boroujeni

Nitrate contamination of drinking water is a common problem in many parts of the world that poses a serious threat to public health and environment. In this research, the performance of a new rotary electrocoagulation reactor model for removal of nitrate in presence or absence of turbidity has been investigated.

In this study, aluminum and iron electrodes were analyzed in parallel and monopolar arrangement. At each test time, a sample of 370 liters was prepared and the effects of operating parameters such as initial nitrate concentration, current density, annular reactor speed, optimum time, electrode materials and presence of turbidity on nitrate removal were evaluated.

The results indicated that the optimum utilization parameters were material of aluminum electrode, current density of 22.8 A/m2, annular reactor speed of 13.3 rpm and optimum time of 90 min, under which removal efficiency was 95.7%. The presence of turbidity has decreasing effect on nitrate removal and at nitrate concentration of 225 mg and with increasing in turbidity, the removal efficiency decreased from 81% to 48%. For aluminum electrode, the consumed energy in optimum utilization condition was 0.74 kWh/m3.

The results of this study showed that the introduced batch rotary reactor model was able to remove the high nitrate content from aquatic environments with ease of use and this model is recommended to be used for drinking water treatment plants.

Background & Body mass index and waist circumference do not distinguish subcutaneous fat from visceral fat, which is associated with high levels of cardiovascular dysfunction. The aim of present study was to evaluate the non-invasive respiratory fitness (CRF) in men and women in Isfahan and the possible relationship between the new indicators of abdominal obesity with CRF. In a cross-sectional study on healthy subjects aged 25 to 65 years old in Isfahan, a total of 248 subjects were male and female with a mean age of 37.31 ± 11.39 men and 41.99 ±12.91 men volunteered for the study. Abdominal obesity data includes ABSI, BAI, WHR, cardiopulmonary function (maximum oxygen consumption derived from step by step protocols, rocket and Bruce) and physiological (systolic and diastolic blood pressure) and heart rate were collected and analyzed. The average number of daily steps in men and women was 6172 and 6341, respectively, which was lower in both groups than normal values. In contrast, visceral obesity indices were highly range than those in the same age group. In addition, pedometer Vo2max values were 30.58 ± 10.51, 59.59 ± 91.8 and Vo2max, respectively, were 38.04 ± 14.66, 43.13 ± 13.51, and Vo2max Bruce, and 32/45 ± 4/03 ,44/26 ± 5/51 It was found that almost all body composition indices other than ABSI were negatively related to VO2max by step-by-step protocols and rocket protocols. Our data emphasizes the necessity to develop interventions to improve CRF and to prevent the increase of obesity. Longitudinal research will be required to confirm a potential link of causality between these variables.

With recognizing principles of pediatric care, the need is rather felt for self-efficient nurses. Self-efficacy is expected to be the most influential among factors affecting nurses’ function. Yet, caring self-efficacy perception of pediatric nurse’s perspective has not been studied in Iran. The present study was conducted to benchmark caring self-efficacy perception of pediatric nurses’ perspectives. This study conducted with qualitative conventional content analysis approach. Participants included 27 pediatric nurses and instructors, selected purposively. Data were collected using semi-structured interviews, and analyzed using conventional content analysis method. Management of care process, Communicational ability, Altruism, Proficiency, were extracted main themes as of caring self-efficacy in this study. Results indicated that caring self-efficacy perception is a multi dimension concept and management of care process, communicational ability, and altruism, proficiency were more important dimension of caring self efficacy in pediatric nurse’s perspectives. These results can be used by nursing managers and instructors to help develop empowerment and efficacy of nurses, especially in pediatric care.

Major histocompatibility complex (MHC) class II deficiency is a rare primary immunodeficiency disorder (PID) with less than 200 cases worldwide. Here, we report an 8 month–old girl with MHC class II deficiency with a novel homozygous mutation in RFXANK gene (NM_001278728: exon 5: c.495G>A: p.Trp165*) and normal CD4+ T cell counts, diagnosed by whole exome sequencing (WES) and negative HLA–DR proteins on peripheral blood mononuclear cell (PBMC) in flow cytometry. She was referred with pneumonia, prolonged fever, resistance to antibiotics (ceftriaxone, clindamycin, and vancomycin), and low serum immunoglobulin (IG) levels, while natural killer (NK), B, and T cells were normal. She received intra-venous immune-globulin (IVIG) replacement, broad spectrum antibiotics, and anti-fungal treatments. The presented case report is interesting not only because of the rarity of the PID but also due to normal CD4+ T cell counts. According to our experience, we suggest that physicians consider MHC class II deficiency in families with consanguineous marriages, even with normal CD4+ T cell counts. At the first, the diagnosis of the disease could be successfully perform using WES, and finally, treatment with hematopoietic stem cell transplantation can save the patients’ lives.

The process of scouring is removal of sediments from river bed, caused due to moving water or waves. Scour can be classified into two broad categories: General scour and local scour. Contraction scour, as a type of general scour, occurs due to a reduction in channel cross-sectional area. Local scour on the other hand occurs due to the direct effect of an obstruction on the flow field. Contraction scour is observed where the flow is constricted due to the placement of structures like bridges etc. The flow accelerates in constrictions which increase the bed shear stress and the turbulence associated with it. The development of contraction scour is noted when the critical shear stress of the bed materials is overcome by the bed shear stress. This paper provides a comprehensive discussion on scour within channel contractions. Scour within a channel contraction occurs where the waterway is restricted by the foundations or road approach embankments of a bridge. Alternately, contraction scour takes place when a bridge is located at a natural contraction in the river width. Contraction scour is an important phenomenon in rivers. To reach the aims of this work, both experimental and numerical modeling has been done. In this study, the experiments curried out in a flume with length of 20 m and width of 0.6 m, located in hydraulic laboratory of Shahrekord University. The average size of the sediments in the flume was d50 = 0.78 mm. The bed sediment layer was 16 cm thick. The experiments were run with three different discharges: 20, 30 and 40 l/s and flow depth was regulated at 30 cm. Also, the experiments were conducted with four different contractions of 20 cm, 30 cm 40 and 50 cm wide, which was resulted in three different the contraction ratio of 0.33, 0.5 and 0.67. SSIIM computer model has been used for contraction scour prediction in stream for two different conditions, including sudden (with angle of 90o) and gradual (with angle of 50o) contractions. Calibration of SSIIM model was conducted based on the results from the experimental study. SSIIM numerical model is capable of solving the Navier-Stokes equations on three-dimensional network with k-ε turbulence model. Likewise, it utilizes volume control with power upstream or second-order law for discretizing equations. This software also addresses to solve the passive pressure field using iteration technique and simple method (semi-implicit method for solving equations with pressure). After calibration of experiments to analyze the output results, Tecplot software was employed because the display of the obtained results from scouring through SSIIM was not clear. In current study, parameters such as flow pattern, scouring pattern, and water depth were simulated. Calibration of results was carried out by the experimental data. With monitoring model results, the start of scour for all models in the beginning of the narrowing part and the side walls was simulated. The greatest value of the scouring achieved at the same place as in experimental model. According to the results of the model regarding flow pattern simulation, it can be stated that flowing lines are constricted by reaching to narrowing part beginning and along the narrowing section changed to parallel lines. At the end of constriction, flow lines are being expanded and at the gradual opening, rotational currents are formed. Maximum amount of scour was calculated 12 cm in flow rate of 40 L/s and 20 cm constriction with 9.09% error that this amount was measured 11 cm in the laboratory. In addition, the least amount of scour was measured 1.8 cm in flow rate of 20 L/s and 40 cm constriction with 20% error in numerical model and 1.5 cm in the laboratory. Obtained results showed that the model was adequate for modeling of contraction scour, in parameters of scouring maximum depth, erosion pattern and circular flows. Accuracy of the model was acceptable according to the average of Nash – Sutcliffe coefficient of 0.923, average error of 10.18 and the maximum error of 20%. Based on the calibrated model, contraction scour was simulated for sudden transition and results showed that scour maximum depth was increased at a rate of 29.5%, comparing with gradual transition. This indicated that gradual transition plays a positive role to reducing contraction scour.

Drug error is one of the unforgivable human errors. Challenges such as lack of national statistics and refuse of drug errors report are more important and its recognition is a must. The aim of this study was to evaluate nurses, pharmacologists, and doctors’ attitude toward medication errors, including factors that may contribute to errors, barriers to reporting them, and possible preventive measures. In this descriptive analytic study in December 2017, a survey was conducted of 91 Nurses, pharmacologists, doctors working on medical wards at an educational hospital in Chaharmahal and Bakhtiari Province in Iran. The study data were collected by a self-report questionnaire. The obtained data were analyzed in SPSS V. 16. The commonest identified causes of medication errors were doctors’ illegible handwriting, nurses’ tiredness, and distraction or interruption while administering the prescribed drugs. According to the study participants, the most important reasons for not reporting errors were the administration system and fear of being blamed. The introduction of hospital policies and implementing structured protocols on drug administration may decrease medication errors. It is also helpful to start preventive strategies such as holding regular education sessions in pharmacology and numeracy.

  Genetic and environmental factors are involved in the incidence of schizophrenia and bipolar disorder. Many reports confirm that several common genes are connected with these two psychotic disorders. Several neurotransmitters may be involved in the molecular mechanisms of schizophrenia and bipolar disorder. We aimed to estimate the role of two talent genes: DAOA in neurotransmission of glutamate and COMT in neurotransmission of dopamine to guide the treatment of schizophrenia and bipolar disorder. Blood samples (n=100 for schizophrenia, n=100 for bipolar I disorder and n=127 for case control) were collected from individuals unrelated in the southwest of Iran. The SNPs (rs947267 and rs3918342 for DAOA gene/ rs165599 and rs4680 for COMT gene) were genotyped using the PCR-RFLP method. Our finding was studied by logistic regression and Mantel-Haenszel Chi-square tests. We observed an association in rs3918342, rs165599 and rs4680 single nucleotide polymorphisms and schizophrenia and bipolar I disorder. In addition, our data demonstrated that the rs947267 was related to bipolar I disorder but there was no association between this SNP and schizophrenia. In conclusion, this result supports the hypothesis that variations in DAOA and COMT genes may play a role in schizophrenia and bipolar disorder

One of the most important roles of nurses in the war was the application of management interventions, which led to provide better services for the wounded soldiers. The purpose of this study was to explore the Management behaviors of civilian nurses in the Iran‑Iraq war.
The historical research methodology and thematic analysis using in‑depth interviews were applied to gather data. This study was conducted in 2010‑2012 in five big cities of Iran, and involved 18 male nurses who were selected by purposeful sampling method.
The interviews of the nurses revealed a main category as the management behaviors of the nurses in the war. Six subcategories were obtained, namely call up for the war, establishing emergency teams, managing the therapeutic units, managerial innovation during war operations, teamwork and variety of roles of nurses in the war.
This study demonstrated how the nurses adapted to the harsh a situation without any previous experience on management in crises such as wars and increased medical treatment facilities outcome using management principles.

Cohesive sediments are composed primarily of clay-sized material, which have strong interparticle forces due to their surface ionic charges. As particle size decreases, the interparticle forces dominate the gravitational force, and the settling velocity is no longer a function of only particle size. When, under certain conditions, the attractive forces exceed the repulsive ones, colliding particles stick together, forming agglomerations known as "flocs" with size and settling velocities much higher than those of the individual particles. This phenomenon is known as "flocculation" (Baldock et.al, 2004). In a flocculated cohesive sediment suspension, the settling unit is the floc rather than the individual particle. The settling velocity of cohesive sediment particles, also is called the fall velocity, is one of the key variables in the study of sediment transport and is important in understanding suspension, deposition, mixing and exchange processes (Partheniades, 2009). Adding a chemical solution in a mixture of water and sediment changes the physicochemical of the sediments and the flocculation of the clay particles may increase or decrease. Today, in many countries the wastewater is used for irrigation sector as an additional water resource. Wastewater in combination with other water resources change the physicochemical characteristics of the water and it causes changing in hydrodynamic behaviors which one of them is the effect of wastewater concentration on the fall velocity of cohesive sediments in channels and water transfer Systems (khastar-Boroujeni, 2018). Therefore this study focuses on the effect of urban wastewater on cohesive sediments transport to improve water quality and manage the irrigation systems. For this purpose, some experiments were carried out in an annular flume using a mixture of cohesive sediment and water with combination of three levels of wastewater for evaluating their effects on the fall velocity of cohesive sediments.

 

The purpose of this study was to investigate the effect of attentional focus and frequency of feedback on performance and kinematics in basketball free throwing.

In this semi-experimental research, fifty students were randomly selected using convenience sampling method, and were randomly divided in one control and 4 experimental groups (internal focus and 33% feedback, internal focus and 100% feedback, external focus and 33% feedback, and external focus and 100% feedback). Experimental groups conducted six blocks of ten attempts (every day two blocks of ten attempts) in one week, and in three sessions of training, and received internal or external focus feedback with the corresponding frequency (33% or 100%). After 72 hours, retention and transfer tests were performed with ten-attempt blocks. Performance (throwing accuracy) and kinematic data (joint angle and range of motion) were collected. Data were analyzed using ANOVA with repeated measures and one way ANOVA.

Feedback with external focus (100% and 33%) was more effective in improving throwing performance in retention and transfer tests (P < 0.050). Kinematic data analysis showed that external focus feedback groups had the least maximum flexion in the knee joint in retention test compare to acquisition stage (P < 0.050). Moreover, external focus groups had the least maximum flexion at the knee in retention test compared to internal focus groups (P < 0.050). In range of motion of the knee, external focus groups had more range of motion in retention and transfer tests compared to internal focus groups (P < 0.050).

Performance improvement in external focus groups may be limited to certain changes in kinematic data, and in line with constrained-action hypothesis.

Untreated procedural pain leads to long‑term and short‑term complications in neonates. Preventing pain in sick infants and neonates, whose conditions are getting worse, not only is a professional and legal duty but also a prevention measure to decrease future psychological and even neurological complications. Therefore, nurses should prevent newborns’ pain. The aim of this study was to compare the effects of massage and breastfeeding on the pain of the neonates.
This was a clinical trial conducted among 75 full‑term and near‑term infants who underwent venipuncture. The newborns were randomly allocated to the following groups (n = 25 for each): group 1, breastfeeding; group 2, massage; and group 3, control. In the first group, venipuncture was done 2 minutes after breastfeeding. In the second group, massage was done with effleurage technique for 3 minutes and venipuncture was done 2 minutes after massage. The Neonatal Infant Pain Scale (NIPS) was used for pain measurement in the first 30 seconds of venipuncture. Data were analyzed by t‑test and one‑way analysis of variance (ANOVA).
The lowest mean pain score recorded in the massage group (0.92) whereas it was 4.84 in the breastfeeding group and 6.16 in the control group. ANOVA test and post‑hoc statistics revealed that both interventions resulted in a significant reduction of the pain scores.
According to the findings of this study, the lowest pain score was in massage group, then in breastfeeding group and control group accordingly. Considering the fact that massage and breastfeeding are natural, useful, and cost free interventions and do not need any special facility, these methods are suggested in pain management and pain control during painful procedures administrated for infants.

Food-producing animals are under suspicion for the reservoir and colonization of ESBL (extended-spectrum beta-lactamase)-producing bacteria especially Enterobacteriaceae and therefore infection of the humans with them. The increasing reports on the ESBLs presence in the pathogenic and commensal Escherichia coli isolates have been a concern worldwide. These strains can be attributed to one of the main phylogenetic groups and subgroups. Several studies have shown the relationship between the phylogeny and antimicrobial resistance of E. coli strains.
The aim of this study was to analyze the phylogenetic group of ESBL-producing E. coli and detect its phenotype using the multiplex polymerase chain reaction (PCR) and combined disk method.
Two hundred five E. coli fecal isolates were obtained from 103 calves (90 healthy and 13 diarrheic) and 102 dairy cows (healthy) from 8 farms in Khuzestan province, Iran. The triplex PCR method was used to allocate the E. coli isolates based on the presence or absence of 3 genes (chuA, yjaA, and tspE4.C2) to yield 4 definite phylogenetic groups and 7 subgroups. Phenotypic ESBL-producing E. coli was determined using the double disk diffusion method according to the manufacturer’s instructions and Clinical & Laboratory Standards Institute (CLSI) guidelines.
A total of 65.04% and 22.3% of isolates from calves and 70.5% and 20.5% of isolates from dairy cows belonged to phylogroups B1 and A, respectively. In addition, no isolate from the diarrhoeic calves was found to belong to group B2 and subgroups D2 and A0. A low prevalence (2/205 isolates, 0.97%) of ESBL-producing E. coli was found only in the samples of dairy cows which belonged to the phylogenetic group A and phylogenetic subgroup A1. There was no statistically significant relationship between the phylogenetic group and the production of ESBLs (P = 0.11). There was also no difference between the E. coli isolates from calves and dairy cows in the production of ESBLs (P = 0.5).
There was no statistically significant relationship between the phylogenetic group and the production of ESBLs (P = 0.11). There was also no difference between E. coli isolates from calves and dairy cows in the production of ESBLs (P = 0.5). Based on these results, there is a low prevalence of ESBL-producing E. coli in the dairy farms of Khuzestan province. However, further large scale investigations are necessary to control the antibiotic resistance in the human and animal foodstuff.

Development of critical thinking and practical skills has remained a serious and considerable challenge throughout the nursing educational system in Iran. Conventional methods of teaching such as lectures as the dominant method used in higher education system is a passive style which ignores critical thinking. Therefore, the aim of this study was to compare the effect of instruction by Concept-Mapping and conventional Method on critical thinking skills of nursing students.
This quasi-experimental study was carried out on 70 nursing students of Tehran Nursing and Midwifery schoolwho were selected through convenient sampling method, then were divided randomly into the two equal Experimental and Control groups. Educational content was presented in the form of Concept-Mapping in the Experimental group and Lecture,Demonstration and Practicalexercises in the control group. Data collection included a demographic information and California Critical Thinking Skills (form B) questionnairewhich was completed at the beginning and at the end of the fourth week of Instructional period. Data were analyzed using SPSS software (V: 21), descriptive and analytical Statistics; at the significant level P Before the intervention, the mean of critical thinking skill score was 9.71±2.66 in concept mapping group and 9.64 ± 2.14 in conventional group and the difference was not significant (P=0.121), but after the intervention, a significant difference was found between the intervention and conventionalgroup (15.20±2.71 vs 10.25±2.06, P=0.003).
Using Concept mapping strategy in the education of nursing students may lead to developing critical thinking skills as one of the important missions of higher education. So it is recommended to usethis method in clinical nursing education.

Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss.
CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges.
Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term.

Although numerous natural or synthetic drugs have been tested for their radioprotective capacity, yet no suitable drug has been introduced for routine clinical use. In this study the radioprotective effect of "a new herbal immunomodulator" commercially known as IMOD, specifically made to decrease the side effects of HIV virus, was investigated on mouse bone marrow cells.
Female NMRI mice (in a group of five) were exposed to 2 Gy gamma radiation following three days of intravenously injection (IV) of IMOD at various doses. Mice were sacrificed 48 and 72 h after irradiation. Bone marrow was flushed and slides for bone marrow smears were prepared according to standard method. After staining slides in May Grunwald and Giemsa, polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were scored for presence of micronucleus (MN).
The results showed that gamma irradiation increased the frequency of micronuclei dramatically and excreted cytotoxic effect of cell proliferation. Injection of various doses of IMOD before irradiation however, led to a considerable reduction in the frequency of micronuclei in bone marrow erythrocytes as well as cellular toxicity.
Results indicated radioprotective capability of IMOD with a dose reduction factor (DRF) of about 2.3 at a dose of 20 mg/kg body weight. The considerably high DRF might be indicative that IMOD besides being an immunomodulator might also posses’ antioxidant property.

Expansion equal channel angular extrusion (Exp-ECAE) is a severe plastic deformation (SPD) operation for processing bulk materials. In the current study, AA7075 Al was SPD-processed by expansion equal channel angular extrusion (Ex-ECAE) at various temperatures and ram velocities. Then, using split Hopkinson pressure bar (SHPB), the severely deformed products were compressed at room temperature and strain rates of 0.1~3000 s-1. Both the strain rate sensitivity (SRS) and the apparent activation volume (AAV) were determined for all deformed samples. The results revealed that the Ex-ECAE operation has noticeably increased the SRS. The tensile strength at a strain rate of 3000 s-1 was 6 times increased by conducting Ex-ECAE at 100 °C and with a ram velocity of 7 mm/min. Ex-ECAE was also capable of considerably decreasing the AAV. The results showed the yield stress of both the Exp-ECAE and the annealed samples increased with increasing the strain rate. Also, the results showed that after the Exp-ECAE process, the AAV reached to 6.3 b3 from the initial values of 118.5 b3 in the annealed state.

Nurses’ clinical competency plays an important role in the care of preterm infants. On the other hand, burnout is one of the most important factors in reducing the nurses’ efficiency. With regard to the importance of the role of nurses, and the vulnerability of the infants, the purpose of this study was to investigate the relationship between nurses’ burnout and clinical competency in NICUs.
The descriptive cross-sectional study was conducted with the participation of 86 nurses working in the NICUs of hospitals in Isfahan, Iran. Census sampling method was used in the NICUs of educational hospitals in 2014. Data were collected by a questionnaire including demographic characteristics, Patricia clinical competency, and Maslach burnout scales. Data were analyzed by the statistical tests of independent t-test and Pearson correlations test with the significance level of á Six dimensions of clinical competency and three dimensions of nurses’ burnout were assessed at three levels (weak, moderate, and strong levels). Statistical tests showed that clinical competency was at a moderate level in all fields. Of the dimensions of nurses’ burnout, emotional exhaustion was moderate, depersonalization was weak, and personal performance was strong. The results showed that nurses` burnout and clinical competency in the NICUs were at a moderate level and had a significant negative relationship (r = −0.322, P = 0.003).
Results showed that burnout had a negative relationship with competency. Therefore, managers are suggested to improve nurses’ competency and diminish their job burnout through better and more applicable planning.

Healthcare areas, especially fertility care (commonly accompanied with high emotions, as well as long-term and recurring treatment periods) could exclusively benefit from patient-centered care (PCC). Despite evident advantages of PCC, this approach has not been practiced as a routine procedure in current clinical environments yet, even in western developed countries. Therefore, this review aimed to evaluate the significance and different aspects of PCC, while emphasizing on patient-centered fertility care, its challenges, and applicable recommendations in this regard.
This narrative review was conducted on 29 relevant medical and clinical papers (published during 1990-2015) collected using various national and international databases (e.g., SID, Magiran, Medlib, Google scholar, Proquest, Pubmed, Wiley, Science direct, and Scopus). Key words and phrases used in this review were “infertility”, “fertility care”, “childlessness”, “patient-centered care”, “patient-centered fertility care” “shared decision-making”, “infertile patient preferences”, and “patient involvement in fertility care”.
According to the literature, implementation challenges of patient-centered fertility care were reported as different individual and organizational factors. These factors include lack of professional motivation to change, underestimating the significance of patient-centeredness by healthcare professionals, difficulty in translation of feedback into concrete measures, lack of time and financial resources, insufficient experience of healthcare professionals with regard to identification of needs and preferences of patients, traditional organizational culture, and common misconceptions.
Promotion of patient-centered fertility services requires the identification of infertile needs and priorities of individuals, designation of interventional and supportive programs based on sociocultural characteristics of the community to fulfill such preferences, and considering patients as the most significant stakeholders of each healthcare center. This review might provide important data for healthcare professionals and policymakers aiming to improve patient-centered fertility care.

Background& Amis: Self-efficacy as the main predictor of nurses’ behavior plays an important role in nurses’ professional behavior. However, the various aspects of this concept have not been taken into consideration. The present paper attempts to explore perceived self-efficacy of proficiency in pediatric nurses.
This study is part of a larger study on the caring self-efficacy concept that was conducted through content analysis and from a qualitative approach in 2014 in Iran. 27 nurses and pediatric clinical instructors participated in this research according to the purposive sampling employed in the study. Data was collected through semi-structured interviews. The collected data was analyzed using conventional content analysis method.
The proficiency concept has two main categories “Technical Capabilities” including clinical skills, creativity in care, Atraumatic care, and “care based on professional knowledge” including Knowing That and Knowing How.
This paper introduces “proficiency” as one of the most aspects of caring self-efficacy in pediatric nurses. This finding can be used by nursing administrators and instructors to help perceived self-efficacy of nurses, especially in the area of pediatric caring and to enhance quality of pediatric caring.

Background and Upon centuries, wars have taken over countries due to theadvancement of sophisticated warfare,causingserious injuries among soldiers. Nurses are directly involved in preoperative and postsurgical patient care. One of the most remarkable contributions of the Iranian operating room nurses was to provide medical care for wounded soldiers in field hospitals during the Iran-Iraq war. This study aimed to explore the experiences of civilian operating room nurses infield hospitals at the frontlines during the Iran-Iraq war.
This study was conducted using historical research methodology and oral history method throughin-depthinterviews with civilian nurses engaged inoperating rooms during the war.Participants were selected via snowball sampling. This study investigated nursing practice in operating rooms as recountedby 16 civilian nurses who served in field hospitals inthe Iran-Iraq war during 1980- 1988.
This study had six descriptive themes focusing on the experiences of nurses engaged in operating rooms during theIran-Iraq war, and the results were obtainedin a narrative style. The main themes extracted from the study were“establishment of medical centers in the frontlines”, “organization of emergency medical teams”, “establishment of operating rooms”, “nursing duties inthe operating room”, “documentation of medical interventions”, and “vulnerability of nurses in the operating room”.
The findings of this study will significantly enhance the current knowledge regarding operating room nursing practiceduring the Iran-Iraq war, enabling a greater understanding of this particular medical experience.

Nurses are considered the largest and most important human resource for healthcare organizations. Self-efficacy as the main predictor of nurses’ behavior plays an important role in nurses’ professional behavior. However, the various dimensions and threats of caring self- efficacy concept have not been taken into consideration.
The present paper attempts to identify threats to self-efficacy as an important aspect of the concept of pediatric nurses’ caring self-efficacy.
This study is part of a larger study on the caring self-efficacy concept that was conducted through content analysis and from a qualitative approach in 2014 in Iran. Twenty-seven nurses and pediatric clinical instructors participated in this research according to the purposive sampling method employed in the study. Data were collected through semi-structured interviews. The collected data were analyzed using the conventional content analysis method.
“Threats to self-efficacy” was one of the main themes extracted from the interview analysis results in the present study. The theme consists of two main categories “individual barriers,” including not having a caring attitude and not being interested in children, and “organizational barriers,” including an inefficient educational system, not developing professional capabilities, non-valuation of the organization in a caring context, a poor rewards system, and inappropriate managerial policies.
Nursing management and custodians of nursing trainings can break through the barriers to self-efficacy by knowing these factors and making changes in the educational programs and providing supporting policies. This can be an important step toward improving nurses’ inefficacy and ultimately improving the provision of quality healthcare services.

Parent–infant attachment is an important factor in accepting parenting role, accelerating infant survival, and adjusting to the environment outside the uterus. Since family supportive interventions can strengthen the parent–infant caring relationship, this study sought to investigate the relationship between mother–infant attachment and satisfaction of the mothers with the supportive nursing care received in the neonatal intensive care unit (NICU).
In this descriptive–correlational study, 210 mothers with premature infants who were hospitalized in the NICUs affiliated to Isfahan Medical University hospitals took part. The data were collected via Maternal Postnatal Attachment Scale and researcher’s self‑tailored questionnaire based on Nurse Parent Support Tool. Pearson correlation coefficient and multiple linear regressions were used to analyze the collected data.
The results showed that the overall score of mother–infant attachment and the overall score of maternal satisfaction correlated with a correlation coefficient of r = 0.195. Also, the overall score of mother–infant attachment and mothers’ satisfaction scores in the emotional, communicative‑informative, and self‑confidence domains correlated with correlation coefficients of r = 0.182, r = 0.0.189, and r = 0.0.304, respectively. The results of multiple regression analysis revealed that about 15% of changes in the dependent variable (mother–infant attachment) could be explained by different dimensions of mothers’ satisfaction.
The results of the study showed that mother–infant attachment improved by increasing mothers’ satisfaction of supportive nursing care. Therefore, it seems necessary to increase maternal satisfaction through given nursing care support, in order to promote mother–infant attachment.

It remains controversial if dairy product intake is associated with risk of stroke. Limited information is available from Middle East countries in this regard. This case‑control study was conducted to assess the relationship between dairy consumption and risk of stroke in Iranian adults. In this study, 195 stroke patients (recognized based on clinical findings and computed tomography scan) hospitalized in neurology ward of Alzahra University Hospital were enrolled. Controls (n = 195) were selected with convenience nonrandom sampling procedure from other wards of this hospital. A validated food frequency questionnaire was used to assess participants’ usual dietary intakes. Data on other variables were collected by the use of questionnaires. Patients with stroke were older (P < 0.001), had lower weight and body mass index (P < 0.05) and were more likely to be male (P < 0.05) and less likely to be obese (P < 0.001). After adjustment for age, sex and total energy intake, Individuals with the highest consumption of low‑fat dairy had a significantly decreased risk of stroke (odds ratio [OR]: 0.58; 95% of confidence interval [CI]: 0.34–0.99), while those with the highest intake of high‑fat dairy had a 2‑fold increased risk of stroke. The association between high‑fat dairy consumption and stroke even persisted after additional adjustments for physical activity, smoking and dietary variables (OR: 2.02; 95% CI: 1.02–4.02); but the association between low‑fat dairy intake and stroke disappeared after these adjustments (OR: 0.84; 95% CI: 0.44–1.58). We found a significant positive association between high‑fat dairy consumption and risk of stroke. Further prospective studies are required to confirm this finding.

Parents are the first providers of psychological and physical needs of the children, and the role of father in fulfillment of these needs is clear. Periodical absence of a man due to offshore work not only affects his spouse but also the children as well. The present study aimed to compare the physical growth status of the children of offshore staff working for Iranian National Drilling Company with based staff.

This is an historical Cohort (retrospective cohort) study in which 80 male and 80 female primary school students of the staff working in Iranian National Drilling Company were selected through random sampling method. Data collection tool was a digital scale and a standard tape meter to measure weight and height of the children. Collected data were analyzed by descriptive statistics and binary logistic regression through SPSS.

Data analysis showed that mean weight, height and BMI were 137.21 cm, 35.74 kg, and 18.35 among the offshore staff’s children, and 145.8 cm, 43.74 kg and 20.25 in based staff’s children respectively. By use of National Standard growth charts of Iranian Ministry of Health, the number of children with delayed growth was calculated, and compared in both groups. The results showed that the highest frequency in offshore staff group was for the children with normal BMI (42.8%), and in based staff group, it was for the overweight children (52.5%). Meanwhile, the BMI showed no significant difference between the children in offshore and based groups. The percentages of short stature among the children in offshore and based staff groups were 20% and 3.8% respectively, which shows a significant difference.

Based on the findings, fathers’ periodical offshore work is associated with a reduction in children’s height growth, but this association is not significant for BMI.

Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real‑life experiences in conducting qualitative research in health reveal these issues. The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others.