Spiritual well-being and moral distress among Iranian nurses

Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. Research design: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: Mean scores of spiritual well-being and moral distress were 94.73+15.89 and 109.56+58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r ¼ �.053, p ¼ .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. Discussion and conclusion:This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress an

Joint Velocity Scalar Filtered Density Function for Large Eddy Simulation of Turbulent Reacting Flows

The joint ``velocity-scalar' filtered density function (FDF) methodology is developed and implemented for large eddy simulation (LES) of turbulent reacting flows. In FDF, the effects of the unresolved subgrid scales (SGS) are taken into account by considering the joint probability density function (PDF) of the velocity and scalar fields. An exact transport equation is derived for the FDF in which the effects of SGS convection and chemical reaction are in closed forms. The unclosed terms in this equation are modeled by considering an equivalent set of stochastic differential equations (SDEs) which is similar to that typically used in Reynolds-averaged simulation (RAS) procedures. The SDEs are solved numerically by a Lagrangian Monte Carlo procedure in which the It^o-Gikhman character of the SDEs is preserved. The consistency of the proposed SDEs and the convergence of the Monte Carlo solution are assessed. It is shown that the FDF results agree well with those obtained by a ``conventional' finite-difference LES procedure in which the transport equations corresponding to the filtered quantities are solved directly. The FDF results are also compared with those obtained by the Smagorinsky closure, and all the results are assessed via comparison with data obtained by direct numerical simulation of a temporally developing mixing layer involving transport of a passive scalar. It is shown that all the first twomoments including the scalar fluxes are predicted well by FDF. The predictive capabilities of the FDF are further demonstrated by LES of reacting shear flows. The predictions show favorable agreements with laboratory data, and demonstrate several of the features as observed experimentally

Argon Plasma Coagulation in Treatment of Post Intubation Tracheal Stenosis

INTRODUCTION: Acquired tracheal stenosis can be created by various malignant or benign causes. The most common cause of acquired non-malignant tracheal stenosis is endotracheal intubation, even for a short period. Argon plasma coagulation is a non-contact method of thermal hemostasis. Argon plasma coagulation can be used easily and fast and has low depth of penetration. METHODS: This study is single blinded. Subjects are patients with tracheal stenosis after endotracheal intubation who were selected by non-probability sampling and were studied from March 2007 to November 2009 in bronchoscopy and laser center of Masih Daneshvari Hospital, Tehran. First, for each patient, a diagnostic flexible bronchoscopy was performed to identify the type, location, and severity of the stenosis. Then, under general anesthesia, patients underwent rigid bronchoscopy. Then, with Argon plasma coagulation device (ERBE VIO 200D) the stenosis was removed as possible. After two weeks, a new PFT (pulmonary function test) was done for checking the obstructive signs.RESULTS: Of these 34 patients, 24 were asymptomatic for more than 1 year and responded to treatment(70/6%), 5 were asymptomatic for more than 10 months and less than 12 months (14/7%) and 5 did not have asymptomatic periods more than 10 months, and did not respond to treatment. In PFT follow-ups, FEV1 in all patients who were asymptomatic for more than 10 months had a significant progress; therefore, in 27 out of 29 patients at the end of the study, FEV1 was more than 90% and 2 patients had FEV1 of 70-90%.CONCLUSION: In fact, although the surgical treatment remains the main treatment of tracheal stenosis after intubation (PITS), if this method is not possible for any reason, APC is very useful as a safe and effective method

The Effect of Foot Massage on the Consciousness Levels in Comatose Patients With Brain Injury Hospitalized in Intensive Care Unit (Icu): A Randomised Control Trial

Introduction: Coma results from traumatic or non-traumatic brain injuries. Foot massage can influence the level of consciousness in comatose patients. The purpose of this study was to determine the effects of foot massage on the level of consciousness in comatose patients due to brain injury who were hospitalized in the ICUs of selected hospitals in Qazvin. Methods: This study was a clinical trial which was conducted on 40 patients with coma who were hospitalized in the ICUs of Shahid Rajaee and Razi hospitals in Qazvin in 2014. Patients were assigned to case and control groups, using randomize blocked allocation. Massage of both feet was performed in a Stroke manner (5 minutes for each foot) and once a day for 14 days. Then, the level of consciousness was recorded using Glasgow Coma Scale. Statistical tests (chi-square, Independent t-test, dependent t-test and Repeated Measures variance analysis) were used for analysis. Results: The results showed that there is significant difference between the mean of consciousness level before (5.80±1.58) andafter (10.6±2.41) massage in the intervention group(P=0.001). While the mean of consciousness level was (5.3±1.72)before and (6.94±3.03)after the intervention in the control group andit was not statistically significant (P=0.06). Conclusion: Foot massage could increase the level of consciousness among patients in comatose patients due to brain injury. It is recommended to use this intervention for increasing patientsconsciousness level

The Predictive Factors of Job Performance in Nurses' Moral Distress

Introduction: Moral distress is one of the most complex ethical problems for nurses working in Intensive Care Units. Desired job performance of the nurse guarantees the quality of health care provided to patients and is an important factor in accelerating the process of treatment and recovery of patients. This study was conducted to investigate the predictive factors of job performance in nurses' moral distress. Methods: This is a descriptive cross-sectional study, in which 256 nurses working in ICU wards of private and public hospitals of Qazvin province (from January to March 2019) were selected through convenience sampling method. Demographic characteristics questionnaire, Six Dimension Scale of Nursing Performance and Modified Moral Distress Scale-Revised were used for data collection. Statistical analysis was performed using linear regression model test in SPSS 22. Results: The results showed that the mean score of nurses' moral distress was 171.37±55.63. In multivariate linear regression model, only educational dimension of job performance in both frequency (β=-26.37, P=0.001) and quality (β =-76.15, P=0.025) correlated significantly with moral distress. Conclusion: Based on the results of the present study, educational dimension of job performance is a predictive factor for moral distress. Therefore, steps can be taken to reduce moral distress inclinical settings, such as the use of nurses with specialized training in Intensive Care Units, paying special attention to teaching ethical issues in nursing centers and holding retraining courses for nurses. Keywords: Job performance, Moral distress, Nursin

Design of experiments approach for the development of a validated method to determine the exenatide content in poly(lactide-co-glycolide) microspheres

Due to the lack of pharmacopeia guidelines for injectable microspheres based on poly (D, L-lactide-co-glycolide) (PLGA), an internal method validation is a critical prerequisite for quality assurance. One of the essential issues of developing peptide-based drugs loaded PLGA microspheres is the precise determination of the amount of peptide drug entrapped in the microspheres. The aim of this study is the development and optimization of a method for measuring the drug content loading of PLGA microspheres using exenatide as a model peptide drug. Exenatide-loaded PLGA microspheres were prepared by a double emulsion solvent evaporation method. The extraction method to determine exenatide content in microspheres was optimized using Design of Experiments (DoE) approach. After the initial screening of six factors, using Fractional Factorial design (FFD), four of them, including type of organic solvent, buffer/organic solvent ratio (v/v), shaking time and pH, exhibited significant effects on the response, namely the exenatide loading, and a Box-Behnken design (BBD) was subsequently applied to obtain its optimum level. The optimum level for organic solvent volume, buffer/organic solvent ratio, shaking time, and pH were 4 ml, 1, 5.6 hrs, and pH 6, respectively. The exenatide content in microspheres under these conditions was 6.4 ± 0.0 (%w/w), whereas a value of 6.1% was predicted by the derived equation. This excellent agreement between the actual and the predicted value demonstrates that the fitted model can thus be used to determine the exenatide content

Susceptibility of Males and Females of Cucumber Fruit Fly, Dacus ciliatus, to Various Insecticides in the Laboratory Conditions

Abstract The cucumber fly, Dacus ciliatus Loew., is a destructive pest of cucurbit crops in some regions of Iran. Susceptibility of adults of D. ciliatus to various insecticides (deltamethrin, dimethoate, trichlorofon, spinosad, acetamiprid, and malathion) was investigated. The insecticide toxicity was tested through contact method in three stages (males only, females only, and a mixture of males and females). The results showed that the used insecticides excellently affected on males and females of D. ciliatus through contact toxicity. Also, their effect on the mixture of males and females was acceptable. In addition, dimethoate and deltamethrin were better than the others. The LC 50 values of these two were less than 1 mg L -1 . Also, except for acetamiprid, LC 50 vales of all other insecticides on males and females were close

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) versus adult T-cell leukemia/lymphoma (ATLL)

ObjectivesHuman T cell leukemia virus-1 (HTLV-1) infection may lead to one or both diseases including HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) or adult T cell leukemia lymphoma (ATLL). The complete interactions of the virus with host cells in both diseases is yet to be determined. This study aims to construct an interaction network for distinct signaling pathways in these diseases based on finding differentially expressed genes (DEGs) between HAM/TSP and ATLL.ResultsWe identified 57 hub genes with higher criteria scores in the primary protein-protein interaction network (PPIN). The ontology-based enrichment analysis revealed following important terms: positive regulation of transcription from RNA polymerase II promoter, positive regulation of transcription from RNA polymerase II promoter involved in meiotic cell cycle and positive regulation of transcription from RNA polymerase II promoter by histone modification. The upregulated genes TNF, PIK3R1, HGF, NFKBIA, CTNNB1, ESR1, SMAD2, PPARG and downregulated genes VEGFA, TLR2, STAT3, TLR4, TP53, CHUK, SERPINE1, CREB1 and BRCA1 were commonly observed in all the three enriched terms in HAM/TSP vs. ATLL. The constructed interaction network was then visualized inside a mirrored map of signaling pathways for ATLL and HAM/TSP, so that the functions of hub genes were specified in both diseases.Peer reviewe

Advances in Rootstock Breeding of Nut Trees: Objectives and Strategies

The production and consumption of nuts are increasing in the world due to strong economic returns and the nutritional value of their products. With the increasing role and importance given to nuts (i.e., walnuts, hazelnut, pistachio, pecan, almond) in a balanced and healthy diet and their benefits to human health, breeding of the nuts species has also been stepped up. Most recent fruit breeding programs have focused on scion genetic improvement. However, the use of locally adapted grafted rootstocks also enhanced the productivity and quality of tree fruit crops. Grafting is an ancient horticultural practice used in nut crops to manipulate scion phenotype and productivity and overcome biotic and abiotic stresses. There are complex rootstock breeding objectives and physiological and molecular aspects of rootstock–scion interactions in nut crops. In this review, we provide an overview of these, considering the mechanisms involved in nutrient and water uptake, regulation of phytohormones, and rootstock influences on the scion molecular processes, including long-distance gene silencing and trans-grafting. Understanding the mechanisms resulting from rootstock × scion × environmental interactions will contribute to developing new rootstocks with resilience in the face of climate change, but also of the multitude of diseases and pests.info:eu-repo/semantics/publishedVersio