Environmental enrichment reverses stress-induced changes in the brain-gut axis to ameliorate chronic visceral and somatic hypersensitivity.

Introduction: Behavioral therapies, including cognitive behavioral therapy, hypnotherapy and stress management activities, have emerged as effective treatments for irritable bowel syndrome (IBS), a female predominant disorder of the brain-gut axis. IBS, affecting over 10% of the global population, typically presents with abnormal bowel habits and abdominal pain due to visceral hypersensitivity. While the mechanisms underlying how behavioral therapies treat IBS are still elusive, we had previously shown that chronic stress alters gene expression in brain regions critical for stress processing and nociception. We found that exposure to an enriched environment (EE), the rodent analogue of behavioral therapies, prior to and during the stressor was sufficient to prevent stress-induced changes in glucocorticoid receptor (GR) expression in the central nucleus of the amygdala (CeA) and hippocampus. Pre-exposure to EE also inhibited stress-induced increased colonic permeability and was able to block the induction of stress-induced visceral and somatic hypersensitivity. However, it remains unknown if EE can reverse chronic viscerosomatic hypersensitivity that persists following exposure to stress. We hypothesized that EE after chronic stress would be sufficient to reverse stress-induced changes in i) GR expression in the CeA and hippocampus, ii) ameliorate stress-induced colonic hyperpermeability and iii) restore normal visceral and somatic sensitivity in male and female rats. Methods: Male and female rats were exposed to daily water avoidance stress (WAS). After confirming the rats had developed visceral hypersensitivity, 50% of the animals were housed in EE for 2 weeks while the other 50% remained in standard housing (SH). At the end of this period, we assessed visceral and somatic sensitivity. We also collected colon tissue to measure colonic permeability. Micro-punches of tissue from the CeA and hippocampus were isolated to measure GR expression. Control animals not exposed to WAS were kept in SH for the duration of the study (n = 8 per group). Results: In both male and female rats, EE reversed stress-induced visceral (p < 0.001) and somatic (p < 0.01) hypersensitivity when compared to WAS animals housed in SH to levels comparable to control animals. EE exposure also reversed changes in GR expression in both the hippocampus (p < 0.01) and CeA (p < 0.01), normalizing GR expression to control levels. EE exposure ameliorated stress-induced colonic hyperpermeability in both male (p < 0.01) and female (p < 0.01) rats compared to WAS rats in SH. Conclusion: Our findings suggest that behavioral therapies are viable therapeutic options for IBS as they can counter the stress-induced pathophysiology underlying IBS symptoms including visceral hypersensitivity, increased colonic permeability and altered gene expression.

Serodiagnosis of human brucellosis by an indirect ELISA test using recombinant outer membrane protein 19 kDa (rOMP19) as an antigen.

BACKGROUND: Brucellosis remains one of the global health concerns that reemerges in recent years. Delayed or inaccurate diagnosis end to a long treatment duration and financial burden; therefore, finding a good antigen for detection of specific anti-Brucella antibodies is crucial. We intended to evaluate the serodiagnosis value of recombinant Brucella outer membrane protein 19 kDa (rOMP19) using indirect ELISA system compared with Rose Bengal test. RESULTS: The OMP19 sequence was successfully cloned into pET-28a and produced in E. coli cells (DE3). After extraction and purification of rOMP19, this protein was used for designing indirect ELISA to detect anti-Brucella antibodies in 73 human sera, including 6 brucellosis-positive and 67 brucellosis-negative samples. The accuracy of rOMP19 ELISA was evaluated by receiver operating characteristic (ROC) curve and then compared with Rose Bengal plate test and a commercial anti-IgG Brucella ELISA kit. In comparison with Rose Bengal plate test, the area under the ROC curve was 0.985 (95% CI, 0.96-1.00). From coordinates of the curve, the optimal cut-off value was selected at 0.147, in which the diagnostic sensitivity was 100%, and the specificity was 94%. At this cut-off point, 10 samples were diagnosed as positive (6 true positives and 4 false positives), while negative samples were all correctly diagnosed. The results of our designed rOMP19 ELISA was the same as data obtained from commercial ELISA kit, which applied LPS as an antigen. CONCLUSIONS: We concluded that OMP19 is an efficient antigen for the serodiagnosis of human brucellosis.

A comparison of nurses and elderly patients' perceptions of caring behaviors in intensive care units.

OBJECTIVE: Differences in patients and nurses' perceptions of caring behaviors arouse patient dissatisfaction. Continuous monitoring and assessment of caring behaviors has revealed its problems, and this in turn would promote care services by planning rational interventions and removing the problems. The present study aimed to compare nurses and elderly patients' perceptions of nurses' caring behaviors in intensive care units in accordance with Watson's transpersonal caring theory. METHODS: In this descriptive-analytical study, 70 nurses were selected using the census method, and 70 elderly patients over 60 years old were also selected using purposive sampling method from the intensive care units of Lorestan University of Medical Sciences during 2012-2013. Caring Behavior Inventory for Elders (CBI-E) was adopted in this research to detect the nurses and elderly patients' perceptions of caring behaviors. In the data analysis phase, Kruskal-Wallis, Mann-Whitney U, and Pearson correlation tests were used. RESULTS: The research findings revealed no statistically significant difference between the total scores of nurses' 83.80 (22.93), 95% CI [78.40, 89.20] and elderly patients' 80.09 (26.00), 95% CI [74, 86.20] perception of nurses' caring behaviors (P=0.379). From the viewpoint of the nurses and elderly patients, responding quickly to a patient's call 100.00 (0.00), 95% CI [100.00, 100.00] had the highest mean scores and patient participation in caring process had the lowest mean scores among nurses 22.86 (33.71), 95% CI [15.00, 30.80] and elderly patients 14.29 (28.41), 95% CI [7.63, 20.90]. CONCLUSION: This study indicated the elderlies and nurses' similar perceptions of caring behaviors in intensive care units. This finding would help nurses to recognize and prioritize the elderly patients' care needs, thereby promoting the quality of care services.

A comparison of nurses and elderly patients' perceptions of caring behaviors in intensive care units / Comparación de las percepciones del personal de enfermería y de los pacientes de edad avanzada sobre las conductas de cuidado en las unidades de cuidados intensivos

Objective: Differences in patients and nurses’ perceptions of caring behaviors arouse patient dissatisfaction. Continuous monitoring and assessment of caring behaviors has revealed its problems, and this in turn would promote care services by planning rational interventions and removing the problems. The present study aimed to compare nurses and elderly patients’ perceptions of nurses’ caring behaviors in intensive care units in accordance with Watson's transpersonal caring theory. Methods: In this descriptive-analytical study, 70 nurses were selected using the census method, and 70 elderly patients over 60 years old were also selected using purposive sampling method from the intensive care units of Lorestan University of Medical Sciences during 2012–2013. Caring Behavior Inventory for Elders (CBI-E) was adopted in this research to detect the nurses and elderly patients’ perceptions of caring behaviors. In the data analysis phase, Kruskal–Wallis, Mann–Whitney U, and Pearson correlation tests were used. Results: The research findings revealed no statistically significant difference between the total scores of nurses’ 83.80 (22.93), 95% CI [78.40, 89.20] and elderly patients’ 80.09 (26.00), 95% CI [74, 86.20] perception of nurses’ caring behaviors (P=0.379). From the viewpoint of the nurses and elderly patients, responding quickly to a patient's call 100.00 (0.00), 95% CI [100.00, 100.00] had the highest mean scores and patient participation in caring process had the lowest mean scores among nurses 22.86 (33.71), 95% CI [15.00, 30.80] and elderly patients 14.29 (28.41), 95% CI [7.63, 20.90]. Conclusion: This study indicated the elderlies and nurses’ similar perceptions of caring behaviors in intensive care units. This finding would help nurses to recognize and prioritize the elderly patients’ care needs, thereby promoting the quality of care services.(AU)

Objetivo: Las diferencias en las percepciones de los pacientes y las enfermeras sobre las conductas de cuidado despiertan la insatisfacción de los pacientes. El seguimiento y la evaluación continuos de las conductas de cuidado han puesto de manifiesto sus problemas, lo que a su vez promovería los servicios de cuidado mediante la planificación de intervenciones racionales y la eliminación de los problemas. El presente estudio tenía como objetivo comparar las percepciones de las enfermeras y de los pacientes ancianos sobre las conductas de cuidado de las enfermeras en las Unidades de Cuidados Intensivos de acuerdo con la teoría de Watson's Transpersonal Caring. Métodos: En este estudio descriptivo-analítico, se seleccionó a 70 enfermeras mediante el método de censo, y 70 pacientes ancianos mayores de 60 años mediante el método de muestreo intencional de las Unidades de Cuidados Intensivos de la Lorestan University of Medical Sciences durante 2012-2013. En esta investigación se adoptó el Caring Behavior Inventory for Elders (CBI-E) para detectar las percepciones de las enfermeras y de los pacientes ancianos sobre las conductas de cuidado. En la fase de análisis de datos, se utilizaron las pruebas de Kruskal-Wallis, U de Mann-Whitney y la correlación de Pearson. Resultados: Los resultados de la investigación no revelaron diferencias estadísticamente significativas entre las puntuaciones totales de las enfermeras, 83,80 (22,93), IC del 95%: 78,40-89,20, y las de los pacientes ancianos, 80,09 (26,00), IC del 95%: 74 - 86,20, de percepción de las conductas de cuidado de las enfermeras (p=0,379). Desde el punto de vista de las enfermeras y de los pacientes de edad avanzada, la respuesta rápida a la llamada de un paciente (100,00 [0,00], IC del 95%: 100,00-100,00) tuvo las puntuaciones medias más altas y la participación del paciente en el proceso de cuidados tuvo las puntuaciones medias más bajas entre las enfermeras (22,86 [33,71], IC del 95%: 15,00-30,80)...(AU)

Environmental enrichment prevents stress-induced epigenetic changes in the expression of glucocorticoid receptor and corticotrophin releasing hormone in the central nucleus of the amygdala to inhibit visceral hypersensitivity.

INTRODUCTION: Stress is a known trigger for the symptoms of irritable bowel syndrome (IBS), a gastrointestinal (GI) disorder that presents with abnormal bowel habits and abdominal pain due to visceral hypersensitivity. While behavioral therapies have been used to attenuate IBS symptoms, the underlying mechanisms by which these therapies interact with stress-induced pathology remains to be delineated. Here we use a rat model to test the hypothesis that exposure to environmental enrichment (EE) inhibits stress-induced changes within the brain-gut axis to prevent visceral and somatic hypersensitivity and colonic hyperpermeability. METHODS: Female rats (n = 8/group) were housed in EE one week before and one week during exposure to water avoidance stress (WAS) while controls were housed in standard cages (SH). One day after the final WAS exposure, colonic and somatic sensitivity were assessed by the visceromotor response (VMR) to colorectal distension (CRD) and withdrawal threshold elicited by an electronic von Frey on the hind paw of the rats respectively. All rats were returned to SH for 3 weeks before colonic and somatic sensitivity were reassessed on day 28. The rats were then immediately euthanized and the spinal cord was collected to assess changes in neuronal activation (assessed via ERK phosphorylation) in response to noxious CRD. A separate cohort of animals (n = 8/group) that did not undergo behavioral assessments was euthanized the day after the final WAS exposure and the central nucleus of the amygdala (CeA) was collected to investigate WAS and EE induced epigenetic changes at the glucocorticoid receptor (GR) and corticotrophin releasing hormone (CRH) promoter. The colon from these rats was also collected to assess colonic permeability via changes in transepithelial electrical resistance (TEER) in vitro. RESULTS: Exposure to stress persistently increased VMR to CRD (P < 0.01) and decreased the hind paw withdrawal threshold (P < 0.001) in female rats. WAS also decreased TEER in the colon tissue of female rats (p = 0.05). In the CeA, WAS induced a decrease in histone acetylation at the GR promoter but increased histone acetylation at the CRH promoter and reduced GR-CRH interactions in the CeA. Analysis of the spinal cord showed that WAS increased CRD-evoked ERK phosphorylation in the dorsal horn. Exposure to EE prevented WAS-induced changes in the CeA, dorsal horn and colon respectively to prevent visceral and somatic hypersensitivity. CONCLUSION: Our data reveals that behavioral therapies can produce long lasting molecular and epigenetic changes that can prevent stress-induced pathologies even after completion of the therapy. These results highlight the potential mechanisms by which behavioral therapies may ameliorate visceral pain associated stress-related pathologies such as the irritable bowel syndrome.

Challenges in the Management of Care of Brain-Dead Patients in the Donation Process: A Qualitative Content Analysis.

BACKGROUND: In care of brain-dead patients, nurses face several challenges. It is important to determine the context behind these challenges since they affect the performance of nurses and the organ donation process. OBJECTIVE: To identify factors affecting the emergence of challenges related to the management of brain-dead patients by nurses in the donation process. METHODS: In this qualitative conventional content analysis, data were collected by performing 28 semi-structured and in-depth interviews with nurses working in the ICUs. Purposive sampling started from March 2014 until saturation, which was reached in June 2016. Data analysis occurred simultaneously with data collection. RESULTS: Qualitative analysis of contents provided from interviews led to the extraction of themes that showed the experience of nurses about the challenges of caring for brain-dead patients in the donation process. These themes included "doubt and conflict in accepting the situation" and "defects in an effective and targeted care system." In the end, the main theme of "inconsistency and incompatibility of care management" was abstracted. CONCLUSION: According to the results of the study, factors involved in the emergence of challenges for nurses in care management included defects in education or managerial problems, which increased tension for nurses.

Molecular detection of Theileria spp. and Babesia ovis Infection in Sheep in Baneh, Iran.

The purpose of the present study was to investigate the Theileria and Babesia infection in sheep using polymerase chain reaction (PCR) assay in Baneh, Iran. Theileria and Babesia are apicomplexan parasites that have both vertebral and invertebrate hosts. These protozoa, which are transmitted by tick vectors, are considered to be the most important causes of parasitic diseases in Iran.The detection methods of Babesia and Theileria spp. are morphological examination, serology tests, and more recently, molecular assays, such as PCR. In this study, a total of 66 blood samples were collected and analyzed using specific primers for Theileria annulata, T. ovis, T. lestoquardi, and Babesia ovis. Two PCR methods were used, namely semi-nested PCR and competitive PCR. Based on the results of the PCR assay of 66 sheep blood samples, B. ovis, T. ovis, T. lestoquardi, and T. annulata were detected in 57 (86.4%), 28 (42.4%), 0, and 16 (24%) cases, respectively. Detection of low levels of protozoan infection with high morbidity in the tested animals shows their status as a carrier that keeps the infection in the region and extends the protozoan life cycle. Another important factor is the geographical situation of Baneh as a border city since the hemoprotozoan infection is present in this region. Moreover, piroplasmida infection was found in Iraq and other neighboring provinces. Therefore, animal husbandry in Baneh is at the risk of infection with Babesia and Theileria. The collected data in this study are useful for reaching a better understanding of the epizootiology of theileriosis and babesiosis, in order to control and prevent the diseases in this region.

Effects of tramadol administration on male reproductive toxicity in Wistar rats The role of oxidative stress, mitochondrial dysfunction, apoptosis-related gene expression, and nuclear factor kappa B signalling.

AIM: The present study investigated the role of redox balance, inflammation, mitochondrial dysfunction, and apoptosis in Tramadol (Tra)-induced testicular toxicity. METHOD: Twenty-four male Wistar rats were randomly divided into either the control group or the groups receiving different doses of Tra (25, 50, and 75 mg/kg/day, i.p.) for 21 successive days. Testicular tissues were collected for oxidative stress, mitochondrial function, sperm assays and histopathological evaluation. Real-time polymerase chain reaction was performed to evaluate the markers of inflammation and apoptosis. RESULTS: Tra caused a significant reduction in the sperm count, motility and morphology, while it caused a marked increase in oxidative stress parameters. In addition, Tra induced testicular mitochondrial dysfunction due to the collapse of mitochondrial membrane potential and mitochondrial swelling. It also led to the significant inhibition of anti-apoptotic Bcl-2 expression, besides a significant increase in pro-apoptotic Bax expression. There was a significant increase in the level of tumour necrosis factor-α, interlukin-1ß and nuclear factor kappa B. Histopathological degenerative changes were observed in the testis after Tra exposure. CONCLUSIONS: The present results suggest that Tra exposure may lead to reproductive toxicity due to the loss of the antioxidant defence system, mitochondrial dysfunction, and activation of inflammatory and apoptotic pathways (Tab. 4, Fig. 5, Ref. 63).

The effects of functionalization of carbon nanotubes on toxicological parameters in mice.

Carbon nanotubes (CNTs) have emerged as a new class of multifunctional nanoparticles in biomedicine, but their multiple in vivo effects remain unclear. Also, the impact of various functionalization types and duration of exposures are still unidentified. Herein, we report a complete toxicological study to evaluate the effects of single- and multiwalled carbon nanotubes (SWCNTs and MWCNTs) with either amine or carboxylic acid (COOH) surface functional groups. The results showed that significant oxidative stress and the subsequent cell apoptosis could be resulted in both acute and, mainly, in chronic intravenous administrations. Also, male reproductive parameters were altered during these exposures. The amino-functionalized CNTs had more toxic properties compared with the COOH functionalized group, and also, in some groups, the multiwalled nanotubes were more active in eliciting cytotoxicity than the single-walled nanotubes. Interestingly, the SWCNTs-COOH had the least alterations in most of the parameters. Evidently, it is concluded that the toxicity of CNTs in specific organs can be minimized through particular surface functionalizations.

Ultrabroadband 3D invisibility with fast-light cloaks.

An invisibility cloak should completely hide an object from an observer, ideally across the visible spectrum and for all angles of incidence and polarizations of light, in three dimensions. However, until now, all such devices have been limited to either small bandwidths or have disregarded the phase of the impinging wave or worked only along specific directions. Here, we show that these seemingly fundamental restrictions can be lifted by using cloaks made of fast-light media, termed tachyonic cloaks, where the wave group velocity is larger than the speed of light in vacuum. On the basis of exact analytic calculations and full-wave causal simulations, we demonstrate three-dimensional cloaking that cannot be detected even interferometrically across the entire visible regime. Our results open the road for ultrabroadband invisibility of large objects, with direct implications for stealth and information technology, non-disturbing sensors, near-field scanning optical microscopy imaging, and superluminal propagation.

Linaclotide inhibits colonic and urinary bladder hypersensitivity in adult female rats following unpredictable neonatal stress.

BACKGROUND: Irritable bowel syndrome (IBS) and bladder pain syndrome (BPS) are female-predominant, chronic functional pain disorders that are associated with early life stress (ELS) and therapeutic options for such patients remain limited. Linaclotide, a guanylate cyclase-C (GC-C) agonist, relieves abdominal pain and bowel symptoms in adult patients suffering from IBS with constipation. Here, we test the hypothesis that linaclotide will reverse colon and bladder hyperalgesia in a female-specific rodent model of adverse early life experience. METHODS: Neonatal rats were exposed to an odor-attachment learning paradigm of early life stress (ELS). In adulthood, the effect of linaclotide (3 µg kg-1  d-1 , p.o.) on colonic and bladder sensitivity was assessed via quantification of the visceromotor response to colorectal distension and the frequency of withdrawal responses to the application of von Frey hairs to the suprapubic region. In another cohort of rats, the effect of linaclotide on ELS-induced colonic and bladder permeability was investigated via measurements of transepithelial electrical resistance (TEER). KEY RESULTS: Rats exposed to unpredictable ELS exhibited colonic and bladder hypersensitivity that was significantly reduced by linaclotide compared to vehicle-treated controls. Colonic and bladder tissue isolated from adult rats exposed to unpredictable ELS exhibited a decrease in colonic and bladder TEER that was reversed by linaclotide. CONCLUSIONS AND INFERENCES: Our results demonstrate that neonatal rats exposed to unpredictable ELS develop increased sensitivity and permeability of the colon and bladder in adulthood through a mechanism involving activation of peripheral GC-C signaling.

The consequences of violence against nurses working in the emergency department: A qualitative study.

BACKGROUND: Workplace violence (WPV) in healthcare organizations can lead to serious consequences that negatively affect nurses' lives and patient care. There is limited research on the deeper, underlying consequences of WPV for emergency nurses, particularly among emergency nurses in Iran. METHODS: A qualitative exploratory design was utilized. Semi-structured interviews were conducted with sixteen nurses working in emergency departments in five hospitals in west and east Azerbaijan of Iran. Data were analyzed using conventional content analysis. RESULTS: "Suffering nurses" emerged as a primary theme of underlying consequences of WPV for emergency nurses. Four sub-themes of suffering were revealed: "mental health risks"; "physical health risks"; "threats to professional integrity"; and "threats to social integrity." CONCLUSION: Emergency nurses suffer from consequences following WPV. These consequences may not be addressed by staff health and safety programs, putting nurses at further risk. The findings of this study can help policy makers, healthcare leadership, and managers better understand the consequences of WPV so they can advocate for and establish WPV prevention programs and support for nurses who have experienced WPV. Preventing violence and providing support for nurses will ensure a safe workplace and safer patient care.

The effects of family-centered affective stimulation on brain-injured comatose patients' level of consciousness: A randomized controlled trial.

BACKGROUND: Despite the well-defined effects of sensory stimulation, the knowledge of the pure effects of affective stimulation is scarce. OBJECTIVE: To evaluate the effects of family-centered affective stimulation on the level of consciousness among comatose patients with brain injuries. DESIGN: This study was designed as a three-group double-blinded Randomized Controlled Trial. METHODS: Ninety consecutive patients with traumatic brain injuries and a Glasgow Coma Scale score of 5-8 were selected. Patients were randomly allocated to an experimental, a placebo, and a control group using permuted block randomization. Affective stimulation intervention was provided to patients in the experimental group by their family members twice a day during the first seven days of their hospitalization. In the placebo group, a sensory stimulation program was implemented by a fixed trained person who was not familiar with the patients. Patients in the control group solely received sensory stimulation which was routinely provided to all patients. The level of consciousness among the patients using the Glasgow Coma Scale and Coma Recovery Scale-Revised were measured both before and after a family visit. The SPSS software (version 17.0) was used to analyze the data through running the one-way and the repeated measure analyses of variance. RESULTS: Despite an insignificant difference among the groups regarding baseline level of consciousness, the results of the one-way analysis of variance revealed at the seventh day of this study, however, the level of consciousness in the experimental group was significantly higher (9.1±2.1) than the placebo (7.2±1.1), the control groups (6.6±1.7) (P<0.001), subsequently. Moreover, at the seventh day of the study, the Coma Recovery Scale score in the experimental group (11.9±3.7) was significantly greater than the placebo (9.0±2.0) and the control (6.6±1.6) groups (P<0.001). Recovery rate and effect size values also confirmed the greater effectiveness of affective stimulation compared with pure sensory stimulation. CONCLUSION: Our findings in this study indicate that early family-centered affective stimulation is more effective than sensory stimulation in improving the level of consciousness among comatose patients with brain injuries. Family-centered affective stimulation is recommended to be integrated into the nursing curricula and routine care plans for comatose trauma patients in intensive care units.

From threat to gradual lifestyle changes: Iranians' experiences with chronic illnesses.

AIM: This study aimed to explore and describe the experience of making a healthy lifestyle change among the patients with chronic illness. BACKGROUND: Despite the existence of different evidence on the critical role of lifestyle in the prevention and management of chronic diseases, many people face challenges in terms of starting and maintaining a healthy lifestyle. METHODS: A descriptive qualitative study with in-depth semi-structured interviews was carried out in 2015 in Iran. Thirty-four patients with common chronic illnesses were invited to the study using purposive sampling. The collected data were analysed by content analysis. FINDINGS: The main themes were: trying to remove the perceived threat, considering and trying to do physical activities, considering and planning for a healthy diet, striving to manage stress and having gradual acceptance of new habits and coping with them. LIMITATIONS: The participants were selected from among those with chronic illness. However, there is also a need to assess the family and healthcare providers' perspectives. CONCLUSION AND IMPLICATIONS FOR NURSING: The perceived threat of the disease plays an important role in the process of changing to a healthy lifestyle in Iranian with chronic illnesses. It is necessary for healthcare providers, especially nurses, to use this threat as a golden opportunity to accelerate changes in patients' behaviours. IMPLICATIONS FOR NURSING POLICY: Findings may help policy makers become aware of the need for nurses to create community-based nursing in Iran. Community nurses can remind patients of perceived threats to their health to motivate them for continued healthy behaviours. Therefore, nursing curricula should be revised and educational programs utilise a community-based health approach.

Relationship among moral authority and emotional empowerment: perspectives of clinical nurses in Imam Reza (AS) Kermanshah, 2015.

Background. The objective of the present research is to establish the connection among the decent masters of the emotional empowerment perspectives of nurses in Imam Reza (AS) Kermanshah Hospital in 2015. Methods. The required information are gathered at the start of the towering utilization of the Internet search and library. Data relevant to the communication are gathered by using questionnaires. Standard information are gathered. The population of the research included all formal hospital-training nurses, meaning the persons responsible with the behaving of patients in Medical Sciences Kermanshah University, respectively 550. Based on the formula of the Cochran, 226 questionnaires were simple random Bayat samples; 219 surveys are delivered, used, and returned from the ultimate population. The accuracy and their confirmation are already under investigation and confirmation. Findings. The findings indicated a psychological association with the ethical leadership and the enabling nurses. There is also a clear (sig = .000). Moreover, there is a direct and clear link [sig = .000] between the moral leader and enabling the psychological views of the nurses. Discussion. Based on the results of the present research, it can be said that the master of morality led to the emotional empowerment of nurses. The moral evil leader of the yen means creating faith, work happiness, increased efficiency and it activates the effective organizational goals.

Relationship between patient safety and accountability of nurses in Al-Zahra Gilangharb Hospital in 2015.

Introduction. The purpose of this research was to investigate the connection between the patient safety and the accountability of nurses in Gilangharb Hospital in 2015. Methods. This research was a cross-sectional study conducted in Al-Gilangharb, in 2015. The data needed for research was taken from the library and an internet search and was gathered by using standard questionnaireThe professional and caring nurses' questionnaire was based on the extension evaluation office Nursing Care, Ministry of Health and Medical Education and demographic information and questions about 4 different roles of nurses were prepared and included. Moreover, patient safety was highlighted in a validation questionnaire, validated by experts judging group of teachers and academics, which was established. Cronbach's alpha test was used to assess the reliability. Finally, the reliability and professional standards of nursing care, patient safety questionnaire 093. 86/ 0 percent calculated the population of Gilangharb Hospital nurses (n = 70) and, in the strata selected, a statistical analysis using data from the questionnaires included in the SPSS statistical software, version 21, took place. Results. The patients' safety and accountability was observed at the level of 95 percent by using the Spearman correlation (SIG = .000). The correlation coefficient was (R=.768). Also, the dimensions of responsibility between the patient's safety (regarding the role of the nurse teacher, manager, researcher, and clinician) at 95 percent and the positive use of Spearman correlation was found (SIG = .000). Conclusions. Given the correlation among the patient protection and accountability, it can be said that the nurses in all roles (educator, researcher, administrator, and clinical specialist) have been successful, so, we suggested that given the experience, expertise and abilities, they have made an efficient use of their lifting power.

Spiritual care in nursing: a concept analysis.

BACKGROUND: Around the world, spiritual care in nursing is a critical part of providing holistic care, but within our profession, there is a lack of certainty over the meaning of spirituality and delivery of spiritual care, including nurses thinking of spirituality as religion. METHODS: We adopted the eight-step Walker and Avant's concept analysis approach to provide a definition of the concept, searching and analysing international and national online databases. Inclusion criterion included that articles were published between 1950 and 2012 in English or Persian language. Finally, 151 articles and 7 books were included in the analysis. FINDINGS: The attributes of spiritual care are healing presence, therapeutic use of self, intuitive sense, exploration of the spiritual perspective, patient-centredness, meaning-centred therapeutic intervention and creation of a spiritually nurturing environment. Spiritual care is a subjective and dynamic concept, a unique aspect of care that integrates all the other aspects. It emerges in the context of nurses' awareness of the transcendent dimension of life and reflects a patient's reality. The provision of spiritual care leads to positive consequences such as healing for patients and promotion of spiritual awareness for nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The conceptual definition of spiritual care provided in this study can help clinical nurses, educators and nurse managers to develop and implement evidence-based health policies, comprehensive staff training programmes and practical quality assessment guidelines to try to ensure that all nurses are competent to include relevant spiritual care in practice. CONCLUSION: A comprehensive definition of the concept of spiritual care ensued. The findings can facilitate further development of nursing knowledge and practice in spiritual care and facilitate correction of common misconceptions about the provision of spiritual care.

Effects of preconditioning with normobaric hyperoxia on Na⁺/Ca²âº exchanger in the rat brain.

BACKGROUND: Recent studies suggest that normobaric hyperoxia (HO) reduces hypoxia-reoxygenation injury in the rat brain. We have attempted to determine the effect of HO on Na(+)-Ca(2+) exchangers (NCX) in the rat stroke model. METHODS: Rats were divided into two experimental groups. The first group was exposed to 95% inspired HO for 4h/day for 6 consecutive days (HO). The second group acted as the control, and was exposed to 21% oxygen in the same chamber. Each main group was subdivided to middle cerebral artery occlusion (MCAO-operated) and intact (without any surgery) subgroups. After 48 h from pretreatment, MCAO-operated subgroups were subjected to 60 min of right MCAO. After 24h reperfusion, neurologic deficit score (NDS) and infarct volume were measured in MCAO-operated subgroups. The NCXs expression levels of the core, penumbra and subcortical regions were assessed in sham-operated and intact subgroups. RESULT: Preconditioning with HO decreased NDS and infarct volume, and increased the expression of NCX1, NCX2 and NCX3 in the penumbra, NCX2, NCX3 in the core and NCX1 and NCX3 in the subcortex. CONCLUSION: Although further studies are needed to clarify the mechanisms of ischemic tolerance, HO partly is associated with the expression of NCX1, 2, 3 consistent with an active role in the genesis of ischemic protection.

Lifetime and current waterpipe use among adolescents in Tehran, Islamic Republic of Iran.

Waterpipe use among Iranian adolescents has become a matter for concern. A descriptive, cross-sectional community-based survey was performed in 2010 to determine the prevalence of waterpipe use and associated factors among Iranian adolescents in Tehran, Islamic Republic of Iran. After multi-stage, random cluster sampling 1201 adolescents aged 15-18 years old responded to a questionnaire based on the Youth Risk Behavior Surveillance. The prevalence of current waterpipe smoking (at least once in the previous 30 days) was 28.0%, significantly higher among males (34.8%) than females (21.4%). A total of 45.1% of adolescents reported lifetime use (ever use) of waterpipes and 34.2% had ever shared a waterpipe. In multivariate logistic regression analysis the significant correlates of current waterpipe use for both males and females were having smokers among friends and family members, while for males, older age and educational failure were also risk factors.