PURPOSE: Although nursing presence is a foundation for professional nursing practice and has known positive outcomes such as patient satisfaction and recovery; it is not well known. The ambiguity surrounding how to define nursing presence has challenged its evaluation and education. Therefore, in an attempt to discover attributes of this underdeveloped concept and studying it in a new context, concept development is essential. The purpose of this study was to clarify the concept of nursing presence through concept development, to produce a tentative definition of this subjective concept in clinical practice. METHODS: Concept development was carried out using Schwartz-Barcott and Kim's hybrid model including, theoretical, fieldwork and final analysis phases. First, 29 related articles available on the databases from 1990–2015 were reviewed and analyzed. Then, 22 interviews were conducted with 19 participants, followed with inductive content analysis. At last, an overall definition was performed. RESULTS: Nursing presence can be explained as co-constructed interaction identified by deliberate focus, task-oriented/patient-oriented relationship, accountability, clarification, and ubiquitous participation. Nursing presence requires clinical competence, self-actualization, reciprocating openness, and conducive working environment. Worthwhile communications, balance/recovery, and growth and transcendence are the main consequences of this concept. CONCLUSION: Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.
Clinical Competence ; Education ; Humanism ; Nurse-Patient Relations ; Nursing ; Patient Satisfaction ; Qualitative Research ; Social Responsibility

In this study a disperse dye immunoassay method was standardized and evaluated for detection of antibodies against Neospora caninum in cattle. Sera from 150 cattle with a recent history of abortion were collected and tested by commercial ELISA kit and a standardized in-house dye immunoassay system. The positivity rate for the sera used in this study was 34.6% for the disperse dye immunoassay (DDIA) compared to 32% obtained by ELISA kit. This study showed no significant difference between DDIA and ELISA. The results indicated that the DDIA provide an economic, simple, rapid and robust test for detection of N. caninum infection in cattle.
Animals ; Antibodies, Protozoan/*blood ; Cattle ; Cattle Diseases/*diagnosis/parasitology ; Coccidiosis/diagnosis/parasitology/*veterinary ; Diagnostic Tests, Routine/*methods ; Female ; Immunoassay/methods ; Neospora/*immunology ; Staining and Labeling/methods ; Veterinary Medicine/*methods

OBJECTIVE: Dysmenorrhea is one of the most common problems for women, especially during their reproductive age. Various studies have examined the effects of vitamins D and E and ginger supplements. This study aimed to investigate the individual effects of each of these supplements on dysmenorrhea. METHODS: This single-blind clinical trial was conducted in 2016 on students aged 18 to 25 years who complained of mild to severe dysmenorrhea. The participants were randomly assigned into 4 groups: vitamin D, vitamin E, ginger, and placebo. The effects of the supplements on the severity of dysmenorrhea were evaluated in 2 successive cycles using the visual analog scale (VAS) and a questionnaire. RESULTS: Initially, 240 female students were enrolled in the study; thereafter, 40 students were excluded from the study owing to follow-up loss. The average VAS score for dysmenorrhea in the entire study population was 7.13±0.80 before the intervention; the mean VAS score after the first and second months of supplement use was 5.37±1.51 and 4.93±1.48, respectively. The highest reduction in pain severity was observed in the ginger group (F=74.54, P<0.001). CONCLUSION: Vitamin D, vitamin E, and ginger significantly reduced the severity of dysmenorrhea, with ginger having the most significant effect followed by vitamin D and vitamin E. Given the low risk of these supplements, more studies must be conducted on their use as opposed to analgesics.
Analgesics ; Dysmenorrhea ; Female ; Follow-Up Studies ; Ginger ; Humans ; Menstrual Cycle ; Visual Analog Scale ; Vitamin D ; Vitamin E ; Vitamins

OBJECTIVES: Genetic disorders are the main causes of many other diseases. Integrating genetic data into Electronic Health Records (EHRs) can facilitate the management of genetic information and care of patients in clinical practices. The aim of this study was to identify the main requirements for integrating genetic data into the EHR system from the medical geneticists' perspectives. METHODS: The research was completed in 2018 and consisted of two phases. In the first phase, the main requirements for integrating genetic data into the EHR system were identified by reviewing the literature. In the second phase, a 5-point Likert scale questionnaire was developed based on the literature review and the results derived from the first phase. Then, the Delphi method was applied to reach a consensus about the integration requirements. RESULTS: The findings of the first phase showed that data elements, including patients' and healthcare providers' personal data, clinical and genetic data, technical infrastructure, security issues and functional requirements, should be taken into account before data integration. In the second phase, a consensus was reached for most of the items (mean ≥3.75). The items with a mean value of less than 2.5 did not achieve a consensus and were removed from the final list. CONCLUSIONS: The integration of genetic data into the EHRs can provide a ground for increasing accuracy and precision in the diagnosis and treatment of genetic disorders. Such integration requires adequate investments to identify users' requirements as well as technical and non-technical issues.
Consensus ; Delivery of Health Care ; Diagnosis ; Electronic Health Records ; Genetics ; Humans ; Investments ; Medical Informatics ; Methods

BACKGROUND: Job stress and job satisfaction are important factors affecting workforce productivity. This study was carried out to investigate the job stress, job satisfaction, and workforce productivity levels, to examine the effects of job stress and job satisfaction on workforce productivity, and to identify factors associated with productivity decrement among employees of an Iranian petrochemical industry. METHODS: In this study, 125 randomly selected employees of an Iranian petrochemical company participated. The data were collected using the demographic questionnaire, Osipow occupational stress questionnaire to investigate the level of job stress, Job Descriptive Index to examine job satisfaction, and Hersey and Goldsmith questionnaire to investigate productivity in the study population. RESULTS: The levels of employees' perceived job stress and job satisfaction were moderate-high and moderate, respectively. Also, their productivity was evaluated as moderate. Although the relationship between job stress and productivity indices was not statistically significant, the positive correlation between job satisfaction and productivity indices was statistically significant. The regression modeling demonstrated that productivity was significantly associated with shift schedule, the second and the third dimensions of job stress (role insufficiency and role ambiguity), and the second dimension of job satisfaction (supervision). CONCLUSION: Corrective measures are necessary to improve the shift work system. “Role insufficiency” and “role ambiguity” should be improved and supervisor support must be increased to reduce job stress and increase job satisfaction and productivity.
Appointments and Schedules ; Efficiency* ; Job Satisfaction*

BACKGROUND: Nowadays, stroke leads to a significant part of the adult mortality and morbidity and also it could result in some neurological deficits in the patients' lives. Cell therapy has opened a new approach to treat the brain ischemia and reduce its terrible effects on the patients' lives. There are several articles which show that the cell therapy could be beneficial for treating brain stroke. In this study, we have planned to present a new cell therapy method for stroke by administration of Mesenchymal stem cells and differentiated neural stem cells without astrocytes. METHOD AND MATERIALS: The Mesenchymal stem cells were isolated from tibia and femur of a 250~300 g rat and they were cultured in DMEM/F12, 10% fetal bovine serum, 1% Pen/Strep. Neural stem cells were isolated from 14 days rat embryo ganglion eminence and were cultured in NSA media containing Neurobasal, 2% B27, bFGF 10 ng/ml and EGF 20 ng/ml after 5 days they formed some neurospheres. The isolated neural stem cells were differentiated to neural lineages by adding 5% fetal bovine serum to their culture media. After 48 hours the astrocytes were depleted by using MACS kit. RESULTS: The group that received Mesenchymal stem cells systemically and differentiated neural stem cells without astrocytes had the best neurological outcomes and the least infarct volume and apoptosis. It could be understood that this cell therapy method might cause almost full recovery after brain stoke. CONCLUSION: Using combination cell therapy with Mesenchymal stem cells and differentiated neural stem cells with removed astrocyte could provide a novel method for curing brain stroke.
Adult ; Animals ; Apoptosis ; Astrocytes ; Brain Ischemia ; Brain* ; Cell- and Tissue-Based Therapy* ; Culture Media ; Embryonic Structures ; Epidermal Growth Factor ; Femur ; Ganglion Cysts ; Humans ; Mesenchymal Stromal Cells ; Mortality ; Neural Stem Cells ; Rats* ; Stroke* ; Tibia

OBJECTIVE: Postoperative nausea and vomiting is one of the most common side effects after anesthesia in surgeries, such as cesarean section. This study aimed to investigate the effect of ginger and metoclopramide in the prevention of nausea and vomiting during and after cesarean section.METHODS: This clinical trial was conducted on 180 patients aged 18–40 years who underwent cesarean section under spinal anesthesia. The first group received 10 mg of metoclopramide via intravenous injection (metoclopramide group), and the second group received 1 g of oral ginger (ginger group) half an hour before spinal anesthesia. The frequency and severity of nausea and vomiting during surgery and at 2, 6, 12, and 24 hours postoperatively were compared in both groups. To analyze the results, the t-test, chi-square test, and Mann-Whitney test were used.RESULTS: There was no significant difference in the frequency of nausea and vomiting between the 2 groups during operation, 2 hours and 6 hours after surgery (P=0.182, 0.444 and 0.563 respectively). The severity of nausea and vomiting was also similar in the 2 groups (P=0.487 and 0.652 respectively); however, the metoclopramide group had a lower systolic blood pressure (P<0.001; df=2.176; f=18.66) and mean arterial pressure (P<0.001; df=2.176; f=6.36) than the ginger group.CONCLUSION: The results revealed that ginger reduced nausea and vomiting to the same extent as metoclopramide in patients undergoing cesarean section.TRIAL REGISTRATION: Iranian Center for Clinical Trials Identifier: IRCT201611028611N3

Background: This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace. Methods: This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS22 and AMOS20 software. Results: The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items—58-item final version of the scale—six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively. Conclusion This study confirmed that the psychometric features of the 58-item final version of PAWPQ-SCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

OBJECTIVES: Brain stroke is the second most important events that lead to disability and morbidity these days. Although, stroke is important, there is no treatment for curing this problem. Nowadays, cell therapy has opened a new window for treating central nervous system disease. In some previous studies the Mesenchymal stem cells and neural stem cells. In this study, we have designed an experiment to assess the combination cell therapy (Mesenchymal and Neural stem cells) effects on brain stroke. METHOD AND MATERIALS: The Mesenchymal stem cells were isolated from adult rat bone marrow and the neural stem cells were isolated from ganglion eminence of rat embryo 14 days. The Mesenchymal stem cells were injected 1 day after middle cerebral artery occlusion (MCAO) and the neural stem cells transplanted 7 day after MCAO. After 28 days, the neurological outcomes and brain lesion volumes were evaluated. Also, the activity of Caspase 3 was assessed in different groups. RESULT: The group which received combination cell therapy had better neurological examination and less brain lesion. Also the combination cell therapy group had the least Caspase 3 activity among the groups. CONCLUSIONS: The combination cell therapy is more effective than Mesenchymal stem cell therapy and neural stem cell therapy separately in treating the brain stroke in rats.
Adult ; Animals ; Bone Marrow ; Brain* ; Caspase 3 ; Cell- and Tissue-Based Therapy* ; Central Nervous System ; Embryonic Structures ; Ganglion Cysts ; Humans ; Infarction, Middle Cerebral Artery ; Mesenchymal Stromal Cells* ; Neural Stem Cells* ; Neurologic Examination ; Rats* ; Stroke*

PURPOSE: Escherichia coli O157:H7 is one of the most important pathogens which create hemorrhagic colitis and hemolytic uremic syndrome in human. It is one of the most prevalent causes of diarrhea leading to death of many people every year. The first diagnosed gene in the locus of enterocyte effacement pathogenicity island is eae gene. The product of this gene is a binding protein called intimin belonging to the group of external membrane proteins regarded as a good stimulants of the immune system. Chitosan with its lipophilic property is an environmentally friendly agent able to return to the environment. MATERIALS AND METHODS: Intimin recombinant protein was expressed in pET28a vector with eae gene and purification was performed using Ni-NTA and finally the recombinant protein was approved through western blotting. This protein was encapsulated using chitosan nanoparticles and the size of nanoparticles was measured by Zetasizer. Intimin encapsulated was prescribed for three sessions among three groups of oral, injection, and oral-injection using Chitosan nanoparticles. Challenge was performed for all three groups with 108 E. coli O157:H7 bacteria. RESULTS: Intimin produced by chitosan nanoparticles improves immunological responses through the adjuvant nature of chitosan nanoparticles. Chitosan may be used as a carrier for transportation of the prescribed vaccine. Among the mice, encapsulated intimin could be able to provide suitable titers of IgG and IgA by the aid of chitosan nanoparticles. Results of mice challenge showed that decreased the bacterial shedding significantly. CONCLUSION: Results showed that the chitosan nanovaccine with intimin protein may be used as a suitable candidate vaccine against E. coli O157:H7.
Animals ; Bacteria ; Bacterial Shedding ; Blotting, Western ; Carrier Proteins ; Chitosan ; Colitis ; Diarrhea ; Enterocytes ; Escherichia coli ; Genomic Islands ; Hemolytic-Uremic Syndrome ; Humans ; Immune System ; Immunoglobulin A ; Immunoglobulin G ; Membrane Proteins ; Mice ; Nanoparticles ; Transportation