Experimental demonstration of rainbow trapping of elastic waves in two-dimensional axisymmetric phononic crystal platesa).

Structures with specific graded geometries or properties can cause spatial separation and local field enhancement of wave energy. This phenomenon is called rainbow trapping, which manifests itself as stopping the propagation of waves at different locations according to their frequencies. In acoustics, most research on rainbow trapping has focused on wave propagation in one dimension. This research examined the elastic wave trapping performance of a two-dimensional (2D) axisymmetric grooved phononic crystal plate structure. The performance of the proposed structure is validated using numerical simulations based on finite element analysis and experimental measurements using a laser Doppler vibrometer. It is found that rainbow trapping within the frequency range of 165-205 kHz is achieved, where elastic waves are trapped at different radial distances in the plate. The results demonstrate that the proposed design is capable of effectively capturing elastic waves across a broad frequency range of interest. This concept could be useful in applications such as filtering and energy harvesting by concentrating wave energy at different locations in the structure.

The effect of oropharyngeal mother's milk on nutritional outcomes in preterm infants: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Oropharyngeal interventions are an accepted method to improve the nutritional performance of premature infants. Considering the countless benefits of breast milk and the few studies on the use of breast milk as an oral-pharyngeal intervention, this study was conducted with the aim of determining the effect of oral-pharyngeal administration of breast milk on nutritional outcomes in premature infants. MATERIALS AND METHODS: In this clinical trial, 80 premature infants hospitalized in the neonatal intensive care unit of Amir al-Mu'minin Hospital in Semnan (a city in Iran) were randomly assigned to intervention (n = 40) and control groups (n = 40). Infants in the intervention group were given breast milk, and infants in the control group were given sterile water as a placebo. The data collection tool included demographic and clinical questions checklist, including sex, gestational age, weight, milk administration time, lavage and its amount, vomiting, abdominal distension, and so on. Data analysis was performed using SPSS23. RESULTS: The mean volume of total milk received by infants (p = 0.047) and the mean volume of milk received by mouth (p < 0.000) at the time of discharge were higher in the intervention group. Moreover, the time to start enteral nutrition in the intervention group was lower than in the control group (P = 0.012). Administering mother's milk through the oropharyngeal method led to a reduction in infants' length of stay in the hospital (P = 0.022). CONCLUSION: Based on the results of the present study, the oropharyngeal administration of breast milk in the first days after the birth of premature infants admitted to the hospital improves the outcomes related to their nutritional status. Therefore, it is suggested that this convenient, safe, and feasible method be used in hospitalized premature infants as soon as possible so that premature infants can benefit from the important advantages of breast milk.

The relationship between empowerment and compassion satisfaction, compassion fatigue, and burnout in nurses during COVID-19 outbreak.

BACKGROUND: The quality of nurses' professional life is at stake in crises such as COVID-19. Empowerment helps employees perform better and advance the goals of the organization. This study aimed to investigate the relationship between empowerment and the quality of nurses' professional life during the outbreak of COVID-19. MATERIALS AND METHODS: The current cross-sectional study was conducted in 2021 in the hospitals of Babol University of Medical Sciences with the participation of 200 nurses providing care for COVID-19 patients who were included in the study by convenience sampling method. Data collection tools included the Empowerment Questionnaire (Leader Empowerment Behaviors Scale, Structural Empowerment, and Psychological Empowerment) and the Professional Quality of Life Questionnaire. SPSS software version 23 was used to analyze the data. Multiple linear regressions were used to investigate the relationship between empowerment and quality of professional life. RESULTS: In the majority of nurses, compassion satisfaction 140 (70%), burnout 172 (86%), and compassion fatigue 126 (63%) were at moderate level. A significant relationship was found between compassion satisfaction and Leader Empowerment (R = 0.54, P =. 001), Psychological Empowerment (R = 0.55, P =. 001), and Structural Empowerment (R = 0.42, P =. 001) and Compassion Fatigue and Leader Empowerment (R = 0.35, P =. 001), psychological empowerment (R = 0.42, P =. 001), and structural empowerment (R = 0.49, P =. 001). CONCLUSION: Nursing managers' attention to empowerment strategies in crises such as COVID-19 can improve compassion satisfaction and reduce compassion fatigue in nurses. It is also necessary to implement policies and guidelines for the development of psychosocial support to health promotion of the workplace, education, informing, and empowering nurses.

Effect of eye shield and ear muffs on pain intensity during venous blood sampling in premature infants: a clinical trial study.

BACKGROUND: Today, due to the side effects of drugs, there is a greater desire to use non-pharmacological interventions to relieve pain caused by painful procedures. Using non-pharmacological interventions in combination is more effective than using them alone in relieving the pain of infants. Reducing sensory and environmental stimuli such as visual and auditory stimuli is one of the non-pharmacological methods to relieve pain. The aim of this study was to investigate the effect of using eye shield and ear muffs on pain intensity during venous blood sampling of premature infants. METHODS: In this clinical trial study, 148 premature neonates admitted to the Neonatal Intensive Care Unit of Rouhani and Children Hospitals in Babol were randomly assigned to four groups of 37. Fifteen minutes before intravenous blood sampling until 15 min later, in the first group, eye shield; in the second group, ear muffs, and in the third group, eye shield plus ear muffs were used. In the fourth group (control), blood sampling was performed routinely. NIPS pain scale and demographic questionnaire were used to collect the data. RESULTS: The results showed that during the venous blood sampling was a significant difference between the mean pain intensity of neonatal in the eye shield plus ear muffs group (3.14 ± 0.71), the ear muffs group (4.43 ± 1.21), the eye shield group (5.41 ± 1.04).) and the control group (5.94 ± 0.84) (P = 0.001). Moreover, after the venous blood sampling, there was a significant difference between the mean neonatal pain intensity in the eye shield plus ear muffs group (1.19 ± 0.39), the ear muffs group (1.43 ± 0.50), the eye shield group (1.33 ± 0.37) and the control group (1.89 ± 0.90) (P = 0.001). CONCLUSIONS: In this study, the pain severity during and after venous blood sampling in the ear muffs plus eye shield was lower than in other groups. Therefore, a combination of ear muffs and eye shield is recommended as a better pain reliever when performing venous blood sampling in premature infants.

Investigation of chronic diseases in patients with inflammatory bowel disease: A hospital-based case-control study.

Background: Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD. Methods: In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups. Results: Two hundred and twenty-nine (81.78%) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95%CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95%CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95%CI: 1.40, 5.34, P= 0.003 ), anemia (OR = 2.53, 95%CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95%CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95%CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95%CI: 1.06, 2.95, P= 0.028). Conclusion: The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients.

Investigating the professional identity and resilience in nursing students during the COVID-19 pandemic.

BACKGROUND: Professional identity includes the values and beliefs of a nurse that guide her thinking, action, and interaction with patients. The stressful conditions of the COVID-19 pandemic may have affected nursing students' resilience and attitudes toward their profession. Therefore, the aim of this study was to investigate the professional identity and resilience in nursing students during the COVID-19 pandemic. MATERIALS AND METHODS: This cross-sectional descriptive study was performed in November and December 2020 with the participation of all nursing students of Babol University of Medical Sciences who spent at least one semester of internship in a hospital during the COVID-19 pandemic. Data were collected using demographic questionnaire, Connor-Davidson resilience scale, and nursing students' professional identity scale. Data analysis was performed using independent t-test, ANOVA, and correlation tests at a significance level of 0.05. RESULTS: Nursing students in the 3rd, 5th, and 7th semesters have spent a minimum of 13 and a maximum of 151 days of internship during the pandemic period. The mean score of professional identity of nursing students was 61.86 ± 9.34 and their mean resilience score was 32.08 ± 13.54. The resilience score of 92% of students was below 50. Professional identity was significantly stronger, and resilience was considerably higher in students who were satisfied with their profession and lived with their families (P < 0.05). In other words, students with higher professional identity scores had higher resilience (r = 0.39, P = 0.000). CONCLUSION: Despite a good professional identity score, the resilience of nursing students during the COVID-19 pandemic is low. Therefore, professors and the clinical education system should provide more support for students in such stressful times as the COVID-19 pandemic period.

The effect of concurrent use of swaddle and sucrose on the intensity of pain during venous blood sampling in neonate: a clinical trial study.

BACKGROUND & OBJECTIVE: Infants undergo painful procedures while receiving care and treatment. Blood sampling is the most common painful procedure for infants. Pain control plays a significant role in preventing unwanted physical and psychological effects. Therefore, this study aimed to investigate the effect of concurrent use of swaddle and sucrose taste on the pain intensity during venous blood sampling in neonates. METHODS: In this clinical trial study, 60 infants admitted to the neonatal ward of Amirkola Hospital were randomly divided into four groups of 15 patients. In the first group, the infants were swaddled before blood sampling. In the second group, sucrose was administered to infants. In the third group, the neonates were swaddled and given sucrose simultaneously, and in the fourth group (control), blood sampling was performed routinely. PIPP pain scale and demographic questionnaire were used to collect the data. Data analysis was performed using SPSS23. RESULTS: The results showed a significant difference between the mean pain intensity in neonates in the sucrose-swaddle group (4.53 ± 1.30) and the sucrose (7.73 ± 2.73), swaddle (9.86 ± 33.33), and control (12.13 ± 2.06) groups during blood sampling (P < 0.001). Besides, after blood sampling, there was a significant difference between the mean pain intensity in neonates in the sucrose-swaddle group (4.33 ± 1.23) and the sucrose (8.13 ± 2.66), swaddle (7.73 ± 2.78), and control (10.00. ± 1.96) groups (P < 0.001). CONCLUSION: The present study showed that pain severity during and after venous blood sampling was lower in the swaddle-sucrose group than in other groups. Therefore, it is recommended that the combined method of swaddle-sucrose be used in infants as a better pain reliever when intravenous blood sampling is performed.

The challenges of supporting nursing students in clinical education.

Clinical education requires creating a supportive atmosphere for learners and nursing students, who need support to be prepared for their future profession. The purpose of this study is to investigate the challenges of supporting the nursing students in clinical education. This article reviewed studies conducted between 2009 and 2019 with the keywords including support, challenge, students, education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as databases. Among the 926 articles obtained during the two review stages, which were based on the inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles used in this study are as follows: qualitative (16 articles), descriptive analytical and cross-sectional (12 articles), review (3 articles), and mixed-methods (1 article). The focus of all studies was on the students' clinical education environment. The participants of the studies were undergraduate nursing students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4 articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the students included violence, fear, and anxiety; socio-cultural challenges, environmental-organizational stresses; and ineffective clinical education. The findings of this study showed that nursing students face many challenges in the clinical setting. Therefore, the managers of educational and health-care centers should give a high priority to their students' support programs.

The association of high-risk behaviors and their relationship with identity styles in adolescents.

BACKGROUND: Adolescence is considered an important stage in the onset of high-risk behaviors. Identity styles have significant pathological effects in various aspects of high-risk behaviors. The present study was conducted aiming at investigating the association between high-risk behaviors and identity styles in adolescents. MATERIALS AND METHODS: The present cross-sectional research studied 384 girls and boys studying in the second grade of High School in Babol in 2018. Data collection was done through a demographic questionnaire, Mohammadkhani's Risky Behaviour Questionnaire, and Berzonsky's Identity Style Inventory. Data analysis was performed using Chi-square test, Pearson's correlation coefficient, and linear regression analysis. P ≤ 0.05 was considered statistically significant. RESULTS: The mean age of adolescents was 17.21 ± 48.4 years (aged 16-19 years). Aggression (23.4%), relationship with the opposite gender (14.5%), smoking cigarettes and hookah (10.9%), consuming alcohol (9.3%), suicidal thoughts and attempts (5.7%), running away from home (3.9%), and consuming psychotropic substances (1.8%) were among the most common high-risk behaviors observed in the adolescents. The scores of high-risk behaviors were negatively correlated with the identity scores of informational style (4.56 ± 3.107), normative style (4.45 ± 2.581), and identity commitment style (4.15 ± 2.245) and positively correlated with the scores of diffuse-avoidant style (4.15 ± 3.089). Regression analysis showed that only the informational style had a negative and significant correlation with high-risk behaviors. CONCLUSIONS: The present study showed significant prevalence of high-risk behaviors and its relationship with identity styles in adolescents, which requires regular and planned health education intervention at schools.

Undiagnosed hypertension and diabetes among the elderly in Amirkola, North of Iran.

BACKGROUND: As populations of elderly grow, the prevalence of type 2 diabetes and hypertension increases. These diseases can be asymptomatic for a long time and cause irreversible damages to organs. Therefore the aim of this study was to evaluate the prevalence of undiagnosed hypertension and diabetes among the elderly in Amirkola. METHODS: This is a descriptive/analytical cross-sectional study and a part of the first phase of a cohort study on the health status of the elderly in Amirkola (a city in the North of Iran) which has been conducted on all people aged 60 and over since 2011. The demographic information was collected using a questionnaire, the hypertension was diagnosed by measuring blood pressure in lying down- position and the diabetes was diagnosed by measuring fasting blood glucose level. RESULTS: This study was conducted on 1568 elderly participants including 703 (44.8%) females and 865 (55.2%) males. The overall prevalence of diabetes was 30.6% of which, 23.3% was diagnosed and 7.4% was undiagnosed. Nearly one-fourth (24.1%) of the participants with diabetes were unaware of their disease. Thirty-one percent of the people with undiagnosed diabetes also had undiagnosed hypertension. The overall prevalence of hypertension in this study was 62.8%, including 41.2% diagnosed and 21.5% undiagnosed hypertension. CONCLUSION: Regarding the results of this study and the high prevalence of undiagnosed diabetes and hypertension in elderly, improving the individual's general awareness and screening in older adults for timely management are necessary.

Qualitative study on the experiences of hepatitis B carriers in coping with the disease.

AIM: Hepatitis is a systemic infection that causes restrictions in the life of many patients due to its chronic nature and it necessitates the use of coping strategies to improve the quality of life. This study aims to demonstrate the experiences of hepatitis B carriers in coping with the disease. METHODS: The present study was conducted by using a qualitative content analysis. The data were collected through 18 unstructured and in-depth interviews from 2014 to 2016 at medical centers, a gastrointestinal and liver diseases research center in the cities of Babol and Amol (northern Iran) and Tabriz (north-western Iran) with patients infected with hepatitis B. The study was carried out by using purposive sampling. RESULTS: The data analysis led to the extraction of the main theme, "attempting an active expansion of interactions," and its three subthemes, including: "denial of the disease," "protecting oneself or others," and "coping with the disease." CONCLUSION: Patients with hepatitis B use different strategies to cope with this disease. In order for patients to properly face the disease and to live with minimum challenges and limitations, they need to be suitably understood and supported. Therefore, consideration of education and consultation programs regarding the different aspects of this disease is urgent.

Polypharmacy among the Elderly.

INTRODUCTION: Older people are at risk for polypharmacy due to multiple chronic diseases. Considering the lack of information in this regard, the aim of this study was to investigate the state of polypharmacy among the elderly in the city of Amirkola in northern part of Iran. MATERIALS AND METHODS: This descriptive/analytical cross-sectional study is a part of Amirkola Health and Aging Project that was conducted on 1616 individuals aged 60 years and over. The data about medications were gathered through interviews and observation of prescriptions and medications consumed by patients. The data were analyzed by SPSS software version 18, and P ≤ 0.05 was regarded significant. RESULTS: In this study, 1616 individuals including 883 men (54.6%) and 733 women (45.3%) were investigated. The average age of individuals was 69.37 ± 7.42. Among the investigated individuals, 526 including 368 men (41.7%) and 158 women (21.6%) consumed no medications. The prevalence of polypharmacy in this study was 23.1%, which was 32.7% in women and 15.2% in men (odds ratio = 1.51, 95% confidence interval: 1.10-1.93). The most prevalent group of medications used in both genders was cardiovascular drugs. CONCLUSIONS: Regarding the considerable prevalence of polypharmacy among the elderly, especially in aged women, serious efforts are required to manage polypharmacy. Provision of educational programs for physicians, personnel of pharmacies, and the staff of health-care centers in order for appropriate and safe consumption of medications in aged people is absolutely necessary.

The Prevalence of Anemia and its Association with Depressive Symptoms among Older Adults in North of Iran.

BACKGROUND: Anemia is the most prevalent blood disorder in older adults which can have negative effects on the quality of life and lead to the onset of depressive symptoms. We aimed to determine the prevalence of anemia accompanied by depression among older people in the city of Amirkola, north of Iran. STUDY DESIGN: A cross-sectional study. METHODS: Overall, 1616 older people aged 60 and over (883 males and 733 females) were enrolled in the city of Amirkola, north of Iran since 2011. To diagnose anemia we used WHO criterion which is a hemoglobin value of less than 12 and 13 g/dl in women and men, respectively. We also used Geriatric Depression Scale (GDS) to detect the presence of depression symptoms. The data were analyzed using SPSS version18.0 and statistical tests. RESULTS: The prevalence of anemia was 19% (302 out of 1616 participants). The prevalence of anemia in women was 20.3% and in men was 17.9%. In people with and without depressive symptoms it was 23.2% and 15.8%, respectively. The mean hemoglobin level in people with and without depressive symptoms was 13.29 ±1.63 and 13.96 ±1.50, respectively (P<0.001). According to logistic regression model, depressive symptoms were most highly related to gender (OR=3.67; 95% CI: 2.80, 4.81) and besides that smoking, Mini-Mental Estate Examination (MMSE), diabetes and anemia (OR=1.46; 95% CI: 1.09, 1.95) were related to depression. CONCLUSION: Significant prevalence of anemia and direct association with depressive symptoms in the elderly reflect the need for proper planning for prevention interventions, accurate and continuous screening of these diseases.

The Social Stigma Experience in Patients With Hepatitis B Infection: A Qualitative Study.

The social stigma in patients with hepatitis B virus infection has caused several complications for both the patients and the associated medical system. This study aimed at demonstrating the social stigma experienced by these patients in Iran. This is a qualitative study using a content analysis approach with references to primary and secondary sources. The data were collected through 15 unstructured and in-depth interviews conducted in 2014. By analyzing the data, two main themes were noted: extrinsic concepts of social stigma (causing reprehension, embarrassment, and discrimination) and intrinsic concepts of social stigma (sense of rejection, isolation, and frustration). The analysis of participants' experiences showed that social stigma is a simple lack of knowledge among the patients and society and it is more intense in the first days after the diagnosis. Stigma is prevalent among patients with hepatitis B virus, causes them to hide the disease, and provokes various complications for them as well as society. This study emphasizes the necessity of implementing health education programs about hepatitis B and its associated stigma, especially considering the potential impact of a mass media campaign.

Psychological Reactions among Patients with Chronic Hepatitis B: a Qualitative Study.

INTRODUCTION: Hepatitis B is the most prevalent type of viral hepatitis. Psychological reactions among patients with hepatitis B infection is considerably different and affects their decision about treating and following up the disease. The present study aims at explaining the psychological demonstrations experienced by these patients. METHODS: In this qualitative study, a total of 18 patients with hepatitis B (8 women and 10 men) were selected by purposive sampling method. Data were collected by unstructured in-depth interviews during 2014-2015 in the medical centers of three cities in Iran. All interviews were recorded, typed and analyzed by the conventional content analysis approach. RESULTS: By analyzing the data, the main theme including psychological instability, with three sub-themes were emerged: grief reaction (stupor, denial, anger and aggression), emotional challenges (worry and apprehension, contradiction with beliefs, fear of deprivation, fear of stigma, waiting for death and prognosis ambiguity) and inferiority complex (social withdrawal, sense of humiliation and embarrassment and sense of guilt and blame) were acquired. CONCLUSION: The findings indicate that patients with hepatitis B experience various psychological reactions that need to be controlled and managed by themselves or healthcare providers. Thus, implementation of health interventions with emphasis on psychological care to prevent problems and execution of educational and consultation programs about hepatitis especially by medical centers and mass media is seems necessary.