[Factors influencing nurses' readiness to implementation of electronic health records]

Introduction: Personnel readiness is the major factor for implementation of Electronic Health Records [EHR]. On the other hand, nurses play an important role to the delivery of care. This study aimed to determine factors influencing nurses' readiness to implement EHR

Methods: This descriptive - cross sectional study was conducted on the nurses in the teaching hospital affiliated to Golestan University of Medical Sciences in 2013. The data was collected by a valid and reliable structured questionnaire. Data was analyzed using Descriptive statistics

Results: Data analysis indicated that the factor of perception and awareness of the characteristics and advantages of EHR [4.76 +/- 0.45] had the highest score, whereas the factor of ensuring the security and confidentiality in the EHR [4.21 +/- 0.81] and participation in the design and implementation phase of EHR [4.29 +/- 0.71] had the lowest score

Conclusion: The most obvious finding to emerge from this study is that most nurses believe that awareness of benefits and understanding of EHR concepts, increases their readiness to implement EHR. Thus, this issue should be considered by policy makers of information technologies

[ ethnobotanical study on the medicinal plants of zarm-rood rural district of neka [mazandaran province]]

Medicinal usage of plants is a main part of indigenous people culture which has been formed during centuries in rural area. This knowledge is regarded as a suitable guideline to discovering of novel drugs in modern medicine. This study has tried to determine and introduce the medicinal plant species, the parts and the way of usage of plants of Zaram-rood in Neka area [North of Iran] using indigenous people questioning. The flora of the region was studied during the years of 1391 and 1392. At first, the villages and paths were carefully identified by using the appropriate geographical maps and the information was gathered by interviewing with knowledgeable indigenous people. The plant samples were collected from their natural habitats and identified by floristic references. They were deposited in Sari Payame Noor University Herbarium. A total of 64 medicinal plant species belonging to 51 genera and 34 families were collected and identified. The largest families from the viewpoint of species number are Rosaceae and Lamiaceae with 9 and 7 species, respectively. The most medicinal effects were observed in remedy of digestive, blood circulation, and urine excretion system disorders. Amongst identified medicinal plants, 16 species were introduced with new usages. Ethnobotanical knowledge of the area has more remained in old people memory and it is possible to be vanished in later decades. As a result, documenting of this knowledge is necessary. Moreover, there is a good chance to find species with more and useful pharmacological features through ethnobotanical studies

Antibacterial activity of alcoholic extracts of two Clematis L. [Ranunculaceae] species from Iran

Despite the discovery of numerous antibiotics, drug resistance still remains as a major problem. Therefore, it is important to introduce and replace new sources of drug such as medicinal plants with antimicrobial properties. The genus Clematis [Ranunculaceae family] has six species in Iran. Aerial parts of Clematis have been used to cure fever and chronic diseases such as Rheumatism in traditional medicine. In this research, antibacterial activity of ethanolic and methanolic extracts of aerial part in two major species of the genus in Iran [contains C. orientalis and C. ispahanica] were studied. Aerial plant parts were dried in shade, powderized and then ethanolic and methanolic extracts were prepared. Antibacterial activity of the two extracts was measured against six laboratory standard strains including gram positive and gram negative bacteria by disc diffusion. Minimum inhibitory concentrations were also determined using broth microdilution. Results showed that antibacterial activity of methanolic extracts is stronger than the ethanolic one. Also, C. ispahanica has stronger antibacterial activity in comparison to C. orientalis. Gram positive test bacteria showed the most susceptibility to both extracts compared to gram negative organisms. According to antibacterial effects of alcoholic extracts, it seems necessary to diagnose effective antibacterial components to compare results with existed finding and introduce a new trapeutic source

[Maternal death due to postpartum rupture of cerebral aneurysm]

The latest reported incidence of subarachnoid hemorrhage due to aneurysms and arterio-venous malformations [AVMs] is around 15 per 100,000 pregnancies. It is also the third leading cause of maternal death from non obstetric causes accounting for 12% of total mortality. A pregnant woman with 42 years old G5P4Lch4 had vaginal delivery in 12 Aug 2009. One week after delivery she was visited by General Physician due to headache. She was admitted with signs of dizinous, vomiting projectile and painful stimuli, hospital consciousness level 5 and coma. CT scan was demonstrated a massive bleeding inside the brain. Massive hemorrhage into the ventricle was detected following neurosurgery. She was dead due to cardiac arrest after 10 days. Based on this case report, woman with headache following delivery should be recommended for cerebral aneurysm

[A comparison of data elements of nursing minimum data set]

Introduction: Standard data processing plays an important role in patient care. Nursing data forms the first level of nursing informatics. These are essential tools for documentation of nursing process by methodology of assessment, diagnosis, interventions, outcomes, evaluation and documentation of patient care. Nursing minimum data set [NMDS] is the first action for standardization of gathering unified and essential nursing data for using in multiple sets and patient groups. The objective of this research was comparison of data elements of nursing minimum data set

Methods: This was a descriptive-comparative study and was done at 2009. Nursing minimum data set in the US, Thailand, Belgium, Finland, Canada, Netherlands, Swiss surveyed. Data collection was performed through internet search, books and journals. Results presented in statistical tables

Result: Findings showed that all countries had a national NMDS. In all NMDSs, Nursing data elements divided to three groups: Nursing care, patient and service elements. There is a nursing minimum data set for nursing management in US. There is no NMDS in Iran

Conclusion: Since every countries of this study have a domestic NMDS and also there is no standard in Iran for which data elements must include in Electronic Health Records, then creating an Iranian Nursing Minimum Data Set [IrNMDS] is essential. For identifying Iranian NMDS, we recommend that a professional and legal organization administer to creating of a NMDS

[Cloning and expression of n-teminal domain of pseudomonas aeruginosa flagellin and evaluation of antibodies raised against it on motility inhibition of pseudomonas aeruginosa]

Pseudomonas aeruginosa is an opportunistic pathogen that causes severe and lethal infections in immunocompromised individuals. This bacterium possesses a single polar flagellum. Flagellum and its subunit Flagellin play important roles in the pathogenesis of P. aeruginosa. Flagellin induces immune responses by interaction of its N-terminal domain with TLR-5. Our main aims of this study were cloning and expression of N-terminal domains of flagellin and evaluation of antibodies raised against it on motility inhibition of P. aeruginosa. The DNA sequence coding for the first 161 amino acids of flagellin was PCR amplified and cloned into a pET-28a expression vector. Recombinant protein was over expressed in BL-21[DE3], and purified by Ni-NTA resin. The immune reactivity of recombinant truncated flagellin was evaluated by Western blotting. The recombinant protein was injected into a rabbit and antibodies raised against it were evaluated for the cell motility inhibition of P. aeruginosa 8821M. The N-terminal domain of Flagellin was successfully overexpressed in Escherichia coli BL-21[DE3] host strain. Anti-native and anti-N-terminal flagellin antibodies reacted with the recombinant protein. Motility inhibition assay demonstrated that polyclonal antiserum against N-teminal flagellin is able to inhibit the motility of P. aeruginosa 8821M. The N-terminal domain of flagellin may be used for development of a new recombinant vaccine against P. aeruginosa infections

Infection of MSCs by adenovirus expression system expressing NRF2 as a cytoprotective factor

Poor viability of Mesenchymal Stem Cells [MSCs] following transplantation is one of the major challenges in their therapeutic application. Manipulation of MSCs by the genetic engineering method is one of the strategies used to protect the cells against cytotoxic microenvironment. However, maintaining multi differentiation capacity of MSCs following manipulation is important. We investigated if the manipulation of MSCs with NRF2 affects the multi differentiation capacity. MSCs were isolated from bone marrow. NRF2 was isolated and TOPO cloned into the pENTR vector. The recombinant vector was transferred into pAD/CMV/V5-DEST vector by gateway technology. Recombinant adenovirus was produced in AD293 cells, followed by being infected into MSCs. Expression of NRF2 was verified by RT-PCR. The NRF2 engineered MSCs were exposed to stress conditions followed by the evaluation of the cells viability and apoptosis. Finally, NRF2 expressing MSCs differentiation into osteoblast and adipocyte lineages was studied. NRF2 was successfully expressed in MSCs. NRF2- MSCs differentiation into osteoblast and adipocyte lineages indicating overexpression of NRF2 does not affect the differentiation property of MSCs. Expression of NRF2, a well known cytoprotective factor, by using adenovirus expression system does not intervene in the differentiation capacity of MSCs. NRF2-MSCs might be applicable for stem cell-based cell therapy in future

study of effectiveness of blended learning approach for medical training courses

Blended learning as a method of learning that includes face to face learning, pure E-learning and didactic learning. This study aims to investigate the efficacy of medical education by this approach. This interventional study was performed in 130 students at different clinical levels participating in class sessions on [congenital adrenal hyperplasia and ambiguous genitalia]. Sampling was done gradually during 6 months and all of them filled a pretest questionnaire and received an educational compact disk. One week later, a presence class session was held in a question and answer and problem solving method. Two to four weeks later, they filled a posttest questionnaire. There was a significant correlation between pretest and posttest scores and the posttest scores were significantly more than the pretest ones. Sub-specialized residents had the most and the students had the least attitude towards blended learning approach. There was a significant correlation between the research samples' accessibility to computer and their attitude and satisfaction to blended learning approach. Findings generally showed that the blended learning was an effective approach in making a profound learning of academic subjects

[Seroepidemiologic study of HAV infection in Tehran province: a population based study]

Hepatitis A is a viral infection which is transmitted via fecal-oral route and its prevalence is directly related to the public health standards. The prevalence rate of this infection is different in different populations. The aim of this study was to determine the prevalence of hepatitis A antibody and assess the need for vaccination against hepatitis A in Tehran Province. This descriptive analytical cross-sectional study was conducted from 2006 to 2007 in Tehran Province. 448 subjects were selected by random cluster sampling. Blood samples were collected and demographic data were recorded in a questionnaire. Anti-HAV antibodies were measured by ELISA competitive method. Chi-square test and student t-test were used for statistical analysis. This study included 287 women and 161 men. Anti-HAV antibody was positive in 405 subjects [90.4%]. There were no significant relationships between HAV seropositivity and different age groups or gender. The results of our study showed a high prevalence of antibody in this region which is compatible with those of WHO results. Our results were similar to those obtained in Zabol City and eastern parts of Golestan Province but were not compatible with the results of the studies from Isfahan and Tabriz. At the present time there is no need for vaccination in this region

[Frequency of risky behaviours among students in Babol Universities [2009]]

The safety of teenagers and young are the major factor in developing a community and they are also the major group at risk of behavioural problems. So, this study was performed to evaluate the prevalence of risky behaviours among different university students in Babol, located in Norther of Iran. This cross sectional study was carried out in a random sample of 882 Babol university students including medical university, university of engineering and Azad University with roughly equal sampling ratio with respect to university and gender. The data was gathered by a designed questionnaire including demographic characteristics, physical involvement with others [violence], cigarette smoking, drug abuse, physical inactivity, overweight and obesity. In statistical analysis the Chi square test was used to determine the association of risky behaviours with demographic characteristics. The results revealed that in general the prevalence of physical involvement with others [violence] during a recent year was 33.3% current cigarette smoking 13.7%, overweight and obesity 25.6%, physical inactivity 15.3% and drug user during recent year 0.3%. In general, the prevalence of some risky behaviour was more in boys than girls [P<0.001], and it was more in single than married [P<0.001] and in residence of dormitory and rented houses than personal houses [P<0.001] and also in engineering and Azad university in contrast to medical university [P<0.001]. For example, the prevalence of cigarette smoking was 25.7% in boys and 3.6% in girls [P<0.001]. This study showed a rather high frequency of risky behaviours among students in Babol city in North of Iran

[Informational and structural needs of nursing data classification in computerized systems]

Healthcare classification systems help to gather information and process health data. Nursing management focus on developing computerized records to answer legal, managerial and clinical needs. The Classification systems help organizations to use nursing data. This study investigated informational and structural needs of nursing data classification. This descriptive-comparative study was carried out in 2009. Current classification systems for nursing were investigated and their specifications were gathered in a questionnaire. The items were prioritized by experts in four degrees. Using statistical analysis items with a priority over 80 percent [average 2.4] were selected. Findings about nursing diagnosis, intervention and outcomes showed that diagnosis item [average 2.93 out of 3], intervention item [average 2.52 out of 3], and outcome item [average 2.84 out of 3] should be presented in the system. Structure of nursing data classification was identified as a hierarchical and combinational classification. The computerized terminology [average 1.86 out of 3] had no priority. It is suggested to make decisions for standardizing nursing data to use in computerized systems. Since, nursing system in Iran is moving toward defining tariff for nursing services, coding nursing care components will help this plan to be developed

Effects of polygonum aviculare herbal extract on proliferation and apoptotic gene expression of MCF-7

One of the most common malignancies in women is breast cancer. Although several treatments for breast cancer are available, application of herbal medicine as a supplementary treatment is a new option to help curing the disease. In this study anticancer effects of Polygonum avicular herbal extract was investigated. Polygonum avicular extract was obtained by methanol. MCF-7 cell line was treated with different concentrations of Polygonum avicular [50, 100, 150, 200, 250, 300,350 400 ng/ micro l] for different time lengths [6, 12, 24, and 48 hrs]. MTT assay and Flow Cytometry were used to evaluate cell proliferation and apoptosis, respectively. RT-PCR was also carried out to evaluate the expression of apoptotic genes. Results showed that Polygonum avicular induced cytotoxicity in MCF- 7 cell line at concentrations higher than 300 ng/ micro l and this was confirmed by the highest rate of cell death as measured by Trypan Blue and MTT assays. RT-PCR results showed up-regulation of P53 and down-regulation of Bcl-2 proteins which implied the ability of Polygonum avicular to induce apoptosis in MCF-7 cells and confirmed its anticancer property. Further studies are required to evaluate effects of the extract on other apoptotic genes

[Nursing minimum data set: an essential need for Iranian health care system]

Nurses are the largest groups in health care delivery system. Nursing Information systems [NIS] are important for improving nursing performance, increasing nursing knowledge and providing data and information needed for nursing. Identifying Nursing Minimum Data Set [NMDS] is the first step for development of NIS. Considering the absence of NMDS in Iran, this study was conducted with the aim of assessing NMDS needs and giving recommendations for Iran health care system. It was a descriptive developmental study. NMDS was searched in several countries; nursing data elements gathered into a questionnaire and then, were prioritized by experts. Using SPSS-PC [v.16.5], mean scores of priorities were calculated and those with more than 80% of mean score [m=2.9] were selected. Findings showed that most data elements had high priority from within nurses, perspective except "residential status [m=2.34 of 3]", "nurses, employment startup date [m=2.36 of 3]", "number of patients [m=2.32 of 3]", "employment end date [m=2.29 of 3]", "Reimbursement type [m=2.23 of 3]", Nurse Gender [m=2.05 of 3] and Nursing budget [m=1.97 of 3]. Elements for Iranian Nursing Minimum Data Set [IrNMDS] were offered as nursing care data elements [5 Items], Patient data element [14 Items] and service data element [14 Items]. Validity and reliability assessment of data set content, in-service education for nurses and more comprehensive studies regarding the clinical use of this data set is recommended

[Application of expired platelets in the preparation of platelet gel and study of proliferative effects of expired platelet derived growth factor on variety of cell lines]

There is growing evidence indicating that growth factors derived from platelets can be used in wound healing. This study aimed to investigate whether old platelets can be used as the main material for preparation of platelet gel and as substitute for FBS and FCS in cell culture medium. In this exprimental study, platelets were prepared from voluntary blood donors by centrifugation. To prove the hypothesis that the platelet gel and the growth factor derived from expired platelets are able to propagate different cells, platelet derived factors were prepared from both new and expired platelet-rich plasma. The concentration of platelet-derived growth factors was measured by ELISA and cell proliferation was measured by MTT assay. The results showed the high quality of platelet gel obtained from old platelets. Our results also revealed that old platelets released growth factors similar to those released by new platelets. The growth factors derived from old and new platelets had the same proliferation effects on MSC, CHO, and Fibroblast cell lines Old platelets released the same growth factors that new platelets did; this showed that old platelets as valuable constituents of blood are cost effective to be used

Expression of green fluorescent protein [GFP] using in vitro translation cell free system

One of the major concerns about recombinant protein production is its possible toxicity for the organism. Purification of the recombinant protein is another challenge in this respect. Recently In Vitro translation cell free system that provides a coupled transcription-translation reaction for protein synthesis to overcome the above mentioned problems has been emerged. The aim of this study was expression of GFP as a marker for gene expression and protein in In Vitro translation system. pIVEX2.3-GFP plasmid was cloned to E. coli and the plasmid DNA extracted. In Vitro translation was performed with RTS 100 E. coli Hy kit according to manufacture's instructions. Expression of recombinant fusion protein, His- GFP, was determined by SDS-PAGE, ELISA and western blot analysis. Expected size of recombinant protein was detected in SDS-PAGE and further confirmed by western blot analysis and ELISA. Results showed that In Vitro translation is suitable for expression of recombinant protein and fusion of the recombinant protein with His-tag facilitates the purification

[Induction of heme oxygenase -1 by lipocalin 2 mediated by NF-kB transcription factor]

Effect of lipocalin 2 on the expression of heme oxygenase I, II and NF-kB transcription factor was the purpose of this survey. Lcn2 was cloned to pcDNA3.1 plasmid by using genetic engineering method. The recombinant vector was transfected to CHO and HEK293T to establish stable cell expressing lipocalin 2. The presence of lipocalin 2 gene in these cells was confirmed by using through RT-PCR and western blot analysis. Expression of Lcn2 was also down-regulated by siRNA in A549 cell line. Expression of heme oxygenase I, II and NF-kB transcription factor were determined in both ectopic expression Lcn2 cells and Lcn2 down regulated cells by using of RT-PCR and western blot analysis. The results showed that the expression of heme oxygenase I and those of NF-kB were higher in cells expressing recombinant lipocalin2 compared with the control cells. On the other hand, expression of heme oxygenase I and NF-kB in siRNA transfected cells was down-regulated. These findings indicate that lipocalin2 induces the expression of HO-1 and suggest Lcn2 through NF-kB induces HO-1 expression

Uninvestigated dyspepsia and its related factors in an Iranian community

To determine the prevalence and determinants of uninvestigated dyspepsia in the Iranian population. A cross-sectional study conducted in Tehran province from May 2006 to December 2007, included 18,180 adult persons selected randomly. The study took place at Shahid Beheshti University, MC, Tehran, Iran. A questionnaire was completed in 2 steps. In the first part, personal characteristics and 11 gastrointestinal symptoms were inserted. Those who reported at least one of these 11 symptoms were referred for the second interview, which consisted of questions on different gastrointestinal disorders based on Rome III criteria, including uninvestigated dyspepsia. The prevalence rate of uninvestigated dyspepsia was 8.5% [10.9% in women and 6.4% in men]. Among the subjects diagnosed with dyspepsia, bothersome postprandial fullness was the most common symptom [41.5%]. Uninvestigated dyspepsia was more common in low educated and widowed participants. Approximately 41.4% of patients had a history of depression, and 66.1% had self report of stress. The prevalence of functional irritable bowel syndrome in patients with uninvestigated dyspepsia was 8.3% and gastroesophageal reflux disease was 64.9%. Uninvestigated dyspepsia has a less common prevalence in the general Iranian population than developed countries. Women, older, obese, widowed, and low education subjects are more likely to suffer from dyspepsia

[Effect of growth factors of platelet gel on proliferation and differentiation of mesenchymal stem cells]

Mesenchymal stem cells [MSCs] are bone marrow populating cells, which posses an extensive proliferation potential. In isolation and expansion protocols for clinical scale production of MSCs, fetal bovine serum [FBS] is used as a supplement with potential risk for infections as well as immunological reactions. Autologous platelet gel is made from a natural component of the patient's own blood. Activated platelets release growth factors are mitogenic for MSCs. In vitro studies have indicated that concentration of growth factor varies according to platelet concentration, methods of preparation and mechanism of platelet growth factors release. The aim of our study was to investigate the effect of platelet growth factors on the proliferation and differentiation of human mesenchymal stem cells. Mononuclear cells of bone marrow were collected in 10% FBS growth medium. The expanded cells were characterized by flow cytometric analysis of specific surface antigens. Analysed markers included CD45, CD34, CD166, CD105, CD90, and CD44. The gel is formed by adding calcium and thrombin to platelet rich plasma [PRP]. Treated PRP was incubated for 30 min, 6, 24, 48 and 72 hours in incubator. Growth factors concentrations in supernatants were determined by ELISA. Human mesenchymal stem cells were cultured in the complete medium that supplemented with 10% FBS or Platelet growth factors for 8 days. The rate of proliferation was evaluated by MTT assay. Expanded cells were seeded on calcium phosphate scaffold. Cells growth and morphology on scaffold were analyzed by SEM. Isolation and expansion of MSCs in the complete medium supplemented with platelet growth factors were successful and morphology of cells was compatible with that of FBS. Cells were highly positive for CD90, CD166, CD44 and CD105 and negative for CD34, CD45. There was no significant difference between expression of markers on cells expanded with platelet growth factors and FBS. We demonstrated that platelet growth factors provide a significantly higher proliferative effect on MSCs than those of FBS. MSCs cultured in the presence of growth factors maintain their osteogenic differentiation properties. Osteogenic differentiation was indicated by deposition of mineralized matrix stained with Alizarin red and increased expression alkaline phosphates. Platelet growth factors can be used in place of FBS to provide a safer and more effective culture condition to expand MSC for clinical purposes. MSCs cultured in the presence of platelet growth factors maintain their osteogenic properties

[Evaluation of morphologic changes of mandibular symphysis after chin cup therapy in skeletally C1 III patients]

Chin cup is a orthopedic appliance for treating growing skeletally C1 III patients. The amount of chin forward movement in addition to morphologic changes in bony structure. Determines the final profile of treated patients. The aim of this study was to evaluate the amount of morphologic changes of symphysis after chin cup therapy in skeletally C1 III patients. In this clinical trial, twenty eight cephalometries before and after chin cup therapy of 14 skeletally C1 III patients were analyzed. Landmarks introduced by Ricketts were determined to evaluate the symphysis individually were evaluated and analyzed. Data were analyzed by paired t and pearson tests with P<0.05 as the level of significance. The results showed that the height of symphysis increased after treatment [P=0.02], but its depth decreased [P=0.04]. The sysmphysis turned down and back. These findings suggest that in C1 III malocclusions with a prognathic mandible, chin cup therapy creates changes in the horizontal dimention of symphysis morphology, which improves the C1 III profile. If the patient isn't a vertical grower, vertical changes of symphysis would be desired. In addition, changes in the vertical dimension of the mandible [body and ramus] could be observed as a backward and downward rotation

study on curative centers managers, knowledge and attitude levels about Hospital Informatics Systems

Researches showed the effective role of applying the hospital information systems [HIS] in upgrading quality of the curative care services, increasing satisfactions, and improving treatment economy. Due to the necessities of the HIS development and the important role of managers knowledge and attitudes, present study carried out to achieve the level of Golestan curative centers [province] managers knowledge and attitudes in 2006. Present study is a cross-sectional descriptive study, has been done on 73 people of the Golestan curative centers managers who agreed to participate in this study in the year 2006. A valid and reliable questionnaire have been sent for each manager. After completing the questionnaire, collected data analyzed by SPSS software. Our research findings showed that 59.3% of managers had average knowledge, and 95.1% had a positive attitude about the HIS. Maximum knowledge scores belonged to the medical records staffs, and minimum knowledge scores to operation theaters and hospital officers. Maximum level of the positive attitude found for laboratories staffs and minimum to finance and operation theaters department. Due to the average levels of Golestan curative centers managers knowledge and attitudes about HIS, to improve HIS usage at all different departments, to hold the training courses to improving the level of knowledge is necessary