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Background: Physical restraints (PRs) are frequently used in adult critical care units to protect staff and prevent self-harm, despite the fact that they represent significant safety risks. Restraint complications may have an impact on the patient's long- and short-term outcomes. This study aims to examine the recent evidence on the use of PR in adult critical care. Method: This integrative review included the studies published between January 2009 and December 2019 and the literature search was conducted in July 2020. The databases searched included EBSCOhost, Ovid, ProQuest, PubMed, Wiley Online Library, SCOPUS, and ScienceDirect. The keywords included in the search were restraint, critical care, intensive care, ICU, mechanical ventilation, intubation, nursing, and experience. A checklist based on the CASP checklist and the JBI Critical Appraisal Tool was used to assess the methodological quality. Results: The findings were evaluated and summarized into seven key topics after twenty-one publications were found to be evaluated. i) High prevalence of PR application in adult critical care unit; ii) determinants of PR applications; iii) types of PR in adult critical care units; iv) decision maker of PR; v) moral and ethical dilemma in PR application; vi) awareness and guidelines for PR applications; vii) common complications and use of sedation, analgesics, antipsychotic drugs in PR application. Conclusion: The number of days PR is used is related to the risk of an adverse event. In order to standardize nursing practice, ICU nurses require greater training on the ideas of PR use. Evidence-based recommendations will assist critical care nurses in making the best judgments possible concerning the use of PR.

Evaluating the stability of some acrylic-based polymers (Paraloid B72, Lascaux® Hydroground 750, and Pébéo Satin Matt Picture Varnish).• Thermal and UV accelerated ageing were performed on laboratory model samples according to literature data . • The evaluation process was performed using optical microscopy, colorimetry, scanning electron microscopy, and FTIR spectroscopy . • Among the tested products, the Matt picture varnish (based on acrylic resin and polyethylene wax) showed the best durability against ageing procedures.

Cairo's 19th-century buildings with historic and cultural importance are decorated with a prosperous coloring palette. In the present work, samples of pictorial layers and gilded surfaces from El-Gawhara Palace, the Great mosque of Muhammad Ali Pasha, and the Palace of Shubra were studied. Since there is a research gap concerning the painting materials in those monuments, the present study aims to characterize the pictorial surfaces in the studied buildings and to compare the results with other paintings from the same period. The material characterization included microscopic examination via an optical digital microscope. The surface morphology, microstructure, and the elemental identification were accomplished using a field-emission scanning electron microscopy and energy-dispersive X-ray micro-analyzer. In addition, Fourier transform infrared spectrometer was used to confirm some findings. The results allowed a sufficient understanding of the paint layers and their chemical nature. The analytical methods revealed ultramarine blue (Na 7 Al 6 Si 6 O 24 S 3 ) as the blue coloring material in the studied buildings. Further, an obvious discoloration in the blue paint layer from El-Gawhara Palace was reported. Green earth was identified in the great mosque of Muhammad Ali Pasha and in Shubra Palace. Lead (II) oxide (massicot, PbO) was used for the yellow color in Shubra Palace and a mixture of lampblack and magnetite (Fe 3 O 4 ) was possibly used for the black color in El-Gawhara Palace. For the gilding technique in Shubra Palace, mechanically adhered gold-silver leaves were preferred.

Background: The intensive care unit (ICU) is a busy and complex workplace, and several work-related and personal factors are known to make ICU nurses more vulnerable to moral distress than other healthcare professionals. It is crucial to identify these factors to guide future studies and preventive strategies. This scoping review explores such factors to present current knowledge on the factors that trigger moral distress and to guide future research by reviewing studies to explore and summarize factors that trigger moral distress in ICU nurses.   Methods: The PubMed, EBSCO, and CINAHL Plus databases were searched to identify potentially relevant studies published between 2011 to 2022. Inclusion criteria: peer-reviewed studies published in English that provided results regarding factors causes or correlated to moral distress in ICU nurses. After removing 63 duplicates, 371 papers were excluded after title and abstract screening, leaving 47 articles for full-text screening. A further 30 articles were excluded as their outcomes did not include factors that caused moral distress, or were not specific to ICU nurses, so 17 studies were eventually analysed using qualitative content analysis through an inductive approach. The findings of the articles were extracted and coded independently by two authors, and data were grouped and categorized. Results: The content categories of factors contributing to ICU nurses' moral distress were organized into themes and subthemes. Four major themes were identified: Powerlessness, end-of-life care, ineffective teamwork, and personal characteristics of ICU nurses.   Conclusions: This review highlights the factors that contribute to moral distress in critical care nurses, which are mainly attributable to the organizational climate and the nature of the ICU clinical environment. Descriptive and intervention studies (experimental or action research) must investigate causality between identified variables to inform management strategies to improve support for ICU nurses’ coping relative to moral distress.