Through the eyes of nurses: a content analysis of nurses' experiences in caring for COVID-19 patients

BACKGROUND

In the current global climate, the nursing staff has placed a significant emphasis on developing effective self-protection strategies and implementing measures to prevent the transmission of infectious diseases, with a particular focus on the highly communicable COVID-19 virus. Ensuring the safety and well-being of both healthcare providers and patients has made it imperative to incorporate this aspect into healthcare provision.

OBJECTIVE

The study aimed to describe the experiences of nurses in providing care for patients infected with COVID-19.

METHODOLOGY

This qualitative content analysis study, following COREQ guidelines, involved 18 nurses who were taking care of COVID-19 patients at Shahid Mohamadi Hospital, a general hospital in Bandar Abbas, Hormozgan Province. The hospital is affiliated with Hormozgan University of Medical Sciences and the research was conducted in 2022.The sampling method was purposive, and unstructured interviews were used. Data collection continued until data saturation was achieved. Data analysis was performed continuously and concurrently through the collection of data using conventional content analysis methods.

FINDINGS

The qualitative analysis of the data revealed three main themes centered on challenges related to nurses' self-care, patient care, and the healthcare delivery system.

CONCLUSION

Overall, to address the challenges faced by healthcare providers caring for COVID-19 patients, their needs must be prioritized. This includes establishing a prepared healthcare system, implementing strategies to protect their well-being, and learning from their experiences for future disease outbreaks and disasters.

Nursing University Students' Experience of Online Education in COVID-19 Pandemic: A Content Analytic Study

COVID-19 pandemic and the consequent online mode of education have challenged the national educational system and higher education. Thus, the present research aimed to explore students' experience of the advantages and disadvantages of online education at Bandar Abbas University of medical sciences during the pandemic. The present qualitative research conducted a content analysis of 26 nursing students' experiences. The sampling method was purposive. Unstructured face-to-face interviews were conducted with participants of the study to collect the required data. The interview protocol was followed. The required social distance was kept, and the ethical code was adhered to. The participants were interviewed as already arranged at a place of convenience. The interviews took between 40 and 60 minutes, depending on the immediate condition. The data collection continued until data saturation. The data analysis led to the extraction of 5 themes and 8 categories, including teacher-student miscommunication, student-student miscommunication, evaluation issues, anxiety, distancing from active learning, materials/sources, lack of physical attendance, non-educational activities, and 22 subcategories. The present findings could help professors and education authorities to better understand students' expected learning and the challenges of online education. They could, thus, be better aware of the existing barriers and could better plan to remove them.

Bioreducible polyethylenimine core-shell nanostructures as efficient and non-toxic gene and drug delivery vectors

Low molecular weight branched polyethylenimine (LMW bPEIs 1.8 kDa) have received considerable attention for the fabrication of nucleic acid carriers due to their biocompatible and non-toxic nature. However, due to the inadequate nucleic acid complexation ability and transportation across the cell membrane, these show poor transfection efficacy, limiting their clinical applications. Therefore, to overcome these challenges, in this study, we have grafted bPEI 1.8 kDa with a disulfide bond containing hydrophobic moiety, 3-(2-pyridyldithio) propionic acid (PDPA), via amide linkages through EDC/NHS-mediated coupling to obtain N-[3-(2-pyridyldithio)] propionoyl polyethylenimine (PDPP) conjugates. The best formulation for nucleic acid transfection was evaluated after preparing a series of PDPP conjugates by varying the amount of PDPA. In an aqueous environment, these PDPP conjugates self-assembled to form spherical shaped core-shell PDPP nanostructures with size ranging from ∼188-307 nm and zeta-potential from ∼ +3 to +19 mV. The positively charged surface of the core-shell nanocomposites helps in the binding of plasmid DNA (pDNA), its transportation inside the cell, and protection against enzymes. Evaluation of PDPP/pDNA complexes on mammalian cells revealed that all these complexes showed significantly improved transfection efficacy without hampering cytocompatibility. Amongst all, the pDNA complex of PDPP-2 exhibited the best transfection efficiency (i.e. >6-fold) in comparison to pDNA complex of the native bPEI. The nanocomposites exhibited the redox responsive behavior advantageous for therapeutic delivery to the tumor cells. The core of the nanostructures facilitate the encapsulation of a hydrophobic model drug, ornidazole. In vitro drug release analysis showed a faster release rate in response to a reductant mimicking the cellular environment. Altogether, these nanostructures have great potential to co-deliver both drug and gene simultaneously in response to tumor cell reductive microenvironment in vitro and could be used as the next-generation delivery system.

Clinical relevance of nitrated beta 2-glycoprotein I in antiphospholipid syndrome: Implications for thrombosis risk

Β₂-Glycoprotein I (β₂GPI) is an important anti-thrombotic protein and is the major auto-antigen in the antiphospholipid syndrome (APS). The clinical relevance of nitrosative stress in post translational modification of β₂GPI was examined.The effects of nitrated (n)β₂GPI on its anti-thrombotic properties and its plasma levels in primary and secondary APS were determined with appropriate clinical control groups. β2-glycoprotein I was nitrated at tyrosines 218, 275 and 309. β₂-glycoprotein I binds to lipid peroxidation modified products through Domains IV and V. Nitrated β₂GPI loses this binding (p < 0.05) and had diminished activity in inhibiting platelet adhesion to vWF under high shear flow (p < 0.01). Levels of nβ₂GPI were increased in patients with primary APS compared to patients with either secondary APS (p < 0.05), autoimmune disease without APS (p < 0.05) or non-autoimmune patients with arterial thrombosis (p < 0.01) and healthy individuals (p < 0.05).In conclusion tyrosine nitration of plasma β₂GPI is demonstrated and has important implications with regards to the pathophysiology of platelet mediated thrombosis in APS. Elevated plasma levels of nβ₂GPI in primary APS may be a risk factor for thrombosis warranting further investigation.

Low-Voltage Domain-Wall LiNbO3 Memristors

Application of conducting ferroelectric domain walls (DWs) as functional elements may facilitate development of conceptually new resistive switching devices. In a conventional approach, several orders of magnitude change in resistance can be achieved by controlling the DW density using supercoercive voltage. However, a deleterious characteristic of this approach is high-energy cost of polarization reversal due to high leakage current. Here, we demonstrate a new approach based on tuning the conductivity of DWs themselves rather than on domain rearrangement. Using LiNbO₃ capacitors with graphene, we show that resistance of a device set to a polydomain state can be continuously tuned by application of subcoercive voltage. The tuning mechanism is based on the reversible transition between the conducting and insulating states of DWs. The developed approach allows an energy-efficient control of resistance without the need for domain structure modification. The developed memristive devices are promising for multilevel memories and neuromorphic computing applications.

Bifunctionally engineered polyethylenimines as efficient DNA carriers and antibacterials against resistant pathogens

In this study, we have designed and developed two series of bifunctional conjugates by tethering polyethylenimine with streptomycin. By varying the amount of streptomycin, conjugates, polyethylenimine-streptomycin, have been synthesized and characterized spectroscopically. Gel electrophoresis assay revealed a slight decrease in the cationic charge density on the conjugates as these retarded the mobility of pDNA at higher w/w ratios. Further, transfection studies showed that both the series of conjugates transfected the mammalian cells efficiently with low-molecular weight polyethylenimine-streptomycin conjugates were more competent (∼9-fold enhancement with respect to native bPEI) exhibiting high cell viability too. Besides, both the series of conjugates displayed excellent antibacterial activity on pathogenic bacteria, even better than native streptomycin on resistant strains. Altogether, these results ensure the promising potential of the projected bifunctional conjugates as safe and efficient gene delivery vectors as well as antibacterials for future biomedical applications.

Quantification of NETs-associated markers by flow cytometry and serum assays in patients with thrombosis and sepsis

INTRODUCTION

Neutrophil extracellular traps (NETs) are networks of extracellular fibres produced from neutrophil DNA with a pathogenic role in infection, thrombosis and other conditions. Reliable assays for measuring NETs are desirable as novel treatments targeting NETs are being explored for the treatment of these conditions. We compare a whole blood flow cytometry method with serum assays to measure NETs-associated markers in patients with sepsis and thrombosis.

METHODS

Patients with deep venous thrombosis (n = 25), sepsis (n = 21) and healthy controls (n = 23) were included in the study. Neutrophil surface NETs markers were determined by flow cytometry on whole blood samples by gating of neutrophils stained for surface citrullinated histone (H3cit) and myeloperoxidase (MPO). Serum double-stranded (ds) DNA, MPO, myeloid-related protein, nucleosomes, DNAse, elastase, human high-mobility group box 1 and MPO-DNA complexes were quantified as circulating markers of NETs.

RESULTS

Neutrophil NETs markers by flow cytometry and serum NETs markers were significantly higher in patients with thrombosis and sepsis compared with healthy controls. Neutrophil NETs markers significantly correlated with the serum marker dsDNA.

CONCLUSION

Flow cytometry detection of neutrophil NETs markers is feasible in whole blood and correlates with serum markers of NETs. We propose the flow cytometry detection of MPO/H3cit positive neutrophils and serum dsDNA as simple methods to quantify cellular and extracellular NET markers in patients with thrombosis and sepsis.

The outcomes of peer-led diabetes education in comparison to education delivered by health professionals in Iranian patients

Education is an important aspect of care for diabetic patients. This study aimed to compare the effect of education by health care provider and peer on self-care behaviors among Iranian patients with diabetes. In this clinical randomized control trial, we enrolled 120 patients with type 2 diabetes who were referred to the Diabetes Clinic at a university medical center hospital in an urban area of Iran. Participants were randomly allocated into three groups. Patients in care provider group (CPG) received additional education provided by a nurse, other than routine education in a Diabetes Clinic. Patients in peer education group (PEG) received education given by a peer. Patients in control group (CG) received the routine education in accordance with the usual procedures at the Diabetes Clinic. Data collected at baseline and 12 weeks (3 months) were demographic variables and diabetes self-care activities. Self-care behaviors post intervention differed significantly by group; PEG patients demonstrated the greatest improvement. CG patients' self-care behaviors did not change significantly and were significantly lower than scores by CPG and PEG patients. In line with the World Health Organization recommendations, future studies are warranted to confirm the effectiveness of peer-led education among diabetic patients in the Iranian culture.

Application of the Betty Neuman systems model in the nursing care of patients/clients with multiple sclerosis

Objective

This study aimed to assess the application of the Betty Neuman systems model to the care of patient/clients with multiple sclerosis.

Methods

This clinical study resulted from the application of the nursing process to a patient/client admitted with multiple sclerosis in the neurological ward of a hospital in an urban area of Iran.

Results

A patient/client was evaluated according to the Neuman model. Intrapersonal stressors (physiological, psychological, socio-cultural, and spiritual), interpersonal stressors (being away from family and children) and extra-personal stressors (aggression and psychological pressure from the spouse) were found. Based on the examination, 12 nursing diagnoses based on the taxonomy of the North American Nursing Diagnosis Association International, and nursing care based on three levels of prevention that are important in the view of Neuman, are presented. The results were used in the classification of nursing interventions and the classification and nursing outcomes respectively.

Conclusions

The results suggest the desirability of care and patient/client satisfaction in the evaluation of nursing care based on the Neuman model. The model can be used as a framework to help nurses care for patients/clients. Thus, the application of this model and other models is recommended in the nursing care of patients/clients.

Effects of RF-EMF Exposure from GSM Mobile Phones on Proliferation Rate of Human Adipose-derived Stem Cells: An In-vitro Study

BACKGROUND

As the use of mobile phones is increasing, public concern about the harmful effects of radiation emitted by these devices is also growing. In addition, protection questions and biological effects are among growing concerns which have remained largely unanswered. Stem cells are useful models to assess the effects of radiofrequency electromagnetic fields (RF-EMF) on other cell lines. Stem cells are undifferentiated biological cells that can differentiate into specialized cells. Adipose tissue represents an abundant and accessible source of adult stem cells. The aim of this study is to investigate the effects of GSM 900 MHz on growth and proliferation of mesenchymal stem cells derived from adipose tissue within the specific distance and intensity.

MATERIALS AND METHODS

ADSCs were exposed to GSM mobile phones 900 MHz with intensity of 354.6 µW/cm² square waves (217 Hz pulse frequency, 50% duty cycle), during different exposure times ranging from 6 to 21 min/day for 5 days at 20 cm distance from the antenna. MTT assay was used to determine the growth and metabolism of cells and trypan blue test was also done for cell viability. Statistical analyses were carried out using analysis of one way ANOVA. P<0.05 was considered to be statistically significant.

RESULTS

The proliferation rates of human ADSCs in all exposure groups were significantly lower than control groups (P<0.05) except in the group of 6 minutes/day which did not show any significant difference with control groups.

CONCLUSION

The results show that 900 MHz RF signal radiation from antenna can reduce cell viability and proliferation rates of human ADSCs regarding the duration of exposure.

Electrodialysis heterogeneous ion exchange membranes modified by SiO2 nanoparticles: fabrication and electrochemical characterization

In the current study mixed matrix heterogeneous cation exchange membranes were prepared by solution casting technique. The effect of SiO(2) nanoparticles in the polymeric solution on the physicochemical properties of prepared membranes was studied. Scanning optical microscope images showed uniform particle distribution and relatively uniform surfaces for the prepared membranes. The membrane water content was reduced by silica nanoparticles in the membranes' matrix. The membrane ion exchange capacity, membrane potential, transport number and selectivity were improved initially by an increase of SiO(2) nanoparticles concentration up to 1%wt in prepared membranes and then showed a decreasing trend with a further increase in additive ratio from 1 to 4%wt. The ionic permeability and flux were also decreased initially by an increase of silica nanoparticles concentration up to 0.5%wt in the membrane matrix and then increased again with a further increase in nanoparticles concentration from 0.5 to 4%wt. Moreover, the results exhibited that using silica nanoparticles in the membrane matrix caused an obvious decrease in areal electrical resistance. The opposite trend was found for membrane mechanical strength using SiO(2) nanoparticles.

A numerical study on deformation of Newtonian droplets through converging cylindrical dies

In this work, the dynamic deformation of a viscose Newtonian droplet passing through cylindrical converging dies has been studied. The changes in the interfacial area between two immiscible Newtonian fluids have been considered as a variable representing the time-dependent deformation of a circular droplet along converging dies. To do so, a surface tracking method has been incorporated into a finite element code, developed by the authors, which quantifies the deformation of the droplet through the converging path, and where the surface area of the deformed drop has been consequently chosen as a criterion for a two-phase interface. In this study, it has been revealed that by changing both rheological and geometrical parameters it is possible to manage the value of interface area between two phases. Ultimately, a unique curve is developed for each droplet to primary phase viscosity ratio which can correlate drop deformation with geometrical parameters.

Polyurethane flexible foam fire resisting by melamine and expandable graphite: Industrial approach

According to importance of the safety issues especially in air industry, fire-resisted parts and interiors consumption are increasing. Seat foam has a huge fraction of the airplane interior and this makes it essential to become safer. From another point, planning to phase out some of the halogenated flame retardants because of persistence in the environment, bioaccumulation, and toxicity. In recent years, halogen-free fire retardants have been more investigated. In this work, we have concentrated more on two well-known, solid, halogen-free fire retardants, expandable graphite and melamine, and compared their performance according to their fire behavior, physical properties, and production phenomena.

In vitro and in vivo proliferation, differentiation and migration of cardiac endothelial progenitor cells (SCA1+/CD31+ side-population cells)

BACKGROUND

Side-population (SP) cells are a select population identified by a capacity to efflux Hoechst dye and are enriched for stem/progenitor cell activity. Previous studies suggested that cardiac SP (CSP) cells could be divided into SCA1(+)/CD31(-) and SCA1(+)/CD31(+) CSP cells. SCA1(+)/CD31(-) CSP cells have been shown to be cardiac stem/progenitor cells. However, SCA1(+)/CD31(+) CSP cells have not been fully characterized.

OBJECTIVE

The aim of the present study was to characterize SCA1(+)/CD31(+) CSP cells in the adult mouse heart, and investigate their abilities to proliferate, differentiate, vascularize and migrate in vitro and in vivo.

RESULTS

Using fluorescence-activated cell sorting (FACS), RT-PCR, and assays of cell proliferation, differentiation and migration, and a murine model of myocardial infarction (MI), we showed that SCA1(+)/CD31(+) CSP cells express stem cell and endothelial-specific genes, and reside in the blood vessels. These cells were able to proliferate, differentiate, migrate and vascularize in vitro and in vivo. After MI, SDF-1α and CXCR4 were up-regulated in the damaged myocardium and on SCA1(+)/CD31(+) CSP cells, respectively. Our results further showed that SDF-1α induced migration of these cells in vitro. Importantly, we found that SCA1(+)/CD31(+) CSP cells could migrate into the ischemic region from the non-ischemic area within the myocardium and form a vascular tube-like structure after MI.

CONCLUSIONS

Based on the gene expression profile, localization of SCA1(+)/CD31(+) CSP cells, and their ability to proliferate, differentiate, migrate and vascularize in vitro and in vivo, we postulate that SCA1(+)/CD31(+) CSP cells may represent endothelial progenitor cells in the mouse heart.

Effect of adding ketamine to pethidine on postoperative pain in patients undergoing major abdominal operations: a double blind randomized controlled trial

To determine the effect of adding ketamine to pethidine in reducing post-operative pain in patients undergoing major abdominal operations, in a double blind randomized controlled trial, 100 patients aged 15-60 years who were candidate for elective major abdominal surgery allocated into two groups of pethidine + ketamine group (5 mg pethidine and 0.25 mg kg(-1) ketamine) or pethidine and placebo group (10 mg pethidine and NS) according to the regimen prescribed in postanesthesia care unit. Severity of pain (using visual analogue scale), prescribed dose of pethidine and side effects were recorded until 24 h after operation. Regarding post-operative pain, pethidine + ketamine group showed significant lower scores in all the times except 0 min, 2, 6 and 16 h. Nausea was significantly less frequent amongst pethidine + placebo group at times of 0, 15, 30 and 45 min (p < 0.05). Comparison of two groups did not show significant differences in prescribed pethedine dose in 0, 9, 12, 16, 20 and 24 h (p > 0.05). Yet, the mean dose of administered pethidine as rescue analgesic was significant lower in pethidine + ketamine group compared to pethidine + placebo group (112 +/- 31.5 mg vs. 133.5 +/- 24.5 mg, p < 0.001). In conclusion, our results showed that co-administration of ketamine and pethidine in postanesthesia care unit will improve postoperative pain and reduce narcotic consumption. It may, however, increase rate of postoperative nausea in the first hour after operation.

The surveillance of mental health and the strategies that families of the patients with seizure need to cope with stresses

Introduction

Seizure is a common disease happening in all countries that surely affects life style of patient and his/her family; such patient needs helps of others to obviate his/her needs and delayed help leads to mental health impairment of the patient and his/her family.

Method & materials

This was a descriptive-correlative study in which 150 ones of patients families were selected via the systematic sampling method.

We used three kinds of questionnaires to gather data including personal information questionnaire, General health questionnaire and Carver-Scheier-Veintrab’s questionnaire of stress coping Strategies.

Findings

The results showed that 56.7% of investigated units had inappropriate state of mental health and 92% used moderate-level guidelines to cope with stresses.

The majority of family members of the patients with seizure (93.8%) had moderate level of mental health and similarly used moderate-level stress coping strategies(P = 0.000, S = 0.3).

Conclusion

The findings of this study can result in a new plan to elevate the mental health level and also can train families of the patients with seizure and other chronic diseases how to cope with stresses.