A systematic review of nursing students' attitude and related factors towards pressure ulcer prevention.

The purpose of this review study is to investigate the attitude of nursing students toward the prevention of pressure ulcers (PUs) and related factors. From February 1, 2023, a comprehensive search was conducted in international and Persian electronic databases such as Web of Science, PubMed, Scopus, Iranmedex, and Scientific information database (SID). The keywords obtained from Medical Subject Headings, including "Attitude", "Nursing students", and "Pressure ulcer" were used in this search. The quality assessment of the present studies in this systematic review was based on the appraisal tool for cross-sectional studies (AXIS tool). A total of 6454 nursing students participated in ten cross-sectional studies. All students were studying at the undergraduate level and 81.20% of them were female. Nursing students were in the first (39.27%), second (28.19%), and third and fourth (32.54%) academic years. Among the participants, 49.86% have completed at least 2 clinical units. The mean scores of attitudes toward PU prevention in nursing students based on attitude toward PU prevention (APuP) and researcher-made questionnaires were 75.01% and 68.82%, respectively. The attitude of nursing students was influenced by various factors, including age, sex, academic year, clinical experience, number of clinical units, experience in caring for PU patients, previous courses on PU in the curriculum, and contribution of training to knowledge. Also, in the present study, the positive relationship between the attitude and knowledge of nursing students was shown as the only significant correlation. In sum, the attitude of the majority of nursing students toward the prevention of PUs was at a satisfactory level. Therefore, it is expected to transfer the necessary knowledge to them with proper planning so that preventive actions can be carried out by following the guidelines.

Green Synthesis, Characterization, and Antiparasitic Effects of Gold Nanoparticles against Echinococcus granulosus Protoscoleces.

Echinococcosis, or hydatidosis, is one of the most important zoonotic diseases, which is initiated by the larval stage in the clasts of Echinococcus granulosus. For the treatment of hydatidosis, surgery is still the preferred method and the first line of treatment for symptomatic patients. Unfortunately, most of the scolicidal agents that are injected inside cysts during hydatid cyst surgery have side effects, including leaking out of the cyst and adverse effects on the living tissue of the host, such as necrosis of liver cells, which limits their use. This work was carried out to study the lethal effect of green synthesized gold nanoparticles (Au-NCs) against hydatid cyst protoscoleces. Au-NCs were green synthesized using the Saturja khuzestanica extract. Au-NCs were characterized by UV-visible absorbance assay, electron microscopy analysis, X-ray diffraction (XRD), and Fourier transform infrared (FTIR) spectroscopy. Scolicidal properties of Au-NCs (1-5 mg/mL) were studied against protoscoleces for 10-60 min. The effect of Au-NCs on the expression level of the caspase-3 gene as well as the ultrastructural examination was studied by real-time PCR and scanning electron microscopy (SEM). The cytotoxicity of Au-NCs on hepatocellular carcinoma (HepG2) and normal embryonic kidney (HEK293) cell lines was also studied by the cell viability assay. The obtained Au-NCs are cubes and have an average size of 20-30 nm. The highest scolicidal efficacy was observed at 5 mg/mL with 100% mortality after 20 min of treatment for hydatid cyst protoscoleces. In ex vivo, Au-NCs required more incubation time, indicating more protoscolicidal effects. Au-NCs markedly upregulated the gene level of caspase-3 in protoscoleces; whereas they changed the ultra-structure of protoscoleces by weakening and disintegrating the cell wall, wrinkles, and protrusions due to the formation of blebs. We showed the effective in vitro and ex vivo scolicidal effects of Au-NCs against hydatid cyst protoscoleces by provoking the apoptosis process of caspase-3 activation and changing the ultrastructure of protoscoleces with no significant cytotoxicity against human normal cells. However, additional studies should be conducted to determine the possible harmful side effects and accurate efficacy.

The experiences of psychiatric patients, their caregivers and companions in upholding patient dignity during hospitalization: A qualitative study.

INTRODUCTION: The quality of care and patient satisfaction is closely linked with dignity, which is a crucial component of therapy and care. However, there is very little study on dignity in the context of mental health care. Planning for ongoing patient care might benefit from an understanding of the notion of dignity by exploring the experiences of patients, caregivers and companions of patients who have a history of hospitalization in mental health institutions. To retain patients' dignity while they were being treated in mental wards, this study sought to understand the experiences of patients, caregivers and companions of patients. MATERIALS AND METHODS: This investigation was qualitative. Semistructured interviews and focus groups were utilized to collect the data. The purposeful sampling method was employed for participant recruitment, which continued until data saturation. Two focus group discussions and 27 interviews were conducted. Participants included 8 patients, 2 patients' family members (companions), 3 psychologists, 4 nurses and 11 psychiatrists. Two focus group discussions were held with seven family members or companions of patients. Thematic analysis was used for data analysis. RESULTS: The primary theme that emerged was the infringement of patients' dignity, through negative guardianship, dehumanization and violations of their rights. Subthemes included dehumanization, worthlessness and namelessness, patient rights violations and stripping patients of authority. CONCLUSION: Our results suggest that, regardless of the severity of the illness, the nature of psychiatric illness significantly compromises patients' dignity. Mental health practitioners, due to their sense of guardianship, may unintentionally treat patients with mental health disorders, thus compromising the patient's dignity. PATIENT OR PUBLIC CONTRIBUTION: The research team's experiences as a psychiatrist, doctor and nurse informed the study's objectives. Nurses and psychiatrists who work in the healthcare industry designed and conducted the study. The primary authors, who are healthcare providers, collected and analysed the required data. Furthermore, the entire study team contributed to the writing of the manuscript. Study participants were involved in the data collection and analysis.

The role of Curcuma longa essential oil in controlling acute toxoplasmosis by improving the immune system and reducing inflammation and oxidative stress.

Background: Chemotherapy with synthetic drugs is the principal approach for toxoplasmosis treatment; however, recent studies reported the limitations and adverse side effects of these chemical drugs. Objective: This study aimed to examine the in vitro and in vivo effects of Curcuma longa essential oil (CLE) against the Toxoplasma gondii RH strain. Methods: The in vitro effect of different concentrations of CLE on T. gondii tachyzoites was assessed by cell viability assay. Flow cytometry and apoptosis analysis were performed, and nitric oxide production by CLE was also evaluated in tachyzoites. BALB/c mice were orally treated with various doses (1.25, 2.5, and 5 mg·kg-1·day-1) of CLE for 2 weeks. After the induction of acute toxoplasmosis in the mice, their survival rate and the mean number of peritoneal parasites were checked. The hepatic level of antioxidant enzymes and oxidative stress markers was evaluated by commercial kits. The mRNA expression level of proinflammatory cytokines such as interleukin 1-beta (IL-1ß) and interferon-gamma (IFN-γ) was evaluated by quantitative real-time PCR. Results: CLE, especially at 50 µg/ml, showed potent inhibitory effects on T. gondii tachyzoites. It increased the survival rate (ninth day) and reduced the mean number of peritoneal tachyzoites in the infected mice. CLE dependently increased (p < 0.01) the number of necrotic and apoptotic cells as well as NO production. CLE significantly (p < 0.05) reduced the hepatic level of oxidative stress markers but increased (p < 0.001) the antioxidant enzymes and proinflammatory cytokines in the infected mice, with no important toxicity for vital organs. Conclusion: The findings of this survey revealed the significant in vitro inhibitory effects of CLE on T. gondii tachyzoites. The results also exhibited promising in vivo effects of CLE. CLE improved the survival rate of infected mice and reduced the parasite number in them. Although the mechanisms of action of CLE are not clear, our study demonstrated its beneficial effects on acute toxoplasmosis by strengthening the immune system and reducing inflammation and oxidative stress. Still, more studies are required to confirm these results.

High potency of magnetic iron oxide nanoparticles covered by piroctone olamine against cystic echinococcosis.

This study examined the synthesis of magnetic iron oxide nanoparticles coated with PO (FOMNPsP) and assessed their in vitro, ex vivo, and in vivo effects against cystic echinococcosis. The FOMNPsP was synthesized through the alkalization of iron ions in a deoxygenated form. In vitro and ex vivo protoscolicidal effects of FOMNPsP (100-400 µg/mL) were evaluated on hydatid cyst protoscoleces by the eosin exclusion test for 10-60 min. The effect of FOMNPsP on caspase-3 gene expression and exterior ultra-structural of protoscoleces was assessed by real-time PCR and scanning electron microscopy (SEM), respectively. In vivo effects were assessed by evaluating the number, size, and weight of hydatid cysts among infected mice. The FOMNPsP size was < 55 nm, and the most frequent particles were in the 15-20 nm range. In vitro and ex vivo assays revealed that the highest protoscolicidal effect was observed at 400 µg/mL with 100% lethality. After exposure of protoscoleces with FOMNPsP, the level of gene expression of caspase-3 was dose-dependently increased (p < 0.05). By SEM, the FOMNPsP-treated protoscoleces showed wrinkles and bulges resulting from the formation of blebs. FOMNPsP significantly decreased (p < 0.01) the mean number, size, and weight of the hydatid cyst. FOMNPsP revealed the potent protoscolicidal traits through disrupting the cell wall and apoptosis induction. The results also indicated the promising effect of FOMNPsP in controlling hydatid cysts in the animal model. Although FOMNPsP is safe for human normal cells, more investigations are required to clarify its toxicity and precise mechanisms of action.

The prevalence of intimate partner violence among Iranian pregnant women: a systematic review and meta-analysis.

BACKGROUND: Intimate partner violence against pregnant women is an important public health concern and human rights issue. According to the various findings of previous studies, this study was conducted to assess the pooled prevalence of intimate partner violence against Iranian women. METHODS: In this systematic review and meta-analysis, a literature search was conducted in databases such as PubMed, Scopus, Web of Science, MagIran, and Scientific Information Database without a time limit. Heterogeneity was assessed by Cochrane Q test statistics and the I2 test, and the results were incorporated into a random effects model to estimate the prevalence of intimate partner violence. Data analysis was performed using R software version 4.3.2. RESULTS: The overall prevalence of intimate partner violence was reported to be 51.5% (95% confidence interval (CI) 45.0-58.1), and the prevalence rate of physical, sexual, and psychological intimate partner violence was 18.0% (95% CI 15.1-20.9), 22.1% (95% CI 17.7-26.60) and 43.2% (95% CI 36.6-49.8), respectively. The lowest level of physical, sexual, and emotional intimate partner violence rate was observed in district 1 of Iran (includes Tehran, the capital of Iran and the surrounding provinces). The rate of physical and sexual intimate partner violence prevalence decreased with the increased mean age of the husband (P=0.005) and the mean age of the wife (P=0.035), respectively. CONCLUSIONS: Studies included in this review report that more than half of Iranian women experience violence during pregnancy. In order to prevent adverse maternal and neonatal consequences, it is necessary to identify these women and introduce them to support centres.

Non-invasive diagnostic test for cow's milk allergy: A cross-sectional, descriptive study.

BACKGROUND: Cow's milk allergy is a common type of allergy in infants that is caused by the immune response to proteins in cow's milk. Digestive manifestations, atopic dermatitis, and respiratory discomfort are some of the clinical manifestations that appear; however, none of them are objective criteria to confirm the diagnosis, which may result in misdiagnosis, treatment hindrance, and parental concerns. Therefore, new methodologies for an accurate and immediate diagnosis is essential. METHODS: In this descriptive study, infants referred to the pediatric health center in Sulaymaniah were selected during a period of 1 year. The data were collected using a demographic questionnaire and the Cow's Milk Related Symptom Score (CoMiSS). Chi-squared and independent t tests were used to analyze the data. RESULTS: The findings of the present study indicated that among 250 infants (117 boys, 133 girls), with a mean ±  SD age of 2.9 ± 1.6 years, 21% were breastfed, 39% were fed both cow's milk and breast milk, and 60% were fed only cow's milk. The contingency of cow's milk allergy was positive in 35% of infants. According to this questionnaire, 18% of the participants got a score of 0-5, 47% scored 6-11, and 35% scored ≥ 12. A significant relationship was found between cow's milk allergy and the participants' diet (p < 0.001). A significant association was also found between age-dependent growth index (weight p = 0.04, height p = 0.01, and head circumstance p = 0.02) and cow's milk allergy. CONCLUSION: Although common problems in infancy such as colic and reflux may interfere with an accurate diagnosis of cow's milk allergy, give false-positive results, and decrease the reliability of CoMiSS; there is a need for non-invasive and easy methods for early diagnosis and improving awareness to encourage parents to take preventive measures.

What challenges do people face in response to the long-term use of face masks?

BACKGROUND: The world is ceaselessly adapting to the ever-changing circumstances surrounding the COVID-19 pandemic, and face masks have become a part of our daily routine. Considering the fact that face masks are here to stay, there are challenges people experience regarding wearing them. In this descriptive study, we aimed to investigate the frequent outcomes of long-term use of face masks in the general population. METHODS: Twenty-five nursing students who attended the university wearing face masks owing to the current pandemic were selected. The data were collected using semi-structured interviews. The interviews were transcribed verbatim and analyzed according to the qualitative content analysis according to the Graneheim and Lundman method. RESULTS: The mean current age of the students was 20 (standard deviation [SD] = 2.5) years, and 60% of the students were women. The two main themes that emerged during data analysis were: 1. Physical health related problems, which included 3 categories; a) skin reactions, b) respiratory consequences, and c) visual complaints 2. Socioeconomic problems, including the 3 categories of; a) communication failure, b) personal style and appearance, and c) economic factors. CONCLUSION: We support the necessity of face masks for a safe reopening of communities. Considering their advantages, some basic measurements are necessary to reduce the abovementioned concerns.

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.

Psychometric properties of the Farsi version of diabetes burnout scale in patients with type 1 diabetes.

OBJECTIVE: Diabetes burnout refers to the feeling of exhaustion and frustration in the management of diabetes, which can lead to treatment non-adherence, poor glycemic control, and a high prevalence of diabetes complications. Measuring diabetes burnout requires accurate and standard instruments. The aim of this study was to evaluate the psychometric properties of the Farsi version Diabetes Burnout Scale (F-DBS). METHODS: This cross-sectional study was performed on 550 patients with type 1 diabetes (262 men and 288 women) referred to diabetes centers in different cities of Hamedan province (Asadabad, Hamedan, Malayer, and Nahavand) in 2021. The mean age and duration of the disease in these patients were 35.58 (SD=14.32) and 15.02 (SD=10.60) years, respectively. Data were collected using the Diabetes Burnout Scale (DBS), Patient Health Questionnaire-9 and Kessler psychological distress scale. After forward-backward translation, face, content and convergent validity were performed. To evaluate the construct validity, convergent validity, exploratory and confirmatory factor analysis were performed. Internal consistency was examined with Cronbach's alpha coefficients. RESULTS: In the exploratory factor analysis, two factors of exhaustion (five items) and detachment (seven items) were extracted, which together explained 46.58% of the total variance. In confirmatory factor analysis, the fit indices were appropriate. There was a significant positive correlation between diabetes burnout and depression (r = 0.30, p < 0.001) and psychological distress (r = 0.36, p < 0.001). Cronbach's alpha coefficient of diabetes burnout, exhaustion and detachment were 0.813, 0.846 and 0.812, respectively. CONCLUSION: The Farsi version of the Diabetes Burnout scale has acceptable validity and reliability and can be used in various studies.

Death Anxiety in the Iranian Elderly: A Systematic Review and Meta-Analysis Study.

The present study aimed to estimate the standard score of death anxiety in the Iranian elderly. In this systematic review and meta-analysis, national and international databases were searched from inception to January 2022. All the observational studies published in Persian and English, which reported a death anxiety score based on the Templer death anxiety scale, were selected. The standard score of death anxiety in the elderly was 50% (95% CI: 45-56). No correlation was observed between the year of publication (p = .092) and sample size (p = .94) with the standard score of death anxiety in the elderly. With increased age, death anxiety scores declined. Publication bias was not significant (p = .340). Iranian seniors achieved half of the total score of death anxiety, which indicated the average level of death anxiety. Providing training to effectively manage death anxiety is essential to preventing the adverse consequences of extreme death anxiety.

Prevalence of hookah smoking among Iranian pupils and university students: An updated systematic review and meta-analysis.

OBJECTIVE: Today, smoking is considered a pressing global health issue. The present study aimed to estimate the total prevalence of hookah smoking among pupils and university students in Iran. MATERIALS AND METHODS: This systematic review and meta-analysis were conducted via searching in databases such as Scientific Information Database (SID), MagIran, Scopus, PubMed and Web of Sciences from inception to October 2021. We targeted observational studies evaluating the prevalence or frequency of hookah smoking among Iranian pupils and university students. Data analysis was performed using a random-effects model, and the heterogeneity of the articles was assessed using Cochran's Q test and the I2 statistic. RESULTS: In total, 124 studies conducted on 155 115 subjects were reviewed. The lifetime prevalence of hookah smoking among high school students and university students was estimated at 34.4% and 32.3%, respectively. In addition, the frequency of hookah smoking within the past month/week (point prevalence) was estimated at 21.5% and 16.6% in university students and pupils, respectively. The frequency of hookah smoking within the past year (period prevalence) was also reported to be 22.5% and 20.8% in these groups, respectively. No significant correlation was observed between the prevalence of hookah smoking, sample size, year of publication and the mean age of the participants. Region 5 had the highest lifetime prevalence (41.7%) and period prevalence (27.1%). However, Region 1 had the highest point prevalence of hookah smoking (27.2%). CONCLUSIONS: According to the results, hookah smoking is highly prevalent among Iranian pupils and university students. Therefore, proper educational interventions are required in the form of workshops and curricula to raise awareness regarding the hazardous effects of this unhealthy habit on the young generation.

Systematic review on medicinal plants used for the treatment of Giardia infection.

BACKGROUND: However, broad adoption of herbal remedies for giardiasis is at present hampered by uncertain findings of investigation not always sufficiently powered. This study was aimed at systematically reviewing the existing literature in herbal medicines to treat giardiasis. METHODS: This review was carried out 06- PRISMA guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility (SyRF) database. The search was performed in five databases which are Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation for all published articles (in vitro, in vivo, and clinical studies). The searched words and terms were: "Giardia", "giardiasis", "extract", "essential oil", "herbal medicines", "anti-Giardia", "In vitro", "In vivo", "clinical trial" etc. RESULTS: Out of 1585 papers, 40 papers including 28 in vitro (70.0%), 7 in vivo (17.5%), 2 in vitro/ in vivo (5.0%), and 3 clinical trials (7.5%) up to 2020, met the inclusion criteria for discussion in this systematic review. The most widely used medicinal plants against Giardia infection belong to the family Lamiaceae (30.0%) followed by Asteraceae (13.5%), Apiaceae (10.5%). The most common parts used in the studies were aerial parts (45.0%) followed by leaves (27.4%) and seeds (7.5%). The aqueous extract (30.0%), essential oil (25.4%) and hydroalcholic and methanolic (10.5%) were considered as the desired approaches of herbal extraction, respectively. CONCLUSION: The current review showed that the plant-based anti-Giardia agents are very promising as an alternative and complementary resource for treating giardiasis since had low significant toxicity. However, more studies are required to elucidate this conclusion, especially in clinical systems.

A common but unknown disease; A case series study.

BACKGROUND: The present study is conducted to introduce a common disease of abdominal wall which has received less attention in scientific resources. In traditional medicine sources Some scholars believe that this condition occurs due to the movement of the abdominal muscle near the umbilicus or nave laterally movement of nave. DESIGN: A case series study. METHOD: the study did not receive any funding. This study was a case series study. The study population was all patients who following repeated hospital visits did not improve, and for their last try, they visited a traditional clinic, and were diagnosed with umbilical hernia during a period of 5 months. Data were collected using demographic information questionnaire, and a complete health history taking. RESULTS: nave sliding is an abdominal wall defect and gastrointestinal and psychological problems are listed as the most prominent sign and symptoms. higher body mass index and presence of a first-degree relative with the same problem could be a predictor factor. CONCLUSION: Nave sliding is a common disease that there are a few scientific literatures about it and needs more attention from clinicians to avoid false diagnoses and requires more academic research to clarify any ambiguous side about it to promote the treatment process in a more scientific and approved methods.