Investigating the level of moral distress and its related factors among nurses in mazandaran burn center

Background and purpose: Moral distress is a common phenomenon in nursing professional and burn nurses are constantly faced with making different moral decisions for patients who are in terrible conditions. Therefore, nurses in burn units experience moral distress as mental tension. This study was conducted to determine the severity of moral distress and the factors associated with that in burn nurses. Materials and methods: A descriptive- analytical study was conducted using census sampling on 172 nurses working in Mazandaran burn center, 2014. Data was collected through identifying demographic and occupational characteristics of the nurses (using relevant questionnaires) and Corley’s Moral Distress Scale. Data analysis was performed applying Mann-Whitney and Kruskal-Wallis test. Results: The mean score for moral distress was 105.65±52.39 which indicates a moderate level experienced by nurses. Kruskal-Wallis test showed a significant positive correlation between educational level and level of moral distress (P=0.011). There was no significant association between moral distress and other individual and professional characteristics (P>0.05). Conclusion: Moral distress is accompanied by many complications that have direct effects on nurses’ professional practice. Therefore, nurse managers should consider this issue and plan for programs on appropriate coping strategies. © 2015, Mazandaran University of Medical Sciences. All rights reserved

Correlation of serum adiponectin level with some biochemical and metabolic factors in stable hemodialysis patients

Introduction: Serum adiponectin is a hormone secreted by the adipose tissue and its level usually increases in patients with renal insufficiency. In uremic condition, it not only loses its protective role against atherosclerosis, but also becomes a risk factor. This hormone is a direct predictor of cardiovascular complications in patients with renal failure. Objectives: This study was designed to assess the association between serum adiponectin with various parameters in in a group of non-diabetic hemodialysis patients. Patients and Methods: In this study, 73 hemodialysis non-diabetic patients were selected and fasting blood samples were taken to measure adiponectin and some other biochemical parameters. Waist circumference, abdominal circumference, weight and body mass index (BMI) were measured. Pearson statistical test was used to find the association between adiponectin and mentioned parameters. Results: Adiponectin level was negatively and significantly associated with weight (P<0.001), BMI (P<0.001), waist circumference (P<0.05), abdominal circumference (P<0.01), and triglycerides (P<0.01). Conclusion: According to the results of our study, serum adiponectin level in hemodialysis patients was negatively associated with weight and BMI which indicates the likely effect of the hormone. As a result, finding of exact connections between this cytokines and the risk factors of atherosclerosis and hypercatabolism may help to introduce serum adiponectin as a measurable and important marker for atherosclerosis and may be used as an index for prognosis of mortality in this type of patients. Keywords: Adiponectin, Kidney failure, Hemodialysis Please cite this paper as: Tamadon MR, Heidari M, Dris F, Mardani S. Correlation of serum adiponectin level with some biochemical and metabolic factors in stable hemodialysis patients. J Parathyr Dis 2015;3(1):20-24. Copyright © 2015 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

The effect of different concentrations of oxygen on postoperative nausea and vomiting after spinal anesthesia

چکیده: زمینه و هدف: تهوع و استفراغ از عوارض شایع پس از عمل جراحی به روش بیهوشی عمومی و نخاعی می باشد. جهت پیشگیری یا درمان تهوع و استفراغ پس از عمل از داروهای مختلف استفاده شده که علیرغم استفاده از آنها این عارضه کماکان پس از عمل جراحی بطور شایع دیده می شود. از طرفی در برخی از تحقیقات استفاده از اکسیژن با غلظت بالا توانسته است سبب کاهش تهوع و استفراغ پس از عمل جراحی، متعاقب بیهوشی عمومی شود. با توجه به آنکه تاکنون هیچ تحقیقی در مورد تأثیر اکسیژن بر روی تهوع و استفراغ پس از عمل جراحی تحت بیهوشی نخاعی انجام نشده است در این تحقیق اثرات اکسیژن با غلظت های مختلف مورد بررسی قرار گرفته است. روش بررسی: در این مطالعه که از نوع کار آزمایی بالینی دوسوکور است تعداد 132 بیمار با مشخصات ASAI,II (American Society of Anesthesiologyists) در محدوده سنی 70-15 سال، داوطلب عمل جراحی جا اندازی و ثابت کردن باز شکستگی ساق پا تحت بِیهوشی نخاعی، بطور تصادفی به سه گروه مساوی تقسیم شدند. پس از انجام بِیهوشی نخاعی با محلول بوپی واکائین 5/. در حین عمل از اکسیژن با غلظت های 30 (گروه اول)، 50 (گروه دوم) و70 (گروه سوم) استفاده شد. تعداد دفعات استفراغ با مشاهده و شدت تهوع به کمک پرسشنامه (Visual Analogue Scale=VAS) ثبت گردید. اطلاعات بدست آمده توسط آزمون های کای دو و ANOVA و با استفاده از نرم افزار SPSS مورد تجزیه و تحلیل آماری قرار گرفته و 05/0p< معنی دار قلمداد گردید. یافته ها: نتایج این بررسی نشان داد که بین میانگین تعداد دفعات استفراغ، شدت تهوع و میزان مصرف متوکلوپرامید حین عمل و در ساعات 2، 12 و 24 پس از عمل، در گروههای 1، 2 و 3 اختلاف آماری معنی دار وجود نداشت. نتیجه گیری: استفاده از اکسیژن با غلظت های بالاتر، در مقایسه با دوزهای کمتر باعث کاهش تهوع، استفراغ و یا مصرف متوکلوپرامید و حین عمل و پس از عمل جراحی نمی شود

The quality of life in boys with Duchenne muscular dystrophy

We conducted a study to evaluate the quality of life in boys with Duchenne muscular dystrophy aged 8–18 years, compared with that in matched healthy controls. A total of 85 boys with Duchenne muscular dystrophy aged 8–18 years and 136 age, sex and living place matched healthy controls were included in this study. Patients and one of their parents separately completed the 27-item Persian version of KIDSCREEN questionnaire (child and adolescent version and parent version). From the children's perspective, the quality of life in patients was found to be lower in two subclasses: “physical activities and health” (p < 0.001) and “friends” (p = 0.005). Parental estimation of their sick child's quality of life was significantly lower than children's own assessment in two subclasses: “physical activities and health” (p < 0.001) and “general mood and feelings” (p < 0.001). Our results indicate that boys with Duchenne muscular dystrophy have quite a satisfactory quality of life. A happier and more hopeful life can be promoted through increasing social support and improving the parental knowledge regarding their child's more positive life perspective. © 2016 Elsevier B.V

Investigation and Comparison Effects of Fluid Injection Type in Thrust Vector Control

In this research, the effects of some liquid side injection from nozzle wall into exhaust gas of combustion chamber are studied. The side injection against main flow is as elliptical solid thing that change the symmetric of flow field on nozzle wall and causes some different pressure distribution on wall, and finally causes thrust vector deviation. Flows interaction causes some physical phenomena as bow shock wave in front of injection region. This paper explain the effects of this wave and variation velocity & pressure distribution at different cross sections of flow field and comparison results of air and other liquid fluid in thrust vector control system. The results are compared with experimental data and have well agreement with them. The results show that Freon is one of best injection liquid for this type of thrust vector control. Performance of Injection is optimum in relative position 35 to 40% nozzle divergence length

Comparison of Hemodynamic Variations, Bispectral Index and Myoclonus Score of Propofol Dosage in Anesthesia Induced Patients

Aims Propofol is the most widely used intravenous anesthetic medication. It is necessary to assess the doses of the medication to determine proper anesthetic depth and to prevent its side-effects. The aim of this study was to compare 1 and 2.5mg/Kg doses of propofol in hemodynamic changes, myoclonus degree, and bi-spectral index (BIS) monitoring level in patients under anesthetic induction. Materials & Methods In the two-blind random clinical trial study, 92 patients being candidate for surgery wit general anesthesia induction were studied in Shahr-e Kord Kashani Center in 2013. The subjects, selected via simple sampling method, were randomly divided into two groups. The first and the second groups were received 1 and 2.5mg/kg doses of propofol, respectively. Hemodynamic, myoclonus, and BIS indices were measured at four different times in the groups. Data was analyzed by SPSS 17 using independent T and Chi-square tests, as well as repeated ANOVA and Fisher’s test. Findings There was no significant difference between the groups in the hemodynamic variables such as systolic and diastolic blood pressure, mean arterial blood pressure, pulse rate, and BIS (p>0.05). In addition, the change rates of the variables were the same. Nevertheless, there was a significant difference between the groups in the pulse change rate (p=0.032). There was no significant difference between the groups in myoclonus (p>0.05). Conclusion The hemodynamic changes and the changes in myoclonus degree and BIS are the same in 1 and 2.5mg/kg doses of propofol in the patients undergoing anesthetic induction

Computational and Experimental Investigations of Boundary Layer Tripping

Supersonic flow over a tapered body of revolution has been investigated both experimentally and numerically. The experimental study consisted of a series of wind tunnel tests on an ogive-cylinder body. Static pressure distributions on the body surfaces at several longitudinal cross sections, as well as the boundary layer profiles at various angles of attack have been measured. Further, the flow around the model was visualized using Schlieren technique. Tests with a natural development of the boundary layer and with tripping were also carried out. All tests were conducted in the trisonic wind tunnel of Qadr Research Center. Our results show that artificial boundary layer tripping has minor effect on the static surface pressure distribution (depending on its diameter and installation location), while the changes in total pressure around the body were significant. Tripping the boundary layer increased its thickness, changed its profile particularly near the body surface. Two oblique shock waves were formed in the front and behind the trip wire. In this study, using multi-block grid, the thin layer Navier-Stokes (TLNS) equations were solved around the above models. Also patched method was used near the interfaces. Good agreements were achieved when the numerical results were compared with the corresponding experimental data

Comparison of polyaluminum silicate chloride and electrocoagulation process, in natural organic matter removal from surface water in ghochan, Iran

Removal of Natural Organic Matter (NOM)is one of the most important objectives of water treatment plants but reducing these pollutants either present in water as dissolved or suspended form is not as efficient as is required in conventional treatment plants. The purpose of this study was comparison performance of composite polyaluminum silicate chloride (PASiC) and electrocoagulation (EC) process by aluminum electrodes in NOM removal from raw surface water.Удаление природных органических веществ (ПОВ) является одной из наиболее важных задач при очистке поверхностных вод. Однако удаление ПОВ, находящихся в растворенной форме или в виде суспензий, не настолько эффективно, как это требуется при работе водоочистных сооружений. Изучено влияние мутности, общего органического углерода (ООУ), адсорбции ПОВ при длине волны 254 нм (УФ254 нм), ХПК, щелочности в процессе электрокоагуляции и при использовании композитного четыреххлористого кремния полиалюминия (КЧКП).Видалення природних органічних речовин (ПОР) є одним з найбільш важливих завдань при очищенні поверхневих вод. Проте видалення ПОР, що знаходяться в розчиненій формі або у вигляді суспензій, не настільки ефективно, як це потрібно при роботі водоочисних споруд. Вивчений вплив каламутності, загального органічного вуглецю (ЗОУ), адсорбції ПОР при довжині хвилі 254 нм (УФ254 нм), ХПК, лужності в процесі електрокоагуляції і при використанні композитного чотирьоххлорістого кремнію поліалюмінію (КЧКП)

Investigation of Flow Field in a Typical Hypersonic Wind Tunnel over a Standard Mode

In order to start designing a new hypersonic wind tunnel, it is important to have a pre-view about physical phenomena in a typical Hypersonic Wind Tunnel (HWT). In present research, it is tried to view phenomenologically the aerodynamics of flow in a typical HWT by Computational Fluid Dynamics (CFD). The considered HWT consists of a curved nozzle in nominal Mach number 12, free-jet type test section, a test model and a convergent-divergent diffuser. Aerodynamics of flow in the nozzle exit and test section, conical shock wave system in the diffuser and flow over a standard model (HB-2) are investigated. A method is introduced for numerical simulation of capturing the free shear layer in free-jet test section based on the vorticity distribution of flow. The aerodynamics behavior of HB-2 model is investigated in various Mach numbers and flow domains. The results make a better view of some aerodynamic phenomena in a free-jet type test section of wind tunnel that are rarely considered. This research is conducted towards the project of designing and manufacturing the industrial hypersonic wind tunnel for Qadr Aerodynamic research Center