maryam esmaeili

Many patients may experience unexpected clinical deterioration during hospitalization, and the severity of this clinical deterioration is associated with in-hospital mortality. Therefore, an effective triage tool for quick identification of risk factors and in-hospital mortality is essential. Currently, several scoring systems are used to predict clinical deterioration and in-hospital mortality. This study was conducted with the aim of investigating the accuracy of early warning score tools in predicting in-hospital mortality.

  In this review study, the  related  articles searched by using the keywords Early warning score, Triage early warning score, and Inhospital mortality and their persian equivalents in Jahad Daneshgahi Database, Iran Scientific Research Institute, Database of Iranian Journals, Springer, Medline, PubMed, and Google Scholar.

Based on the prisma diagram, 95 articles were found. And according to the aim of the study, 32 related articles were selected. The results showed that the triage early warning score tool is more accurate in predicting in-hospital mortality.

Early warning score systems are useful tools in patient risk management. Meanwhile, triage early warning score has more power in predicting clinical deterioration and in-hospital mortality, considering that age is one of its parameters.

Professional autonomy and commitment are factors influencing the retention process in the nursing profession, job satisfaction and quality of care in Critical Care Units (CCUs). The level of education of nurses plays an important role in their ability to develop autonomy and commitment. This study was conducted with the aim of investigating the relationship between autonomy and professional commitment with the level of education.

The present study is a cross-sectional study was conducted in the year 2021 in the CCUs of hospitals affiliated to Qom University of Medical Sciences. The study population consisted of 160 nurses working in CCUs who were selected by available method. Research tools included demographic questionnaire, autonomy and professional commitment questionnaire. In order to determine the relationship between the variables, Pearson correlation, analysis of variance and independent t tests were used.

According to the findings, the average score of professional commitment in the CCUs in general (12.82 ± 91.14) and the average score of professional autonomy in nurses (74.10 ± 15.35) was reported, which shows the commitment and high professional autonomy of the nurses working in these units. Among the different dimensions of professional commitment, the highest score was related to engagement with the nursing profession with an average of 3.63 ± 0.78 and the lowest score was related to understanding of nursing with an average of 3.02 ± 0.56. Professional autonomy in the performance-based autonomy dimension had the highest mean (25.26 ± 6.31) and value-based autonomy dimension had the lowest mean (23.87 ± 6.15). Professional autonomy had a significant relationship with the level of education (P = 0.020).

The findings showed that there is a significant relationship between commitment and professional autonomy. Therefore, familiarizing nurses with the factors affecting professional autonomy, including increasing and updating knowledge, can be effective in increasing professional autonomy. Considering the autonomy in the performance of nurses in CCUs, it can increase the quality of care by increasing professional commitment. Also, the findings showed that considering the limited level of education, it cannot be concluded that nurses with a bachelor's degree show higher autonomy and professional commitment.

It is essential to provide family-centered care and pay attention to the families of critically ill patients. Consequently, the present study determined the relationship between the needs and resilience of family members of patients hospitalized in Intensive Care Units (ICUs) of hospitals affiliated to Shahrekord University of Medical Sciences in 2021.

The present cross-sectional, descriptive-correlational study, was conducted in order to investigate the relationship between the needs and resilience of families of critically ill patients. The study population included the family members of all patients hospitalized in the ICUs of hospitals affiliated to Shahrekord University of Medical Sciences in 2021, who were selected by available sampling. For this purpose, 149 family members were selected and answered the demographic questionnaire, the Connor-Davidson Resilience Scale (CD-RISC) and Critical Care Family Needs Inventory (CCFNI).

Based on the findings, the average score of family needs was 143.14 ± 21.75, which showed a high level of needs. The highest need of family members was related to the dimension of assurance and information and the lowest need was related to the dimension of support. The mean resilience score was 70.04 ± 16.89, which shows that the family members had acceptable resilience. According to the adjusted resilience score of family members, the highest score was related to the dimension of spirituality and the lowest score was related to the dimension of control. There was a direct and significant relationship (P<0.05) between resilience and all the dimensions of family needs.

Improving nurses' knowledge and awareness of the needs, mental health status and resilience of family members in ICUs can lead to improved resilience and reduction of negative psychological consequences of family members during hospitalization and even after discharge by adopting solutions to meet these needs, as well as implementing training programs. Supporting the family is essential to identify and understand the importance and priority of their needs to meet these needs properly and to pay attention to the mental health and resilience of families.

Today, despite the increasing complexity in organizations, conflict has become a natural phenomenon in the professional and personal life of employees. Conflict among nurses is considered a very important issue in service provider organizations, and conflict management is a systematic and purposeful process of finding satisfactory solutions for the parties involved in the conflict. This study was conducted with the aim of "determining the conflict management style of nurses in hospitals affiliated with Zanjan University of Medical Sciences".

This research is a descriptive and correlational study that was conducted in hospitals affiliated to Zanjan University of Medical Sciences in 2019. 180 nurses who met the inclusion criteria were selected using a stratified random sampling method with proportional allocation. The data collection tool in this study included questions related to demographic information and Thomas Kilman's conflict management style questionnaire, which was completed by nurses in the form of self-reporting. The data were analyzed using descriptive statistics and inferential statistics including Pearson's correlation coefficient, independent t, analysis of variance and in SPSS-25 software.

The frequency of conflict management style in nurses includes Compromise style with (37.2 percent), Accommodative style with (33.3 percent), avoidance style with (12.2 percent), Collaborative style with (8.9 percent) and Finally, the style was competitive with (8.3 percent). Among them, the highest frequency was related to the compromise style and the lowest frequency was related to the competition style.

Conflict is inevitable, but the way conflict is managed determines its results. Therefore, learning how to deal with conflict is particularly important because nurses must be able to effectively participate in the process of solving it and adopt a constructive attitude when dealing with conflict in order to ensure safe and effective nursing and care. Also, this training is necessary for the managers of the organization because they must identify the occurrence of conflict in time and recognize its causes and act effectively in directing and resolving the conflict.

 The health and safety of the employees of any industry is one of the most important issues to prevent the occurrence of accidents. This study aimed to identify and assess related risks in a battery-manufacturing industry using FMEA method and estimate the ratio of the cost of accidents to prevention.

 In this descriptive and analytical study, the production activities of the industry were first identified. Then the work process, employee duties, and Potential risks were determined by the HAZID method. Evaluation and prioritization of risks were done using FMEA method. Risks whose RPN was higher than 145 were determined as important risks and the ratio of incident cost to accident prevention was calculated.

In 62 active units of this industry, 716 risks were identified and prioritized, 16 of which (2.23%) had RPN above 145 with the highest priority. The financial pulp unit with falling and fire hazards and the assembly unit with the risk of fumes and lead dust leakage with RPN 245 were among the most dangerous units and hazards identified in the industry. In all units except one unit, the ratio of the cost of accidents to prevention varied from 1.2 to 25.

 The results showed that it is necessary to consider the correction of the important risks by the industry officials, according to the set priorities so that potential accidents caused by these risks are minimized. This prioritization can play an effective role in optimal risk management and reduce related costs.

In recent years, yield losses due to chickpea chlorotic dwarf virus (CpCDV, Mastrevirus, Geminiviridae) infection have been intensified in a large number of plants such as watermelon, okra and cotton and the virus has been reported around the world (Kanakala and Kuria 2018). In the current study, natural infection of watermelon with CpCDV was investigated. Watermelon samples showing leaf chlorosis, hardness and discoloration of the flesh with whitish stripes, deformation and increasing seed abortion of fruits (Fig. 1) were collected from watermelon-growing farms in Behbahan (Khuzestan Province) in 2018. Total DNA of the samples was extracted from leaf tissue using the cetyltrimethylammonium bromide (CTAB) method followed by the enrichment of the extracted circular DNA molecules by rolling circle amplification (RCA) method using phi 29 DNA polymerase (TempliPhi kit, GE Healthcare, USA). Polymerase chain reaction (PCR) tests using RCA product as DNA template and the primer pair CpCDV-752-F/CpCDV-1326-R (Askari et al. 2021) resulted in the amplification of an expected 575 bp DNA fragment (Fig. 2) indicating the infection of the all tested samples with CpCDV. The definitive infection of a PCR positive sample (W1) with CpCDV was confirmed by sequencing of PCR product.

 Sleep disorders are one of the most common complications in patients undergoing open-heart surgery. Cognitive-behavioral therapy (CBT-I) is used as a way to improve sleep quality.

 This study aimed to determine the effect of a nurse-led CBT-I on sleep quality among patients undergoing open-heart surgery.

 This prospective randomized clinical trial was conducted on 90 patients undergoing open-heart surgery in both intervention and control groups (N = 45). The control group received routine care. The intervention group received 10-12 sessions of nurse-led CBT-I. The demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. The data was analyzed in SPSS v. 22 software using X2, independent sample t test, analysis of covariance (ANCOVA), and paired t test.

 The majority of samples were in the age range of 31 - 40 years (33.33%) and male (53.33%). The results of the independent t test showed that the mean total PSQI score in the 2 groups before the intervention was not significantly different (P = 0.245). Also, the results of ANCOVA showed that the mean total PSQI score after the intervention has a significant difference in the 2 groups (P = 0.0001).

 Nurse-led CBT-I intervention helps to improve the sleep quality of patients after open-heart surgery by reducing their automatic thoughts that affect behavior. Thus, it is recommended that training in nurse-led CBT-I be included in the nurses' academic training program, as well as in continuing education programs for nurses working in heart surgery wards.

The present study was conducted to assess the effectiveness of positive mindfulness training on the cognitive regulation of emotion and the number of seizures in adolescents with Pseudo-epilepsy. This research was semi-experimental with a time series design of one group and no control group in three stages: pre-test, post-test, and one-month follow-up. The statistical population included adolescents aged 14 to 18 years with Pseudo-epilepsy in Isfahan City in 1401. In this research, 14 adolescents with pseudo-epilepsy were selected and divided into two groups of boys and girls (7 people in each group). These two groups received the positive mindfulness training program in 8 sessions. The questionnaire used included a demographic questionnaire to measure the number of convulsive attacks and a cognitive emotion regulation questionnaire (Garnefski, 2001). The statistical method was the analysis of variance with repeated measurements and LSD post hoc test and was analyzed with the SPSS-24 program. The results showed that this intervention had a significant effect on the cognitive regulation of emotion and the number of convulsive attacks (P<0.05) and was able to affect the positive strategies of cognitive regulation of emotion (F=680.23, P=0.002), the negative strategy of cognitive regulation excitement (F= 485.35, P= 0.001) and the number of convulsive attacks (F= 304.20, P= 0.001). Therefore, the positive mindfulness training program can be used as an efficient method to reduce negative cognitive emotion regulation strategies and the number of seizures and increase the use of positive cognitive emotion regulation strategies in adolescents with Pseudo-epilepsy

Transferring a patient from the intensive care unit to the general ward is an anxiety-inducing process that is associated with feelings of insecurity, discomfort, dependency, and increased need. The most important goal of any care program is to satisfy the patient's needs and create a feeling of comfort. The aim of this study was to determine the effect of designed transitional care program on anxiety and general comfort of the patients undergoing coronary artery bypass graft during transfer from open-heart surgery intensive care unit to general ward.

This study was a non-randomized clinical trial with a control group which included 62 patients who were candidates for transfer from the open-heart surgery intensive care unit of Imam Khomeini Hospital in Tehran to the general ward in 2021. The patients were selected by convenient method. The control group received the routine care and were followed up. The experimental group pursued the designed transitional care program in addition to routine care. This program had 4 dimensions: 1-waiting for transfer, 2-support, gradually reducing dependence and increasing independence, 3-communication and strengthening the care triad, and 4-continuity of integrated and need-based care which was implemented by selected and trained nurses in cooperation with the researcher, physician, patients and families for 5-7 days.  Spielberger's anxiety Questionnaires and general comfort scale were completed before the transfer and on the day of the patient's discharge. Using SPSS version 26, the results were analyzed by Fisher's exact, Chi-square, paired and independent t-tests at a significance level of 0.05.

The results showed that the designed transitional care program could significantly reduce anxiety and increase the general comfort of the patients undergoing coronary artery bypass graft (p≤0.000).

Considering the impact of the intervention on the variables under study, use of the designed program as a suitable care program during patient transfer can be suggested.

While dishonesty is considered unethical, its occurrence within the healthcare system is not rare; therefore, addressing and controlling this behavior requires targeted interventions to address its root causes. This study investigates the encounters of patients with COVID-19, their families, and healthcare workers with white lies during the COVID-19 pandemic in Iran.

In this qualitative study, we employed a content analysis approach. Semi-structured interviews were conducted with 50 participants, including healthcare workers, individuals diagnosed with COVID-19, and their families. The research was carried out at teaching hospitals affiliated with the Tehran University of Medical Sciences in 2020. For data analysis, the methodology proposed by Graneheim and Lundman was used. In addition, the management and analysis of data were facilitated through MAXQDA software, version 12.

This study included 23 female and 27 male participants, with a mean age of 35±6.3 years. Through data analysis, a total of 3201 codes were identified and subsequently organized into 5 main categories as follows: social stigma, media inconsistencies, fear and uncertainty, negligence, and breaking free from quarantine. These categories further branched into 11 sub-categories.

Employing white lies as a means to sidestep social stigma and discrimination, along with grappling with fear and xenophobia, emerged as prevalent experiences. The articulation of transparent and truthful information at the community level plays a crucial role in priming public perceptions to acknowledge factual circumstances. To achieve this, healthcare authorities and the media bear the responsibility of disseminating coherent and honest information, thereby mitigating and managing the proliferation of rumors within the community amidst the ongoing pandemic.

Uncertainty in the form of demand fluctuation has been determined as one of the most affecting sources of risk in supply chain management problems. This paper aims to determine the optimal supplier selection, order allocation, and synchronizing delivery process of a single product in a supply chain with several suppliers and a single buyer considering uncertain demand. The assumption regarding the inventory scheme contributes to the complexity of the model. The proposed model considers the total cost of the whole supply chain under demand sets related to different economic situations. A robust model is then proposed using a convex nonlinear scenario-based stochastic programming with the objective of minimizing the total system expected cost. Finally, we conduct several numerical studies to evaluate the performance of the proposed model and study the effect of variation of the scenario set data on the model outputs.

A coalition loyalty program (CLP) is a business strategy adopted by companies to increase and retain their customers. An operational challenge in this regard is to determine the coordination mechanism with business partners. This study investigated the role of revenue-sharing contracts (RSCs) considering customer satisfaction in coalition loyalty reward supply chain planning. A two-stage stochastic programming approach was considered for the solution considering the demand uncertainty. We aimed to investigate the impact of RSCs on the decision-making and profitability of the host firm of this supply chain taking into account the maximization of the profit coming from the CLP compared to the more common wholesale price contract (WPC). After the model was solved, computational experiments were performed to evaluate and compare the effects of RSCs and WPCs on the performance of the loyalty program (LP). The results revealed that RSC is an effective incentive to increase the host’s profit and reduce its cost. These findings add new insights to the management literature, which can be used by business decision makers.

Intensive Care Units (ICUs) are considered as one of the most complex hospital units due to their high sensitivity and special conditions. Therefore, nurses in special care departments experience many challenges such as moral injury and conflict with management elements that can affect their performance and health. Moral injury is defined as guilt, social isolation and emotional numbness, which can affect the performance and physical and mental health of nurses. Therefore, the present study was conducted with the aim of investigating the relationship between moral injury in nurses and the ethical climate of critical care units.

The present study was a cross sectional research that was conducted in 2022 in the ICU and Critical Care Unit (CCU) departments of hospitals affiliated to Tabriz University of Medical Sciences. The study population included 266 nurses working in CCUs who were selected by simple random method. Research tools included demographic questionnaire, moral injury questionnaire and ethical climate.

According to the findings of the present study, the average score of the ethical climate of special care units in general was 77.31 ± 6.84 and the average score of moral injury among nurses was 40.67 ± 3.93, which indicates the favorable ethical climate of ICUs and severe moral injury in nurses working in these departments. Among the different dimensions of Ethical climate, the highest score was related to the instrumental dimension with an average of 22.65 ± 3.57 and the lowest score was related to the independent dimension with an average of9.11 ± 2.13. By using the Pearson's correlation coefficient, no significant relationship was observed between ethical climate and moral injury. However, moral injury had a significant and inverse relationship with the organization's ethical climate rules and regulations subscale (P = 0.24, r = -1.38) and had no statistically significant relationship with the other ethical climate subscales (P>0.05).

The findings showed that there is no significant relationship between the moral injury of nurses and the ethical climate of CCUs. Therefore, moral injury in nurses includes complex components and concepts that can be influenced by several factors. Also, the findings showed that the increase in organizational rules and regulations in CCUs will reduce the moral injury in nurses working in CCUs, so managers and trustees of medical systems should pay attention to this issue and take measures. Practices can reduce moral injury and also increase health and job satisfaction in nurses.

Medical tourists create an issue that needs to be investigated in different parts of the world. Increasing expectations of health tourists for health services improves the quality of nursing care services for foreign clients. Due to globalization, nurses are required to handle the increasing number of overseas visitors and immigrants.

This study was conducted to assess cultural capability in the professional care of nurses for medical tourists in Iran.

We conducted 23 semi-structured interviews in 2021 - 2022 in this qualitative study. The interviewees included nurses from international wards and wards with international patients, patients, patient companions, and doctors. The interviews were conducted using a goal-oriented method. After recording, the data were analyzed using the conventional qualitative content analysis of Lundman and Graneheim.

In this study, a main theme called “Cultural capability in professional care” was categorized into 8 categories: “Culture-oriented language communication,” “Culture-oriented communication interactions,” "Cultural humility," "valuing cultural diversity," "context-based client training," and "respectful communication.".

Cultural capability in the professional care of nurses is important for providing comprehensive and quality care because patients come with different cultural beliefs and from different geographical areas.

Nowadays, the football business and players’ transfer have become integral in managing professional sports, which has become a pivotal part. Therefore, clubs try to sell, buy, and remove players. This study aimed to model the transfer of players based on the game theory approach. The Nash bargaining equilibrium was determined for the player, seller, and buyer club.

A model was represented in terms of clubs’ profit, players’ wages, and bargaining power of each party using a generalized Nash bargaining model. By solving the model, the optimal transfer fee was calculated.

Results show that the transfer fee depends on the bargaining power of clubs. Bargaining power of players and factors may be the rank of the source club in the previous season, the financial value of the source club, age, nationality and height of the player, performance of the player in the last season, number of substitutes in and out of the field, number of goals and assistances, number of yellow, red, and double yellow cards in previous season all are experimental factors on the bargaining power of players. Notably, the factors may differ in different leagues and various posts played by players.

Originality: 

Game theory is a theoretical framework for solving conflicts in political and social affairs. This study used this framework to solve the problem of transferring football players from one club to another, which is unique.

Auditory stimulation is a treatment method for sensory deprivation of comatose patients, which helps wake up the patient by activating the choroid plexuses in the brain.

This study aims to determine the effect of auditory stimulation with occupational noise on the consciousness level of comatose patients with traumatic brain injury (TBI).

This clinical trial was conducted on 50 comatose patients with TBI hospitalized in intensive care units of one of the hospitals in Qom City, Iran. They were randomly assigned to two groups of control (n=25) and intervention (n=25) using the block randomization method. The intervention group received auditory stimulation with occupational voice for 10 days in the morning and evening shifts, each for 15-20 minutes. The consciousness level of patients was evaluated before and after stimulation using the Glasgow Coma Scale (GCS). The obtained data were analyzed using descriptive statistics, the Chi-square test, the independent t test, and the generalized estimating equations model.

The Mean±SD ages of the patients were 35.92±14.68 years in the intervention group and 33.32±13.74 years in the control group. No significant difference was observed between the two groups regarding demographic or disease-related variables. The Mean±SD scores of GCS before the stimulation were 5.28±1.81 in the control group and 5.12±1.90 in the intervention group. This difference was not statistically significant. The Mean±SD scores of GCS after the stimulation were 6.60±3.25 in the control group and 8.80±4.05 in the intervention group. This difference was statistically significant (P=0.038). The level of consciousness in the intervention group increased more than in the control group in the 10th day of study.

Auditory stimulation with occupational noise can increase the consciousness level of comatose patients with TBI. Auditory stimulation can raise the consciousness level of these patients hospitalized in intensive care units.

With the advent of the COVID-19 pandemic, challenges were created in educating nursing and midwifery students. However, the clinical education of these students is still ongoing. Predicting students' behavior in providing care during crises, including the COVID-19 pandemic, is an influential factor in continuing clinical education for nursing and midwifery students. The aim of this study was to determine the predictors of the willingness to care for COVID-19 patients in nursing and midwifery students of Tehran University of Medical Sciences.

This cross-sectional study was performed with the participation of 210 nursing and midwifery students of Tehran University of Medical Sciences in autumn 2021. The sampling method in this study was convenient method. In this study, data were collected using demographic information and planed behavioral theory tools. After completing the data collection process, data analysis was performed using SPSS16 software in two sections: descriptive and inferential analysis. A significance level of 0. 05 was considered.

Nursing and midwifery students of Tehran University of Medical Sciences have a high desire to provide care for patients with Covid-19 during their clinical training. The average score of the desire to care for the patients with covid-19 was 57.98±15.08. The constructs of attitude towards behavior, subjective norms and perceived behavioral control respectively had the highest mean score of willingness to care for patients with Covid-19. Among these variables, attitude variable 51%, mental norm 68% and control beliefs explain 55% of the changes in willingness to take care of a patient with covid-19 by students.

Based on the findings of the present study, mental norms play the most important role in the occurrence of students' behavior, so it is necessary to focus more on the mental norms of students in providing services in special and acute conditions such as the Covid-19 pandemic. Beliefs of control and attitude are also among the other factors affecting the desire to care for patients with covid-19 among nursing and midwifery students, which should be considered in order to train these students to provide care to covid-19 patients.

 People living with multiple sclerosis experience mood and mental health disorders more than the general population. The aim of this study was to determine the effectiveness of positive psychotherapy on mental toughness and cognitive flexibility in patients with multiple sclerosis.

 The research method was semi-interventional with a pre-test-post-test design and a one-month follow-up with a control group. The study population included 30 patients with multiple sclerosis who referred to a neurologist office in Isfahan in 2020. Thirty of them were selected using available sampling method during a call and randomly divided into two equal interventional and control groups. The participants in the interventional group receive a positive psychotherapy for eight 90-minute sessions per week. Clough Mental Toughness Questionnaire (MTQ) and Cognitive Flexibility Questionnaire (CFI), before and after completing the training and one month after the intervention was implemented. Data were analysed using mixed analysis of variance test and SPSS Statistics for Windows, version 22.0 (SPSS Inc., Chicago, Ill., USA).

 The mean (SD) age of participants in the interventional group was 33 (4.7) and in the control group was 33.7 (5.3). The mean (SD) of the mental toughness in the interventional group in the pre-test was 108.3(32) which increased to 124 (29) in the post-test (P< 0.001). But in the follow-up one month later, it showed a slight decrease to 123 (29). Also, the mean (SD) of the cognitive flexibility in the pre-test was 66.5 (21.7) increased to 84.6 (27.4) in the post-test (P<0.001). But in the follow-up, it decreased to 80.1(25). The changes in the control group were not significant in both tests.

 The study showed that positive psychotherapy increased mental toughness and cognitive flexibility in patients with multiple sclerosis.

The rock mass permeability is one of the most important parameters regulating to the groundwater flow through the fracture’s rocks. The permeability distribution is an important part of estimating inflow into tunnels. The common methods to rock mass permeability estimation such as lugeon tests are expensive and very time consuming. The use of intelligent methods to estimate or classify data, especially in engineering problems, has been common in recent decades. Many algorithms have been designed and optimized for this purpose. Support vector machines (SVM) is one of these methods. In this paper, using the SVM method, the Amirkabir tunnel has been classified from the permeability point of view. In order to optimize the parameters of this algorithm, random search method has been selected. The results show that the accuracy of modelling using this method based on experimental data is around 94.59%. Based on this result, amount 85% of tunnel length is classified in the low permeability category and water inflow into tunnel from this part of tunnel is negligible

The role of inflammatory cytokines, such as tumor necrosis- alpha (TNF-α) and IL-8, in gastric carcinogenesis has been investigated, but their impact remains to be further elucidated.

In this study, we measured the serum concentrations of these cytokines and H. pylori serostatus in dyspeptic patients, presenting with normal mucosa (NM = 53), chronic gastritis (CG = 94), and gastric cancer (GC = 82), by ELISA.

Moderate levels of TNF-α were detected in the NM group (19.9 ± 19.5 pg/ml), which were nearly doubled in patients with CG (35.7 ± 28.0 pg/ml) and drastically declined in GC patients (1.8 ± 5.9 pg/ml). The serum levels of IL-8, however, were not statistically different amongst these three groups.

TNF-α serum concentration seemed to undergo up- and downregulation, when moving from NM to CG and from CG to GC, respectively. If confirmed in a prospective study, this cytokine can behave as a serum indicator of gastric inflammation and malignant transformation.

Coronary Artery Disease (CAD) complications cause patients to experience a great deal of concerns and challenges that have adverse effects on their mental health. This study aimed to assess the effect of an empowerment program on life orientation and optimism in CAD patients.

This randomized clinical trial was conducted on 84 CAD patients admitted to post‑CCU wards of Tehran Heart Center during 2018–2019 Patients were allocated to intervention and control groups by block randomization method based on inclusion criteria. Demographic and disease characteristics, and optimism and Life Orientation Test‑Revised (LOT‑R) questionnaires were completed before and eight weeks after intervention. In the intervention group, an empowerment program was implemented. Data were analyzed by independent t‑test, paired t‑test, and Chi‑square test.

The results showed that the mean of patients’ age in the intervention and control group was Mean [Standard Deviation (SD)] 54.59 (7.93) and 55.92 (7.81) years, respectively. Most patients in both intervention (61.90%) and control (66.70%) groups were male. The majority of patients in the intervention group (92.90%) and the control group (95.20%) were married. There were no significant differences between the two groups in terms of demographic characteristics and disease history before the intervention (p > 0.05). After the intervention, a significant difference was observed in the life orientation and optimism scores between the intervention and control groups (p < 0.001).

By stimulating self‑awareness, providing knowledge and encouraging patients to control, and manage their disease, the empowerment program changes patients’ view of their disease, and increases their optimism and positive life orientation. 

Transitional care is considered an effective strategy to ensure continuity of care. The comprehensive investigation of this concept and its requirements during patient transfer has been neglected. The aim of this study is to explore nurses' experience of transitional care in the open-heart surgery intensive care unit and its requirements.

Methods & Materials: 

This qualitative study was conducted using the conventional content analysis approach. A purposeful sampling method with maximum variation was performed among the nurses involved in the transfer process. Data were collected using 8 in-depth semi-structured interviews and analyzed using the Granheim and Lundman method.‎

The main categories included the process of patient transfer and transitional care requirements. The sub-categories of the patient transfer process included pre-transfer, handover, and care measures after settlement in the general ward. The sub-categories of transitional care requirements included psychological preparation of the patient, the necessity of consolidating communication, maintaining continuity of care, patient education, and support, and considering the family's position in transitional care.

The study concluded that transitional care is an interactive and dynamic process that extends from the physician's decision to transfer the patient from the ICU to the discharge phase in the general ward. Paying attention to the requirements of transitional care can provide solutions to strengthen and organize this process. Therefore, it is suggested to apply the findings of this study in planning the strategies related to transitional care.

Most organizations use different channels to offer products and services in order to increase their market share and attract more customers. In a supply chain with more than one sales channel, product pricing is a critical issue in the decision-making process. Proper pricing can be very effective in reducing the conflict between channels and increasing the profitability of existing channels. In this paper, a pricing strategy between the dual retail and chain channels is presented to maximize profits by considering a discount in the chain channel and a revenue sharing contract between the manufacturer and the chain stores. The input parameters of the problem are adjusted using the Taguchi method and solved by the particle swarm metaheuristic algorithm in order to validate the model. Regarding the short solution time of the proposed algorithm, it has a good quality and efficiency in comparison to GAMS software. In addition, the gap of the objective value obtained by the proposed algorithm is less than 1% compared to the GAMS output. The results also show that the potential demand of the retail channel has a higher impact on the profit of the supply chain, in comparison to other parameters.

Context:

 The infectious disease caused by the novel coronavirus has spread all over the world for the first time. A key factor in containing infectious diseases is compliance with health recommendations such as social distancing and home quarantine.

This study aimed to analyze the public perception of noncompliance with home quarantine during the coronavirus disease 2019 (COVID-19) pandemic.

Settings and Design:

 This qualitative study was conducted in Iran (Ardabil and Kermanshah) in 2020. The research data were collected from 15 participants living in urban communities by conducting in-depth, semi-structured, and face-to-face individual interviews.

The purposive sampling technique was used with maximum variation in this study. Statistical Analysis Used: Data were analysed using content analysis and MAXQD-10 software was used to manage data.

A total of 15 participants comprised the final sample after data saturation. They were aged 18–51 years old. Regarding the research purposes, data analyses resulted in three categories and six subcategories: uncertainty (uncertainty about the News and uncertainty about job security), the need for serious governmental interventions (supportive interventions and legal interventions), and the fear of quarantine consequences (financial livelihood consequences and physical-psychological consequences).

Compliance with home quarantine requires the support of people and officials to contain infectious diseases. Home quarantine is not complied by the public for various reasons such as distrust, the need for supportive governmental interventions, and the fear of negative consequences. Apparently, governmental support plays a central role in solving livelihood problems.