A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor) Abyad Medical Center & Middle East Longevity Institute Azmi Street, Abdo Center, 2nd Floor PO BOX 618, Tripoli LEBANON Tel & Fax: 961 6 443684/5/6 Email: aabyad@cyberia.net.lb Web: www.amc-lb.com

The editorial team and the production team would like to wish all our readers and colleagues a happy New Year and a successful 2015. This issue presents several papers on different issues related to nursing area in the region.

A review paper looked at the use of patient-based pain education to reduce barriers to cancer pain management. Many cancer patients with pain report that they are undertreated, despite the utilization of best international guidelines for treating cancer pain. Barriers to cancer pain management are thought to have a contributory role in the under treatment of pain. The authors found that all of the articles reviewed indicated that pain education can reduce barriers to cancer pain management. The author concluded that pain education programs are an effective approach in the treatment of patient-related barriers to cancer pain management. It is strongly recommended to integrate PEP within treatment course of cancer pain. Further, it is reinforced that all institutions dealing with cancer patients hold specialized health care professionals who are able to administer PEPs.

A randomized control study was done between the 1st of March 2012 and the end of April 2013 at King Hussein Medical Center was carried to assess the value of short-term decadron therapy on prevention of post operative nausea and vomiting following caesarean section. During this period a total of 100 full term women scheduled for elective caesarean section under spinal anaesthesia. 50 women were given 8 mg decadron injection and another 50 women were considered as control group. There was no significant difference among both groups with respect to age, weight, parity, duration of anaesthesia and surgery. In the decadron group, nausea and vomiting were absent in 62% of patients, while only nausea and vomiting were absent in 22% of patients in control group. The authors concluded that Dexamethasone significantly decreased the total incidence of nausea and vomiting in patients underwent caesarean section under spinal anesthesia compared with control group. Also dexamethasone injection is simple to administer and provide safe and very effective antiemetic protection

A paper from Jordan looked at methods to improve sleep in Jordanian Intensive care unit patient
Sleep is essential for well-being and recovery from illness. The critically ill are in significant need of sleep but at increased risk of sleep loss and disruption. Sleep is considered to be physically and psychologically restorative and essential for healing and recovery from illness
Studies used different tools to assess sleep process quality (fragmentation, sleep stage changes, wake after sleep onset, EEG sleep patterns), quantity (total sleep time and time spent in each sleep stage) and distribution over the 24-h cycle in ICU`s patients. The most used methods were polysomnography (PSG), nursing observations, and Subjective measures of sleep include questionnaires incorporating visual analogue and Likert scales, for example the Richards Campbell Sleep Questionnaire (RCSQ), the Sleep in the Intensive Care Unit Questionnaire (SICQ) and the Verran/Snyder Halpern (VSH) Sleep Scale.

A study from Saudi Arabia explored nurses' knowledge about palliative care in an intensive care unit in Saudi Arabia. In Saudi Arabia, approximately 23,000 persons are diagnosed with cancer every year. According to the World Health Organization (WHO), palliative care is a holistic activity that involves physical, psychosocial and spiritual human needs to enhance quality of life for patients and their families. Eight individual qualitative semi-structured interviews were conducted. Interviews were audiotaped and transcribed verbatim. The palliative care concept was not familiar for most ICU nurses but it was applied in their daily work. Most nurses provided physical care at the end of life to keep the body intact. Some nurses highlighted that dying patients did not feel pain to be treated and did not have emotions to be supported. The authors concluded that nurses had insufficient knowledge of palliative care and how to apply it in ICU setting. The provision of additional education in palliative care is recommended in order to improve the knowledge of palliative care among nurses.

A review paper on Compassion is presented from Amman. Compassion is a type of meditation therapy which has been used recently. Compassion has many definitions, one of these definitions is the feeling that emerges in witnessing another's suffering and that motivates a following desire to hel). Hofmann, Grossman, and Hinton describe compassion as a path leading to greater awareness, aimed to focus awareness upon alleviation of the suffering of all sensitive beings. Moreover, compassion is thought to have arisen as the affective element of a caregiving system, designed to help raise vulnerable progeny to the age of viability.