Neonatal Intensive Care Units Nurses' Attitude Toward Advantages and Disadvantages of Open vs Closed Endotracheal Suction

Background: The vital issue of protecting the airway and maintaining ventilation in preterm infants makes tracheal suctioning an important procedure. The decision to use closed or open endotracheal suction method depends on the clinical status of infants and the nurses’ skills and preferences. Objectives: The current study aimed to compare the two methods based on the perceptions of the nurses working in Neonatal Intensive Care Units (NICU). Patients and Methods: A comparative-descriptive study carried out on 35 NICU nurses in Taleghani and Al-Zahra teaching hospitals in Tabriz, Iran, in 2013. Data were collected by self-administered questionnaire (13 Items). Data analysis, including t-test was performed using SPSS Ver. 13. A P ≤ 0.05 was considered statistically sig­nificant. Results: According to the nurses’ point of view, there are differences between characteristics of open and closed endotracheal suctioning methods (P < 0.001). By using closed endotracheal suction, the risk of traumatizing airway, developing pneumonia, increasing intracranial pressure, prolonging emergency suctioning, developing intra-ventricular hemorrhage, blood stream infection, physiological instability and lowering positive end-expiratory pressure (PEEP) are reduced. Meanwhile, lower cost, lower risk of extubation, comfort and easy washing procedure were reported as advantages of open suction. Conclusion: Closed endotracheal suctioning was evaluated to be better than the open method in the preterm neonates. More studies, especially experimental and efficient cost analysis, are recommended

Enhanced response of the regular networks to local signals in presence of a fast impurity

We consider an array of inductively coupled Josephson junctions with a fast impurity (a junction with a smaller value of critical current), and study the consequences of imposing a small amplitude periodic signal at some point in the array. We find that when external signal is imposed at the impurity, the response of the array is boosted and a small amplitude signal can be detected throughout the array. When the signal is imposed elsewhere, minor effects is seen on the dynamics of the array. The same results have been also seen in presence of a single fast spiking neuron in a chain of diffusively coupled FitzHugh-Nagumo neurons.Comment: 6 pages, 5 figures, arXiv admin note: substantial text overlap with arXiv:1108.460

Challenges of the preceptors working with new nurses: A phenomenological research study

© 2016. Introduction: Preceptors play an important role in the transition of new nurses to the practice setting, however, preceptorship experience has been perceived as stressful by preceptors. This study aimed to explore the lived experiences of nurse preceptors working with new nurses. Method: This qualitative study used the hermeneutic phenomenological design to explore the experiences of six nurse preceptors working with new nurses in a tertiary pediatric teaching hospital in Northwest of Iran, who were recruited by purposive sampling. Data were collected using in-depth semi-structured individual interviews between July 2014 and March 2015, and analyzed using the Diekelmann's seven-stage method. Results: Data analysis revealed three themes: 1) preceptorship as a challenging and stressful role; 2) lack of support; and 3) lack of appreciation. Preceptorship as 'a challenging and stressful role' was the constitutive pattern that unified the themes. Conclusion: The preceptorship of new nurses is challenging and stressful. Preceptors endure several roles concurrently, thus, their workload should be balanced appropriately in order not to compromise with one another and evade burnout. The preceptors need to be well supported and their contribution be appropriately recognized. Setting clear objectives and realistic expectations, and having clear policies and guidelines in place should help develop a preceptorship program that is more likely to bring about positive outcomes for both preceptors and new nurses

An Investigation on Adoption of Socio-Culturally Based Teaching Strategies Among Iranian Clinical Nurse Educators

Background: In today’s complex healthcare environments, the traditional teaching strategies and learning models are unable to prepare learners to confront with rapid changes. Some education scholars believe that the teaching strategies based on socioculturally theory are more responsible and efficient. Objectives: The present study was conducted to investigate socio-culturally-based teaching strategies being adopted or assigned by Iranian clinical nurse educators as high priorities. Patients and Methods: A descriptive study was conducted on 38 nurse educators from two nursing and midwifery faculties in Tabriz and Urmia, Iran. Data were collected over a period of 2 months in 2010 using the Phillip’s Adoption Appraisal Instrument, developed by Bonk & Kim. The instrument items have been ranked on a 4-point Likert-type scale and ordered in 10 subscales. The data were analyzed using SPSS software version 13.0. The overall mean, standard deviation, and confidence interval 95% were calculated for each subscale to determine the rank distribution of subscales. Results: All strategies were known as a moderate adoption (2.72 ± 0.44 of 4), however prioritizing in adoption of socio-culturally-based teaching strategies from clinical nurse educators’ viewpoints indicated that 60% of strategies were evaluated as the most adopted strategies, 10% as the least, and the other 30% in moderate mode. Conclusions: Due to the importance of socio-culturally-based theory strategies in clinical settings and the moderate adoption of strategies from clinical nurse educators’ viewpoints,educational planners and policymakers should prepare required prepositions to progress the adoption and the usage of these strategies

Coping With Stress in Iranian School-Age Children

Background: Methods learnt by children to cope with stress will be used in their adolescence. Failure to learn adaptive coping strategies causes some mental, physical and behavioral problems which continue until adulthood. Objectives: The current study was conducted to investigate the methods of coping with stress among Iranian school-age children. Patients and Methods: A descriptive study was conducted in which a randomly selected sample of 839 students of third to fifth grade of primary school in Tabriz, Iran participated. The data were collected using the Schoolagers` Coping Strategies Inventory questionnaire. SPSS software was employed to analyze the data by percentage, absolute frequency, and linear regression test. Results: All coping methods inserted in the questionnaire were used by students. More than 70% of students mentioned “pray”, “say I’m sorry or tell the truth”, and “try to relax, stay calm” out of 26 cases of coping strategies. According to more than 60% of children, “pray”, “say I’m sorry or tell the truth”, and “draw, write, or read something” were the most useful coping methods and “pick on someone” and “yell or scream” were not mostly used by the children under study. Conclusions: Children use variable methods to cope with their stress. Therefore, parents, health trainers and school authorities should distinguish non-adaptive methods of children and teach them the adaptive coping strategies

The image of nursing, as perceived by Iranian male nurses

The stereotypical public image of nursing is a major concern for male nurses around the world. In this study, we explored how Iranian male nurses perceived the public view of nurses, and their perceptions of themselves. A qualitative descriptive design and content analysis were used to obtain data from 18 purposely-selected male hospital nurses with a baccalaureate nursing degree in Tabriz, Iran. Semistructured interviews were conducted and analyzed. Two main themes emerged: (i) the outsider's view of nursing, which referred to the participants' perceptions of their public image; and (ii) the insider's view, which related to the male nurses' perceptions of themselves. Results included personal transition into a positive professional self-image through the educational process, and continued public perception of nursing as a female profession ill-suited for a man. Strategies to improve the insider's and outsider's views of nursing are listed to help recruit and retain more Iranian male nurses

Organizational Activities in Nursing Research Transfer from Viewpoint of Nurse Educators in Iranian Universities of Medical Sciences

Background: Transferring research-based knowledge into practice would help to maximize the quality of health care. However, the role of knowledge producers and the organizational roles related to knowledge transfer have been largely ignored. Objectives: This study was accomplished with the aim of describing the organizational activities needed to transfer the findings of nursing research from the viewpoint of nurse educators in Iranian Universities of Medical Sciences. Patients and Methods: This descriptive study was carried out with participating 279 nurse educators of medical sciences universities. Data were collected using Knowledge Translation Self-Assessment Tool for Research Institutes (SATORI). Results: Nursing faculty members evaluated the organizational activities of transferring the knowledge of nursing research at the “medium” level and for the domains of “the question of research” and “promoting the use of evidence” at a “weak” level and in the domains of “knowledge production” and “knowledge transfer” at a “medium” level. Conclusions: Organizational activities related to the knowledge transfer of nursing research are demonstrably low (medium at best). It is recommended that in each faculty and with the participation of all faculty members, the research transferring procedure should be assessed and all necessary changes needed to improve the research transferring procedure should be implemented

First Results of Magnetic Field Penetration Measurements of Multilayer SIS Structures

The performance of superconducting RF cavities made of bulk Nb is limited by a breakdown field of Bp ≈200 mT, close to the superheating field for Nb. A potentially promising solution to enhance the breakdown field of the SRF cavities beyond the intrinsic limits of Nb is a multilayer coating suggested in [1]. In the simplest case, such a multilayer may be a superconductor-insulator-superconductor (S-I-S) coating, for example, bulk niobium (S) coated with a thin film of insulator (I) followed by a thin layer of another superconductor (S) which could be e.g. dirty niobium [2]. Here we report the first results of our measurements of field penetration in Nb thin films and Nb-AlN-Nb multilayer samples at 4.2 K using the magnetic field penetration facility designed, built and tested in ASTeC

Evaluation of visibility of foreign bodies in the maxillofacial region: Comparison of computed tomography, cone beam computed tomography, ultrasound and magnetic resonance imaging

Background: Detection of foreign bodies (FBs) is challenging. Selection of a fast and affordable imaging modality to locate the FB with minimal patient radiation dose is imperative. Objectives: This study sought to compare four commonly used imaging modalities namely cone beam computed tomography (CBCT), magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound (US) for detection of FBs in the head and neck region. Materials and Methods: In this in vitro study, iron, glass, stone, wood, asphalt, and tooth samples measuring 0.1 � 0.5 � 0.5 cm were placed in the tongue muscle, soft tissue-bone interface and nasal cavity in a fresh sheep�s head and subjected to MRI, US, CT and CBCT. A total of 20 images were captured by each imaging system from the six materials in the afore-mentioned locations. The images were observed by an expert oral and maxillofacial radiologist and a general radiologist. To assess reliability, 20 images were randomly observed by the observers in two separate sessions. The images were classified into three groups of good visibility, bad visibility and invisible. The data were analyzed using SPSS version 18, Wilcoxon Signed Rank, Pearson chi square, and Fisher�s exact tests. Results: All FBs in the tongue and at the soft tissue-bone interface had good visibility on US (P = 1.00). Also, CBCT and CT had significantly different performance regarding FB detection (P < 0.001). All wooden samples in the nasal cavity were invisible on CT scans; while, only 20 of them were invisible on CBCT scans. MRI showed significant differences for detection of FBs in the three locations (P < 0.001). MRI could not locate iron samples due to severe artifacts and only showed their presence (bad visibility) but other FBs except for wood and tooth in the nasal cavity (100 invisible) had good visibility on MRI. Conclusions: Ultrasound is recommended as the first choice when FB is located within the superficial soft tissues with no bone around it. In case of penetration of FB into deeper tissues or beneath bone, CT or CBCT are recommended. Otherwise, considering lower dose, CBCT is preferred over CT. We can use MRI if the FB is not ferromagnetic. However, CT is the first choice in emergency situations because of higher sensitivity. © 2016, Tehran University of Medical Sciences and Iranian Society of Radiology

Recipients' experiences after organ transplantation

Background: After organ transplantation, many patients have diverse experiences; they face many changes in the physical and emotional aspects of their life. Patients' understandings of the post-transplantation period influence their adaptation to the changes. There is a need to improving the knowledge of patients' unique experiences of post-transplantation period and the changes occur in their life. Objective: To explore the experiences of organ recipients in the post-transplantation period. Methods: In a qualitative research using a hermeneutical phenomenological approach, data were collected from April 2015 to June 2016. Participants were consisted of 15 patients who received organ chosen using a purposive sampling method. In-depth semi-structured interviews were held with them. The collected data were analyzed using Diekelmann's hermeneutical analysis approach. Results: The data analyses led to the development of 3 main themes and 17 subthemes as "back from the grave" with the subthemes of "organ as the God's deposit," "God as the source of life," and "new life" "chapter of prosperity" with the subthemes of "the spring of the body," "recovery," "peace and joy," "benevolent and good behavior," "renewal," "opportunity of being together again," "golden age," "positive perspective," "the sense of normality," "the return of health," and "spiritual evolution" and "the fall" with the subthemes of "a lack of energy," "the mirage of transplantation," and "hell on the earth." Conclusion: The patients had diverse experiences of the post-transplantation period, which varied from the feeling of exhilaration and youth to losing energy and the wish for not undertaking organ transplantation. © 2018, Iranian Society for Organ Transplantation