mohamad asghari jafarabadi

Premature birth and subsequent admission to the neonatal intensive care unit (NICU) may impair the neurodevelopment of neonates. The present study aimed to determine the effect of developmental care on neurodevelopmental outcomes of newborns.

This quasi-experimental study was conducted on 105 premature neonates (in three groups of 35 newborns). The control group received conventional care, and the intervention group 1 received developmental care beginning since admission to NICU stay. In addition, the intervention group 2 received developmental care since entering the delivery or operating room. The developmental outcomes were evaluated based on the Ages and Stages Questionnaire (ASQ) and Bayley-III Scales of Infant and Toddler Development. Moreover, magnetic resonance imaging was performed to evaluate the brain myelination at the adjusted age of 12 months.

The obtained findings showed that the frequency rates of communication and language impairment were significantly lower in the intervention group 2, compared to those reported for the control group and intervention group 1, based on the ASQ. The comparison of the scores of the Bayley subscales (i.e., cognition, language, and motor) showed that the frequency of language impairment was significantly higher in the control group, compared to those reported for the intervention group 1 (P=0.012) and intervention group 2 (P=0.024). No significant difference was observed in terms of the neonates’ brain myelination (P>0.05).

The obtained results showed that developmental care, especially when initiated since birth, may improve some aspects of developmental outcomes in preterm newborns.

The quality of care affects patients’ satisfaction. To provide high quality care, nurses face ethical challenges in daily practice. Moral sensitivity is the first phase in moral implementation. This study aimed to determine the relationship between nurses’ moral sensitivity and patients’ satisfaction in medical wards.

In descriptive correlational study 198 nurses and 198 patients in 17 medical wards filled out the "Moral Sensitivity Questionnaire (MSQ)" and "Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ)", respectively. Nurses were sampled by the census method. For each nurse, a patient was selected randomly from the same ward. Data were analyzed using SPSS ver13.

The highest scores were in the dimensions of "Relational orientation" and "Following the rules", and the lowest scores were in the dimensions of "Autonomy" and "Experiencing moral conflicts". The highest level of patients’ satisfaction was with "nurses’ professional performance" 3.98 (1.09), and the lowest level was with "nurses’ routine work" 2.69 (1.22). There was no significant relationship between the mean of patient satisfaction and moral sensitivity of nurses.

Considering that nurses had a higher score in dimension of "Following the rules" and a lower score in dimension of "Autonomy", It seems ethical performance in the real situation is not merely due to the nurses’ moral sensitivity and It seems the complexity of the organization causes nurses face difficulties in making decisions related to clinical practice; therefore, policy makers in the health system should be able to identify barriers.

IntroductionMany different tests have been introduced for screening of gestational diabetes mellitus (GDM).The Objectives of this study were comparison of diagnostic value of fasting plasma glucose (FPG) with 100 gram oral glucose tolerance test (OGTT) and determining the suitable cut-off point of plasma glucose with best sensitivity and specificity for diagnosis of gestational diabetes mellitus (GDM).Materials and MethodsThis study was a clinical trial and Carried out on 242 women in Karaj-Iran. After doing 50 gram glucose challenge test (GCT), if 1-hour plasma glucose was ≤130 mg/dl, the 3 hours 100 gram OGTT was performed. The diagnostic values of FPG and 1, 2 and 3 hours plasma glucose were compared by receiver operating characteristic curve (ROC). ResultsOverall 50 gram GCT was positive in 41/3%. Then 100 gram OGTT for these was performed, 36% were identified as GDM. With using below surface of ROC curve for FPG (o/75), 1-hour (0/87), 2-hour (0/95) and 3-hour (0/75) plasma glucose determined that FPG with cut-off point ≤91 mg/dl had 63.89% sensitivity rate and 76/56% specificity rate for diagnosis of GDM. However, 2-hour plasma glucose with cut-off point ≤153 mg/dl had highest level of sensitivity rate (91/67%) and specificity rate (89/06%).ConclusionTwo-hour glucose with cut-off point ≤153 mg/dl had the best sensitivity and specificity rate in diagnosis of GDM. Therefore, 100 gram OGTT recommended for screening of GDM.