Chief Advisor

Srimat Swami Satyadevananda, SecretaryRamakrishna Mission Seva Pratishthan, Kolkata.

Editorial Board

Ms. Sikha Banerjee, M.Sc. (N)Nursing Superintendent, R.K.M.S.P

Ms. Bharati Chatterjee, M.Sc. (N)Principal, Ma Sarada College of Nursing, R.K.M.S.P

Ms. Sujata Sengupta, M.Sc. (N)Vice Principal, Ma Sarada College of Nursing, R.K.M.S.P

Editor

Ms. Madhuchanda Guhathakurta, M.Sc. (N) Principal, School of Nursing, R.K.M.S.P

Co-Editor

Ms. Nupurkana Dutta, B.Sc.(N) Dy. Nursing Superintendent, R.K.M.S.P

Ms. Suchanda Sikdar, M.Sc. (N) Lecturer, Ma Sarada College of Nursing, R.K.M.S.P

Ms. Senjuti Mullick, B.Sc. (N) Sister Tutor, School of Nursing, R.K.M.S.P

Editorial Address :Office of Nursing Superintendent,Ramakrishna Mission Seva Pratisthan99 Sarat Bose Road, Kolkata-700 026Phone No. - (033) 2475-3636

Research publication is done with due permission from the researcher. Articles published withreferences from books and websites.Number 3, September-November, 2014.

Quarterly News Letter for Promoting Excellence in Nursing

From the Desk of Editorial Board

Our 3rd volume of nursing “News and Views” is been published. Thanks to writers,specially to little Angels (Student Nurse) who have shared their views to enrich thejournal.

Contents

Page No.

1. Food Safety — Ms. Arpita Chandra 3

2. Nursing Responsibilities for A Patient Receiving Chemotherapy— Ms. Swaranita Dey 5

3. Recognition And Early Management of The CrticallyIll Ward Patient — Ms. Binita Saho 8

4. Proper Care of Intravenous Channel Site — Ms. Santa Sarbabidya 10

5. Diabetes Foot Care — Ms. Soma Biswas 11

6. Signs of Stroke (Fast) — Ms. Sanchita Banerjee 13

7. Measures To Reliefe Low Back Pain — Ms. Swagata Das 14

8. A Short Case Report — Mrs. Soma Kundu 16

9. How to Cope With Depression Without Seeking Professional Help— Ms. Arpita Jana 18

10. The Effects of Music Therapy on Anxiety Related ToTerminally Ill Patients — Ms. Arpita Das 21

11. Studies Done on Effects of Mobile Phones on Human Health— Ms. Monalisa Chakraborty 23

12. Research Study to Evaluate The Effectiveness of A Planned TeachingProgramme on Common Accidents, Their Prevention and First AidManagement Among Mothers of Toddlers in A Selected RuralCommunity of West Bengal — Mrs. Suchanda Pal 26

13. Neonatal Care Workshop 29

Food SafetyMs. Arpita Chandra

1st Year, G.N.M. Student, School of Nursing, RKMSP

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Introduction :-

Food safety is a scientific discipline describinghandling, preparation and storage of food inways that prevent food borne illness.

General Principles of Food Safety :-

The five key principles of food hygiene,according to WHO are-

i. Prevent contaminating food withpathogens spreading from people, petsand pests.

ii. Separate raw and cood foods to preventcontaminating the cooked foods.

iii. Cook foods for the appropriate lengthof time and at the appropriatetemperature to ki l l pathogens.

iv. Store at proper temperature.

v. Do use safe water for cooking.

Food Borne Infections:-

Certain food borne infections which effectsthe individual is highlighted as:-

Group Examples of illness in each group

Bacterial diseases Typhoid Fever, Paratyphoid Fever, Salmonellosis, Staphylococcalintoxication, Cl. perfringens illness, Botulism, B. cereus foodpoisoning, E. coli diarrhea, Non-cholera vibrio illness, V.Parahaemolyticus Infection, Streptococcal infection, Shigellosis,Brucellosis.

Viral disease Viral hepatitis, Gastroenteritis.

Parasites Taeniasis hydatidosis, Trickinosis, Ascariasis, Amoebasis,Oxyuriasis.

Food Hygiene :-

It is necessary to observe the following factsin food hygiene:-

l Contaminated sewerage water shouldnot be used in the irrigation of the landespecially for fruits and vegetablesproduction.

l Food should be transport in such a waythat safe packing, appropr ia tetemperature, preventing infection whenstorage.

l Special attaintion should be given somefood articles e.g. milk, meat, fish,vegetables etc. like-

l Sterilization of milk by boiling, fruits arewashed before eating, milk and fishshould be fresh and all articles shouldbe covered.

l Maintain cleanliness in the kitchen anddining rooms and also arrangement forwater, drainage and space.

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l Wash hand before taking food or servingfood.

Food Safety and Standard Act - 2006 :-The standards for quality and safety laiddown in the Food Safety and Standard Act(FSSA) - 2006 are harmonized standardsand applicable through out the country andall other standards / specifications becomenull and void.

Conclusion :-

Under the provision of FSSA - 2006, FSSAIhas also taken several measures forensuring transition from PFA Act to the newregulatory region. FSSAI also reviewed thesteps taken by the states and Unionterritory for the implementation of the Act.

Reference :

l Park. K, Preventive And Social Medicine,

M/s. Banarsidas Bhanot, 19th edition, page no. -

521

l K. Swarnkar’s, Community Health of Nursing,

N. R. Brother, 3rd edition, page no. – 347-349

l http:// www.google.com. Food Safety- Wikipedia,

the free encyclopedia.

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Introduction: Chemotherapy is the use ofantineoplastic drugs to promote tumor celldestruction by interfering with cellular functionand reproduction. It includes the use of variouschemotherapeutic agents and honmones.Oncology nurses are engaged in a collaborativepractice with all members of the care team toprovide optimal management of patient withcancer. The nurses are faced with increasedresponsibility for coordinating quality care withfewer resources.

Safety measure in handling chemotherapy

Cytotoxic drugs are generally hazardous, sominimum exposure is required. Theundermention points are to be remembered :-

1. To use personal protective equipments likegloves, disposable gowns, respirators toprevent exposure to the Cytotoxic drugs.

2. To use personal safety measures like –

l To prepare Cytotoxic drugs in a verticallaminar flow hood.

l To wash hands after removing PPE(Personal Protective Equipment)

l To wrap gauze around the neck of ampoules

Nursing Responsibilities for A Patient Receiving ChemotherapyMs. Swaranita Dey

G.N.M. 2nd Year, Batch September 2012, School of Nursing, RKMSP

when opening to decrease dropletcontamination.

l To prime all IV tubing with normal saline.

l To label all syringes and IV tubingcontaining chemotherapeutic agents as“hazardous material”.

l To keep all foods and drinks away frompreparation area.

l To place an absorbent pad directly underthe injection site to absorb any accidentalspillage.

3. To safe disposal of Antineoplastic agents,Body fluids and Excreta is needed to bedone.

l To discard gloves and gown into a leakproofcontainer.

l To use leakproof containers to needles.

l To linens contaminated with chemicals orexcreta of patients receiving chemotherapyshould be kept in separate waste bag andlabeled as “hazardous waste bags”.

l Use non sterile gloves for disposing bodyExcreta within 48 hours.

Problem Nursing Management

1. Nausea & vomiting 1. a) Teach patient to eat & drink when notnauseated.

b) To administer antiemetics prophylicticallyprior to chemotherapy & as when required.

c) To use diversional activities.

Nursing Management of Problems Caused by Chemotherapy :

6

Problem Nursing Management

2. Diarrhoea 2. a) To give antidiarrhoeal agents as needed.

b) Encourage low fiber, low residue diet.

3. Hepatotoxicity 3. a) To monitor Liver function test.

4. Anemia 4. a) To monitor hemoglobin and hematocrit levels.

b) Administer iron supplements anderythropoietin.

5. Thrombocytopenia 5. a) To observe for signs of bleeding(e.g.Petechiae,Ecchymosis), hence monitor for platelet counts.

6. Alopecia 6. a) To suggest ways to cope with hair loss (e.g-Wigs)

b) Cut long hair before therapy.

c) Avoid excessive shampooing, brushing &combing of hair.

7. Chemotherapy induced skin 7. a) Alert patient to potential skin changes.Changes like-

l Hyperpigmentation (Increased b) Encourage patient to avoid sun exposure.colouration produced in body bydeposition of pigment)

l Telangiectasis (Localised collectionof distended blood capillary vesselsappearing as a red spot which lookslike a spider)

l Acral Erythema (Flushing of skindue to dilatation of blood capillariesin dermis)

8. Haemorrhagic cystitis 8. a) To monitor manifestations such as(Bleeding from site where there is urgency & frequency of haematuria.inflammation of urinary bladder)

b) To administer supportive care agents tomanage symptoms.

9. Peripheral neuropathy (Any of 9. a) Monitor the urine outputa group of disorders affecting thesensory & motor nerves in theperipheral system)

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10. Pneumonitis 10. a) Monitor for dry hacking cough, fever &extertional dyspnoea.

11. Cardiotoxicity (Toxicity of Heart) 11. a) Monitor heart rate with ECG & cardiacEjection fraction.

b) Drug therapy may need to be modified forsymptoms detoriating cardiac function studies.

12. Fatigue 12. a) Tell patient that fatigue is an expected sideeffect of therapy.

b) Encourage patient to rest when fatigued.

Problem Nursing Management

Management of Cancer Pain :

Moderate to severe pain occurs inapproximately 50% of patients who arereceiving chemotherapy. A thorough painassessment by using the” Pain assessmentscale” is mandatory. Data need to beobtained and documented at regular intervalson the location & intensity of pain.

Drug therapy, including non steroidal anti-inflammatory drugs, opoids & adjuvant painmedications should be used. Analgesics(Morphine, Pentanyl) should be given atregular schedule. Side effects of drugs isneeded to be looked after.

Non-pharmacologic interventions includingrelaxation therapy & imagery is useful forpain management.

Psychological support :

A positive attitude of patient, family & healthcare provider toward cancer & cancer

treatment have an effect on the patient’squality of life. It is very much needed foreveryone to exhibit a caring attitude,maintaining a relationship of trust, assisthim/her in setting goals helping him/her tomaintain hope. All these can providePsychological support to a cancer patient.

Conclusion :

Providing nursing care to patients receivingchemotherapy presents many challenges.The nurse must have knowledge ofPharmacology of antineoplastic agents,proper techniques of drug prepation &administration & drug interactions andpossible adverse effects of individual agents.Oncology Nursing will continue to developas a dynamic element within the health caredelivery process with meticulous nursingmanagement of these case who considersthemselves as terminally ill patients.

Reference:

l Bucher Linda, Driksen S. R., Heitkemper M. M., Lewis S.L., O’Brien P.G., Medical Surgical Nursing,Published by Elsevier publishers, Seventh edition, Page no 275-300

l Cancer guide http:// cancerguide.org

l Can support www.cansupport.org

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Critical illness is any disease process whichcauses physiological instability leading todisability or death within minutes or hours.Fortunately such instability can be reliablydetected by deviations from the normal rangein simple clinical observations such as level

Recognition and Early Management of

The Crtically Ill Ward PatientMs. Binita Saho

B.Sc. Nursing 3rd year, Ma Sarada College of Nursing, RKMSP

of consciousness, respiratory rate, heartrate, blood pressure and urinary output.Here a very brief examination for cardinalfeatures of critical illness is made thatfocuses on key aspects of neurological andcardio respiratory function.

Bedside examination for cardinal features of critically ill patients:-

Patient Category Clinical Observations

Appearance Neurological Respiratory Cardiovascular

Not critically ill Normal • Alert

• Co-operative

Normal pattern

Respiratory rate > 8< 20b/min

Heart rate -60-100b/min systolicblood pressure> 90mm of Hg

Potential criticalillness

• Sweaty

• Pale

• Anxious

• Agitation

• Confusion

• Eyes open tovoice only

• Accessorymuscle use

• Respiratoryrate <8b/minor 20-30b/min

Heart rate>100b/min

Systolic bloodpressure <90 mmof Hg

Urinary out put

Critically ill • Grey

• Blue

• Mottled skin

• Unrespon-sive or eyesopen to painonly

• Fitting

Silent chest

Respiratoryrate < 8, >30b/min

Agonalrespirations

Heart rate<50b/min

Heart rate >150b/min

Systolic bloodpressure < 60 mmof Hg

Anuric

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RECOGNITION AND EARLY MANAGEMENT OFTHE CRTICALLY ILL - WARD PATIENT

Patient referral

Bedside examination

Critically ill Potentially Critically ill Not Critically ill

Call for help Definitive plan History

Resuscitation ABCDE Reappraise treatment Physical examination

Diagnostic process Enhanced monitoring Diagnosis

Definitive plan Reappraise diagnosis Definitive plan

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Proper Care of Intravenous Channel SiteMs. Santa SarbabidyaWard Incharge, RKMSP

A venous cannula is inserted into a veinprimarily for the administration of I/V fluidsand for administering medicines or blood.

I/V therapy should be safe and should causeless pain to the patient.

Some of the most commonly recognizedcomplications of I/V therapy include phlebitis,occlusion in filtration, extravasation andinfection.

To prevent all complications, some nursingmeasure should be followed :

l Selection of I/V channels site. Try to selectwhere vein is long, straight andaccessible, ensuring not near any bonyprominence and joint.

l With the exception of emergency situationit is crucial that the patient’s preferencesare taken into account to prevent patient’spain phobia.

l Proper hand wash before the procedureis very much important.

l Always clean and make the area freefrom floral bacteria.

l Prevention of complications and safe I/Vmanagement requires assessment, thesecan prevent devastating patient injuries.

l All patients with an I/V access deviceshould have the access site checkedevery shifted for sign of phlebitis.

l Ear ly recogni t ion can preventcomplication, Pain is warning sign, whenpain is reported it should not be ignoredas often this an indication of anassociated risk, such as occlusion,phlebities or infection.

l Application of cold compress at leastthrice a day can prevent pain andswelling.

l Correct flushing technique can minimizethe potential for intra luminal vascularaccess device (VAD).

l Always loop the I/V or B/T set with VADto minimize catheter movement improvepatients comfort reduce I/V catheterrestarts extend dwell t imes andsignificantly reduce overall complications.

11

Diabetes is a condition characterized by highblood glucose levels. Our body has an organcalled ‘Pancreas’ which is responsible forproducing insulin that in turn regulates ourblood glucose levels. In diabetic patientseither cells don’t use insulin properly i.e. theinsulin can’t fully “unlock” the cell to allowglucose to enter (insulin resistance) orpancreas may not produce enough insulin(insulin deficiency). Glucose begins toaccumulate in blood.

Constant high levels of glucose in the bloodeventually lead to Diabetic complicationswhich can drastically reduce your quality oflife. It is important to take control of bloodglucose levels so as to prevent progressioninto these complications.

Diabetes Foot CareMs. Soma Biswas

Lecturer, Ma Sarada College of Nursing, RKMSP

Check Your Feet Every Day!

Foot problems can literally developovernight. It is essential to check your feetdaily for the following:

q Cuts, blisters or sores

q Change in temperature (hot or cold)

q Change in colour (pale, red, blue)

q Swelling

q Pain

q Dry cracking skin

q Sweaty skin

q Athlete’s foot or other rashes

q Signs and symptoms of infection

q Corns and calluses

Referrence :

l O’Brien JA, et al. “Direct Medical Costs ofComplications Resulting From Type 2 Diabetesin the US.” Diabetes Care 1998 21:7 pp 1122-8.

l Singh N, Armstrong DG, Lipsky BA. “PreventingFoot Ulcers in Patients with Diabetes.” JAMA.2005 Jan 12 : 293(2) : 217-28.

12

HOW TO TAKE CARE OF YOUR FEET

13

Introduction :

Stroke occurs when there is an ischemia to a part of the brain or hemorrhage into thebrain. That results in death brain cells. The term brain attack is increasing, being used todescribe stroke, it communicates the urgency recognizing the clinical manifestation of thesame to treat as a medical emergency.

Signs of Stroke (Fast)Ms. Sanchita Banerjee

Lecturer of Ma Sarada College of Nursing, RKMSP

Recognize the signs of stroke call Emergency. A stroke is always a medical emergency.Using the FAST test involves asking three simple questions:

Face Check their face. Has their mouth drooped?

Arm Can they lift both arms?

Speech Is their speech slurred? Do they understand you?

Time Is critical. If you see any of these signs call Emergency straight away

Facial weakness, arm weakness and difficultywith speech are the most common signs ofstroke, but they are not the only signs. Othersigns of stroke may include one, or acombination of :l Weakness or numbness or paralysis of

the face, arm or leg on either or bothsides of the body.

l Difficulty speaking or understandingl Dizziness, loss of balance or an

unexplained fall.

l Loss of vision, sudden blurring ordecreased vision in one or both eyes

l Headache, usually severe and abruptonset or unexplained change in thepattern of headaches.

l Difficulty swallowing.The signs of stroke may occur alone or incombination and they can last a few secondsor up to 24 hours and then disappear.Refferance:1. American Stroke Association

14

Having a back pain is irritating. And most ofus experience this problem at some point.Back pain can be of different forms-rangingfrom a constant dull ache to abrupt sharpsoreness resulting from various reasons.

Pain in low back can relate to the bodylumber spine, discs between the vertebrae,ligaments around the spine & discs, spinalcord & nerves, muscles of the low back,internal organs of the pelvis & abdomen &the skin covering the lumber area.

v Causes of Low back Pain –

1. Lumber Strain- It is a stretch injury tothe ligaments, tendons & muscles of thelow back.

2. Nerve Irritation – The nerves of thelumber spine can be irritated bymechanical pressure by bone or othertissues or from disease.

3. Lumber Reticulopathy – It is causedby damage to the discs between thevertebrae.

4. Bony Encroachment – Any conditionthat results in movement or growth ofthe vertebrae of the lumber spine canlimit the space (encroachment) for theadjacent spinal cord & nerves.

5. Bone & Joint Conditions – It lead tolow back pain include those existingfrom birth (congenital) those that resultfrom wear & tear (degenerative) or injury.

Measures To Reliefe Low Back PainMs. Swagata Das

Clinical Instructor, Ma Sarada College of Nursing, RKMSP

So, How is Low Back Pain Treated?

Here are some simple self- help tips youcan follow for a quick & effective back painrelief —

1. Keep Exercising – Regular physicalactivity is often the best remedy for backpain. Simple exercise like walking canbe very helpful as people gets out oftheir sitting posture & puts the body ina neutral, upright position. Stay awayfrom strenuous activities & avoidwhatever motion caused the pain in thefirst place.

2. Limit Bed Rest – Studies show thatpeople with short-term low back painwho rest feel more pain & have a hardertime with daily tasks than those whostay active.

3. Maintain Good Posture – Poor posturecan lead to back pain. If you arestanding, stand up straight & keep yourweight balanced on your feet. Makesure that your feet are shoulder –widthapart & your knees slightly relaxed.Your shoulders should be straight linewith your ears & lips.

4. Improve Flexibility– Too much tension& tightness can cause back pain. Putan equal load throught the body fromthe feet all the way up to the head.Always stretch before exercise or otherstrenuous activity & also before bed.

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5. Keep a Healthy Weight – Each ahealthy diet filled with fruits & vegetables& low on processed foods to avoidexcessive weight.

6. Sleep The Right Way – Always sleepon a firm surface for back pain reliefrather than soft mattress that pushesyour back out of alignment. Backsleepers should put pillows under theirknees. Side sleepers should placepillows between their knees to keep theirspine in a neutral position.

7. Apply Ice & Heat – Heating pads &cold packs can comfort tender trunks.Using Ice for the first 48 hrs after aninjury- particularly if there is swelling &then switching to heat.

8. Try Talk Therapy – Back pain is oftenseen with issues such as depression &anxiety. “Your emotional state colorsthe perception of pain”-Moroz says.

9. Use Relaxation Techniques –Meditation, deep breathing & yogawhich help put the mind at rest. It willhelp reduce the perceived pain level.

References:-

1. http://www.medicinenet.com/low_back pain/article.htm

2. http://www.soine-health.com/conditions/lower-back-pain/lower-back-pain-symptoms-diagnosis

3. http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

16

A Short Case ReportMrs. Soma KunduDietitian, RKMSP

A 40 yrs. old middle class female admittedin our hospital with chief complain of vomitingand loose stool for several episodes. Shehas the above complain for a month ago.Different bio-chemical tests reveal that thepatient has very low albumin level (Alb-1.1).Finding of endoscopy reveals Gastric erosionand colonoscopy finding was segmentalcolitis.

Final diagnosis was gluten sensitiveEnteropathy or celiac disease.

Gluten is a type of protein found in wheat,rye, barley and other bakery products. Cellsof villi of these patients become deficient indisaecharidases and peptidases needed fordigestion and the carriers needed totransport nutrients into the blood stream.Decreased release of peptide hormone fromsmall intestine also contributing tomaldigestion.

The atrophy and flattening of the villi wasalso the cause for micronutrient andmacronutrient malabsorption.

Pathophysiology of Gluten Sensitive Enteropathy

GLUTEN

(Component of wheat, ryeand barley protein)

DAMAGE TO SMALL BOWEL

1. Atrophy and flattening of villi.

2. Cellular deficiency of disaccha-ridases and peptidases.

3. Reduced nutrient transportcarriers.

EXTRAINTESTINAL EFFECTS

1. Anaemia

2. Dermatitis herpetiformis

3. Muscle weakness

4. Endocrine disorder

17

1. Complete with drawl of gluten containingfoods like wheat, rye, barley & oats.

2. All kind of bakery products such as whitebread, brown bread, biscuit, cookies,cakes & buns are excluded from thediet.

3. Lactose intolerance also occurs of milk,curd can be given to the patient.

4. Fruits do not contain any gluten so allkinds of fruits are allowed according topatient’s choice.

5. Rice based product like rice, puffedrice,flaked rice are allowed for celiac disease.

6. Egg is the richest source of albumin.Asthese patient has low albumin level.So egg albumin is freely given to thepatient according to patient requirement.

7. Plenty of fluid and electrolyte arenecessary to present dehydration anddiarrhea.

8. Fish & chicken do not contain anygluten. So fish & chicken canbe given.If the patient is non-vegetarian.

9. Energy can be increased by addition ofoil and sugar within the diet.

10. Above all careful scrutiny of all foodlabels during purchase of foods are verynecessary.

Medical Nutrition Therapy For Gluten Sensitive Enteropathy

Important Notes

All kinds of wheat products like —

Maida, Atta, Biscuits, Cookies, Wheat Noodles, Cakes, Pastry, White bread, Brown bread,Bun, Rye, Barley, Suji, Dahlia, Oats are strictly excluded from the diet.

18

How to Cope With DepressionWithout Seeking Professional Help

Ms. Arpita JanaClinical Instructor, School of Nursing, RKMSP

Depression is a serious and common illnessthat touches many people. There are severalbasic techniques that may find to be veryhelpful in treating this condition. Keep readingfor instructions on coping with depressionwithout going to a professional.

Steps

1. Do Something For Others: This will buildself esteem and create gratitude in others,but start small, don't be extravagant orextreme.

2. Use Positive Affirmations: Repeatpositive statements like, "I can do it. I'm allright. Everything is getting better." Find otherthings like that to tell yourself.

3. Replace Negative Thoughts withPositive Ones: Instantly when a negativethought or feeling appears change yourconscious mind: you can only think aboutone thing at a time, so stop negativethoughts by filling up with positive ones.

4.Talk To Your Closest Friend(s): The firstand best step is to let people you care aboutknows your feelings. By doing this, you arelearning some control, building esteem andgrowing a support base. When doing this,tell only someone/some people you candefinitely trust.

19

5. Talk To A Counselor or Doctor At leastOnce: Nobody will have you to"put away"with being depressed. Medication or furthercounseling may be suggested, but thedecision to take these recommendations arealways yours. Again, by doing this you aretaking some control.

6. Get A New Hobby: It may seem like anoff-the-cuff remark, but taking a new, funand interesting hobby increases yourmotivation, gives you a diversion and helpswith concentration and it may also help insocialization.

7. Write Your Feelings: Try to understandyourself a little more. Don't be afraid ofhonesty. Understand that depression canbe a very solitary i l lness, and sounderstanding yourself can make you moreat ease with yourself.

8. Make Black-And-White Decisions: Don'tprocrastinate. You either will or won't getout of bed. You will or won't visit your friend'shouse. Don't think about it - do it! There'snothing to lose. Take control of yourself.

9. Make A List of 10 Things You Want toDo With Your Life Do Your Very Best toWork: Have a day out with friends to takeyour mind of everything.

l Keep your 10 things simple andachievable; event-based. Don't write "bea good person", write "smile at thewaitress every morning",

l Enjoy your work. If you don't enjoy yourwork, talk to someone about how theyenjoy it .

l Juggling is a great hobby to take up, itsthe only recreation proven to increasethe amount of gray matter in the areasof the brain relating to concentration andcognition.

20

l In some women, depression may becaused (or worsened) by low hormonelevels, most commonly progesterone.Progesterone helps keep serotonin levelsfrom dropping too low, and low serotonincan cause depression. Anxiety-depression is most commonly seen,sometimes accompanied by severe moodswings and insomnia; some women mayget more headaches / migraines.

Towards them. When you finish doingeverything on your list, make another one.

Refferance :

1. www.wikihow.com

2. www.helpguide.org

3. www.ehow.com

4. www.manic-depressive.com

21

Introduction :

Anxiety is a common symptom for patientsdiagnosed with a terminal illness, regardlessof whether the patient has a predispositionto anxiety or not. This anxiety presents notonly in patients, but also in their family,friends and caregivers. For those enduringintrusive treatment and ultimately palliativecare, anxiety can become extremelydebilitating and increases as patients becomeaware of their impending death.

Music And Music Therapy in PalliativeCare :

Recorded music has been effective inmanaging anxiety for patients before, duringand after undergoing surgery, and in reducinganxiety for patients on ventilators, and forthose undergoing medical examinations/procedures.

Music therapy (provided by qualified musictherapists, who engage the patient in livemusic experiences, including singing,songwriting, improvisation, and receptivemethods), has an important role to play inthe management of symptomatic issueswithin palliative care. A growing body ofclinical work suggests that music therapy iseffective in addressing physical, emotional,and spiritual, needs of palliative care patients.Research studies have also demonstratedthe benefits of music therapy.

The research studies have conducted

The Effects of Music Therapy on AnxietyRelated To Terminally Ill Patients

Ms. Arpita DasClinical Instructor, School of Nursing, RKMSP

measured the effect of music therapy onreducing anxiety for terminally ill patients.

Krout measured the effectiveness of musictherapy to improve pain control, physicalcomfort, and relaxation. The study involveda single session music therapy intervention.Eighty subjects self-reported levels of paincontrol, physical comfort, and relaxation.

In addition, independent behavioralobservations were made immediately beforeand after the session. Results weresignificant, and the study found that paincontrol, physical comfort, and relaxationwere effectively increased with a musictherapy session, both self-reported by theparticipant and reported by the independentobserver.

Another study was conducted by Caloviniwith 11 terminally ill patients, examined stateanxiety levels (defined by Lazarus 60 asunpleasant emotional arousal in face ofthreatening demands or dangers) withinone music therapy session. A four-itemquestionnaire, and before and after readingsof blood pressure, pulse rate, and extremitytemperature were taken.

The physiologic measures were also takenevery 15 minutes during the music therapyintervention. The study found that stateanxiety was not statistically significantlyaffected by one music therapy session.

22

However, systolic blood pressure and pulserate decreased, and finger temperatureincreased for the participants, which mayindicate a trend toward reduced anxiety.

The study on the conducted effect of musictherapy on pain relief, physical comfort,relaxation, and contentment was examinedby Curtis on Nine terminally ill patients andthree experimental conditions were used:like no music background sound, and music.While significant results were not achieved,

individual responses showed that thebackground sound condition appeared tohave a negative effect, and the musicintervention a positive affect.Conclusion :The Research studies shows that the useof music therapy is to manage anxiety forpalliative care patients have varied in focusand design. Music therapy hence can beimplemented on anxiety, depression relatedto palliative care of patients especially whoare also suffering from other ailments.

HP - Noise CancellingHeadphones

PDM - Patient DirectedMusic Usual Care

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seda

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Mobile phones are an excellent way to carryaround germs, bacteria & the risk for thisrises exponentially for devices belonging todoctors, nurses & other health professionals.Common allergens like pollen & dust arefound on mobile phone’s surfaces.

Many scientific studies have investigatedpossible effects of mobile phone on publichealth, both on residents & clients, whichare as:

Ø Thermal Effect : In the case of a personusing a cell phone, most of the heatingeffect will occur at the surface of thehead, causing its temperature toincrease by a fraction of a degree.

Ø Non-Thermal Effect : The communi-cations protocols used by mobile phonesoften result in low-frequency pulsing ofthe carrier signal. Exposure to radio-frequency signal waves within parts ofthe brain closest to the cell phoneantenna results in increased levels ofglucose metabolism.

Ø Blood Brain Barrier Effect : Themaximum legal limit for mobile radiation,one protein in particular, HSP 27, wasaffected. HSP 27 (Heat Shock Protein)played a critical role in the integrity ofthe blood-brain barrier.

Ø Cancer : Certain studies conducted bythe researcher highlights on the “CancerEffects”, which negates the idea.

Studies Done on Effects of Mobile Phones on Human HealthMs. Monalisa Chakraborty

Clinical Instructor,School of Nursing, RKMSP

l A Danish study (2004) that took placeover 10 years found no evidence tosupport a link between uses of mobilephones & cancer.

l A Swedish study (2005) that draws theconclusion that "the data do not supportthe hypothesis that mobile phone useis related to an increased risk of gliomaor meningioma.

l A German study (2006) that states nooverall increased risk of glioma ormeningioma.

But A study conducted by Hardell LennartDr. in 2007 from Örebro University inSweden on 2 cohort studies and 16 case-control studies showed that Cell phone usershad an increased risk of malignant gliomas,link between cell phone use and a higherrate of acoustic neuroma, tumors are morelikely to occur on the side of the head thatthe cell handset is used, one hour of cellphone use per day significantly increases

tumor risk after ten years or more.

In A February 2008 update on the status oft h e I N T E R P H O N E s t u d y I A R C(International Agency for Research onCancer) stated that:

l There is a link between mobile phoneusage and certain brain tumour & it isanticipated that this danger has farbroader public health ramifications thanasbestos and smoking.

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l The use of cell phones before age 20increased the risk of brain tumors by 5.2,compared to 1.4 for all ages.

The conclusion of the IARC (InternationalAgency for Research on Cancer) wasmainly based on the INTERPHONE study,which found an increased risk for glioma inthe highest category of heavy users (30minutes per day over a 10-year period),although no increased risk was found atlower exposure.

Ø Cognitive Effect: A 2009 studyexamined the effects of exposure toradiofrequency radiation (RFR) emittedby standard GSM (Global System ForMobile) cell phones on the cognitivefunctions of humans. Longer durationof exposure to RFR may increase theeffects on performance.

Ø Genotoxic Effect: RF-EMF (RadioFrequency Electromagnetic Field)can alter the genetic material of exposedcells in vivo and in vitro way.

Electromagnetic Hypersensitivity: Someusers of mobile handsets have reportedfeeling several unspecific during and afterits use; ranging from burning and in the skinof the head and extremities, fatigue, sleep

disturbances, dizziness, loss of mentalattention, reaction times and memoryretentiveness, headaches, malaise,tachycardia, (heart palpitations), todisturbances of the digestive system.

Power:

Newer phones are digital. The older analogphones are expected to be phased out by2006. The major difference is that analogphones use much more power than digital.Analog use about 1.3 Watts, while a digitalmobile phone is designed to operate at amaximum power level of 0.6 watts.

Frequency:

In the United States, mobile phones operatein a frequency ranging from about 850 to1900 megahertz (MHz). In that range, theradiation produced is in the form of non-ionizing radiofrequency (RF) energy. ThisRF energy is different than the ionizingradiation like that from a medical x-ray,which can present a health risk at certaindoses. Lonizing gamma rays and x-rayscan cause cancer when their energy isabsorbed by the tissue and chemical bondsare broken, damaging DNA. RF energy,on the other hand, produces heating oftissue.

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Radiation Frequency:

Disadvantages of Uses of Mobile Phones:

Ø Electromagnetic waves alter (electricactivity of brain) & cause disturbance insleep.

Ø It cause difficulty in concententration,fatigue & headache.

Ø It increase reaction time in a timedependent manner.

Ø They increase the resting bloodpressure.

Ø It reduce the production of melatonin.

Ø They are also implicated in DNA strandbreaks.

Ø Mobile phones damage key brain cells& could trigger the early onset ofAlzhemer’s disease.

Ø Uses of mobile phone can cause braincancer, mouth cancer & leukemia.

Ø Uses of mobile phone can increasetumor of auditory nerve.

Referances:

1. www.who.int/peh-emf/meetings

2. www.seas.upenn.edu

3. www.anextweb.com

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Background of The Study :

Children are the most important group in allsocieties, not because they constitute about40% of the total population, but becausethere is renewed awareness that thedeterminants of chronic disease in later lifeand health behavior are laid down at thisstage. Around 10.6 million children die everyyear before reaching their fifth birthday.Together with infectious diseases, accidentsresulting in injuries among children are theleading cause of death. In a World HealthOrganization (WHO) report, the number ofdeaths caused by accidents was estimatedto be 3.5 million annually. Injuries causemore deaths in children between the agesof 1 to 4 years than in any other childhoodage group.

Need for The Study :

Nurses can be instrumental in helping thenation achieve these goals by being primarycare providers who provide counseling onsafety precautions to parents and children.

Prevention of injuries and accidents can beachieved through effective health teachingprogramme.

Statement of the Problem :

Astudy to evaluate the effectiveness of aplanned teaching programme on common

Research Study to Evaluate The Effectiveness of A PlannedTeaching Programme on Common Accidents, Their

Prevention and First Aid Management Among Mothers ofToddlers in A Selected Rural Community of West Bengal

Mrs. Suchanda PalLecturer, Ma Sarada College of Nursing, RKMSP

accidents, their prevention and first aidmanagement among mothers of toddlersin a selected rural community of WestBengal.

Objectives of the Study :

1) To identify the common types ofaccidents among toddlers.

2) To assess the knowledge of themothers of the toddler on different typesof accidents.

3) To develop and validate a plannedteaching programme (PTP) on commontypes of accidents, their prevention and first aid management.

4) To evaluate the effectiveness of PlannedTeaching Programme in terms of gainin post test knowledge.

5) To find out the association between pretest level of knowledge of mothers withthe variables like socioeconomic status,health related information.

6) To evaluate the opinionnaire onacceptability of the Planned TeachingProgramme.

Variables Under Study :

Independent Variable: Planned teachingprogramme on accidents, their preventionand first aid management.

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Dependent Variable : Knowledge of mothersand acceptibility of planned teachingprogramme.

Conceptual Framework :

The present study is based on Rosenstock’shealth belief model (1974).

Methodology :

The research approach utilized for the studywas evaluative research approach with onegroup pre-test and post-test design.

Setting of The Study :

The study was conducted in a ICDS centreof Buroshanti village, Singur under Ratanpur-II Gram Panchayat.

Population :

In the present study the population wasmothers of toddlers in a selected ruralcommunity of West Bengal.

Sample : The sample of the study wereselected mothers of toddlers in selected ruralcommunity of West Bengal.

Sampling Technique : Non probabilityconvenience sampling technique was usedto select an adequate size of the sample.

Sample Size :- For the present study forty(40) mothers of toddlers were given thequestionnaire to assess their knowledge onaccidents, their prevention and first aidm a n a g e m e n t b e f o r e a n d a f t e rimplementation of planned teachingprogramme.

Data Collection Tools :

Tool- 1 Preliminary assessment regardingcommon types of accidents duringlast year.

Tool- 2 Demographic proforma.

Tool- 3 Modified Srivastava Socioe-conomic Status Scale.

Tool- 4 Health Related Information.

Tool- 5 S t r u c t u r e d k n o w l e d g equestionnaire on accidents, theirp reven t i on and f i r s t a i dmanagement.

Tool- 6 Opinionnaire on Acceptibility ofPlanned Teaching Programme interms of clarity, language, pictureo f the p lanned teach ingprogramme.

Content Validity of The Tools :

Tool- 1 Preliminary assessment regardingcommon types of accidents duringlast year- 100% agreement.

Tool- 2 Demographic proforma - 71%agreement was given. Theysuggested to include code no. onthe right side of the tool. The toolwas modified.

Tool- 3 Modif ied Srivastava Socio-economic Status Scale- 100%agreement.

Tool- 4 Health Related Information- 100%agreement.

Tool- 5 S t r u c t u r e d k n o w l e d g equestionnaire on accidents, theirp reven t i on and f i r s t a idmanagement - Out of 30 questions,26 ques t i ons had 100%agreement. The remaining 4questions had 71% agreement.

Tool- 6 Opinionnaire on Acceptibility ofPlanned Teaching Programme interms of clarity, language, pictureo f the P lanned teach ingprogramme - 100% agreement.

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Reliability of The Tools :

The reliability for the structured knowledgequestionnaire was calculated using KR-20formula and the reliability coefficient was0.84.

Data Collection Procedure :

The data was collected according toavailability of subjects during the timeschedule of 2 weeks (17.11.10- 30.11.10).

The study has two phases:

Phase - I : Preliminary assessment oncommon types of accidents was collectedfrom mothers of toddlers on one day.

Phase - II : On the 1st day pre-test was givenand the planned teaching programme wasalso conducted. On Day 8, post-test wasadministered and opinionnaire onacceptability of planned teaching programmewas collected from mothers of toddlers.

Major findings of study were as follows :

1) Majority of toddlers (62.5%) had falls,15% had foreign body aspiration, 10%had burns and only 2.5% had insectstings.

2) Majority (60%) of the mothers of toddlerswere in the age group of <25 years.

3) Half (52.5%) of mothers of toddlerswere under moderate SES.

4) Majority (55%) had low health relatedinformation.

5) The mean post-test knowledge score(27.3) of mothers of toddlers onaccidents, their prevention and first aidmanagement was higher than the meanpre-test knowledge score (17.8) of themothers of toddlers on accidents, theirprevention and first aid management.

“t” value was computed which indicatesthere was significant increase inknowledge after administration ofplanned teaching programme. (t= 45.23,p<0.05).

6) Chisquare computed between pretestknowledge of mothers with the variablesi.e socioeconomic status, health relatedinformat ion was 5.18 & 6.22respectively at df (1) significant at 0.05level. There is an association betweenpre test knowledge level of motherswith the variables i.e socioeconomicstatus, health related information.

7) Opininion of mothers of toddlersregarding acceptance of PTP- 80%fully agreed to all 4 statement and 20%partially agreed.

The findings of the study revealed that theplanned teaching programme was effectivein increasing the knowledge of mothers oftoddlers regarding accidents, theirprevention and first aid management.

Recommendation :

From the findings of the present studyfollowing studies can be recommended.

1. A similar study may be conducted overa large populat ion for bet tergeneralization of the findings using aprobability sampling.

2. A comparative study can be undertakenin the occurrence of accident in selectedrural and urban areas.

3. Similar study can be conducted onexperimental research approach i.e.pretest and post-test with experimentaland control group in order to identify theeffectiveness of the intervention.

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2 days workshop on “Neonatal Workshop”was organized in Ramakrishna Mission SevaPratishthan on 17th & 18th November’ 2014by the nursing unit of this pratishthan.

The following topics, discussed by theNeonatologist & Nursing Experts are-Assessment of newborn, history & physicalexamination; Identification of high risknewborn; Recent trends in neonatal field;Management of neonatal disease condition;

Care of neonate at birth; NICU nursing careprotocol; Care of extremely low birth weightneonate; Decision making ethical dlemmas,management of neonatal death &bereavement follow-up; Management ofrespiratory distress syndrome.

Hands on practice of neonatal resuscitationwere done by the delegates.

Few photographs are as under :-

Ramakrishna Mission Seva Pratishthan