فهرست مطالب محمدرضا محمدپور

Moral courage is a crucial aspect of the nursing profession that significantly influences the quality of healthcare services. Moral courage refers to the courage or inner strength that an individual exhibits in ethical situations, acting based on their ethical principles, values, and beliefs despite potential negative consequences for themselves. Enhancing moral courage in nurses can lead to better decision-making and improved healthcare quality, thus, the understanding of the various factors related to this characteristic is of great importance. This article aims to investigate the relationship between moral courage and the personal and occupational characteristics of nurses.

This is a cross-sectional descriptive study. The research population in this study consisted of all nurses employed in hospitals affiliated with Mazandaran University of Medical Sciences in the eastern province of Mazandaran. The sample size was determined to be 300 individuals. Sampling was conducted using the convenience sampling method. Data was collected through a questionnaire related to demographic characteristics (age, gender, marital status, education level, type of employment, years of service, service department, shift work, hospital of service, and history of attending ethics courses or seminars), and the Sekerka Ethical Courage questionnaire was utilized. Data analysis was performed using measures of central tendency, standard deviation, independent t-tests, analysis of variance, and multiple linear regression. SPSS 22 software was employed for data analysis, with a significance level of less than 0.05.

The average age of the participants was 32.85±7.54 years. The average score of nurses' moral courage was 60.24±4.37 out of (105), indicating a moderate level. The highest score of moral courage was commonly associated with the moral agent dimension (13.87±1.42) and multiple values (13.43±1.54), while the lowest score of ethical courage was related to the threat tolerance dimension (8.82±1.74). Participation in ethics courses had a significant effect on the moral courage score (P=0.004), where nurses with a history of attending ethics courses obtained higher scores in moral courage. Other variables did not have a significant impact on the ethical courage score. Regression analysis results also showed that only participation in ethics courses had a significant effect on the moral courage score, as nurses without a history of attending these courses scored lower (1.26 units).

Based on the findings of this study, it was revealed that participation in ethics-related training courses has a significant impact on nurses' ethical courage. These results indicate that ethics-related education (familiarity with professional ethics principles in nursing, values, and ethics in nursing decision-making, ethics in patient confidentiality and privacy, ethical collaboration and interaction with colleagues and other members of the healthcare team, patient involvement in ethical decision-making, ethical relationships with patient's families, and respect for their rights) can help strengthen and enhance nurses' ethical courage. Since ethical courage plays a crucial role in nurses' decision-making in challenging situations, designing effective and appropriate educational programs in this area can contribute to improving the quality of care and fostering a more ethical environment in the nursing setting.

Moral sensitivity, as the cornerstone of nursing ethics, paves the way for nurses to provide effective and ethical care to patients. One of the examples of ethical care is paying attention to patients’ rights and supporting them. The present study was conducted with the aim of investigating the correlation between moral sensitivity and patient advocacy in the nurses working at the hospitals affiliated to Mazandaran University of Medical Sciences in the city of Sari.

This cross-sectional study was conducted on 140 nurses working at internal, surgical and intensive care departments of the hospitals affiliated to Mazandaran University of Medical Sciences in Sari from January to May 2022. Sampling was done through simple random sampling method. The data collection tools included Lutzen et al.'s moral sensitivity questionnaire and Hanks' Protective Nursing Advocacy Scale. The data were analyzed through descriptive tests and Pearson's correlation coefficient using SPSS 16 software.

Ethical Considerations: 

In this study, the ethical principles including maintaining confidentiality, obtaining a personal consent and the participants’ freedom of choice to cooperate or not during the study process were observed.

The mean score of moral sensitivity was 69.04±7.39 and that of patient advocacy was 154.71±13.83, both of which were at moderate level. There was a positive and significant correlation between moral sensitivity and patient advocacy (r=0.573 and P<0.01). The results of the regression test showed that moral sensitivity explains 57.3% of the variance of the variable of patient advocacy.

Both moral sensitivity and patient advocacy were at moderate level in the nurses, and there was a positive and significant relationship between them. In order to promote positive outcomes in the patient achieve optimal care and act as a patient advocate, it is necessary to pay attention to moral sensitivity in nurses. Moreover, paying attention to the approaches to increasing it seems to be crucial and indispensable.

One of the most important challenges of hydrological studies is the projection of precipitation variability in a basin in future periods. Atmospheric Ocean General Circulation Models (AOGCMs) can project this variability but in large-scale regions. Various versions of these models have been released, one of which is the CMIP5 series with about 40 dynamic models. In this study, the CCSM4 climate model has been used. The data output of this model is in 1 × 1 (Latitude× longitude) degree. To downscale the precipitation data of this model, the hybrid of two dynamic (WRF1) and statistical methods has been proposed. The study area is the Poldokhtar subbasin in the ​​Karkheh basin and rainfall data between 1996-2005 have been used. First, the precipitation data were downscaled by the WRF model from the range of 1 × 1 degree to 9 × 9 km, and then these data were converted to the range of 3 × 3 km separately by two methods a) hybrid and b) WRF. The results showed that the dynamic downscaling by the WRF model in the range of 9 × 9 km quite shows the precipitation fluctuations during the statistical period. In the 3 × 3 km range, the hybrid method performed better than the WRF method. Finally the results showed that downscaling of precipitation in this basin using both methods is associated with underestimation and should be accompanied by an bias correction method. As a result, by reducing the time and cost of dynamical downscaling of climate models, the findings of this paper can be of great help in making decisions about water resources management in the wet and dry years of the coming decades of a basin.

In this study, the analysis of heat transfer in porous fin considering thermal radiation and natural convection is investigated. In order to model radiation, discrete ordinates method is used. Also, Darcy–Brinkman–Forchheimer model is applied for simulating porous media. A Least square method and numerical simulation (computational fluid dynamics) are applied to obtain the solution of governing equations. In addition, accuracy of LSM results is compared with the numerical simulation results. Moreover, the effects of homogeneous and non-homogeneous porosity along the porous media, Rayleigh number, Darcy number, porosity, surface emissivity, on temperature distribution along the length of porous fin and Nusselt number are investigated. Results show that the numerical simulation and LSM results are in good agreement with each other (With average error of 3.39%). Also neglecting thermal radiation effect in heat transfer analysis of porous fin leads to 10- 20% error in the Nusselt number value. Moreover, by applying nonlinear variable porosity along the porous media, the Nusselt number will increase up to 23% with respect to the homogeneous porosity. So in order to enhance heat transfer rate, porosity profile should be applied appropriately along the porous media.

In this article, the free and forced convectional heat transfer in a rectangular porous fin with considering pressure loss across the fin length is investigated analytically. A well-known Differential transformation method is employed to obtain the solution of energy balance equation. Convergence of obtained solution is examined by previous works and they are found to be in a good agreement. In order to simulate heat transfer through porous media, Darcy model is applied. Also convective heat transfer coefficient is assumed to be constant. Dimensionless temperature distribution is defined as a function of convection and porosity parameters. Also the effects of pressure loss across the fin length on the temperature distribution, rate of heat transfer, fin efficiency and effectiveness of fin are studied. A comparative study is also made between the porous and solid fins for an equal mass of fins. It is highlighted that the porous fin transfer always more heat at specific condition compared to the solid fin. Results show that all of thermal parameters are influenced by pressure loss parameter. So in order to reach to high fin efficiency, pressure loss across the fin length should be controlled.

One of the powerful tools in dust storms analysis that have recently found extensive application is atmospheric-chemistry numerical modeling. Spatial and temporal distribution of Middle Eastern dust for a severe dust event during 4-8 July 2009 was analyzed by Weather Research and Forecasting with Chemistry (WRF/Chem) model simulations and remote sensing observations. The HYSPLIT model is applied to achieve back-trajectories and identify the sources of dust storm in the other way. Analyses of simulated Weather conditions، during maximum dust concentrations in low level، were occurred with high pressure gradient and surface wind shear in present of cyclonic system. This condition was caused extreme value emission of dust and sand from alluvial plain of the Tigris and Euphrates. The simulation results were found to well reproduce spatial and temporal distribution of mineral dust concentrations according to visible images based on the high-spatial resolution NASA MODIS. HYSPLIT model results also showed that most of the back-trajectories from receptors were crossed dry desert areas of north - central Iraq and Syria. These results were also showed good agreement with that obtained from visible bands of MODIS images.