Abstract
Background: One of the most important health issues and global injustices of our age is climate change. Health-care professionals represent the main stone in creating an international effort to deal with the factors that affect health and reduce the inequalities brought on by climate change. So, this study aimed to: Evaluate the effect of didactic program about health care providers' role in facing climate changes and its effects on children health. Research Design: Quasi-experimental design was utilized in this study. Subjects: Included a convenience sampling of 50 physician and 50 nurses who are working at Assuit university children's hospital. Tools of data collection: Four tools; Tool (1): Personal data and sources of knowledge about climate change, Tool (II): A structured interview sheet about physician and nurses' knowledge regarding climate changes. Tool (III): Health care provider’s attitudes toward climate changes. Tool (IV): Daily life practices questionnaire. Results: It noticed that the studied nurses had good knowledge, adequate reported practices, and positive attitudes toward climate change in pre &post intervention with statistically significant differences. Also, the studied physicians had good knowledge, adequate reported practices, and positive attitudes toward climate change in pre &post intervention with a statistically significant difference. Conclusion: Implementation of the program about role of health care providers in facing climate changes and its effect on children health improve their knowledge, attitudes, and reported practices. Recommendations: Continuing educational programs should be provided for health care professionals about environmentally sustainable health care services, practices, and behaviors to improve their knowledge and practices.
Keywords: Climate changes, Children, Health care providers, Role

Abstract Critically care nurses must be competent in care of patients with COVID19 on mechanical ventilation which meets the specialized needs of the patient. Aim: To investigate nurses' level of competence and reported practices among ventilated adult and pediatric patients with COVID 19. Research Design: A descriptive research design was conducted in this study. Setting: The study was conducted in four intensive care units include general, trauma, critical care and pediatric intensive care unit. Subjects: Nurses who have a bachelor’s degree of nursing sciences as a bedside nurse and dealing with patients connected to mechanical ventilation with COVID 19. Tools of data collection: Tool I: clinical scenario assessment tool. Tool two: nurses' reported practices (universal precautions) questionnaire. Results: The majority of nurses were incompetent in all breath types and lung pathological changes (81.7%, 95%, 81.7% 95.0%) respectively, and majority of them had inappropriate reported practice according to policy of sharp equipment and environmental precaution Conclusion: It was found that more than half of studied nurses were incompetent and had inappropriate reported practice in dealing with ventilated patients with covid19. Recommendation: Nurses' level of competence and practices among ventilated patients should be assessed at regular time

Keywords:Adult and Pediatric Patients,Level of Competence,Covid 19,Level of Competence,Mechanical Ventilation & Reported Practices.

Abstract:
Background: Nephrotic Syndrome is one of the prolonged illnesses of childhood that has a major link with behavioral problems. Aim: To assess effect of nephrotic syndrome on the psychosocial aspects of school age children in Assiut City. Research design: Descriptive research design. Sample: 200 children. Tools: Two tools; Tool (1): Children personal and clinical data. Tool (2): Included child behavior checklist; parent form. Results: The study revealed that 52%, 39% and 9% of the studied children had abnormal, normal and borderline problem score respectively. There were statistically significant differences between the total competence score with children age, educational level and duration of illness p-values=0.001, 0.038 and 0.038 respectively. Also, there were positive correlations between total score of problem and total score of competence scales among the studied children. Conclusion: This study pointed out that children who were suffering from nephrotic syndrome are at increased risk of developing psychological difficulties. Recommendations: Community, psychiatric and pediatric health nurses should be trained on how to deal with children suffering from nephrotic syndrome and to detect cases that needs preventive interventions.
Keywords: Nephrotic syndrome, Psychosocial aspects, School age children, Competence, Behaviour & Problem.

Background: Shaken baby syndrome (SBS) is the most common cause of death or serious
neurological injury resulting in life-long disability among infants and young children less than 5
years of age. The study aimed to evaluate the effect of an evidence-based prevention program for
nurses on the period of PURPLE crying in infants and shaken baby syndrome. Study design:
A quasi-experimental (pre-post-test) research design was used to achieve the aim of this study.
Sample: A convenient sample was selected of 100 pediatric nurses from (PICU &NICU) and
outpatient pediatric clinic in Assiut University Children's Hospital.. Tools: Three tools were used to
collect the needed data. Tool one: It was composed of three parts: Part one: Personal data of studied
nurses. Part two: Shaken infant syndrome knowledge assessment questionnaire. Part three: It was
included a nurse's knowledge assessment questionnaire on the PURPLE Crying Period. Tool Two:
Nurses' thoughts and attitudes about shaken baby syndrome hazards. Tool Three: Scale of Infant
Crying Knowledge. Results: 65 % of nurses had a satisfactory level of knowledge about the period
of PURPLE crying in infants which increases to 96% post-test. in the pre-test, 73% of nurses had
appropriate beliefs and attitudes regarding shaken baby syndrome hazard while in the post-test most
of the nurses (89%) had appropriate believes and attitudes with a highly statistically significant
difference between the nurses believes and attitudes in pre and posttest (P=0.004). Conclusion:
Implementation of an Evidence-Based prevention program had a positive effect on understanding
the period of PURPLE crying in infants which reduced the hazards of Shaken Baby Syndrome in
infants. Recommendations: Nurses should teach parents and give them a booklet about the period
of PURPLE crying and practices to prevent hazards of shaken baby syndrome on the infants
discharge from PICU or NICU.
Keywords: Evidence-Based Program, Infants, Nurses, PURPLE Crying & Shaken Baby Syndrome.

Abstract
Background: The World Health Organization has specified (COVID-19) to be a contagion. People's communicable disease information, attitude, and practices (KAP) might have a great effect on whether they might detect the protective procedures. The study aimed to assess Knowledge, Attitude, Practice and psychological response of Pediatric nursing students toward COVID-19 at Assiut University. Method A descriptive research design was used. The study was done at Faculty of Nursing, Assuit University with A convenient sample of all third year the pediatric nursing students who approved to contribute in the study. Tool of data collection: four tools were used in this study Tool I: It included personal data, Tool II: It includes 28 questions about student’s attitude toward spread of Covid 19, Tool III: It includes 9 questions about psychological response, Tool IV: It includes 14 questions about students practice Results: The result indicates that more than half of studied sample have adequate knowledge and negative attitude regarding covid19. The majority of studied sample (80.6%) had unsatisfactory practice and negative psychological reaction towards covid19. There is a very highly statistical significance difference between total knowledge and total practice and between total knowledge and total attitude as well. Conclusion: This study showed that the pediatric nursing students had adequate knowledge, unsatisfactory practices, negative attitude and psychological response toward the COVID19 outbreak. Recommendations: Health education programs should be developed according to their areas of knowledge and practice deficits and provided for students
Keywords: COVID-19, knowledge, Attitude, Practice & Psychological responses.

Background: Burns in children remain an important epidemiological problem. Caring for these particularly vulnerable groups requires a multidisciplinary approach to treating burns and reducing their painful impact on children. Aim of the study was to evaluate the effect of therapeutic hospital clown use on children's behavioral adherence during burn dressing changes. Setting: Assiut General Hospital out-patient burn clinic. Subjects and Method: A quasi-experimental (post-test) research design was used. The study applied one tool which included two parts: Part (I): Included children’s personal and clinical data. Part (II): Involved the child's behavioral observational form which involved 8 classifications such as crying, yelling, activity, mood, communication, interaction with the parents, sensitivity to the environment, and attitude to the nurse. Results: It was found that 76% and 88% of both study &control group had extremity burn with second degree in 68% and 76% respectively. The study results revealed good adherence to the change of burn dressing in the study group children than those in the control group with a statistically significant relation regarding all domains of the children’s adherence (P-Value <0.01). Conclusion: Applying therapeutic hospital clown to children in the study group had a better adherence to burn dressing change than those in the control group. Recommendation: Therapeutic clowning should be included in the hospitals policies and care plans as a basic intervention care for burned children.
Keywords: Burn Dressing, Behavioral Adherence, Children, Therapeutic Hospital Clown.

Abstract:
Background: Papworth breathing is a relaxation technique through which patients can change physical, emotional, and stressful behaviors using their thought. This technique is based on muscle relaxation and the patient learning how to achieve mental relaxation. Biological, social, and psychological aspects of children are all impacted by diabetes, a chronic illness. Stress and pressure from parents, doctors, and other carers are a part of everyday life for kids with diabetes mellitus. Aim: The study aimed to evaluate the effect of evidence-based papworth breathing technique on anxiety among school-age diabetic children. Subjects and Method: A quasi-experimental (pre-post-test) design implemented for 100 diabetic child (50 study group and 50 control group). Two tools included: Tool I: A designed direct interview form established by the investigators that included personal and clinical data of children. Tool II: Screen for Child Anxiety Related Disorders (SCARED). It was adopted from Birmaher et al. (1997). Results: The mean of all symptoms of anxiety disorders in the study group is less than that of a control group in the post-program phase and follow-up phase with P. Value <0.01. Conclusion: Papworth technique led to an effective improvement in the management of anxiety in daily life. Recommendations: Hospitals should include Papworth technique in their policies and care plans as basic intervention care for children with chronic illness.
Keywords: Anxiety, Diabetes, Evidence-based practice, Papworth breathing technique & school-age children.

Abstract
Reduction in sensory inputs is considered one of the most common complications following intensive care unit (ICU) admission. Changes in physiologic parameters are brought about by auditory stimulation, which hastens recovery. So, this study aimed to examine the effect of mother voice on physiological parameters and level of consciousness of patients in pediatric intensive care unit. Research design and setting: A quiz experimental study was carried out from beginning of March 2022 till end of October 2022 in pediatric ICU at Assiut University Children’s Hospital, Egypt. Sample: A purposive sample of 60 patients was assigned into two equal groups: control and intervention groups. Study tools: Two tools were utilized to collect data: physiological parameters assessment sheet, and Glasgow Coma Scale. Results: The mother's voice had a statistically significant effect on oxygen saturation and level of consciousness in the intervention group compared to the control group at the 3rd day with (p.value < 0.05). While there was no statistical significant difference among the study groups as regard heart rate, systolic and diastolic blood pressure from the 1st to the 3rd day. Conclusion: Auditory stimulation utilizing the mother's voice has a significant effect on improving the level of consciousness and oxygen saturation in comatose pediatric patients. Recommendations: Replication of other studies utilizing multimodal stimulation (auditory, visual, and tactile stimulation) can be used either independently or in combination to examine its effect on several additional factors such as mechanical ventilation and length of stay.
Keywords: Mother Voice, Physiological Parameters, Level of Consciousness, Pediatric Intensive Care Unit.

Abstract:

• Background: The health burden of diabetic nephropathy is exponentially increased by the constant and alarming increase of the incidence of both Type 1 and 2 diabetes mellitus. Aim: The study aimed to evaluate the effect of health educational program regarding nephropathy for mothers of children suffering from Diabetes Mellitus at Assiut City. Subjects and Method: Quasi-experimental (Pre-post-test) design implemented for 100 mothers of diabetic school-age children. Two tools included: Tool I: Part one: Personal and clinical data of children. Part two: Personal data of mothers. Tool II: Part one: Mothers' knowledge. Part two: Mothers' health-related practices. Results: Only 20% of school-age children's mothers had satisfactory knowledge regarding diabetic nephropathy in pretest. While raised significantly to 96% and 93% in posttest 1 and 2. Moreover, 35% of school-age children's mothers had satisfactory health-related practices regarding diabetic nephropathy in pretest. Whereas improved significantly to 82% and 91% in posttest 1 and 2. Conclusion: There was a significant improvement in the school-age children's mothers' knowledge and health-related practices regarding diabetic nephropathy after the educational program implementation. Recommendations: Continuing educational programs are needed to improve mothers' knowledge and practices toward better control of diabetic children.

Keywords: Diabetes, Educational program, Nephropathy, Mothers & School-age children.

Abstract:
Renal failure is a life-threating condition in which there is a buildup of waste and fluid in the body due to severe deterioration of kidney function. The prevalence of both acute and chronic renal failure is high in the Arab World. The aim of this study: is to assess the nurses' knowledge and practice related to nursing care of children undergoing hemodialysis at Assiut city. Descriptive and analytic research design was adopted to meet the aim of this study. Subject and methods: This study was conducted in Pediatric Nephrology and Dialysis Unit in Assuit Children University Hospital, El–Mabarah Hospital and El–Eyman General Hospital. The study included convenience sample of 48 nurses from different Nephrology Units at Assiut City. There are two tools used for collecting data in the study, tool one is a structured interview tuestneiianreisseet ceisnsts of two parts: First Part concerned with personal data of the studied nurses as: iurse s ’iiaae and age. Second Part concerned with nurses knowledge regarding renal failure and hemodialysis. Tool two a structurediebservatneialicsecklnst sheet to evaluate the nurses' practice Result: The main results of study demonstrated that there is no statistical significant difference between the nurses' knowledge and their practice regarding nursing care of children undergoing hemodialysis. There is statistical significant difference between the nurses' knowledge scores and their practice with age. Conclusion: The most of AUH nurses had higher score of knowledge related to renal failure and hemodialysis than the ministry of health hospitals. Nurse's practice regarding hemodialysis children in nephrology unit at Assiut university children hospital is higher than that of nurses working at the Ministry of Heath Hospitals. Recommendations: Continuous nursing educational and in-service training programs on kidney dialysis to upgrade the knowledge and skills of practicing nurses, Periodic monitoring of nurses knowledge and practice to evaluate the level of nurses.
Key Words: Renal failure, Hemodialysis, Nurses, knowledge, Practice, Children , Pediatric.