Developing the Principles of Parental Mental Health in the Neonatal Intensive Care Unit (NICU)

Background: Hospitalization of infants in the neonatal intensive care unit (NICU) may disrupt the proper interaction with infants and lead to anxiety and depression, while adversely affecting the role of families. Therefore, it is necessary for healthcare teams to be familiar with the principles of parental mental health in the NICU. The present study aimed to codify the principles of parental mental health in the NICU. Methods: This study was conducted with a triangulation methodology in two steps. In the first step, the principles of mental health care for parents in the NICU were compiled and translated. In the second step, the principles were edited using the Delphi method based on the opinion of experts (physicians, faculty members, and health policymakers). Final principles of parental mental health in the NICU were codified. Results: In total, four general principles of holistic care, relationship with parents in the NICU, special care for establishing communication with families in the NICU, and principles of infants and family care were obtained. Conclusion: Since healthcare teams may not be familiar with the principles of parental mental health in the NICU, the results of the present study could lay the groundwork for promoting the knowledge of healthcare team members in interaction with parents

The core of pomegranate (Punica granatum) seed kernel meal effects of growth parameters of rainbow trout (Oncorhynchus mykiss)

This study was aimed to investigate the effects of pomegranate (Punica granatum) seed kernel meal (pskm) as a supplement in the diet of rainbow trout (Oncorhynchus mykiss), The experiment was carried out in growth in a period of 90 days since the 12/11/2014 until the 12/03/2015 in Abzi Eksir Koesar complex , situated in south east of Tehran. 600 fingerlings with average weight of 6.74 gram and average length of 5.50 centimeter were divided to five treatments, The control group was without any pskm, and the other groups with added 1, 2, 3 and 4 percent pskm Respectively. For greater certainty each treatments had three replicates. Result indicated that pskm caused highest increased growth parameters in treatment 3 with 3 percent pskm, with other treatments and groups. growth parameters including weight with maximum of 47.74 gram, length were 15.03 centimeter, weight gain with maximum of 41.15 gram, length increase with the maximum of 9.71 centimeter, Weight gain percentage with maximum amount of 572.1, specific growth rate with 0.45 and specific length rate with 0.1 mm. All growth parameters with the best value was seen in treatments 3. This result is due to the presence of high levels of appetite stimulants such as polyphenols of pskm (p<0.05). Result also indicated that the level of pskm in treatment 4, did not cause enough different with the control group, mainly because of higher amount of tannin in their diet

Living with cancer challenges: a qualitative analysis of cancer patients’ perceptions in Iran

Aim Cancer patients are confronted with different challenges. The purpose of current study was to explore Iranian cancer patients’ perceptions of these challenges. Subjects and methods The study took a qualitative approach. Semi-structured interviews were held with 26 cancer patients in four university hospitals in Iran. Transcripts of the interviews underwent conventional content analysis, and categories emerged. Results The findings came under two major categories: psychological challenges and socio-cultural challenges. Psychological challenges had two subcategories: repressed wishes, and negative feelings. Socio-cultural challenges also had two subcategories: deteriorated relationships and work distress. Conclusion Findings of the current study have potential to identify psychosocial challenges of cancer patients. These findings propose that psychological support is essential for them. Our results recommend that healthcare providers should work to remain sensitive to cancer patients’ challenges. There is a need for culture-based caring programs that are responsive to these patients

Hashimoto Encephalopathy with an Unusual Presentation of Status Epilepticus Seizures: A Case Report

A 33 yr old man, previously diagnosed with hypothyroidism, presented with decreased level of consciousness and generalized tonic-clonic (GTC) seizure to Namazi hospital, Shiraz, Iran, during April 2015. The patient later referred with another episode of seizure like attack for which he received phenytoin, carbamazepine and levothyroxine and was discharged. During his last admission, the patient was admitted with chief complaints of decreased consciousness and four GTC attacks. On admission, the patients had aphasia, ataxia, loss of verbal communication, eye contact and complete loss of obedience. Thyroid function tests showed low levels of T3 and T4 with high levels of thyroid stimulating hormone. Other blood tests were all either normal or slightly abnormal. Lumbar puncture and CSF analysis had a high titer of Anti-TPO antibodies. With high suspicion of Hashimoto encephalopathy, pulsed methyl prednisolone (10 mg) was administered, however the patient showed little improvement. Therefore, plasmaphresis was started, to which the patient showed dramatic response

An Exploration of the Viewpoints of Parents and Nurses on Care Provision in Neonatal Intensive Care Units

Background: Infants are regarded as a vulnerable group in need of nursing care, particularly during NICU admission. Parents of these infants often experience emotional, psychological and physical upheavals. Therefore, nurses can be of great help to the parents and facilitate a healthy transition from this period. Improper communication with parents, who seek information on their infant's condition, intensifies their stress, fear and misunderstanding. In fact, inadequate communication with healthcare providers and lack of family support are major issues for the parents of NICU-admitted infants. Methods: In this qualitative study, via content analysis, we objectively selected and collected data from parents, physicians and nurses, residing in Isfahan, Iran in 2012. Data saturation was reached after conducting 25 in-depth, semi-structured interviews. Results: Based on the findings, five major categories were extracted: 1) care provision in NICUs; 2) diagnostic difficulties; 3) NICU admission process; 4) challenges of hospitalization; and 5) maintenance of infant viability. Conclusion: Nurses' proper response to parents' questions about the infant's condition reduced stress among parents. Based on the findings, training is essential to healthy family dynamics and infant's well-being, particularly for younger parents who support their infants at home. Also, regular updates on infant's condition could help reduce parents' stress and discomfort

The Iranian Parents of Premature Infants in NICU Experience Stigma of Shame

ntroduction: To explore experiences of Iranian parents with a hospitalized premature infant in Neonatal Intensive Care Unit (NICU) and examine socio-cultural factors associated with having a less than perfect infant. Methods: Purposely selected 21 participants in this study were 6 fathers, 7 mothers, 5 nurses and 3 physicians specialized in neonatology. Semi-structured in-depth interviews using inductive approach and content analysis helped obtain and analyze data by open encoding for classification and theme abstraction. Results: Findings revealed that parents of hospitalized NICU infants in Iran experienced: job and income loss; shattered confidence in parental role; challenges to family dynamics; shame as a social stigma; loss of control; overwhelmed with uncertainties; and stress induced physical and emotional problems. Conclusion: Unique and outstanding finding of this study was the social stigma of shame for parents of an NICU infant which directly explained the socio-cultural aspect of Iranian society where families place great importance on having a healthy and strong infant. Having a premature infant with anomalies is viewed as a family flaw. Physicians and nurses must focus more on communication with parents and fulfill an important role to educate, assure and comfort parents. Establishing support system for parents of NICU infants seem urgently needed to improve parentinfant bonding

The experiences of parents with infants in Neonatal Intensive Care Unit

Background: In recent years significant medical science advances have been made in the field midwifery and infant care. The premature, low birth weight and ill infants are admitted to the technologically advanced NICU for care and they often require long‑term stay. This study addresses parental experiences with the infant care in NICU, explores their concerns regarding nursing supports for parents and offers nurses’ perspectives on performing duties. Materials and Methods: A qualitative inductive content analysis method was applied in 2011 that included a purposely selected group of parents, nurses and physicians from neonatal unit at the Medical Science University of Isfahan. Participants were surveyed and interviewed according to the institutional ethics committee approval and signed informed consents. Results: The content analysis identified two main categories: 1) the definition of stress, which consisted of misgivings, nervous pressure, imbalance, separation and 2) the parents’ reaction to stress, which revealed emotional, psychotic and behavioral reactions as subcategories. Discussion: The medical team awareness of NICU parent experiences is essential to the quality of care. Recognizing the type of parents’ reaction to the whole process by the healthcare team seems essential to the optimum outcome

Correlation of Psychosocial problems with perception of social support families with addicted member admitted

Background and Aim: Addiction as health problem, mental and social of the present century that not only impact on the physical, emotional and social addicted person, but also led to social-psychosocial problems for the community and their families. However, it seems that social support for families in this condition improve their health and compatibility with the conditions. Therefore this study was to examine relation between psychosocial problems with perception of social support families with addicted member. Method: This Study was a descriptive-analytical study and 400 members of the first prime of drug addicted person whom referred to 5-Azar Addicts Rehabilitation Center of Gorgan at 2012 were selected by simple random sampling. Data gathered by Questionnaires of Check List 90- revise (SCL-90), Northouse social support and demographic information. The data were analyzed by Spearman correlation coefficient, Chi-square and Fisher. Results: The results showed that most families participating in this study had moderate anxiety (36.4%) and moderate depression (36.8%) Also 36% of them have low levels of aggression while 35/8% have the moderate of interpersonal sensitivity. Moreover, most subjects (70.3%) displayed moderate levels of perceived social support. The results showed that between the perception of social support, and anxiety (r=-0.347), depression (r=0.347) and interpersonal sensitivity (r=-0.293) there was a significant inverse relationship, while there was no significant relationship between aggression and perception of social support (r=- 0.293). Conclusion: in regard with the salient role of high social support in better copping of the families of addicted people with stressful factors and its role in providing their psychosocial health, the nurses of health centers can develop some supportive groups and increase their knowledge about positive effects of supportive behaviors to give appropriate supportive interventions. Hence, it is necessity for nurses, first, by constantly evaluating the supportive needs of these families and then by using the sources existed in society and families’ contribution to step up efforts to promote psychosocial health conditio

Competitive contagion in networks

We develop a game-theoretic framework for the study of competition between firms who have budgets to “seed” the initial adoption of their products by consumers located in a social network. We identify a general property of the adoption dynamics — namely, decreasing returns to local adoption — for which the inefficiency of resource use at equilibrium (the Price of Anarchy) is uniformly bounded above, across all networks. We also show that if this property is violated, even the Price of Stability can be unbounded, thus yielding sharp threshold behavior for a broad class of dynamics. We provide similar results for a new notion, the Budget Multiplier, that measures the extent to which the imbalances in player budgets can be amplified at equilibrium

Evaluation of the perception of Iranian nurses towards spirituality in NICUs

Background: Holistic care is the evaluation of the physical and mental states of individuals. Considering the importance of spirituality in healthcare and its pivotal role as the first step toward providing spiritual care, this study was conducted to determine the perception of Iranian nurses towards spirituality in neonatal intensive care units (NICUs). Methods: This study was conducted on nine participants using qualitative content analysis. In addition, purposive sampling was used to select the participants. Study setting was the NICUs at hospitals affiliated to Ardabil University of Medical Sciences, Ardabil, Iran. Data collection was performed through semi-structured interviews with the samples. Results: Three main categories were discussed in this study, as follows: 1) "Meaning of spi rituality" with three subcategories of "connectedness to God", "sincerity", and "prayers or recourse to Ahl-al-Bayt"; 2) "nature of spirituality" with three subcategories of "peace of mind", "nursing performance beyond physical health care", and "problem-solving"; 3) "respect for spiritual beliefs" with two subcategories of "respect for beliefs and values" and "persistent faith". Conclusion: The results of this study indicated that the perception of Iranian nurses toward spirituality is directly influenced by their religious tendencies, which denotes the importance of educational courses on spirituality for nurses. Therefore, it is recommended that nursing managers and directors implement training programs for the personnel in order to enhance spirituality