical steps and 38 potential failure modes associated with 11 categories of errors were detected in this process. These categories of errors were newly developed in this study. In total, 17 of 38 potential failures were detected as high-risk failures that occurred during the sample-drawing, checking, preparing, administering, and monitoring steps. For cause analysis of failures and errors, proactive suggested actions were undertaken for 38 potential failure modes, and corrective actions for 17 high-risk failures. Conclusion HFMEA is an efficient and well-organized tool for identification of and reduction in high-risk failures and errors in the blood administration process among nurses without building punitive culture. This tool also helps pay attention to redesigning and standardizing the blood administration process as well as providing training and educational programs for providing knowledge.

Background and study aim:Patients with decompensated cirrhosis suffer from serious sequelae including infections that may endanger life. The study aimed at determination of the incidence, outcomes and risk factors of spontaneous bacterial empyema (SBEM) among patients with cirrhotic ascites and hydrothorax. Patients and Methods: This study included 50 patients subjected to clinical, imaging and biochemical workup including diagnostic tapping of ascitic and pleural fluid to diagnose spontaneous bacterial peritonitis (SBP) by cellular count and SBEM by cellular count and culture. Results: There The mean age was 57.14 years and 52% were males. SBP was found in 25 cases (50%); alone in 15 and with concomitant SBEM in 10. Only 7 (14%) had positive culture of the pleural fluid including five gram positive bacteria. Patients SBP and SBP/SBEM had significantly higher mean age, higher median TLC, and corrected PMN in pleural fluid compared to patients with no infection. The infection group stayed a significantly more duration in hospital. All the four deaths occurred in the infection group, three with SBP/SBEM and one with SBP. By multivariate logistic regression analysis, pleural fluid TLC and corrected PMN and duration of hospital stay were significant independent predictors of SBEM. Conclusion: SBEM is a common sequel of hydrothorax in patients with cirrhotic ascites and its coexistence with SBP leads to higher morbidity and mortality.