فهرست مطالب زینب تابانژاد

Medical staff are in close contact with patients with COVID-19 and they experience burnout, fear, anxiety and depression. Burnout can seriously endanger the mental and physical health of health care workers. The aim of this study was to evaluate the burnout of medical staff during the outbreak of Covid-19 disease by systematic review.

The present study, based on the PRISMA protocol, searched for the keywords "burnout, medical staff and Covid-19" in the PubMed and ScienceDirect databases and the Google Scholar search engine from January 1 to December 30, 2020.

10 articles entered the analysis stage. Based on the analyzed studies, the results of six studies refer to the high level of burnout, two studies refer to the level of moderate to severe burnout and two studies refer to the moderate level of burnout.

The results of the study confirm the burnout of medical staff in Covid-19 that due to lack of disease control, medical staff are at greater risk in the future. Given the prevalence of burnout among health care workers and its consequences, it is imperative that health planners and policymakers adopt appropriate methods and techniques such as increasing personal protective equipment, creating a self-employed alternative workforce, providing recruiting and replacing manpower. Provide adequate social support and ensure the willingness of front-line medical staff to work to prevent this phenomenon.

Despite the essential need for T cells to eradicate infection, the protective role of the humoral response is also evident in the defense response. The aim of this study was to investigate the immunogenic and immunogenic role of rTF/Bp26/Omp31 recombinant chimeric protein in BALB/c mice as a new vaccine candidate.

In this experimental study, in order to evaluate the immunogenicity of the designed recombinant protein, clone, and gene expression were performed in Escherichia coli BL21 (DE3). The protein extracted from the culture of the mentioned cells was purified by Ni-NTA column. Nisome nanocarriers were made using Tovin and Span surfactants, cholesterol, and chloroform through standard methods, and then mixed with the purified protein and prepared for injection into BALB/c laboratory mice.

The evaluation of the immune response indicated the production of antibodies against niosomes containing the recombinant protein, and the amount of antibody production was also different in different injection methods. The statistical data analysis showed the appropriate response of the immune system of laboratory mice.

The results of the study indicate the better efficacy of the nanoniosomes form in the design of the Brucella vaccine and its immune function, and this immunogen structure can be suitable for the design of a vaccine against brucellosis.

 Rhodotorula mucilaginosa (R. mucilaginosa) has emerged as a potential pathogen in immunosuppressed hosts. This fungal agent rarely causes onychomycosis in immunocompetent hosts. In this study, onychomycosis caused by this strain on different fingernails and toenails in an Immunocompetent young adult is reported.

Case Report: 

The patient was an 18-year-old woman with clinical symptoms of powdery, hyperkeratosis brief around erythema in the distal part of a toenail and deformity with a groove on surface of a fingernail who was referred to the Medical Mycology Laboratory of Hazrat Ghaem therapeutic center. After diagnostic procedures, he was treated with oral itraconazole 200 mg/day for 2 months along with topical clotrimazole and sulfacetamide ointment and was cured. The nails responded satisfactorily to the treatment. After two months of stopping the drug, the absence of fungus elements in the clinical samples was confirmed. Diagnosis and identification of the fungus was confirmed by morphological characteristics, culture, and DNA molecular method, and R. mucilaginosa was reported as the etiological agent of onychomycosis. Antifungal drug susceptibility was determined in laboratory using the disk diffusion method according to CLSI guidelines.

 The isolated species was reported as an unusual species of onychomycosis, which needs to be considered by mycology laboratory and clinical specialists for its sensitivity to ketoconazole, itraconazole, and econazole and its resistance to amphotericin B and nystatin.

Stressful experiences related to the workplace and organizational missions cause stress, psychological burden, and physical injuries in police officers. The continuation of these experiences will affect the quality of work-life of police officers. This study aimed to explain the concept of quality of police work-life and factors behind it based on the lived experiences of police officers.

This qualitative study was conducted in 2018–2019 the police organization using the conventional content analysis approach. Participants were police officers who were selected through purposeful sampling with maximum variation. Data were collected from 13 police officers through in-depth semi-structured face-to-face interviews. Interviews were recorded, transcribed verbatim, and analyzed through the conventional content analysis method proposed by Graneheim and Lundman. MAXQDA software was used for analysis and organization.

The factors behind police officers’ quality of work-life were categorized into three main themes namely, "effective management and leadership", "working in bottleneck", and "accepting the working conditions". Each theme consisted of two to six subthemes.

Quality of work-life of police is a contextual, multidimensional concept affected by the type of management and leadership, existence of refreshment and supportive facilities, and the degrees the staff accept their working conditions. Authorities are responsible to improve the police staff’s quality of work-life so that they enjoy their organization and work. Improving the organizational atmosphere by creating pleasant working conditions can help improve the police staff’s quality of work-life despite their difficult working conditions.

Vitamin D is a fat-soluble steroid hormone that helps maintain healthy bones by absorbing calcium and phosphorus. This study aimed to determine the serum level of vitamin D among police staff and use the evaluated results to decide on the staff health and the effectiveness of organizational control and prevention programs.

This descriptive cross-sectional study was performed for 12 months from the start of the year 1399 in Tehran in the population of police staff referred to Medical Centers of police. With ethical and scientific issues being considered, blood samples were taken, and serum levels of vitamin D were measured using immunological kits by the ELISA method. Vitamin values less than 10 ng/ml were considered a severe deficiency, 11-30 were insufficient, and more than 30 were sufficient. Data were analyzed by the SPSS software.

From a total of 442 participants, 80% had severe deficiency or insufficient vitamin D levels (18.9% and 61.1%, respectively), and only 20% had adequate vitamin D levels. The largest deficit was observed among the 21- to 30-year-old age group. A significant difference was seen between age groups (P=0.001). In comparing different job types, administrative job positions had the highest frequency of severe deficiency and insufficient amounts of vitamin D, and the operational job positions had the lowest frequency. This difference was statistically significant
(P =0.02).

The results show that the prevalence of vitamin D deficiency is high among police officers in Tehran (80%), which requires better planning, and appropriate and effective decision-making by the organizationchr('39')s health managers to improve employees’ health.

Trichosporon species are commonly known as causative agents of skin infections and also responsive in some other systemic and disseminated diseases, especially in immunocompromised patients and those with leukemia or lymphoma. Chronic cutaneous infections with Trichosporon have been reported in non-immunocompromised patients, too.

This study is a case report of tinea pedis caused by Trichosporon asahii in an immunocompetent 39-year-old man who was a member of the military force with continuous wearing of army boots during his daytime work. In April of 2019, after visiting a dermatologist, he was referred to the Ghaem medical mycology laboratory of the Department of Health, Rescue and Treatment of Iran Police Force in Tehran. Clinical symptoms were scaling and erythematous patches on his left foot with intensive itching for four-months. In the laboratory, macroscopic and microscopic examination using direct 15% KOH wet mount was carried out as well as culture methods on fungal media (Sabouraudchr('39')s dextrose agar with and without cycloheximide and chloramphenicol). According to microscopic observation and appearance of culture media colonies, the diagnosis was Trichosporon genus as the fungal agent of disorder. Molecular method analysis (PCR) using amplification of ITS region with universal primers (ITS1 and ITS4) and sequencing identified Trichosporon asahii as a causative species of the disease. The patient was treated with topical clotrimazole (twice/day) and oral fluconazole (150 mg/day) for four weeks, and recovered.

The conditions that cause the feet to be exposed to excessive sweating, moisture and darkness for a long time (wearing shoes and army boots for a long time); increase the risk of skin fungal infection. Therefore, full respect for an individual healthy manner seems to be essential.

Life expectancy has increased throughout the world and, as a result, the population of the elderly is also rising. From the age of 30 years old, the human body mass loses about 0.1 to 0.5% of its skeletal muscle mass annually, which is accelerated after the age of 65 years old. Aging is characterized by a decrease in the progression of musculoskeletal and physical activity known as sarcopenia. Sarcopenia has a complex molecular pathogenesis that includes age-related changes in muscles’ neuromuscular activity, muscle protein replacement, the hormone levels and the related sensitivity of human body to these mentioned factors. The pathogenic conditions and other disorders in sarcopenia are the chronic inflammatory states that include oxidative stress and changes in behavioral factors, especially in nutritional status and physical activity. By definition of the European Working Group on Sarcopenia in Older People (EWGSOP), the diagnosis of sarcopenia is determined by the presence of two main factors which are low muscle mass and low muscle function. Besides, specific sarcopenia-related biomarkers have been identified for early diagnosis and accurate identification of the main pathophysiology mechanisms involved in the development of the disease. Since sarcopenia has adverse outcomes on public health in terms of behavioral factors, frailty, hospitalization and mortality of people, it is an important necessity for the social health system to plan some therapeutic approaches to prevention. The main and more important of these therapeutic approaches have known as exercises, nutritional supplements and hormonal therapies. Also, other new therapeutic strategies are under investigation to be introduced in the future. However, currently, it has been shown that only physical exercise has a positive effect on the controlling and prevention of sarcopenia and its adverse effects on human and public health. However, the role of appropriate nutrition is also effective. Therefore, carefully designed studies in terms of better utilization of physical activity are needed to achieve useful therapeutic results for sarcopenia management. Thus, this survey aims to review the other considerable studies on the pathogenesis, appropriate evaluation of the disease and treatment options for sarcopenia.

Moral intelligence is the ability to distinguish true from false, choose appropriately, and ultimately show ethical behavior. Moral intelligence is considered as an effective factor in increasing commitment, accountability, desirable performance, and achieving the goals of the organization. Based on the results of the study by Lennick and Kiel, moral intelligence is comprised of 4 main components including integrity, responsibility, forgiveness, and compassion that are essential for the continuation of organizational and personal success. Therefore, there is a harmony between the values and beliefs in people with high moral intelligence; they have high performance and always link their actions with moral principles. Nurses are also responsible for their actions due to their highlighted role in health care practices and taking huge responsibilities.
The current study aimed at investigating the relationship between moral intelligence and some demographic characteristics in nurses of the intensive care units (ICUs).
The current cross sectional, descriptive-analytical study was conducted on 267 nurses working in the ICUs in Tehran in 2013 selected by the convenience sampling method and examined for moral intelligence. Persian version of the Lennick and Kiel moral intelligence, which its reliability and validity was confirmed previously, was used for data collection. Then, data were analyzed with SPSS version 18 using descriptive and analytical statistics. A P-value The total number of samples was 267 in the age range of 20-50 years, of which 65.54% were female; the majority of study participants was married (73.78%) and had undergraduate education (80.52%). Statistical tests showed that the moral intelligence of most nurses (n=168; 62.9%) was moderate. Also, there was a significant relationship between the gender-dependent variables (P = 0.006), level of education (P = 0.004), overtime hours (P = 0.004), and moral intelligence of nurses in ICUs. There was no significant relationship among age (P = 0.1), work experience (P = 0.09) and marital status (P = 0.3).
Discussion and Based on the nature of nursing profession and relying on the findings of the current research, it is suggested to develop strategic plans, hold in-service ethics workshops, hire qualified nurses, and conduct interventional studies in the same field to enhance moral intelligence and consequently efficiency of health system.

Drug addiction is a major problem. These have been a personal issue - the focus of social scientists in various fields. In the present study, we were decided to Assess of knowledge and attitudes of military personnel in the prevention of addiction by providing a suitable model.
This was a cross - sectional study was performed on 900 military personnel to random sampling - stratified by using a self-administered questionnaire in province of Sistan and Baluchestan. Method reliability was fulfilled (test-retest) in two-week interval by 15 personnel and correlation coefficients obtained from the two tests r =0.81. The internal reliability by using Cronbach's alpha was approved 0/78.
The Suitable knowledge about prevention of drug abuse among the officers and soldiers was 45/6% and 25% that 94/8% of staff had a favorable attitude towards prevention of drug abuse. Between knowledge, age, education, work experience, degree status, Parents living conditions, Addiction relatives and between attitude and level of education, marital status, Parents living conditions, Addiction relatives, there was no significant relationship (P The knowledge of the staff towards prevention of drug addiction was not good knowledge. This show that the purpose and principles of training programs to enhance staff knowledge seems necessary. According to various studies to be effectiveness of the health belief model in changing attitudes, increase awareness for prevention and control of risk behaviors, including addiction is recommended.

Assessment of clinical competence is of great importance in nursing which identifies the scientific gap between university education and clinical needs among graduate nurses. Hence, the aim of this study was to evaluate the clinical competence among MSc students of critical care nursing. In this descriptive cross-sectional study, 250 MSc students of critical care nursing were selected by convenience sampling from 17 state nursing schools of Iran in 2013-2014. A researcher-made questionnaire was used to collect data in five areas of care management, technical competence, individual management, patient-oriented care and scholarship. The content and face validity of the questionnaire were assessed and its reliability was calculated by Cronbach’s alpha coefficient for internal consistency (α = 0.86).A five-point Likert scale was used to measure the items. The collected data were analyzed using independent t-tests and one-way ANOVA. Ultimately, 217 questionnaires were analyzed. The total mean score of clinical competence was 4.30±0.41. The mean scores were 4.38±0.43 for care management, 4.40±0.56 for technical competence, 4.36±0.45 for individual management, 4.29±0.60 for patient-oriented care, and 3.66±0.79 for scholarship. Clinical competence was 4.23±0.43 in males and 4.36±0.39 in females (p=0.001, T=-2.15). There was a significant difference between years of education in scholarship area (p =0.01, T=30.15). The results showed that the clinical competence of female students was higher than male students. Also the level of clinical competence was high in most areas; however, it was different in terms of years of education in the scholarship area. Accordingly, a revised curriculum is recommended to enhance the efficiency of this course. It is recommended that more field studies be conducted on this area.

The liaison nurse role has been defined in many countries for improving the quality of nursing care delivery to patients who are transferred from intensive care units to general medical-surgical wards. The aim of this study was to examine the impact of ICU liaison nurse role on patients’ clinical outcomes after being discharged from intensive care unit. In this two-group controlled clinical trial، a convenience sample of 80 patients was drawn in 2014 from selected military hospitals located in Tehran. Patients were randomly allocated to either the control (40 patients) or the experimental groups (40 patients). After being transferred from intensive care unit to general wards، patients in the experimental group received care from a liaison nurse. A data sheet was used for collecting the study data. The validity of the sheet was confirmed by a panel of ten nursing faculties. The Gutmann coefficient of the scale was 0. 868 which confirmed the acceptable reliability of the sheet. Study data were analyzed by using the SPSS19 and by conducting the Chi-square and independent-samples t tests. Hemodynamic and laboratory parameters in the experimental group were not significantly different from the control group (p value > 0. 05). Conducting further studies for evaluating different aspects of liaison nurse role is recommended

Nowadays، job involvement is introduced as an important factor in the effectiveness of the organization، so that the high job involvement will increase the effectiveness of the organization. The aim of this study was to determine the relationship between job involvement and demographic characteristics of the nurses.

In this cross - sectional descriptive-analytic study، 436 nurses from hospitals in Tehran and Kerman in 2013 were recruited by convenience sampling. The Job Involvement Questionnaire was used for data collection. The cutoff point for job involvement score was 40 and the relationship between job involvement and demographic characteristics of the nurses was evaluated.

Most the average age of participating nurses in the study 31-40 years. The mean score of job involvement was 36. 07± 10. 02. Among the demographic characteristics، in terms of gender، men had higher job involvement than women (P=0. 01). Also، the job involvement of nurses in military hospitals was higher than civilian hospitals (P<0. 001). There was no statistically significant difference between other demographic such as marital status، education، age and work experience with job involvement score (P>0. 05).

According to the low scores of job involvement، attention to the effective factors and motivation factors in environment variables to improve nurses'' job involvement is recommended.

Lifestyle is one of the important factors that affect human health. Today most problems of health, such as obesity, cancer, hypertension and disease and resulted mortality are associated with lifestyle. The aim of the present study was to compare the lifestyle of military personnel and civilians. This descriptive-comparative study was conducted with 200 people, including 100 military and 100 civilians in Tehran. Convenience sampling method was used to selected subjects. Lifestyle questionnaire developed by researchers in four main dimensions (nutrition, stress, smoking and physical activity) was used to collect research data. The mean age of the military group was 40.1 (5.58) and in non-military group was 40.46 (5.52) years. Optimal amount of carbohydrates, fruits, fat consumption of and the mean of physical activity were higher in the military group. However, optimal amount of protein consumption and the mean of stress levels and smoking were higher in non-military (p<0.05), there was no statistically significant difference in the amount of dairy products consumption between two groups. According to the importance of lifestyle in personal health and the necessity of paying attention to all aspects of military and civilian lifestyle, we suggest organized and comprehensive interventions which are consistent with the condition of subjects.

Currently, cardiac transplant is the standard and effective treatment for patients with end stage heart failure. This article is an attempt to offer common techniques of cardiac transplant, pre and posttransplantation care and some points essential for nurses and patients.

As a review article, this study has been conducted on cardiac transplant through electronic search of scientific references of the years 2002-2013.

For end-stage heart failure patients, cardiac transplant must be conducted according to specific principles. Such complications as dysrhythmias, hemorrhage, rejection and infection are among posttransplantation surgery. Intensive nursing care, timely measures and reactions as well as training patients can help retention of transplanted organ and survival of the patient. Discussion and

Due to the special circumstances affecting patients and health system and due to high expenses and stress levels in cardiac transplant, nurses as a part of main team of cardiac transplant surgery, must enhance their knowledge on caring for such patients and play a significant role in trainings needed for rehabilitation and life performance enhancement of patients after transplantation.