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.

Abstract
Background: Choking is an important public health problem for young children. Choking hazards are primarily associated with food, coins, and toys. The comprehensive choking-prevention effort will rely on the education of parents, teachers, and childcare workers. So, this study aimed to: Evaluate the effect of educational Program about first aid and prevention of choking for mothers of preschool-age children. Research Design: Quasi-experimental design was utilized in this study. Subjects: Included a convenience sampling of 200 mothers from outpatient clinics at Assuit university children's hospital. Tools of data collection: Three tools included Personal characteristics of mothers and their children, mothers’ knowledge and practices regarding choking first aids and prevention. Results: The majority of the studied mothers (82.5%) had inefficient knowledge score regarding prevention and first aid of chocking while only 17.5% of them had efficient knowledge before mobile education compared to 99.5 % of them had efficient mean knowledge after mobile education. There were statistically significant differences between the mother’s knowledge and reported practice pre and post-Mobile-based program application for choking prevention (P value <0.001). Conclusion: The mother's knowledge and reported practices regarding choking prevention were improved after the implementation of the mobile-based program. Recommendations: Health promotion programs through nurses using new educational technology about choking first aid and prevention should be directed to mothers, children’s caregivers, and teachers in all pediatric care sittings and nursery schools.

Keywords: First aids, Mothers, Prevention of choking & Program.

Back ground: Stress threatens the wellbeing and perception of adolescents and reduces their ability to cope with threat. Adolescents in foster care are more liable for stress than other adolescents. The aim of this study was to assess the effect of progressive muscles relaxation technique on reducing stress among adolescent at Orphanage in Assiut City. Subjects and method: This study was conducted in three foster care settings at Assiut , these settings were lelianTrasher, Dar-ElSafa and Dar-Elhanan). A quasi Experimental research design was used. A convenient sample of all adolescents either males or females and their ages ranged from 12-18 years. One tool was used in this study. Results: A adolescents in the study group had lower level of stress in posttest1,2,3 than on pretest(severe stress was present in 18.9%,24.3%,27% and 91.9%).Meanwhile there were no statistical significant difference between adolescents in the control group in relation to their level of stress (severe stress was present in 89.2%,86.5%,89.2% and 91,9%).It was concluded that progressive muscle relaxation technique reduces the level of stress among adolescents in study group. Recommendations: Social workers in orphanage institutions should use and teach different types of relaxation techniques as progressive muscle relaxation technique to promote psychological wellbeing of orphan children.

Key Words: Adolescents, Stress, progressive Muscle Relaxation Technique, Orphanage

Abstract
Stress is a natural part of every adolescent's life. Adolescents in orphanage are more liable for stress than other adolescents. The aim of this study was to develop Orphanage Adolescents Stress Scale. Tool: The Orphanage Adolescents Stress Scale was developed by the researcher. Subjects and method: This questionnaire surveys were conducted with 74 adolescents to examine the psychometric properties. The final Orphanage Adolescents Stress Scale 58-items contain four domains: Emotional deprivation, Future planning, Relationships inside the organization, Relationships outside the organization and Stress symptoms. Result: Scale scores showed satisfactory internal consistency and two weeks test–retest reliability. Conclusion: OASS is an effective scale with acceptable psychometric properties and was especially adapted to measure stress in orphanage adolescents. Recommendations: For researchers who have a particular interest in stress among orphan adolescents, the OASS suggested to be effective tool.
Key words: Adolescents, Stress, Scale &Orphanage.