According to chronicity of diabetes and its effect on quality of life, in this study, we aimed to determine some predicting factors of quality of life in patients with type 2 diabetes. Our findings would facilitate planning intervention programs in health promotion field. This cross-sectional study assessed some predicting factors of quality of life among 140 diabetic patients affiliated to an outpatient diabetic center in Isfahan (Iran) in 2011. The instrument for data collection was a multidimensional scale including sociodemographic and health-related data (12 items), diabetes distress (17 items), self-efficacy (8 items), and quality of life (15 items). The collected data was analyzed by statistical tests in SPSS11.5. Our findings showed that some variables such as diabetes distress (P < 0.001) and self-efficacy (P < 0.001) had statistically significant relations with quality of life. The predictive power (R2) was equal to 0.66 in this study. In the multivariate regression model adjusted for other factors, self-management was found to be affected by diabetes distress (β = -0.277; P = 0.01) and self-efficacy (β = 0.161; P < 0.001). Pearson's correlation coefficient revealed that diabetes distress had a linear and reverse with quality of life (r = -0.341; P < 0.001). On the other hand, self-efficacy had a linear and direct relationship with quality of life (r = 0.63; P < 0.001). This study proposed decreasing diabetes distress and enhancing self-efficacy as important factors in improving quality of life and planning interventional programs among patients with type 2 diabetes.

Patient empowerment is an effective way to reach behavioral changes in diabetes control. The purpose of this study was conducted to investigate the effect of the educational program based on the empowerment model on distress and diabetes control in patients with type 2 diabetes. A RCT was conducted with 140 patients with type 2 diabetes randomly allocated to intervention and control group. In the intervention group, patients were divided to five groups with 14 patients in each group and participated in the empowerment model-based education program. In the control group, the traditional education was held. Patients’ empowerment and diabetes control were assessed using the diabetes distress questionnaires and HbA1C, respectively. It was revealed that a diabetes distress was reduced significantly in the intervention group in comparison to the control group. It was also found that with decreasing diabetes distress, the level of HbA1C diminished in the intervention group. Education based on the empowerment model in the intervention group resulted in reducing diabetes distress and improving diabetes control in comparison to the traditional education.

Diabetes is one of most important medical diseases in pregnancy and value of Glycosylated hemoglobin A1C (HbA1c) showed mean of blood glucose in 4-8 weeks ago in these patients. In different studies significant relation were seen between HbA1c and incidence of complications in pregnancy. Aim of this study is to investigate correlation of maternal, perinatal, and neonatal outcomes with mean of HbA1c in insulin dependent diabetic women. This prospective study was performed on 31 insulin dependent diabetic women who cared in Khorasan diabetic research center in year 2004. First demographic characteristic and obstetrical history of participations recorded. Value of HbA1C was measured in three trimesters of pregnancy and subjects divided into four groups based on mean of HbA1C. Fetal and neonatal complications include abortion, congenital malformations, macrosomia, fetal death, hypocalcaemia, hypoglycemia, respiratory distress and so maternal complication include pre eclamsia, polyhydroamnios, preterm labor, retinopathy and type of delivery were studied. Relation between mean of HbA1c and maternal, perinatal and neonatal outcomes statistical analyzed by using SPSS software version 11.5 and t-test. P value less than 0.05 considered significant. Mean of maternal age was 24.5 years that 41.9% women were primigravid. About half of participations (41.9%) had HbA1C equal or higher than 10% and only in 12.9%, HbA1C was in normal range (4.6%-7.6%). There were not significant relation between mean value of HbA1C and maternal and fetal complications including abortion, fetal death, macrosomia, congenital malformation, respiratory distress and so preeclampsia, polyhydroamnios and retinopathy but most of these complications were accompanied with HbA1C higher than 10%. Only respiratory distress syndrome was accompanied with normal value of HbA1C. Relation between preterm labor and HbA1C was significant. (p=0.034). No hypocalcemia was seen in any of neonates who were born of these women. Incidence of fetal, neonatal and maternal complications except hypocalcemia and respiratory distress was related to level of HbA1C more than normal. But relation between preterm labor and level of HbA1C was significant.

Nurses are confronted with practice dilemmas that evoke distress. Moral distress understood as a functional concern. Work engagement is an approach to gaining better understanding of nurse's work experiences. The purpose of this study identifies relation between moral distress and work engagement in nurses.This study designed with Cross-sectional correlation method. Data were collected using the moral distress scale and Utrecht Work Engagement Scale. The instruments were distributed 184 nurses who work in Sirjan's hospitals. The findings indicate that nurses experienced average intensity moral distress and there is significant positive correlation between intensity moral distresses with frequency moral distress. Also show the significant positive correlation between moral distress and work engagement (p=0.011, R=0.188). So we recommend nursing managers to plan strategies in order to increase nurses Work Engagement and experience less moral distress.

IntroductionThe aim of study was to compare umbilical cord blood selenium levels in respiratory distress syndrome (RDS) and non RDS preterm babies. Materials and MethodsUmbilical cord blood selenium levels of all preterm newborn born during a 6-month period were enrolled in the study. They were divided into two groups: RDS and non RDS. Selenium level was assessed by using electro-thermal atomic absorption spectrometry and serum concentration of selenium was compared between the two groups.ResultsDuring the study 150 preterm babies were studied. Mean umbilical cord blood selenium levels were 98.5 µg/L. Among 150 preterm babies 27 (18%) had RDS and 82% no RDS. Mean umbilical cord blood selenium level in RDS and non RDS groups were 96.5 and, 96.6 µg/L respectively (P=0.64). There were no significant differences between the two groups with regard to umbilical cord blood selenium levels. In this study there was no significant relationship between selenium umbilical cord blood level and respiratory distress syndrome in preterm neonates.

Moral distress is described as discomfort or a state of mental imbalance as a result of lack of proper moral action in spite of obstacles such as lack of time sufficient to official opposition superior of medicine limitations, which is policies institution and Ethical interpersonal, or a belief created stress can lead to physical and psychological affect nurses and the performance is reduced. Cross - sectional study aimed to determine the moral distress of nurses in 110 hospitals was carried out of Jiroft. The standard questionnaire of 38 questions of moral distress corly reliability and validity were used to calculate the 88% and 94%. Results were analyzed with the software spss18. Distress intensity (5/3) (total 6-0) and distress frequency (7/2) (6-0 total) were reported in units of study. The findings indicate that the intensity of distress was significantly related to their demographic characteristics. The international distress frequency a variable "hospital service and place of service", there was a significant relationship. Since Distress levels were higher than average, the need for manager's more attention to apply and accomplish training programs about ethical topics and identifying the signs and effects of moral distress and causes and factors effective on this issue demands more discussion.

To compare the incidence of fetal, maternal and neonatal complications amongst women with gestational diabetes mellitus (GDM) and pregnant women with normal glucose tolerance in Shahrood. In order to compare fetal and maternal complications, for all pregnant women who were referred from private clinics and health care settings to Fatemiyeh Hospital for screening of GDM, prenatal care was done in a cohort study. The records of mothers and neonates were obtained from delivery and nursery units. Between GDM group (63 pregnant women) and 1247 pregnant women with normal glucose tolerance, there were significant differences (p<0.001) in the rate of hypertension in pregnancy (9.7% vs. 1.8%), still birth (6.5% vs. 0.4%), hydramnious (8.1% vs.. 0.6%), cesarean section (86.9% vs. 57.6%), and macrosomia (8.1% vs. 2.8%, p<0.05). There was no difference in the rate of pre-eclampsia, pyelonephritis, pre-term delivery, low birth weight, Intra uterine growth retardation, fetal or neonatal malformations, shoulder dystocia and need for resuscitation delivery. There was also no difference in birth weight and other neonatal birth measurements. Among Pregnant women in GDM group who were younger than 25 years and had no risk factors, there was no fetal, maternal and neonatal complications, none of them required insulin therapy in pregnancy and all had normal blood glucose after delivery. Some of the complications were higher in GDM than in normal group, possibly due to poorer glycaemic control. Moreover, according to previous studies, the prevalence of GDM in Iranian pregnant women is comparable with developed countries, so more surveys regarding selective screening and cost effectiveness of universal screening in Iranian population are recommended.

assessment of the relationship between moral distress and attitude towards end of life decision making through critical care nurses. participants were 117 nurses from Shiraz hospital ICU and a questionnaire was used to measure their moral distress and attitude towards end of life decision making. The correlation between intensity and frequency of moral distress is direct and significant (r = 0.703, p = 00) Frequency of moral distress was directly correlated with nurses attitude towards withholding and withdrawing (p=0.03) And toward euthanasia (p= 0.00) and intensity of moral distress was directly correlated with DNR (p=0.03). moral distress of critical care nurses was higher than average and was correlated with end of life decision making.

Premature rupture of membranes (PROM) is a serious complication during pregnancy, which is accompanied by prenatal, neonatal and maternal complications including premature delivery, infection and fetal death. The Purpose of this research is to study the frequency of maternal risk factors and neonatal complications of premature rupture of membranes.
This cross-sectional study was conducted on 309 infants with premature rupture of membranes (more than 18 hours before delivery) from 2009 to 2015. After confirming premature rupture of membranes based on history and speculum examination, a questionnaire containing pregnancy information, delivery information and infant profile was completed and assessed.
FINDINGS: Maternal risk factors included diabetes (23 cases, 12.7%), hypertension (17 cases, 9.5%), smoking (16 cases, 8.9%), history of premature rupture of membrane (16 cases, 8.9%), urinary tract infection (13 cases, 7.2%), thyroid disorders (9 cases, 5%), previous premature birth (8 cases, 4.4%) and cerclage (7 cases, 3.8%). Delivery complications included cesarean (117 cases, 38.1%), oligohydramnios (61 cases, 33.9%), chorioamnionitis (14 cases, 11.6%), placental abruption (17 cases, 9.5%), fetal distress (6 cases, 3.3%), intrapartum fever (6 cases, 3.3%) and placenta praevia (5 cases, 2.8%). Neonatal complications included immaturity (165 cases, 73%), jaundice (108 cases, 59%), neonatal infection (94 cases, 52%), respiratory distress syndrome (65 case, 30.4%) and asphyxia (52 cases, 17%). There was a significant difference between infants with infection and without infection in terms of first and fifth minute Apgar scores, erythrocyte sedimentation, platelet and gestational age (p=0.000).
Results of the study demonstrated that diabetes and hypertension are the most frequent maternal risk factors of premature rupture of membranes. Immaturity, respiratory disorders, asphyxia and infection are the most serious associated problems. It may be possible to reduce neonatal problems with proper measures and management

The emergency department is often associated with congestion and high workload. Emergency nurses usually experience situations that lead to moral challenges, and one of its consequences is moral distress, defined as the most important hidden job challenge among emergency nurses. This study was conducted with the aim of determining nurses’ level of moral distress and factors affecting it in the accidents and emergency department. This cross-sectional study was conducted on 200 nurses working in the emergency department of hospitals in Semnan and Sabzevar, Iran. They were asked to complete the moral distress and demographic questionnaires by self-reporting. The data was analyzed with SPSS 22 using independent t-test and analysis of variance. The mean age of the participants was 32.20 ± 7.2 years. The overall score of moral distress was 54.61 ± 10.1, which shows a low level of moral distress in these public hospitals. The lowest level of moral distress was related to high job satisfaction while the highest score of moral distress was related to unfavorable relationship between nurses and doctors. Considering the negative effects caused by moral distress on the quality of nursing care, it is necessary for managers of organizations to take necessary measures to identify the symptoms of moral distress in nurses and take a positive step towards reducing it by interventions and, as a result, increase the quality of services provided to patients.