SARS-CoV-2 mRNA-vaccine candidate; COReNAPCIN®, induces robust humoral and cellular immunity in mice and non-human primates.

At the forefront of biopharmaceutical industry, the messenger RNA (mRNA) technology offers a flexible and scalable platform to address the urgent need for world-wide immunization in pandemic situations. This strategic powerful platform has recently been used to immunize millions of people proving both of safety and highest level of clinical efficacy against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here we provide preclinical report of COReNAPCIN®; a vaccine candidate against SARS-CoV-2 infection. COReNAPCIN® is a nucleoside modified mRNA-based vaccine formulated in lipid nanoparticles (LNPs) for encoding the full-length prefusion stabilized SARS-CoV-2 spike glycoprotein on the cell surface. Vaccination of C57BL/6 and BALB/c mice and rhesus macaque with COReNAPCIN® induced strong humoral responses with high titers of virus-binding and neutralizing antibodies. Upon vaccination, a robust SARS-CoV-2 specific cellular immunity was also observed in both mice and non-human primate models. Additionally, vaccination protected rhesus macaques from symptomatic SARS-CoV-2 infection and pathological damage to the lung upon challenging the animals with high viral loads of up to 2 × 108 live viral particles. Overall, our data provide supporting evidence for COReNAPCIN® as a potent vaccine candidate against SARS-CoV-2 infection for clinical studies.

Developing and validating the nursing presence scale for hospitalized patients.

AIM: We developed and psychometrically tested the Nursing Presence Scale. BACKGROUND: Nursing presence is a foundation for professional nursing practice; therefore, it is critical to measure this concept. INTRODUCTION: This instrument development study was designed to generate an itemized scale and psychometric testing using a sample of Iranian patients. METHODS: Based on both a concept development and literature review, and finally face and content validity 44-item draft scale was generated. During November 2018-2019, 774 patients were surveyed. Exploratory and confirmatory factor analyses were used to evaluate the scale's construct validity; concurrent and predictive reliability of the nursing presence scale were also evaluated. We also examine the weighting to scale items. RESULTS: The analyses yielded a 36-item, 4-factor scale that adequately fit the data. Cronbach's alpha coefficient for the whole instrument was 0.94. The intra class correlation coefficient was 0.91. Nursing Presence Scale scores were positively correlated with Revised Humane Caring Scale and predicted 25% of missed nursing care. CONCLUSION: This 36-item has good reliability and validity, making it useful for measuring the current condition of nursing presence. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Measuring the frequency of nursing presence allows for data-driven planning and upgrading the inpatient care services.

Experiences of cancer patients about seeking health information: a qualitative study.

OBJECTIVE: Searching for health information is an important strategy in dealing with cancer that contributed to the improved management of cancer. This qualitative study aimed to explore the experiences of cancer patients seeking health information using the conventional content analysis approach. METHODS: The 18 participants were selected by purposive sampling and data were collected through semi-structured in-depth interviews. Data were analyzed by software MaxQDA 10 based on conventional content analysis. RESULTS: Data analysis led to the emergence of three central categories, including "optimal cancer management," "poor information dissemination system," and "perceived health literacy." CONCLUSION: Knowing how cancer patients obtain health information can form the basis to promote patients' health literacy and design a health information dissemination system tailored to the patients' needs.

Effects of HIS-based intervention on patient education process and patient satisfaction with nurses' education.

OBJECTIVE: This quasi-experimental study (before and after intervention) was designed to determine the impact of hospital information system-based intervention on the patient education process and patient satisfaction in cardiac and cardiac intensive care units. RESULTS: Each nurse was observed at the time of patient education on average on eight shifts (total of 256 shifts), and at last 1350 computerized reports before and after the intervention were analyzed and 150 patient satisfaction with nurses' education questionnaires were completed before and after the intervention. After the intervention, the patient education scores were significantly improved (p < 0.001). In addition, the results of a survey of patients about the level of satisfaction with the quality of patient education showed a significant increase compared to before the intervention (p < 0.001). The ability to easily, completely, and quickly edit and record the provided education, eased the process of patient education and documentation.

The High Potency of Polymeric Nanoparticles in the Drug Delivery System for Hypertension Treatment: A Systematic Review.

BACKGROUND: Polymeric nanomaterials with sizes ranging from 10 to 1000 nm are one of the most widely used types of nanoparticles with ideal properties in the drug delivery systems. Here, we decided to systematically review the antihypertensive effects of polymeric nanomaterials in vitro, in vivo, and clinical trials. METHODS: The present review was conducted based on the 06- PRISMA guideline; whereas five English databases, including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation were used for searching the publications related to antihypertensive effects of natural and synthetic polymeric nanoparticles. RESULTS: The results demonstrated that among 1701 papers, 25 papers including 11 in vitro (44%), 6 in vivo (24%), 7 in vitro / in vivo (28%), and 1 in vitro / ex vivo (4%) up to 2020, met the inclusion criteria for discussion in this systematic review. The most used nanoparticles were poly-(lactic- co-glycolic) acid nanoparticle (PLGANPs) (7, 29.2%), chitosan based nanoparticles (6, 25%), followed by polylactide acid nanoparticles (5, 20.8%). CONCLUSION: We concluded that the high potency of polymeric nanoparticles in the drug delivery system was for hypertension treatment. Although the accurate mechanisms are not fully understood; however, some mechanisms, such as sustained release forms with increased bioavailability, increasing oral bioavailability and improving the oral and non-oral absorption, counteracting excessive superoxide and decreasing blood pressure, etc. can be related to these nanoparticles.

The effect of telephone counseling and follow-up on empowering women with breast cancer undergoing chemotherapy.

Empowering women with breast cancer leads to better adaptation to diagnosis and treatment, and reduces the symptoms of cancer. The purpose of the researchers is to determine the effect of a telephone counseling and follow-up program on empowerment of women with breast cancer undergoing chemotherapy. We used a non-randomized clinical trial design. Researchers applied the telephone counseling and follow-up to the intervention group for 8 weeks. At the end of study, the intervention group showed improvement in measures of cancer functional management and breast cancer specific function, along with satisfaction with the decision, general symptoms of cancer and specific symptoms of breast cancer.

Comparison of Behavioral Concerns Priorities among Iranian Adolescent Boys, Parents and Teachers: Reporting the Results of a Modified Delphi.

BACKGROUND: Adolescence is a time of risks and opportunities. This study aimed to investigate and prioritize the behavioral concerns of male adolescents. METHODS: A modified Delphi study (2018-2019) was conducted in two stages. In the first stage, adolescents' behavioral concerns were extracted based on seven qualitative interviews and a focus group. Then, a questionnaire was designed using the obtained data; also, two-round consensus-building approach (rating and ranking) through surveys were conducted among 90students, teachers and parents covered by the Health Departments of Tehran University of Medical Sciences, who had been selected using a stratified cluster random sampling method. Qualitative content analysis was used in the first stage and descriptive statistics in the second stage to analyze the data. RESULTS: In the first stage, eight categories emerged, including relational challenges with parents and other adults; poor interaction with peers; lack of adaptation to conditions; emotional dysregulation; self-esteem and sense of purposefulness issues; materialistic tendencies; cyberspace issues; and non-adherence to religious beliefs. Then 63 behavioral concerns were identified. In each round (rating/ranking), 29/27, 28/29, and 30/30, responses were received for students, parents and teachers, respectively. According to the specified scores given to different issues, ten top problems according to the viewpoint of different groups were extracted. CONCLUSION: "lack of planning and prioritization skill", "insufficient skill for controlling crisis", and "lack of resilience" are the most important priority for male adolescents, teachers and parents, respectively. These findings can be used for planning programs based on the adolescents' behavioral concerns.

Translation and psychometric properties of the Persian version of the position on nursing diagnosis scale.

AIM: To validate the Positions on Nursing Diagnosis scale developed by Lunney and Krenz (1992) in Persian language. DESIGN: Cross-sectional survey. METHODS: A methodological study conducted in two stages of translation (by applying the forward and back-translation method) and psychometric assessment was conducted in a western area of Iran. The scale was completed by 600 nurses selected by quota method from different wards of four provinces. Date of data collection is 1-April-2019 to 1-Dec-2019. RESULTS: The Positions on Nursing Diagnosis scale showed acceptable content validity with index of 0.97. The 20 items of the Positions on Nursing Diagnosis scale load on four factors. The confirmatory factor analysis demonstrated the good fit of the model's indicators. Cronbach's alpha coefficient for the whole instrument was 0.85. The intraclass correlation coefficient was 0.86.

Explaining the effect of authentic and ethical leadership on psychological empowerment of nurses.

OBJECTIVE: This study aimed to explain the effect of authentic and ethical leadership on the psychological empowerment of nurses. BACKGROUND: Ethics-related leadership styles can play an important role in improving employee performance by influencing job satisfaction. However, no study has investigated ethics-related leadership and its impact on the psychological empowerment of nurses. METHOD: The present study is a descriptive correlational study with emphasis on structural equations. A random sample of 384 nurses in public hospitals in Tehran responded to three self-report questionnaires. RESULTS: The authentic leadership variable explains 74.5% of the variance of the psychological empowerment variable. In addition, the variable of ethical leadership explains 87.7% of the variance of psychological empowerment variable. CONCLUSION: Ethical and authentic leadership is effective on the nurses' psychological empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: Ethical and authentic leadership is necessary for managers to psychologically empower nursing staff. Increasing awareness of capabilities of nurses and how decisions and behaviours affect them, balanced information processing, observance of ethics in the workplace, transparency in communication, information and power sharing, all impact justice in the workplace.

Cognitive Impairments and Associated Structural Brain Changes in Metabolic Syndrome and Implications of Neurocognitive Intervention.

Currently, metabolic syndrome has become a global health problem. Alterations in neurocognitive functions among patients with metabolic syndrome are important issues in this disorder. In this paper, studies on metabolic syndrome were reviewed and their importance emphasized for the benefit of experts and policy makers. Metabolic syndrome activates inflammatory mediators that disrupt brain metabolism. These mediators can be activated by metabolic inflammation and microvascular disorders and may further cause damage to the white matter and impair cognitive function. These alterations can result in serious changes in cognitive abilities. The association between cognitive changes and metabolic syndrome has been independently evaluated in several studies. In addition, some areas of research in the field of metabolic syndrome include the effectiveness of neurocognitive interventions to enhance normal behaviors or reduce risky behaviors in patients. Structural brain correlates of health-related behaviors provide a basis for designing more effective behavioral interventions by identifying the corresponding brain regions and using behavioral interventions.

Improving nurses' organizational commitment by participating in their performance appraisal process.

AIMS: To promote the nurses' organizational commitment by their participation in the improvement of the performance appraisal process. BACKGROUND: Organizational commitment is one of the factors that secures safe and high-quality care of patients. It also enhances motivation among nurses, which affected by various factors such as performance appraisal. METHOD: A participatory action research study was undertaken (March 2015 to February 2018) with 39 intensive critical care nurses and nurse managers in Social Security Hospital in Iran, using a complete enumeration sampling method. The data were collected using organizational commitment and job satisfaction questionnaires, focus groups, semi-structured interviews and Delphi technique. RESULTS: Three major themes emerged including inappropriate performance appraisal system, inefficient instruments and unskilled evaluators. There were significant differences between organizational commitment and job satisfaction with performance appraisal process before and after the change in appraisal process. CONCLUSIONS: Nurses' involvement in revising and improving the process of their performance appraisal leads to higher commitment. IMPLICATIONS FOR NURSING MANAGEMENT: Maintaining a committed nursing workforce is vital for high-quality health care. Nurse Managers can improve the process of nurses' appraisal to make more motivation among them and prevent some problems such as job dissatisfaction.

The Effect of Blended Learning on the Rate of Medication Administration Errors of Nurses in Medical Wards.

BACKGROUND: Medication error is one of the most important and most common events threatening patient safety. This study was conducted with the aim to determine the effect of asynchronous hybrid/blended learning on the rate of medication administration errors of nurses in medical wards. MATERIALS AND METHODS: This quasi-experimental study was conducted with a pretest-posttest design in 2019. The participants of this study included 57 clinical nurses working in the medical wards of a selected educational hospital affiliated to Lorestan University of Medical Sciences, Khorramabad, Iran. The study participants were selected through census method. An asynchronous hybrid/blended learning program was used in this study. Data collection was performed using a two-section researcher-made checklist. The collected data were analyzed using descriptive [Mean (SD)] and inferential (paired sample t-test) statistics in SPSS software. A p value of less than 0.05 was considered statistically significant. RESULTS: The results showed that the mean score of total errors in medication administration in the medical wards after the intervention was significantly lower than before the intervention; the mean score of errors before and after the study was 61.67 and 50.09, respectively (t56= 11.41, p < 0.001). CONCLUSIONS: Asynchronous hybrid/blended learning as a type of e-learning, simple, relatively inexpensive, and new educational strategy can improve nurses' performance and reduce medication errors.

Concept Development of "Nursing Presence": Application of Schwartz-Barcott and Kim's Hybrid Model.

PURPOSE: Although nursing presence is a foundation for professional nursing practice and has known positive outcomes such as patient satisfaction and recovery; it is not well known. The ambiguity surrounding how to define nursing presence has challenged its evaluation and education. Therefore, in an attempt to discover attributes of this underdeveloped concept and studying it in a new context, concept development is essential. The purpose of this study was to clarify the concept of nursing presence through concept development, to produce a tentative definition of this subjective concept in clinical practice. METHODS: Concept development was carried out using Schwartz-Barcott and Kim's hybrid model including, theoretical, fieldwork and final analysis phases. First, 29 related articles available on the databases from 1990-2015 were reviewed and analyzed. Then, 22 interviews were conducted with 19 participants, followed with inductive content analysis. At last, an overall definition was performed. RESULTS: Nursing presence can be explained as co-constructed interaction identified by deliberate focus, task-oriented/patient-oriented relationship, accountability, clarification, and ubiquitous participation. Nursing presence requires clinical competence, self-actualization, reciprocating openness, and conducive working environment. Worthwhile communications, balance/recovery, and growth and transcendence are the main consequences of this concept. CONCLUSION: Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.

An explanatory study on the concept of nursing presence from the perspective of patients admitted to hospitals.

AIMS AND OBJECTIVES: To clarify the concept of nursing presence through patients' perception. BACKGROUND: The holistic caring process at the bedside must incorporate the concept of nursing presence. Most of the research about nursing presence is based on nurses' experiences, and research into patients' experiences is minimal. According to goals of patient centredness, the association between the patient satisfaction and nursing presence, and patients' ability to understand this concept, it is important to explore this concept from the patients' perspective. DESIGN: A qualitative approach. METHODS: Based on purposive sampling technique, 12 patients were recruited. After participant observation, 15 interviews were carried out with participants. Data were transcribed verbatim and analysed using conventional qualitative content analysis. RESULTS: Five main categories were drawn from the data including informed concentration, task-centred/patient-centred relationship, clarification of meanings, comprehensive participation and accountable encounter. Data analysis alongside the authors' reflections resulted in the emergence of one overarching theme, 'coconstructed interaction', which shows the notion that effective nurse-patient interaction enhances cooperation, coordination and collaboration in caring and improves nursing outcomes. CONCLUSIONS: Accordingly, the nursing presence would be ideal for patient-centred caring. RELEVANCE TO CLINICAL PRACTICE: Knowing the perspectives of patients is important as the evaluation of nursing care quality should rely on outcome indicators that are sensitive to patients. For instance, client satisfaction and health status acceptance, especially as it relates to coping, comfort level, hope, and participation in decision-making, are included in the nursing outcomes' classification system. Thus, the findings of this study may facilitate improvement in the quality of care by continuous improvement in knowledge, attitudes and abilities of nurses. It is therefore recommended that managers and clinical nurses, by relying on these findings, design the caring activities so that nurses' presence can act as a facilitating factor for improving quality assurance.