Comparison of the effect of 40 and 80 mg/day doses of atorvastatin on changes in lipid profiles among acute coronary syndrome patients: A randomized clinical trial study.

Background: Statins play a vital role in the management of high-risk patients with atherosclerotic cardiovascular disease. The aim of this study was to evaluate the effect of two doses of 40 and 80 mg of atorvastatin on lipid profiles and inflammatory markers among patients with acute coronary syndrome (ACS). Materials and Methods: This single-blind, randomized clinical trial was conducted on 60 patients with ACS referred to Heshmatiyeh Hospital, Sabzevar, Iran. Eligible subjects were randomly assigned to either 80 mg/day (atorvastatin, 80 mg/day) or 40 mg/day intervention (atorvastatin, 40 mg/day) groups. Serum lipid profiles (low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride [TG], and total cholesterol), an inflammatory marker (creatine phosphokinase [CPK]), and liver function biomarkers (alanine aminotransferase, aspartate aminotransferase) were assessed before starting treatment and 3 months later. Results: According to the paired t-test, there was a significant difference before and after intervention in each group regarding mean LDL and HDL values (P < 0.05). The result of the ANCOVA test revealed that the LDL and CPK was substantially lower in the 80 mg/day group as compared to the 40 mg/day group after 3-month intervention (62.45 ± 16.78 mg for 80 mg/day vs. 73.63 ± 20.00 for 40 mg/day P = 0.040 and 84.85 ± 6.53 IU/L for 80 mg/day vs. 120.70 ± 6.41 IU/L for 40 mg/day P = 0.001, respectively). Although the mean of HDL, TG, and cholesterol in the 80 mg/day group was lower than that of the 40 mg/day group after implementing the intervention, these differences were not statistically significant (P > 0.05). Conclusion: Findings suggest that increasing the dose of atorvastatin decreases the mean serum levels of LDL and CPK but has no effect on the mean serum HDL levels and liver function biomarkers.

Temporary Self-Deprivation Can Impair Cognitive Control: Evidence From the Ramadan Fast.

During Ramadan, people of Muslim faith fast by not eating or drinking between sunrise and sunset. This is likely to have physiological and psychological consequences for fasters, and societal and economic impacts on the wider population. We investigate whether, during this voluntary and temporally limited fast, reminders of food can impair the fasters' reaction time and accuracy on a non-food-related test of cognitive control. Using a repeated measures design in a sample of Ramadan fasters (N = 190), we find that when food is made salient, fasters are slower and less accurate during Ramadan compared with after Ramadan. Control participants perform similarly across time. Furthermore, during Ramadan performances vary by how recently people had their last meal. Potential mechanisms are suggested, grounded in research on resource scarcity, commitment, and thought suppression, as well as the psychology of rituals and self-regulation, and implications for people who fast for religious or health reasons are discussed.

Relationship between spiritual intelligence and intolerance of uncertainty, anxiety and fear of Corona in the elderly.

INTRODUCTION: The COVID-19 pandemic has caused physical and psychological health problems in the elderly. Spiritual intelligence has an effect on health and healing. The aim of this study determining the relationship between spiritual intelligence and intolerance of uncertainty, anxiety, and fear of corona in the elderly. METHODOLOGY: A cross-sectional study was done on 207 elderly people who referred to comprehensive health service centers in Mashhad in 2022. The samples were selected based on the inclusion criteria using multistage and cluster sampling. To collect data, various questionnaires were used, including demographic characteristics (age, gender, marital status …), King's Spiritual Intelligence Questionnaire, Freestone's Intolerance of Uncertainty Questionnaire, Corona Anxiety Scale, and Coronavirus Fear Scale. Statistical analysis of variables was done using descriptive and analytical (independent t-test, Mann-Whitney, analysis of variance, linear regression) tests by means of STATA version 14. RESULTS: The average level of spiritual intelligence was 54.1. Participants reported a high level of intolerance of uncertainty (M = 79.2) and fear of corona (M = 14.09). Education, economic status, and marital status were the predictors of spiritual intelligence of the studied subjects (r = 0.24, P < .05). Spiritual intelligence and gender were also related to uncertainty intolerance (r = 0.12, P < .05). Another finding of the study was the superiority of variables of spiritual intelligence and gender in predicting the level of anxiety of corona compared to other variables (r = 0.17, P < .05). CONCLUSION: There was a relationship between spiritual intelligence, education, and gender with the level of fear and anxiety of corona. Therefore, planning and implementing educational projects based on increasing spiritual intelligence for the elderly with priority for elderly women and with a low level of literacy and income is recommended.

Correlations of resilience with coping strategies, and the underlying factors in the nurses working in COVID-19 hospitals.

BACKGROUND: As the core of a health-care team, nurses play a key role in promoting community health, and their job involves witnessing human suffering and pain in health-care settings. The present study aimed to evaluate the correlations between resilience coping strategies, and the underlying factors in the nurses working in COVID-19 hospitals. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted on 320 nurses working in COVID-19 wards for a minimum of 6 months in 2021. The participants were selected via multistage sampling. Data were collected using demographic, resilience, and coping strategy instruments. Data analysis was performed in SPSS version 20. RESULTS: The mean resilience score was 76.94 ± 11.33. The mean scores of emotion-focused and problem-focused strategies were 59.65 ± 4.40 and 96.08 ± 5.38, respectively. The assessment of the correlation between resilience with the emotion-focused and problem-focused strategies showed a positive significant correlation (r = 0.25; P < 0.001 and r = 0.33; P < 0.001, respectively). CONCLUSION: According to the results, the nurses working in COVID-19 wards mostly adopted problem-focused strategies in difficult work conditions depending on the required care provision. Both coping strategies significantly affected the subscales of resilience in the nurses. Therefore, it is recommended that special attention be paid to teaching strategies to cope with anxiety and resilience and develop problem-solving skills in nursing personnel during the emergence and outbreak of new diseases in order to reduce their anxiety.

A New Approach on the pain management of intramuscular injection: A Triple-Blind Randomized Clinical Trial.

BACKGROUND: Pain management is an important part of care provided by nurses. AIMS: The present study aimed to investigate the effect of an innovative method named the skin traction, pressure, and rapid muscle release (TPR) on reducing IM injection pain compared with the Z-track injection method DESIGN: This triple-blind clinical trial investigated 63 patients who required Methocarbamol injection. METHODS: Two, 5-cc methocarbamol injections were given to each patient by the two techniques in two of his/her muscles. In the TPR technique, after applying skin traction and imposing deep pressure on the muscle, the needle was inserted at a 90° angle near the skin and the muscle was released rapidly towards the needle. Hence, the needle was embedded in the muscle. However, muscle release was not applied in the Z-track method. The visual analog scale (VAS) was used to measure pain intensity. For data analysis, T-independent and χ2 tests were used. RESULTS: The findings showed that the mean pain score in TPR and Z-track methods was 1.68 ± 1.20 and 3.76 ± 1.42, respectively. The difference was statistically significant. CONCLUSION: The results of this study showed that the innovative method (TPR) can be used as a substitute for the Z-track method to reduce IM injection pain.

Lived experiences of women with maternal near miss: a qualitative research.

OBJECTIVE: A near-miss experience has long-term and major impacts on mothers and their families. Therefore, evaluating the nature of maternal near-miss (MNM) could shed light on various aspects of the associated complications in women. The present study aimed to determine the lived experiences of women with MNM. METHODS AND MATERIALS: This qualitative research was conducted using conventional content analysis on 10 mothers with an MNM experience, who were selected based on the inclusion criteria. Data were collected via semi-structured interviews about the experiences of the mothers during and after the near-miss incident. Data analysis was performed using the conventional content analysis technique. RESULTS: Five main categories were extracted, including fears and concerns, failure to accept and adapt, tolerating physical and psychological pain and hardships, death experience, and medical team mismanagement. Regret and fear of raising the child with siblings, fear of the re-marriage of the spouse, and fear of complications and costs were among the subcategories of fears and concerns. Lack of adaptation to the complications and prolonged mourning were the subcategories of failure to accept and adapt, and the subcategories of tolerating physical and psychological pain and hardships were a sense of guilt, tolerating physical pain, hopelessness, irritability, hatred toward the medical team, and postpartum depression. In addition, returning to normal life, and seeing/actually feeling death were the subcategories of the death experience. The subcategories of the medical team mismanagement included medical errors, lack of support/negligence, communication problems, and distrust of the medical center. DISCUSSION: According to the results, the mothers were faced with multiple problems, including fears and concerns, failure to adapt to the problem, and numerous physical and psychological issues after an MNM experience. However, they believed that medical errors, the improper communications of the medical team, and their negligence toward patients were among the factors intensifying the complications.

Possibility of Intrauterine Vertical Transmission of Coronavirus Disease 2019 (COVID-19): A Case Report from Iran.

With the onset of Covid 19 disease, the vertical transmission of the disease from mother to neonate was unknown. In this case, a mother affected by a severe Covid 19 a few days before delivery, was examined whether her baby get the disease without breastfeeding and close contact with his mother or not. Finally, the case study show corona virus did not transmitted through blood from mother to the baby and he was completely healthy.

Comparison of the Effect of Cardiac Rehabilitation on Functional Capacity of Diabetic and Nondiabetic Patients after CABG.

BACKGROUND: After a coronary artery bypass graft (CABG), diabetic patients deal with various hemodynamic disorders. This study aimed to compare the effect of cardiac rehabilitation (CR) on the functional capacity of diabetic and nondiabetic patients following CABG. METHODS: This descriptive-analytical study was performed on 40 diabetic and nondiabetic patients attending a similar CR program following CABG. The subjects were selected by convenience sampling and were divided into two diabetes and nondiabetes groups. All patients attended 24 exercise sessions held 3 days a week. The functional capacity of patients was measured and recorded with the metabolic equivalent of Task criterion before and after the CR program. In addition, data analysis was performed in SPSS version 19. RESULTS: In this study, the mean age of the diabetic and nondiabetic patients was 54.45 ± 5.82 and 56.85 ± 5.36 years, respectively. There was no significant difference between the research groups regarding the systolic and diastolic blood pressure (P > 0.05). The mean functional capacity in the diabetes and nondiabetes groups was 4.5 ± 0.79 and 5.2 ± 1.7 before the rehabilitation, respectively. However, the results of Mann-Whitney U-test were indicative of a lack of a significant difference in this respect (P > 0.05). After the CR program, the mean functional capacity in the diabetes and nondiabetes groups was 5.7 ± 1.31 and 6.3 ± 1.7, respectively, demonstrating an insignificant difference in this regard (P > 0.05). CONCLUSIONS: According to the results of the study, there was no significant difference between the diabetic and nondiabetic patients, who underwent CABG, after a CR program. However, replication of the study is warranted.

Evaluation of the effect of selecting gluteal injection site on the pain injection based on anthropometric indices and body shape pattern: A randomised controlled trial study.

AIMS AND OBJECTIVES: This study was aimed at comparing the effect of injection site selection based on anthropometric indices and body shape pattern on pain injection. BACKGROUND: Pain is one of the common complications of intramuscular injection. Selecting the right place for gluteal injection is one of the challenges of nursing which can increase the safety and success of the injection and thereby reduce the pain severity caused by it. DESIGN: Open-label randomized controlled trial study. METHODS: In this study, 162 eligible subjects referred to the emergency unit of Vasei Hospital of Sabzevar, Iran were randomly assigned to three groups of control, anthropometric indices and body shape pattern. Subjects in the control group received dorsogluteal injection (traditional way). In the anthropometric group, body mass index (BMI), waist circumference (WC) and anterior superior iliac spine to iliac tubercle (ASIS-IT), and in body shape pattern group, observed body shape indices (OBS), BMI and sex were used to select the gluteal injection site. Pain injection was assessed using the Visual Analogue Scale (VAS). The CONSORT checklist was used. RESULTS: The mean age of the participant was 39.43 ± 13.16 and 43.21% (n = 70) were male. Based on multiple linear regression analysis, the mean pain injection was substantially lower in body shape pattern as compared to the control group (r2 : .26; bxy = -0.41; 95% CI: -0.81, -0.01; p = .043). The mean pain injection was significantly greater in the left leg injection than right one (r2 : .26; bxy = 0.44; 95% CI: 0.06, 0.81; p = .021). CONCLUSIONS: Findings of this study suggest that the selection of a gluteal injection site based on body shape pattern in comparison with traditional dorsogluteal injection method has a significant effect on pain injection relief. RELEVANCE TO CLINICAL PRACTICE: Nurses can choose the appropriate gluteal injection site based on the body shape pattern to reduce the pain of the intramuscular (IM) gluteal injections.

Lived experiences of patients with COVID-19 infection: a phenomenology study.

Aim To describe experiences of patients with COVID-19 infection. Methods This qualitative research was conducted using a phenomenological approach, and participants were selected via purposive sampling. In total, 14 patients with COVID-19 were selected (nine women and five men) aged 20-60 years. Data were collected via in-depth interviews with open questions and through observation. Data analysis was performed using Colizzi's phenomenological approach. Results Three themes and nine categories were extracted; the main themes were mental strains, physical manifestations, and coping mechanisms. Mental strains entailed concerns, fears and isolation, on the other hand, physical manifestations comprised nervous, respiratory and gastrointestinal system, and systemic disorders. Coping mechanisms included religiosity and home remedies categories. Conclusion Mental strains were the most important issues in the patients with COVID-19, which were interwoven with concerning physical manifestations. Most of the participants used self-medication and spiritual resources to cope with the disease. Therefore, it is recommended to carry out proper planning by healthcare personnel to psychologically and spiritually support these patients, while alleviating physical manifestations of the disease.

Students' perception of problems and benefits of night shift nursing internship: A qualitative study.

INTRODUCTION: Recently, the night shift is included in the curriculum of nursing internship students. However, this shift is associated with some problems and benefits for students, which have been assessed in limited studies. This study aimed to discover and describe the problems and benefits of the night shift for nursing internship students. METHODOLOGY: This qualitative method was carried out with the conventional content-analysis method. In total, 15 seventh-semester and eighth-semester nursing students at Sabzevar University of Medical Sciences, Iran, were selected by purposeful sampling. Data were collected using in-depth semi-structured interviews about students' perceptions of night shift problems and benefits. In addition, data analysis was performed applying the conventional content-analysis technique. RESULTS: In this study, seven main categories were extracted, five of which included problems such as exploitations, being an outsider, moral distress, learning deficits, and annoyance. The other two categories were benefits including gaining new experiences and independence. CONCLUSION: The problems related to the students were the nursing personnel and the educational system of hospitals, which can be dealt with through the interaction of the educational system with hospitals managers in order to clarifying the role of students, fair division of work, and making educational resources available. Moreover, gaining new experiences and independence are among the benefits of the night shift for students, the continuation of which is in favor of nursing education.

Moral Distress and its Influential Factors in the Nurses of the Nursing Homes in Khorasan Provinces in 2019: A Descriptive-Correlational Study.

BACKGROUND: Nurses in nursing homes are constantly faced with various moral decisions in terms of elderly care, which in turn causes moral distress. This study aimed to evaluate the moral distress status and its influential factors in the nursing homes in Khorasan provinces, Iran. MATERIALS AND METHODS: This descriptive-correlational study was conducted on 227 nurses engaged in the nursing homes of Khorasan provinces in 2019. The subjects were selected via census sampling. Data were collected using demographic, occupational, and care center characteristics questionnaire and a moral distress questionnaire. Data analysis was performed in SPSS version 16 using the Mann-Whitney U and Kruskal-Wallis test. RESULTS: The mean (SD) score of moral distress was 28.68 (19.19), and 93.83% of the subjects reported low levels of moral distress. Significant correlations were observed between moral distress and age, work experience, workplace, nurse-physician relations, motivation of the nurses, care facilities, and medical equipment. Furthermore, the highest mean (SD) score of moral distress belonged to the items regarding the lack of work experience 12.19 (3.12). CONCLUSIONS: According to the results, moral distress in the nurses of the studied nursing home was relatively low. Despite the favorable outcome of the study, the age discrimination of nurses by nursing homes should not be overlooked.

Folk theories of gender and anti-transgender attitudes: Gender differences and policy preferences.

Transgender rights and discrimination against transgender people are growing public policy issues. Theorizing from social, cognitive, and evolutionary psychology suggests that beyond attitudes, discrimination against transgender people may derive from folk theories about what gender is and where it comes from. Transgender identity is met with hostility, in part, because it poses a challenge to the lay view that gender is determined at birth, and based on observable physical and behavioral characteristics. Here, in two pre-registered studies (N = 1323), we asked American adults to indicate the gender of a transgender target who either altered their biology through surgical interventions or altered their outward appearance: to what extent is it their birth-assigned gender or their self-identified gender? Responses correlate strongly with affect toward transgender people, measured by feeling thermometers, yet predict views on transgender people's right to use their preferred bathrooms above and beyond feelings. Compared to male participants, female participants judge the person's gender more in line with the self-identified gender than the birth-assigned gender. This is consistent with social and psychological theories that posit high status (e.g., men) and low status (e.g., women) members of social classification systems view group hierarchies in more and less essentialist ways respectively. Gender differences in gender category beliefs decrease with religiosity and conservatism, and are smaller in higher age groups. These results suggest that folk theories of gender, or beliefs about what gender is and how it is determined have a unique role in how transgender people are viewed and treated. Moreover, as evident by the demographic variability of gender category beliefs, folk theories are shaped by social and cultural forces and are amenable to interventions. They offer an alternative pathway to measure policy support and possibly change attitude toward transgender people.

Effect of workshop training along with simulation and support of labor practitioners on their attitude and performance in conducting routine episiotomy.

INTRODUCTION: Routine episiotomy is a common procedure to shorten the second stage of labor. The attitude of individuals is an important factor in episiotomy, which is often carried out without an indication. Therefore, this study aimed to determine the effect of education and support of labor practitioners on their attitude and performance in conducting routine episiotomy. MATERIALS AND METHODS: This was a quasi-experimental study. A sample of 66 midwives, physicians, and midwifery faculty members were selected through the convenience sampling method. The data collection instrument was the questionnaire of personnel's attitude toward episiotomy. This questionnaire was completed by the participants before and 3 months after the intervention. A 16-h workshop about the education of natural childbirth for 2 days was performed on the experimental group. Data analysis was performed using paired t-test and Pearson's correlation test. RESULTS: The findings showed that mean attitude of the participants toward episiotomy was 50.5 ± 1.58 before the intervention, which changed to 61.18 ± 2.5 after the intervention, demonstrating a significant difference between the attitude of the participants before and after the intervention using paired t-test (P < 0.001). In terms of the performance of the midwives, participating in the research, there was a significant decrease in the number of deliveries without episiotomy. CONCLUSIONS: According to the results of the study, education and support of midwifery personnel can change the attitude and performance of these individuals in conducting a routine episiotomy, thereby reducing the number of child deliveries without episiotomy.

Interculturality and cultural intelligence in an academic context: A report from university staff interacting with nursing students.

INTRODUCTION: The cultural diversity of ethnic groups in Iranian academic contexts highlights the importance of enhancing cultural awareness and minimizing cultural conflicts. Therefore, the present study aimed to investigate the intercultural intelligence of the university personnel in interacting with students. MATERIALS AND METHODS: This cross-sectional study was a correlational research conducted on 136 employees in Sabzevar University of Medical Sciences, Iran. The participants were selected by randomized clustered sampling. The data on intercultural intelligence were collected using Earley and Ang's Questionnaire and were analyzed in SPSS using descriptive and inferential statistics. RESULTS: Mean score of intercultural intelligence in the education-research staff, secretarial staff, and student-cultural staff was 41 ± 9, 35.6 ± 8.3, and 44.2 ± 7.7, respectively. ANOVA showed a significant difference in the overall scores of intercultural intelligence across the three groups (P = 0.001); the scores of subsections were also statistically different, the student-cultural staff showing higher intelligence scores than the other groups. Furthermore, the overall intercultural intelligence scores varied significantly across the participants' educational levels so that the score of the staff with bachelor's degree was 37.8 ± 8.7 and those with master's degree was 45 ± 7.8 (P = 001), especially in their metacognitive and cognitive subsection scores. CONCLUSION: The scores of intercultural intelligence were moderate to low in the staff of different working sections of the university. Moreover, the level of education shows impacts on intercultural encounters in this academic setting. The results highlight the need to develop programs in order to raise intercultural understanding in staff.

The Effect of the Cool Dialysate on the Restless Leg Syndrome in Hemodialysis Patients: Randomized Triple-Blind Clinical Trial.

BACKGROUND: Restless leg syndrome (RLS) is a common symptom of some diseases specially observed during hemodialysis. Cooling the dialysate is a safe and nonpharmacological method. The aim of this study was to assess the effect of cool dialysate on RLS in hemodialysis patients. MATERIALS AND METHODS: A total of 79 patients were selected for screening based on the four main criteria set by the RLS International Association. Finally, in line with the inclusion and exclusion criteria, 63 hemodialysis patients were recruited and participated in this clinical trial. The patients were randomly assigned to the intervention group (n = 32) and the control group (n = 31). The intervention group received 35.5°C dialysate and the control group received 37°C dialysate three times a week for a period of 1 month. The severity of RLS was measured in both groups using a standardized RLS questionnaire. Using R software version 3.3.1, the data were analyzed using the Student's t-test, and Wilcoxon test, at 95% confidence interval. RESULTS: In terms of RLS severity, there was no significant difference between intervention and control groups before the intervention (t = -2.11, p > 0.05). After the intervention, the mean (SD) of RLS severity in the control group was 28.77 (5.45) and in the intervention group was 11.66 (4.69), in which t test showed a significant difference between two groups (t = 14.03, p= 0.001). CONCLUSIONS: Using cool dialysate as a nonpharmacological treatment may reduce the severity of RLS in patients on hemodialysis. Therefore, using this method to improve RLS in hemodialysis patients is recommended.

The effects of cool dialysate on quality of sleep among patients undergoing hemodialysis: A randomized clinical trial.

INTRODUCTION: Low quality of sleep is a common problem among hemodialysis patients. This study was conducted to evaluate the effect of a cold dialysis solution on the quality of sleep in patients undergoing hemodialysis. METHODOLOGY: This double-blind clinical trial was performed on 26 hemodialysis patients with chronic renal failure and sleep disorders in the dialysis center of Sabzevar, Iran, in 2016-2017. Of the 26 patients, 13 each were allocated to the intervention and control groups. The patients in both groups received 4 weeks of hemodialysis (3 sessions per week) using a standard solution with a temperature of 37°C. In the next stage, the control group continued to receive the standard-temperature dialysis, while the intervention group received dialysis using a solution with a temperature of 35.5°C for 4 weeks (3 sessions per week). The Pittsburgh Sleep Quality Index was used to assess and compare the quality of sleep before and after the intervention in the two groups. Data were analyzed using R 1.2.3 software, at 95% confidence level. RESULTS: Although the mean scores of sleep quality were not significantly different between the intervention (9.53 ± 3.12) and control (11.23 ± 3.37) groups at baseline, postintervention, significant differences were observed (intervention group: 4.7 ± 4.55; control group: 10.61 ± 2.69; P < 0.001). CONCLUSION: This study showed that dialysis with cold solution is a simple, cost-effective, and nonpharmacological method that can be used to improve sleep quality in patients undergoing hemodialysis.

Resilience strategies against working pressures in midwives: A qualitative study.

INTRODUCTION: The lack of experienced midwifery in obstetrics and gynecology centers would have harmful consequences. Resilience could increase midwives' endurance while caring for women and neonates in the maternity hospitals. Research on resilience of midwives is rare. The purpose of this study was to explore and describe resilience strategies against working pressures in midwives in Sabzevar, Iran. METHODOLOGY: The qualitative study was conducted using content analysis method. Twelve midwives, who had at least 1 year of work experience, were selected by purposeful sampling. Data collection was conducted using semi-structured deep interviews on midwives' resilience strategies. The analysis was carried out using conventional content analysis method. RESULTS: The five main categories of data were extracted, including self-management, supporters in the workplace, sense of usefulness and reassuring, the nature of creation, and life dynamic in the workplace, and accountability. Reading recitation and recourse, obtaining decision-making power, and problem-solving were subcategories of the self-management. Intimate the communication, peer support, physician support, and family support were subcategories of supporters in the workplace. The subcategories of sense of usefulness and reassuring were work autonomy, satisfaction of applying the knowledge in practice, the feeling of energy evacuating with much work, and trying to reassuring mothers. CONCLUSION: All extraction factors were related to the midwife and did not relate to the therapeutic system and management. However, hospital managers can provide their supporting and facilitating role to reduce the risk of depreciation and burnout in midwives.