Development and psychometric properties of Health-Promoting Lifestyle Scale in Colorectal Cancer Survivors (HPLS-CRCS): a mixed-method study

BACKGROUND

Detecting a health-promoting lifestyle in colorectal cancer (CRC) survivors is of paramount importance to manage disease complications, prevent their recurrence, and enhance survival; however, no specialized tool has yet been provided to measure the lifestyle of these patients. Accordingly, this study aimed to develop and determine the psychometric properties of the Health-Promoting Lifestyle Scale in CRC Survivors (HPLS-CRCS).

METHODS

This study was a mixed study with an exploratory sequential design in two phases. Concept analysis was performed in the first phase according to Schwartz-Barcott and Kim's (2000) hybrid model to explain the concept, identify dimensions, and generate items. In the second phase, psychometrics including validity (face, content, and construct) and reliability (internal consistency and stability) were determined. Responsiveness, interpretability, ease of use, item weighting, and scale scoring were also determined.

RESULTS

After explaining the concept, an initial scale encompassing 211 items was developed, content and item analyses were conducted, and the items decreased to 89 items after the face validity assessment. For construct validity, confirmatory factor analysis (CFA) was conducted with a sample size of 500 survivors, and convergent validity was performed for the Persian version of the Health-Promoting Lifestyle Profile II (HPLP-II). Accordingly, 80 items were classified into six factors: activity and rest, spiritual growth, health responsibility, nutrition, interpersonal relationships, and psychological management, with RMSEA = 0.055, χ2/df = 2.484, and χ2 = 6816.516. The reliability of the scale was confirmed, Cronbach's alpha was between 0.865 and 0.928, and the intraclass correlation coefficient (ICC), the standard error of measurement (SEM), the minimal important change (MIC), and the smallest detectable change (SDC) were 0.896, 3.36, 13.86, and 19.87, respectively.

CONCLUSION

The HPLS-CRCS consists of 80 items in six dimensions and is a valid and reliable scale for evaluating the health-promoting lifestyle in CRC survivors. Using this scale to evaluate the healthy lifestyle in these survivors can lead healthcare providers to detect deficiencies and plan the lifestyle of CRC survivors during the post-treatment period.

Health-Promoting Lifestyle among the Survivors of Colorectal Cancer: An Integrative Review

Introduction

Health-promoting lifestyle (HPL) among the survivors of colorectal cancer (CRC) is essential to reduce CRC complications, prevent its recurrence, and improve survival. Nonetheless, there is no comprehensive definition for the concept of HPL in CRC survivors. This study aimed to define the concept of HPL among CRC survivors based on the existing literature.

Methods

This integrative review was conducted in 2021 using Whittemore and Knafl's method. The national and international databases of SID, Magiran, ProQuest, Medline, ScienceDirect, Web of Science, and Scopus were searched. Quality appraisal was performed using the Mixed Methods Appraisal Tool (MMAT) and the data were analyzed using the four-step approach proposed by Whittemore and Knafl.

Results

After data evaluation, 167 documents were included in final analysis. In total, 1863 codes were generated and categorized into eighteen main categories and the three main themes of antecedents, attributes, and consequences. Accordingly, HPL among CRC survivors was defined as "a set of behaviors in the areas of health responsibility, physical activity, nutrition, spiritual growth, psychological management, and interpersonal relations which are affected by socio-demographic characteristics, clinical characteristics, psychological status, physical conditions, time and place limitations, and patient education, and lead to better disease prognosis, better general health status, better bio-psycho-social status, and better quality of life".

Conclusion

The definition of HPL among CRC survivors provided in the present study can be used in counseling, educational, supportive, and care programs for CRC survivors in order to improve their quality of life and survival.

Mothers' lived experience of caring for children with inborn errors of amino acid metabolism

BACKGROUND

Inborn errors of amino acid metabolism are chronic conditions that have many sequels. Mothers of these children are facing different challenges which are underdetermined. This study was done to explore lived experience of mothers caring for these children.

METHODS

This is an interpretive phenomenology with van Manen's approach which has 6 steps. Data were gathered by convenience and purposeful sampling. Nine mothers with different experiences were interviewed and the interviews were audiotaped.

RESULTS

Six final themes were revealed from the exploring mothers' experiences including the future tied to the past, psychosis in the shadow of a lost ideal child, rebellion and blaming, the ways of escaping difficulties, self-forgetting in the shadow of full-time care, passing difficulties in the duality of hope-hopelessness, caring in a continuum of isolation-socialization.

CONCLUSION

Mothers have multiple challenges in taking care of their children, especially psychologically and financially. So, nurses must plan programs for helping mothers of children with inborn errors of amino acid metabolism to reduce the effects of disease on mothers and consequently the children and the whole family.

Evaluating the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS)

BACKGROUND

Precise examination of breast cancer survivors' lifestyles can lead to improved planning and implementation of care and counseling interventions to increase their survival rate and improve their quality of life. Therefore, a valid and reliable instrument needs to be developed. Therefore, the present study aimed to determine the psychometric properties of the Persian version of the Healthy Lifestyle Instrument for Breast Cancer Survivors (HLI-BCS).

METHODS

This methodological study was conducted on 420 Iranian breast cancer survivors between May and November 2022. Participants were selected using convenience sampling. The face, content, construct validity, convergent, and reliability of the Persian version of the HLI-BCS were assessed.

RESULTS

After assessing face, content, and construct validity, the Persian version of the HLI-BCS with five factors and 20 items was provided. The total Cronbach's alpha and intra-class correlation coefficient (ICC) were calculated as 0.86 and 0.79, respectively, which were at acceptable levels. A healthy lifestyle in breast cancer survivors was observed to have strong and significant relationships with quality of life in general (p < 0.001, r = 0.832), physical health (r = 0.786), and mental health (r = 0.809).

CONCLUSION

The Persian version of the HLI-BCS has favorable properties, is consistent with the conditions of breast cancer survivors, and is valid and reliable. This version of the scale can provide adequate and precise information on the lifestyles of these patients.

Educational challenges of family caregivers of vegetative state patients for home care preparedness: A qualitative content analysis

BACKGROUND

Patients with a vegetative state (VS) are completely dependent on caregivers in all physical aspects of their lives. Caring for such patients comes with a great deal of difficulty for family caregivers. As a result, family caregivers must be fully trained and prepared for this role. The present qualitative study was conducted to investigate the educational challenges faced by family caregivers of VS patients for home care preparedness.

MATERIALS AND METHODS

The present qualitative study was conducted through the conventional content analysis method from August 2020 to September 2021 in two provinces of Iran (Sistan and Baluchestan Province; and Razavi Khorasan Province). Fourteen family caregivers of patients in a VS were included in the study. Semi-structured and in-depth interviews were employed to collect data. The Graneheim and Lundman method was utilized to conduct the data analysis using MAXQDA2020 software. Data collection continued until data saturation and the identification of main categories.

RESULTS

As indicated by the data analysis, three categories of "unmet educational needs," "confused caregiver," and "searching for practical knowledge" which included 19 sub-categories described the experiences of family caregivers of patients in a VS concerning challenges they went through in preparation for patient care at home. Participants' experiences revealed that despite the inadequacy of educations provided by health-care providers on knowledge and skills required by family caregivers, they were committed to caring for the patient and trying to acquire the required knowledge.

CONCLUSION

Results indicated that inadequate education and the lack of family caregivers' contribution to caring for the patient in the VS during their stay in the hospital impedes their acquisition of adequate knowledge and skill to care for patients at home. Therefore, healthcare system policymakers should be planning to eliminate the educational barriers faced by family caregivers and expand the educational activities of hospitals' homecare centers to provide educational support of family caregivers after the patient's discharge.

Developing a Spiritual Care Model for Clinical Nurses: A Theory Synthesis

This study was carried out to develop a spiritual care model for clinical nurses. This study has used a 3-step strategy proposed by L. O. Walker and K. C. Avant (2019) for theory synthesis. In the second phase of this study, an integrative review was conducted to retrieve and select relevant articles. A total of 227 documents were included for theory construction. After identifying and defining the basic assumptions of the model, the concept of spiritual care was defined as a paradigmatic concept with a holistic approach. Then the metaparadigmatic concepts (ie, human being, environment, nursing, and health) were defined according to the holistic approach. After defining the model care goals, clinical strategies and interventions were defined according to the goals and the concept of health as an outcome of spiritual care. Nurses' clinical roles were conceptualized within the conceptual framework that includes 3 main steps of nursing process: (1) assessment and identification of the client to explore the spiritual perspective; (2) planning and implementing spiritual care; (3) documenting and evaluating spiritual care. This model can tell clinicians what to do in caring for patients, especially chronic and end-stage patients. Therefore, this model could help provide better care for all clients.

Wideband RCS reduction due to plasma generated by radioactive nuclei for cylindrical object

Radar cross section reduction has been one of the most important research topics in recent years. Plasma-based stealth is a method of reducing the radar cross section, which dampens the electromagnetic waves and reduces the amount of return waves. In this paper, a coating of the radioactive nucleus \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$^{241}{\mathrm{Am}}$$\end{document}241Am on the surface of the cylinder with a radius of 10 cm is considered and the range of the emitted alpha particles and the electron density generated in the air are obtained using the Geant4 code under standard temperature and pressure conditions. By finite element method solution, the radar cross section of the conductive cylindrical object has been simulated and extracted in the presence and absence of plasma created by alpha-particles. The obtained results show a reduction of 5–8 dB \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathrm{m}^2$$\end{document}m2 in the radar cross section in the frequency range of 2–12 GHz for specific activity source of 1 Ci/\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathrm{cm}^2$$\end{document}cm2.

Psychometric Properties of the Persian Version of the Short-Form Survivor Unmet Needs Survey (SF-SUNS) among Cancer Patients

Objective

Accurate identification of the unmet needs of patients with cancer and with a valid and reliable scale leads to the improvement of planning and implementation of nursing care. Thus, this study aims to translate the Short-Form Survivor Unmet Needs Survey (SF-SUNS) into Persian and to assess the psychometric properties of the Persian version among patients with cancer in Iran.

Methods

This study was conducted by methodological design. The translation of SF-SUNS was performed by translation protocol of the Quality of Life Assessment. Qualitative assessment of the face validity was conducted through cognitive interview and content validity was assessed through expert panel. This study used a convenience sampling method for 757 patients with cancer referring to Omid and Imam Reza hospitals in Mashhad, Iran. To determine the construct validity, confirmatory factor analysis and convergent validity were employed. Cronbach's alpha and intraclass correlation coefficient were calculated for reliability.

Results

Total score of unmet needs was 2.20 ​± ​0.73, which indicates the average level of unmet needs in patients with cancer. Content validity ratio and content validity index scores were 0.88 and 0.91, respectively, Cronbach's alpha coefficient was 0.89, and intraclass correlation coefficient was 0.91. Based on confirmatory factor analysis, goodness-of-fit indices confirmed the model fit (χ²/df ​= ​4.43, GFI ​= ​0.90, TLI/NNFI ​= ​0.91, CFI ​= ​0.90, RMSEA ​= ​0.067). In the subscale of unmet work and financial needs, 4 items had a factor loading lower than 0.4, which were omitted from the Persian version. The results revealed a significant difference in the unmet needs and quality of life of patients with cancer (P ​< ​0.001).

Conclusions

The Persian version of SF-SUNS has desirable psychometric properties. It can be used to design and assess interventions to improve the quality of caring, cancer management, and as well as interaction between patients and healthcare providers.

Domestic violence against women, Mashhad, Islamic Republic of Iran: a grounded theory study

Background: Although a silent phenomenon, violence against women has been well studied. Such violence is a universal problem with different regional and cultural patterns; it imposes heavy costs on society. Aims: This study aimed to assess the circumstances and features of domestic violence against women in Mashhad, Islamic Republic of Iran. Methods: This was a qualitative study using the grounded theory approach. Individual semi-structured interviews were held with 24 purposely selected women who had experienced domestic violence and who had gone to the Legal Medicine Organization of Mashhad for help. Data were analysed according to grounded theory. Findings: From analysis of the interview data, seven main categories emerged: risk factors of violence; protective factors against violence; excuses for violence; behavioural and cultural challenges in men; inevitable adjustment; escalation of violence; and presenting to legal medicine organizations. Constant comparative analysis of the data led to the identification of inevitable adjustment as the core variable of the study. Discussion: Inevitable adjustment was the main strategy of women to deal with domestic violence against them. Promoting respect for the universal human rights of women, strengthening the network of services and social support for women and enforcing legal protection are necessary to reduce violence against women.

The Effects of Meaning-centered Play on Spiritual Sensitivity of Children: A Randomized Controlled Trial

BACKGROUND

Spiritual sensitivity is the child's ability to be spiritually aware of what is happening both outside and within him or herself, and the further ability to respond accordingly. On the other hand, play is one of the strategies to develop children's capabilities. Yet, there is limited information about the relationship of play and spiritual sensitivity. The present study aimed to evaluate the effects of meaning-centered play on children's spiritual sensitivity.

METHODS

This two-group randomized controlled trial was conducted on 120 children aged 10-11 who were recruited from two centers affiliated to the institute for intellectual development in Mashhad, Iran, by convenience sampling between May 2016 to January 2018. Samples were allocated to intervention (60) and control (60) groups through random allocation. In the intervention group, a meaning-centered play intervention was implemented in twelve 45-minute sessions, twice a week and for six weeks. The control group had the usual trend of the center's plays and programs. Spiritual sensitivity was measured via the Spiritual Sensitivity Scale for Children (SSSC) before and after the end of the intervention. The data were analyzed via the SPSS software (v. 20.0) using Chi-square, independent-sample t test, Mann-Whitney U and Wilcoxon signed-rank tests. The significance level was less than 0.05.

RESULTS

Although the groups did not significantly differ from each other concerning the pretest mean scores of spiritual sensitivity and its subscales (P>0.05), the posttest values of these scores in the intervention group were significantly greater than the control group (P<0.05). After the intervention, the mean scores of spiritual sensitivity significantly increased in the intervention group (Before: 65.0±13.6, after: 79.4±12.3, P<0.001), but no significant increase was observed in the control group (Before: 66.7±14.6, after: 67.4±12.3, P=0.604).

CONCLUSION

According to the results, it can be suggested that meaning-centered play program can be used in play room in schools, child care centers and hospitals to improve the spiritual sensitivity among children.

TRIAL REGISTRATION NUMBER

IRCT2017022232733N.

Health-Promoting Lifestyle in Colorectal Cancer Survivors: A Qualitative Study on the Experiences and Perspectives of Colorectal Cancer Survivors and Healthcare Providers

OBJECTIVE

Understanding the experiences of survivors and healthcare providers about health-promoting lifestyle (HPL) in colorectal cancer (CRC) survivors is important in planning for coping with the disease, managing treatment side effects, increasing survival, and improving quality of life (QOL). This study was conducted to explore the experiences and perspectives of CRC survivors and healthcare providers about HPL in CRC survivors.

METHODS

This descriptive qualitative study was performed in 2020 at Omid and Imam Reza Hospitals in Mashhad, Iran. Participants were CRC survivors (n = 12) and healthcare providers (n = 33) who were selected by purposive sampling. Data were collected using in-depth semi-structured interview by face to face and then analyzed by Zhang and Wildemuth content analysis method. MaxQDA software was used to organize the data.

RESULTS

Following the treatment of cancer, CRC survivors seek to make changes in lifestyle and they choose a HPL that maintains or improves their health. HPL in CRC survivors includes nutrition, activity and rest, health responsibility, interpersonal relations, spiritual growth, and psychological management. The results showed that HPL can lead to motivation, the ability to self-care and improve daily performance, reduce treatment complications, and increase the QOL.

CONCLUSIONS

CRC survivors can help change their lifestyle patterns with healthy eating, treatment adherence, regular physical activity, and good sleep habits. Furthermore, effective personal and social relationships, spiritual growth, and management of psychological disorders develop health-promoting behaviors in them. CRC survivors also face challenges and limitations in their life after treatment; identifying the components of a HPL in CRC survivors can lead to desirable care, treatment, education, and counseling services.

Oropharyngeal Decontamination for Prevention of VAP in PatientsAdmitted to Intensive Care Units: A Systematic Review

AbstractIntroduction: Oropharyngeal colonization with pathogenic organisms contributes to thedevelopment of ventilator-associated pneumonia (VAP) in intensive care units (ICUs). Oralhygiene care (OHC) is a very effective method for reducing the risk of VAP in these patients.This study aimed to evaluate recent OHC strategies to decrease VAP.Methods: Randomized clinical trials (RCTs) published in the PubMed, Scopus, Embase,Cochrane Library, and Web of Science databases from inception to September 10, 2020 werereviewed to compare the effects of selective oropharyngeal decontamination (SOD) on theincidence of VAP in adult patients requiring mechanical ventilation.Results: Out of a total of 1098 articles reviewed, 17 eligible studies were included for finalanalysis. The results showed that the use of chlorhexidine for oropharyngeal decontaminationreduces the incidence of VAP. However, it had a small effect on gram-negative resistant bacteria.Also, it was observed that the combined use of colistin and chlorhexidine was more effectivethan chlorhexidine alone in preventing VAP. The results of studies on the use of toothbrushes toreduce the incidence of pneumonia are unclear since they used chlorhexidine at the same time.However, tooth brushing is one of the best ways to maintain oral hygiene. Using povidoneiodine,Nanosil, and non-absorbable topical antibiotics reduced the incidence of VAP, whileIseganan did not show a significant effect in this regard.Conclusion: The prophylactic use of topical bactericidal agents in critically-ill patients is effectivein reducing the incidence of VAP. However, the use of non-absorbable topical antibiotics ismore effective than other methods in oropharyngeal decontamination.

Developing an SDSS for optimal sustainable roof covering planning based on UHI variation at neighborhood scale

Nowadays, academics have paid special attention to global warming, because it has several issues such as urban heat island (UHI) related to the quality of life. For this purpose, a spatial decision support system (SDSS) has been developed to investigate the effect of parcels' roof covering type on surface heat island (SHI) values and its variation at the neighborhood scale in Tehran, Iran. This SDSS, as the innovation of the present research, consists of two main steps including estimating the UHI value in the study area and adopting the optimum set of parcels to change their roofs' cover with three types of vegetation, high-albedo material, and flagstone. The first step is accomplished by aggregating various indices related to land cover obtained from Landsat 8 images. The aggregation is done by linear regression method (LRM) with an RMSE and R² equal to 0.942 and 0.897, respectively. Then, the genetic algorithm was used to select the optimal subset, including 10% of the parcels in the area, to change their roof covering type based on minimizing the UHI's variation. The standard deviation obtained after the changes improved from 13.222 to 10.781 °C. The results indicate that to control UHI in the center of the region, it is necessary to inhibit UHI effects at the boundary of the study area with vegetation roof covering since flagstone and high-albedo materials have local effects on controlling the UHI effects.

The Effect of Home Visit Program Based on the Continued Kangaroo Mother Care on Maternal Resiliency and Development of Premature Infant: A Randomized Clinical Trial

BACKGROUND

Premature birth is a crisis for mothers and affects resilience. Premature babies are at risk for developmental disorders. The Kangaroo Mother Care (KMC) can reduce maternal stress and improve the growth of the baby. This study aimed at assessing the effect of home visit based on the continued KMC on maternal resiliency and development of premature infant.

METHODS

This randomized controlled trial conducted on 50 pairs of mothers and premature babies with gestational age of 26-32 weeks who were admitted to Neonatal Intensive Care Unit of Om-al-Banin Hospital, Mashhad, Iran in 2019. The KMC is practiced routinely for all eligible newborns in this hospital. The experimental group continued the KMC one month after discharge at home and received two home visits. Resiliency of the mothers was assessed in admission, discharge, and one month after discharge with the Connor and Davison questionnaire and the development of the newborns was assessed in two months of adjusted age with Ages and Stages Questionnaire (ASQ). Data analysis was performed using SPSS software version 16 and t-test, Mann-Whitney, ANOVA, Friedman, Chi-square, Fishers exact. The significance level was set at P<0.05.

RESULTS

The resiliency score of the mothers one month after discharge was112.50±5.50 and 76.40±5.60 in the experimental and control groups, which was significantly different (P<0.001). The ASQ development score of the newborns in two months of adjusted age was also significantly higher in the experimental than the control group (280.40±15.60vs223.80±22.00) (P<0.001).

CONCLUSION

The results showed that the home visit program based on the continued KMC was effective in increasing maternal resilience and the development of premature infants. Trial Registration Number IRCT20181121041718N1.

The effect of applying Spiritual Care Model on well-being and quality of care in cancer patients

PURPOSE

The study was an attempt to explore the effect of applying spiritual model of nursing care on spiritual well-being and quality of spiritual care in cancer patients.

METHOD

A quasi-experimental study, the present inquiry was carried out with control and intervention groups with participation of 72 patients and 63 nurses in an advanced center in Iran. The Spiritual Care Model (SCM) was designed by the researchers in this study and was performed on the intervention group by nurses after they received proper training. The data were collected using Demographic Information Questionnaire, Spiritual Well-Being Scale (SWBS), and Spiritual Care Delivery Rating Scale (SCDRS) in pre-intervention and post-intervention stages and were analyzed with SPSS v.16.

RESULTS

Before the intervention, the means for spiritual well-being and the quality of spiritual care were not significantly different for the intervention and control groups (p < 0.05). After the intervention, i.e., upon discharge from the hospital, the mean of spiritual well-being in the intervention group was significantly higher than that of the control group (p < 0.001). Based on the opinions of both nurses and patients, the mean of the spiritual care quality was significantly higher in the intervention group in comparison to that in the control group once the intervention was over (p < 0.001).

CONCLUSION

Given the positive effect of the SCM on enhancing the spiritual care quality and improving the patients' spiritual well-being, it is recommended that the SCM be used as a proper guideline and as a model for boosting nurses' professional performance in spiritual care.

Spiritual care interventions in nursing: an integrative literature review

As an important part of the holistic care, spiritual care is considered an indicator of care quality. This study aims to identify and characterize nursing spiritual care interventions. In order to identify and select resources, an integrative review was done. The search was conducted in national and international databases such as Google Scholar, Scopus, INML, Iran Medex, Iran Doc, Web of Science, Wiley, SID, ProQuest, Ovid, Science Direct, PubMed, ebrary, Sage, CINAHL, and Magiran from 1994 to 2018. As a result, 1625 articles were detected, 59 of which were included in synthesis. Data extraction and analysis presented eight categories of spiritual care interventions in the field of nursing including (1) the exploration of spiritual perspective, (2) healing presence, (3) the therapeutic use of self, (4) intuitive sense, (5) patient-centeredness, (6) meaning-centered therapeutic interventions, (7) the creation of a spiritually nurturing environment, and (8) the documentation and evaluation of spiritual care.

Medullary thyroid cancer is associated with high serum vitamin D level and polymorphism of vitamin D receptors

Background

Thyroid cancer is the most common endocrine malignancy. Studies have observed an anti-cancer effect for vitamin D and found that polymorphisms of vitamin D receptors can influence the prevalence of various cancers. The present study investigated the serum level of vitamin D and FokI, BsmI and Tru9I polymorphisms of vitamin D receptors.

Methods

Forty patients with medullary thyroid cancer and 40 healthy controls were investigated. The genomic DNA of the subjects was extracted using saturated salt/proteinase K and investigated by PCR sequencing. Serum levels of vitamin D were evaluated by ELISA. The results were analyzed in SPSS and GraphPad Prism 5 software.

Results

The genotypic and allelic frequencies of FokI and BsmI polymorphisms showed no significant differences between test and control groups. For Tru9I polymorphism, Tt genotype and t allelic frequency in the test group were significantly different from those of the control group. Also, we found Tt genotype and t allelic frequency to be significantly associated with medullary thyroid cancer (MTC) type and the agressiveness of the disease. The average serum vitamin D level was 23.32 ng/mL and 18.95 ng/mL for patients and controls, respectively, and the difference between the two groups was statistically significant. Moreover, we found high serum vitamin D level to be associated with t allelic frequency.

Conclusions

Unexpectedly, the mean serum vitamin D level of the test group was significantly higher than that of the control group. Tru9I polymorphism was found to be significantly correlated with the prevalence of medullary thyroid carcinoma.

Effects of Stachys sylvatica hydroalcoholic extract on the ovary and hypophysis-gonadal axis in a rat with polycystic ovary syndrome

Background

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women. The purpose of this study is to evaluate the effects of Stachys sylvatica hydroalcoholic extract on biochemical and histological parameters in a rat model of polycystic ovary syndrome. Thirty adult female Wistar rats with an average weight of 180 g were divided into five groups of six rats. Animals were divided into groups of control, PCOS (intramuscular injection of 2 mg estradiol valerate, Aburaihan Co., Iran/rat, once), and treated with hydroalcoholic extract of Stachys sylvatica. After 60 days of PCOS induction, 100, 250, and 500 mg/kg BW Stachys sylvatica hydroalcoholic extract were injected intraperitoneally. The control group was just injected with olive oil as a solvent. After 10 days of treatment, animals were weighed and then sacrificed and blood samples were taken from their heart for hormonal studies. Ovaries of all groups were cut for histological studies and fixed in formaldehyde, and 7-μm sections were prepared by microtome and stained using hematoxylin–eosin. The data were analyzed by one-way ANOVA and Tukey-Kramer post hoc test with the SPSS software. The significant level was p < 0.05.

Results

The Stachys sylvatica extract can improve obesity in the PCOS group. The histological and hormonal results showed that PCOS induction can decrease the number of preantral, antral, and Graafian follicles as well as corpus luteum in comparison with the control (p < 0.001), whereas the number of cystic follicles increased significantly (p < 0.001). After treatment with Stachys sylvatica hydroalcoholic extract (500 mg/kg), a significant increase was observed in all these parameters. In addition, the number of cystic follicles decreased significantly (p < 0.001). The level of LH and FSH hormones decreased significantly (p < 0.01) in the PCOS group compared with the control. In contrast, the estrogen level increased significantly (p < 0.01). In the 250 and 500 mg/kg group, treatment with the extract could increase FSH and decrease estrogen concentration significantly relative to the PCOS group (p < 0.01). Results of antral follicle morphometry indicated an increase in follicle diameter and theca thickness, but the thickness of the granulosa layer decreased significantly. An improvement in these measurements was observed in the treated PCOS groups with all doses.

Conclusions

It can be concluded that Stachys sylvatica hydroalcoholic extract can improve some symptoms of polycystic ovary syndrome because of components such as iridoids, flavonoids, and sesquiterpenes with antioxidant and anti-inflammatory effects. In this experiment, 500 mg/kg dose of extract was considered as the most effective dose.

Antibody-Mediated Resistance to Rhizomania Disease in Sugar Beet Hairy Roots

Agrobacterium rhizogenes-mediated transformation of sugar beet hairy roots expressing single-chain variable fragment (scFv) was exploited to evaluate the efficacy of four antibody-based constructs for interfering with the Beet necrotic yellow vein virus infection. The scFv specific to a major coat protein of virus, p21, was targeted to various cellular compartments including the cytosol (pIC and pICC constructs), apoplast (pIA), and mitochondrion (pIM). After mechanical virus inoculation, most of the hairy root clones expressing scFv in the cytosol displayed low virus titers while the majority of transgenic hairy root clones accumulated antibody in outer membrane of mitochondria or apoplast were infected. This hairy root system provided an efficient and rapid approach to initially investigating root disease resistance like rhizomania prior to transform whole recalcitrant plants such as sugar beet.

Fluctuation relation for heat exchange in Markovian open quantum systems

A fluctuation relation for the heat exchange of an open quantum system under a thermalizing Markovian dynamics is derived. We show that the probability that the system absorbs an amount of heat from its bath, at a given time interval, divided by the probability of the reverse process (releasing the same amount of heat to the bath) is given by an exponential factor which depends on the amount of heat and the difference between the temperatures of the system and the bath. Interestingly, this relation is akin to the standard form of the fluctuation relation (for forward-backward dynamics). We also argue that the probability of the violation of the second law of thermodynamics in the form of the Clausius statement (i.e., net heat transfer from a cold system to its hot bath) drops exponentially with both the amount of heat and the temperature differences of the baths.

Vaccination with human amniotic epithelial cells confer effective protection in a murine model of Colon adenocarcinoma

As a prophylactic cancer vaccine, human amniotic membrane epithelial cells (hAECs) conferred effective protection in a murine model of colon cancer. The immunized mice mounted strong cross-protective CTL and antibody responses. Tumor burden was significantly reduced in tumor-bearing mice after immunization with hAECs. Placental cancer immunotherapy could be a promising approach for primary prevention of cancer. In spite of being the star of therapeutic strategies for cancer treatment, the results of immunotherapeutic approaches are still far from expectations. In this regard, primary prevention of cancer using prophylactic cancer vaccines has gained considerable attention. The immunologic similarities between cancer development and placentation have helped researchers to unravel molecular mechanisms responsible for carcinogenesis and to take advantage of stem cells from reproductive organs to elicit robust anti-cancer immune responses. Here, we showed that vaccination of mice with human amniotic membrane epithelial cells (hAECs) conferred effective protection against colon cancer and led to expansion of systemic and splenic cytotoxic T cell population and induction of cross-protective cytotoxic responses against tumor cells. Vaccinated mice mounted tumor-specific Th1 responses and produced cross-reactive antibodies against cell surface markers of cancer cells. Tumor burden was also significantly reduced in tumor-bearing mice immunized with hAECs. Our findings pave the way for potential future application of hAECs as an effective prophylactic cancer vaccine.

The grounded theory of "trust building"

BACKGROUND

Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers.

OBJECTIVE

To develop a grounded theory about spiritual care delivery based on Iranian nurses' perceptions and experiences.

A GROUNDED THEORY APPROACH

A qualitative study using the grounded theory approach.

PARTICIPANTS AND RESEARCH CONTEXT

Data were collected through holding 27 interviews with 25 participants (17 staff nurses, 3 physicians, 3 patients, 1 family member, and 1 nurse assistant). The study setting was the Imam Khomeini Hospital Complex. Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin.

ETHICAL CONSIDERATION

The study was approved by the Ethics Committee of Tarbiat Modares University and the agreement of the administrators of the study setting was got before starting the study.

RESULTS

The core category of the study was "Trust building" which reflected the nature of spiritual care delivery by nurses. Trust building was the result of eight main categories or strategies including creating a positive mentality at hospital admission, understanding patients in care circumstances, having a caring presence, adhering to care ethics, developing meaningful relationships, promoting positive thinking and energy, establishing effective communication with patients, and attempting to create a safe therapeutic environment. Poor interprofessional coordination negatively affected this process while living toward developing greater cognizance of divinity and adhering to the principles of professional ethics facilitated it. The outcome of the process was to gain a sense of partial psychological security.

CONCLUSION

The "Trust building" theory can be used as a guide for describing and expanding nurses' roles in spiritual care delivery, developing care documentation systems and clinical guidelines, and planning educational programs for nursing students and staff nurses.

Promising gene delivery system based on polyethylenimine-modified silica nanoparticles

This article reports on the synthesis and full characterization of innovative silica-based nanoparticle composed of fumed silica as a core decorated with polyethylenimine (PEI) with different molecular weights (25, 10 and 1.8 kDa). Wide range of analytical, spectroscopic, and microscopic methods (TEM, DLS, ζ potential, elemental analysis (EA), TNBS and FTIR) were used to characterize the nanoparticles. Furthermore, transfection efficiency of these nanoparticles as non-viral vector was examined. The silica-PEI conjugates retained both the ability of PEI to fully condense plasmid DNA at low N/P ratios and suitable buffering capacity at the endosomal pH range. PEI-functionalized silica remarkably enhanced EGFP-N1 gene expression in murine neuroblastoma (Neuro-2A) cells up to 38 folds compared to PEI 25 kDa. Meanwhile the results of the cytotoxicity assays indicated that these silica-PEI conjugates have acceptable level of viability.

Catalysts to Spiritual Care Delivery: A Content Analysis

Background:

Despite the paramount importance and direct relationship of spirituality and spiritual care with health and well-being, they are relatively neglected aspects of nursing care.

Objectives:

The aim of this study is to explore Iranian nurses’ perceptions and experiences of the facilitators of spiritual care delivery.

Materials and Methods:

For this qualitative content analysis study, a purposive maximum-variation sample of 17 nurses was recruited from teaching and private hospitals in Tehran, Iran. Data were collected from 19 individual, unstructured interviews. The conventional content-analysis approach was applied in data analysis.

Results:

The facilitators of spiritual care delivery fall into two main themes: living to achieve cognizance of divinity and adherence to professional ethics. These two main themes are further divided into eight categories: spiritual self-care, active learning, professional belonging, personal and professional competencies, gradual evolution under divine guidance, awareness of the spiritual dimension of human beings, occurrence of awakening flashes and incidents during life, and congruence between patients’ and healthcare providers’ religious beliefs.

Conclusions:

The study findings suggest that the facilitators of spiritual care delivery are more personal than organizational. Accordingly, strategies to improve the likelihood and quality of spiritual care delivery should be developed and implemented primarily at the personal level.

Proteomics screening of adenosine triphosphate-interacting proteins in the liver of diazinon-treated rats

AIM

Diazinon (DZN) is one of the most important organophosphorus compounds used to control pests in agriculture in many countries. Several studies have shown that exposure to DZN may alter protein expression in the liver. In order to further investigate the mechanism of DZN toxicity, differentially expressed ATP-interacting proteins, following subacute exposure to toxin, were separated and identified in rat liver.

MAIN METHODS

Male rats were equally divided into four groups: control (corn oil) and DZN (15 mg/kg) by gavage once a day for 4 weeks. After homogenization of liver tissue, lysates were incubated ATP-sepharose beads. After several washes, ATP-interacting proteins were eluted and separated on 2-D polyacrylamide gels. Deferentially expressed proteins were cut and identified using matrix-assisted laser desorption/ionization/time-of-flight and Mascot database. Identified proteins were classified according to their biological process using protein analysis through evolutionary relationships (PANTHER) Web site.

KEY FINDING

In this work, we showed that several key proteins involved in biological processes such as antioxidant system, oxidative stress, apoptosis, and metabolism were differentially expressed after subacute exposure to DZN.

Identification of possible cytotoxicity mechanism of polyethylenimine by proteomics analysis

Polyethylenimine (PEI) is a polycation widely used for successful gene delivery both in vitro and in vivo experiments. However, different studies showed that PEI could be cytotoxic to transfected cells, and the mechanism of toxicity is poorly understood. Identification of PEI-interacting proteins may help in understanding the toxicity pathways. In this study, we investigated proteins that could interact with PEI in human colorectal adenocarcinoma cells (HT29). In order to identify the proteins interacting with PEI, PEI was immobilized to sepharose beads as solid matrix. The HT29 cell lysate were passed through the matrix. PEI-bound proteins were isolated, and further separation was performed by two-dimensional gel electrophoresis. After gel digestion, proteins were identified by matrix-assisted laser desorption/ionization-time-of-flight (TOF)/TOF mass spectrometry. Our data indicated that most of the identified PEI-interacting proteins such as shock proteins, glutathione-S-transferases, and protein disulfide isomerase are involved in apoptosis process in cells. Thus, although this is a preliminary experiment implicating the involvement of some proteins in PEI cytotoxicity, it could partly explain the mechanism of PEI cytotoxicity in cells.

Joint sparse representation of brain activity patterns in multi-task fMRI data

A single-task functional magnetic resonance imaging (fMRI) experiment may only partially highlight alterations to functional brain networks affected by a particular disorder. Multivariate analysis across multiple fMRI tasks may increase the sensitivity of fMRI-based diagnosis. Prior research using multi-task analysis in fMRI, such as those that use joint independent component analysis (jICA), has mainly assumed that brain activity patterns evoked by different tasks are independent. This may not be valid in practice. Here, we use sparsity, which is a natural characteristic of fMRI data in the spatial domain, and propose a joint sparse representation analysis (jSRA) method to identify common information across different functional subtraction (contrast) images in data from a multi-task fMRI experiment. Sparse representation methods do not require independence, or that the brain activity patterns be nonoverlapping. We use functional subtraction images within the joint sparse representation analysis to generate joint activation sources and their corresponding sparse modulation profiles. We evaluate the use of sparse representation analysis to capture individual differences with simulated fMRI data and with experimental fMRI data. The experimental fMRI data was acquired from 16 young (age: 19-26) and 16 older (age: 57-73) adults obtained from multiple speech comprehension tasks within subjects, where an independent measure (namely, age in years) can be used to differentiate between groups. Simulation results show that this method yields greater sensitivity, precision, and higher Jaccard indexes (which measures similarity and diversity of the true and estimated brain activation sources) than does the jICA method. Moreover, superiority of the jSRA method in capturing individual differences was successfully demonstrated using experimental fMRI data.

Evaluation of Protein Ubiquitylation in Heart Tissue of Rats Exposed to Diazinon (an Organophosphate Insecticide) and Crocin (an Active Saffron Ingredient): Role of HIF-1α

INTRODUCTION

Organophosphate compounds, such as diazinon (DZN), are widely used in agriculture and can lead to formation of reactive oxygen species (ROS) in cardiovascular system. ROS are highly toxic since they can cause serious changes in proteins including ubiquitylation. Crocin (a carotenoid isolated from saffron), has protective effects against DZN cardiotoxicity. In this study level of total protein ubiquitylation as markers of oxidative stress and level of ubiquitin-HIF-1α and P53, known substrates of ubiquitylation, in rat hearts exposed to DZN and crocin were evaluated.

METHODS

Rats were divided into 7 groups: corn oil (control), DZN (15 mg/kg/day, gavage), crocin (12.5, 25, 50 mg/kg/day, i. p.) plus DZN, vitamin E (200 IU/kg, i. p., 3 days a week) plus DZN and crocin (50 mg/kg/day, i. p.). Treatments were continued for 4 weeks. Total protein ubiquitylation, total HIF-1α and P53 were analyzed by western blotting. Total HIF-1α and P53 were purified by immunoprecipitation (IP) and ubiquitin- HIF-1α and P53 were analyzed by western blotting.

RESULTS

Higher protein ubiquitylation levels were observed in DZN treated rats. Decrease in ubiquitin-HIF-1α was also shown, and leads to higher HIF-1α protein levels in DZN group. Crocin (50 mg/kg) and vit. E protected cells against DZN protein ubiquitylation. Significant differences were not observed between the ubiquitin - P53 and total P53 protein levels.

CONCLUSION

Our results showed that ubiquitylation could be considered as a marker of oxidative stress in rats exposed to DZN. Increase in level of HIF-α may compensate adverse effect of DNZ in rat heart.

Tailor-made directional emission in nanoimprinted plasmonic-based light-emitting devices

We demonstrate an enhanced and tailor-made directional emission of light-emitting devices using nanoimprinted hexagonal arrays of aluminum nanoparticles. Fourier microscopy reveals that the luminescence of the device is not only determined by the material properties of the organic dye molecules but is also strongly influenced by the coherent scattering resulting from periodically arranged metal nanoparticles. Emitters can couple to lattice-induced hybrid plasmonic-photonic modes sustained by plasmonic arrays. Such modes enhance the spatial coherence of an emitting layer, allowing the efficient beaming of the emission along narrow angular and spectral ranges. We show that tailoring the separation of the nanoparticles in the array yields an accurate angular distribution of the emission. This combination of large-area metal nanostructures fabricated by nanoimprint lithography and light-emitting devices is beneficial for the design and optimization of solid-state lighting systems.

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.

Identification and determination of the fatty acid composition of Quercus brantii growing in southwestern Iran by GC-MS

This article reports the fatty acid composition of the oil extracts from Quercus brantii fruits growing in Kohgiloye va Boyer Ahmad province in southwestern Iran. The oil from Q. brantii fruits was extracted with hexane in Soxhlet apparatus and subsequently identified and determined by using gas chromatography-mass spectroscopy. The results revealed that the major fatty acids were oleic acid (52.99-66.14%), linoleic acid (10.80-11.11%), palmitic acid (8.08-10.06%), stearic acid (0.74-1.57%), α-linolenic acid (0.19-0.35%), erucic acid (0.12-0.15%) and arachidic acid (0.12-0.13%). The total proportion of unsaturated and saturated oil was 64.60-77.27% and 9.17-11.75%, respectively. Results indicate that the fruits of Q. brantii contained 0.19-0.35% omega-3, 10.92-14.77% omega-6 and 53.14-66.26% omega-9. Therefore, Q. brantii can be introduced as rich sources of fatty acid in food dietary and medical health.

Classification of individuals based on sparse representation of brain cognitive patterns: a functional MRI study

Many neurological disorders can change patterns of brain activity observed in functional imaging studies. These functional differences may be useful for classification of individuals into diagnostic categories. However, due to the high dimensionality of the input feature space and small set of subjects that are usually available, classification based on fMRI data is not trivial. Here, we evaluate the use of a Sparse Representation Analysis method within a Fisher Linear Discriminant (FLD) classification method, taking functional patterns characteristic of different cognitive tasks as the data input. As a test dataset, with a clear 'gold-standard' classification, we attempt to classify individuals as young, or older, based only on functional activation patterns in a speech listening task. Thirty two young (age: 19-26) and older (age: 57-73) adults (16 each) were scanned while listening to noise and to sentences degraded with noise, half of which contained meaningful context that could be used to enhance intelligibility. Different functional contrast images were used within K-SVD to generate basis activation sources and their corresponding sparse modulation profiles. Sparse modulation profiles were used in a FLD framework to classify individuals into the young and older categories. The results demonstrate the feasibility of the general approach, and confirm the potential applicability of the proposed method for real-world diagnostic problems.

Haloarchaeobius iranensis gen. nov., sp. nov., an extremely halophilic archaeon isolated from a saline lake

Strain EB21T was isolated from a brine sample from Aran-Bidgol salt lake, a saline playa in Iran. Strain EB21T was an orange–red-pigmented, motile rod and required at least 2 M NaCl but not MgCl2 for growth. Optimal growth was achieved at 3.5 M NaCl and 0.2 M MgCl2. The optimum pH and temperature for growth were pH 7.5 and 40 °C, while it was able to grow at pH 6.0–8.0 and 25–55 °C. Analysis of the 16S rRNA gene sequence revealed that strain EB21T is a member of the family Halobacteriaceae , showing low levels of similarity to other members of the family. The highest sequence similarities, 91.8, 91.7 and 91.5 %, were obtained with the 16S rRNA gene sequences of the type strains of Halobiforma lacisalsi , Haloterrigena thermotolerans and Halalkalicoccus tibetensis , respectively. Polar lipid analyses revealed that strain EB21T contains phosphatidylglycerol, phosphatidylglycerol phosphate methyl ester and phosphatidylglycerol sulfate. Three unidentified glycolipids and one minor phospholipid were also observed. The only quinone present was MK-8(II-H2). The G+C content of its DNA was 67.7 mol%. On the basis of the data obtained, the new isolate could not be classified in any recognized genus. Strain EB21T is thus considered to represent a novel species in a new genus within the family Halobacteriaceae , order Halobacteriales , for which the name Haloarchaeobius iranensis gen. nov., sp. nov. is proposed. The type strain of Haloarchaeobius iranensis is EB21T ( = IBRC-M 10013T  = KCTC 4048T).

Modified polyethyleneimine with histidine-lysine short peptides as gene carrier

There are several strategies that can be utilized to improve transfection efficiency while reducing the cytotoxicity of polyethyleneimine (PEI) as a promising non-viral gene delivery vector. In this study, we evaluated the potential use of lysine-histidine (KH) peptides in modifying the PEI 10 kDa structure and enhancing its efficiency while maintaining low toxicity of PEI. PEI 10 kDa was modified with 6-bromohexanoic acid (alkyl) to increase its lipophilicity. Then, ethylenediamine (EDA) was attached to the carboxylic groups of PEI-hexanoate to restore the primary amines of PEI. Subsequently, six different KH short peptides were conjugated to PEIs and evaluated for the effect of the KH sequence on vector transfection efficiency and cytotoxicity. The transfection efficiency of PEI-peptides complexed with a luciferase reporter gene (pRLCMV) in Neuro-2A murine neuroblastoma cells showed that the PEI conjugated to KHHHKKHHHK peptide had a significantly higher rate of gene transfection efficiency in comparison with other KH peptides. This peptide was conjugated to PEI-alkyl and PEI-alkyl-EDA and significant improvement in efficiency with minimal cytotoxicity was observed. The results obtained suggest that the sequence and content of KH peptides will have a significant impact on the transfection efficiency of modified PEI 10 kDa.

Molecular analysis of MEN1 expression in MCF7, T47D and MDA-MB 468 breast cancer cell lines treated with adriamycin using RT-PCR and immunocytochemistry

BACKGROUND AND THE PURPOSE OF THE STUDY

MEN1 is an important tumor suppressor gene that encodes a nuclear protein called menin. Recent data suggest that interactions between menin and other proteins have important roles in control of the cell cycle and apoptosis. In addition, estrogen receptor (ER), an important prognostic factor is differentially expressed in breast cancer cells. In this study the MEN1 gene and protein expression in MCF7, T47D and MDA-MB-468 breast cancer cell lines with different ER status following exposure to adriamycin (ADR) was investigated.

MATERIALS AND METHODS

Cytotoxicity of ADR on these cell lines was determined using MTT assay. The mRNA and protein levels were analyzed in tested cell lines using RT-PCR and immunocytochemistry (ICC) assays, respectively.

RESULTS

ADR cytotoxicity was highest on MDA-MB-468 and lowest on MCF7 cells. MEN1 mRNA showed significant decrease after ADR exposure only in the MDA-MB-468 cell line. Menin protein expression was higher in MDA-MB-468 and lower in MCF7 cells.

CONCLUSION

Differential molecular responses to adriamycin were observed in cancer cell lines. Molecular data also suggest that MEN1 as a new biomarker can be used in combination with current biomarkers for prediction of response to chemotherapy.