Nursing Care Aesthetic in Iran: A Phenomenological Study

Background: Despite the emphasis of contemporary nursing theories on the belief that nursing is a science and an art in care, published studies show that only the nursing science has developed. Many experts believe that by recognizing and perceiving this concept, the clinical field can develop aesthetic knowledge in nursing and education of students. Objectives: The purpose of this study was to explain clients and nurses perspective of nursing care aesthetics. Patients and Methods: Using an interpretive phenomenology, 12 clients and 14 nurses were interviewed. Participants in this study were purposefully selected and their experiences were analyzed using Van Manen’s hermeneutic phenomenological framework. Results: Emerged themes were as follows: subjective description, overt spirituality, opening desperate impasse, sense of unity, continue to shine, and painful pass and pleasing. According the participants experiences, nursing care aesthetics includes subjective description of spiritual and desirable caring behaviors combined with sense of unity and sympathy between the nurse and the patients, which leads to opening in desperate impasse with creating the feeling of satisfaction and peace in the patient. It is a shining of clinical capabilities and an action beyond what should be combined with a decorating care that leads to a pleasant ending against the pain and suffering of the others for the nurse. Conclusions: Many caring behaviors associate with aesthetic experience for both patients and nurses and despite two different views, findings of this study showed that these experiences were similar in most cases. The aesthetics of nursing care was defined as what reflects the holistic nature of nursing with an emphasis on spirituality and skill. Results of this study are effective in identification of the values existed in nurse caring behaviors and developing of profession by instruction, implementation, and evaluation them

Comparison of analgesic effect of pregabalin-fentanyl and midazolam-fentanyl combinations on the severity of pain in the patients undergoing extracorporeal shock wave lithotripsy: a double-blind clinical trial

Background and Objective: Kidney stone disease goes back to thousands of years ago. Extracorporeal Shock Wave Lithotripsy (ESWL) is currently the first line treatment for this disease. Different analgesics were already used to relieve pain in the patients but they still complain about their pain. Therefore, the effect of two combinations of pregabalin-fentanyl and midazolam-fentanyl was investigated in controlling pain in the patients undergoing ESWL in this study.Materials and Methods: This was double-blind clinical trial on 141 patients visiting Lithotripsy Unit in Peymaniyeh Hospital in Jahrom Town. The participants were selected using a simple sampling method. Inclusion criterion was 8mm < kidney stone < 20mm. Exclusion criteria were 20 kg/m2 < body mass index (BMI) < 30 kg/m2, a history of mental disorders, namely addiction to analgesics and opiates. Finally, the patients were randomly assigned to two groups. One microgram per kilogram fentanyl was administered intravenously and 300mg pregabalin was given orally to the patients ten minutes before surgery in the first group (pregabalin-fentanyl and n = 47). One microgram per kilogram fentanyl and one microgram per kilogram midazolam were injected intravenously to the patients ten minutes prior to operation in the second group (fentanyl-midazolam and n = 46). Then, standard shock wave lithotripsy was carried out in both groups. The severity of pain was measured every 20 minutes during the operation and two hours after the operation using the Visual Analog Scale for Pain (VAS Pain). The collected data was analyzed using SPSS version 21. Descriptive statistics (mean, standard deviation and percent) and analytical statistical tests (Mann-Whitney and Chi-square) were used to analyze the data.Results: The mean age of participants was 43.80±13.71 in the first group (pregabalin + fentanyl) and 39.0±11.19 in the second group (midazolam + fentanyl). Chi-square test results were matched in both groups in terms of age, gender, number of shocks and size of the stone. The Mann-Whitney test results showed a significant difference between the first and second groups in terms of pain score from the first 20 minutes up to 2 hours after drug administration (p-value<0.05). The results also showed that the number of patients experiencing higher than average severity of pain in the second group was significantly less than the first group (pvalue< 0.05).Conclusion: The results of this study showed that the number of patients experiencing higher than average severity of pain in the group receiving midazolam-fentanyl combination was less than the group receiving pregabalin-fentanyl combination. Therefore, it can be deduced that fentanyl in combination with midazolam has a greater analgesic effect on pain relief in the patients undergoing ESWL.Keywords: pregabalin-fentanyl, midazolam-fentanyl, pain, extracorporeal shockwave lithotrips

Combining business process and failure modelling to increase yield in electronics manufacturing

The prediction and capturing of defects in low-volume assembly of electronics is a technical challenge that is a prerequisite for design for manufacturing (DfM) and business process improvement (BPI) to increase first-time yields and reduce production costs. Failures at the component-level (component defects) and system-level (such as defects in design and manufacturing) have not been incorporated in combined prediction models. BPI efforts should have predictive capability while supporting flexible production and changes in business models. This research was aimed at the integration of enterprise modelling (EM) and failure models (FM) to support business decision making by predicting system-level defects. An enhanced business modelling approach which provides a set of accessible failure models at a given business process level is presented in this article. This model-driven approach allows the evaluation of product and process performance and hence feedback to design and manufacturing activities hence improving first-time yield and product quality. A case in low-volume, high-complexity electronics assembly industry shows how the approach leverages standard modelling techniques and facilitates the understanding of the causes of poor manufacturing performance using a set of surface mount technology (SMT) process failure models. A prototype application tool was developed and tested in a collaborator site to evaluate the integration of business process models with the execution entities, such as software tools, business database, and simulation engines. The proposed concept was tested for the defect data collection and prediction in the described case study

Integration issues in the development of a modelling and simulation tool for low volume high-complexity electronics manufacture

In order to design and implement the information systems and modules that could comprise an “industrial strong” knowledge-based tool, links to shop floor systems containing real-time production data and PCA customer information (e.g. bill of materials (BOM), CAD drawings) are required. Details of the issues of implementing the tool in an industrial organisation and the integration of various data sources (e.g. “in-house” developed systems, enterprise resource planning systems, ad-hoc developed databases, machine data and CAD data) are presented in this paper. The application of the CLOVES system in an industrial setup highlights the difficulties in integrating information from design as CAD data and shows how these setbacks could be overcome if the electronics industry were to adopt a common CAD assembly information exchange platform. Hence, this paper concludes that existing automation tool manufacturers should focus exclusively on developing generic connections by adopting industry standards that can facilitate the deployment of “plug and play” tools. This standardisation could in turn help software developers, to provide the electronics industry with more integrated systems that communicate better among loosely coupled information systems and avoid depending on extensive time consuming manual data input

One common polymorphism of cholesteryl ester transfer protein gene in Iranian subjects with and without primary hypertriglyceridemia

Primary hypertriglyceridemia is considered to be a major risk factor for pancreatitis, atherosclerosis and coronary heart disease. Cholesteryl ester transfer protein gene polymorphisms known to be associated with changes in lipid levels. This study was performed by using polymerase chain reaction and restriction fragment length polymorphisms. Genotype distribution and allelic frequencies of polymorphism were determined and compared in primary hypertriglyceridemic and normotriglyceridemic subjects. The results showed that plasma cholesteryl ester transfer protein activity was significantly higher in primary hypertriglyceridemia than in controls (p = 0.001). In this study all individuals with B2B2 genotype had lower plasma cholesteryl ester transfer protein activity, higher high-density lipoprotein than B1B1 and B1B2 genotypes, whereas triglyceride was significantly decreased in this genotype. The genotype and allelic frequencies for this polymorphism differed significantly between primary hypertriglyceridemic patients and controls (p = 0.014 and p = 0.027, respectively). In both groups, CETP Taq 1B polymorphism (presence of B 2 allele) correlated significantly with HDL-C (r = 0.207 and 0.300 in control and patient groups, respectively) and CETP activity (r = -0.193 for controls and r = -0.132 for patients). Taq 1B polymorphism of cholesteryl ester transfer protein gene was associated with changes in lipids profile and plasma cholesteryl ester transfer protein activity in the selected population. © 2007 Asian Network for Scientific Information

Sources of Sleep Disturbances and Psychological Strain for Hospital Staff Working during the COVID-19 Pandemic

Hospital staff members reported increased stress-related workload when caring for inpatients with COVID-19 (“frontline hospital staff members”). Here, we tested if depression, anxiety, and stress were associated with poor sleep and lower general health, and if social support mediated these associations. Furthermore, we compared current insomnia scores and general health scores with normative data. A total of 321 full-time frontline hospital staff members (mean age: 36.86; 58% females) took part in the study during the COVID-19 pandemic. They completed a series of questionnaires covering demographic and work-related information, symptoms of depression, anxiety, stress, social support, self-efficacy, and symptoms of insomnia and general health. Higher symptoms of depression, anxiety, and stress were associated with higher symptoms of insomnia and lower general health. Higher scores of depression, anxiety, and stress directly predicted higher insomnia scores and lower general health scores, while the indirect effect of social support was modest. Compared to normative data, full-time frontline hospital staff members had a 3.14 higher chance to complain about insomnia and a significantly lower general health. Symptoms of insomnia and general health were unrelated to age, job experience, educational level, and gender. Given this background, it appears that the working context had a lower impact on individuals’ well-being compared to individual characteristics

A simulation module for supporting the manufacture of high value added electronics manufacturing

Given the global pressures and demanding requirements for high value added electronics manufacturing, it is vital to make the right decisions on the shop floor. One of the main shop floor level decisions in the domain is the selection of the most appropriate scheduling strategy for the available manufacturing system. Simulation has proved to be a powerful decision support tool. However, very few studies have used this potential to support the evaluation of scheduling strategies in a manufacturing context. A component-based simulation tool to evaluate the performance of scheduling strategies on a particular system is presented in this paper. The component based structure of the simulation tool allows the main problem requirements to be addressed. An example, based on a real company, illustrates the nature of the simulation results and the kind of support that can be obtaine

Characterization of printed solder paste excess and bridge related defects

Surface Mount Technology (SMT) involves the printing of solder paste on to printed circuit board (PCB) interconnection pads prior to component placement and reflow soldering. This paper focuses on the solder paste deposition process. With an approximated cause ratio of 50 – 70% of post assembly defects, solder paste deposition represents the most significant cause initiator of the three sub-processes. Paradigmatic cause models, and associated design rules and effects data are extrapolated from academic and industrial literature and formulated into physical models that identify and integrate the process into three discrete solder paste deposition events - i.e. (i) stencil / PCB alignment, (ii) print stroke / aperture filling and (iii) stencil separation / paste transfer. The project’s industrial partners are producers of safety-critical products and have recognised the in-service reliability benefits of electro-mechanical interface elimination when multiple smaller circuit designs are assimilated into one larger Printed Circuit Assembly (PCA). However, increased solder paste deposition related defect rates have been reported with larger PCAs and therefore, print process physical models need to account for size related phenomena

Integration approach to virtual-driven discrete event simulation for manufacturing systems

This is an Accepted Manuscript of an article published by Taylor & Francis in 'International Journal of Computer Integrated Manufacturing' on 11/06/2014, available online: https://doi.org/10.1080/0951192X.2014.924159.Virtual engineering (VE) environment helps to verify process and resource design through visualisation. By using VE, the impacts of re-configurability and new-process additions in the machine stops can be viewed down to the component level. On the other hand, discrete event simulation (DES) typically forecasts the system behaviour over a period of time to predict future performance. During pre-build stages of machines, DES analysis comes with uncertainties, as most of the parameters in the model are based on the assumptions. Therefore, it was aimed to use the validated and verified data, for example ‘process time’ of a machine component available from the VE-emulated systems, in the DES model. Thus, a systematic algorithm was proposed to integrate the VE tool data, with the DES. This article presents the development of a package known as ‘virtual-driven discrete event simulation’ (VDSim), used to establish an integration between the VE and DES domains. The success of this integration depends upon the quality of information and the compatibility of data flow between these independent domains. VDSim integration will help productivity planners and schedulers to get the best possible options for resource selection at stages even when the resource is not physically present

Vitamin B12 bioaccumulation in Chlorella vulgaris grown on food waste-derived anaerobic digestate

Anaerobic digestion plays a pivotal role in the modern circular economy, as it offers a sustainable solution for converting organic waste into biogas (methane). It also results in a nutrient-rich liquid stream, referred to as digestate. This digestate is extensively applied to agricultural land as fertilizer due to its high macronutrient (N, P) content, but the bioactive micronutrients it contains and their significance for downstream applications remain largely unknown. Here, we investigate whether digestate generated from a vitamin B12-deficient substrate (fruit and vegetable waste) can be enriched in this vitamin through anaerobic digestion, and explore the capability of the microalga Chlorella vulgaris to grow in this medium and bioaccumulate B12. Our findings uncover, for the first time, that substantial amounts of B12 are synthesized during anaerobic digestion, and that C. vulgaris can effectively be enriched with this vitamin when grown in the digestate (10.6 μg Β12·g−1 dry weight). Additionally, we identified that pH-induced ammonia toxicity was the main inhibitor when growing microalgae in the digestate, which allowed us to significantly enhance productivity at lab- and pilot-scale through pH control. The case of B12 synthesis in digestate and accumulation in microalgae highlights the potential for enhancing the value of these waste streams through the identification and utilization of bioactive compounds