Relationship Between Attitude Toward Spirituality and Attitude and Performance of Spiritual Care Among Nurse

Introduction

Although spiritual care is commonly regarded as a nursing task, in practice, it is often provided inadequately.

Objective

The purpose of this study was to examine relationship between attitude toward spirituality and the attitude and performance of spiritual care among nurses who working in hospitals of Iran university of medical sciences.

Methods

This was a correlative-descriptive study. Spiritual Perspective Scale (SPS) and Nursing Spiritual Care Perspective Scale (NSCPS) were used to gather the data. A number of 166 nurses participated in this study.

Results

Findings showed that of nurses’ spirituality attitude score was 4.98 ± 1.1 which indicated high attitude toward spirituality. The total average of nurses’ attitude about spiritual practices was 3.67 ± 0.51, which signified the positive attitude of nurses about spiritual practices. Findings revealed that positive spiritual attitude had a significant correlation with 6 out of 12 expressed spiritual interventions. In addition, spiritual attitude generally had a significant positive correlation with spiritual interventions. The positive spiritual attitude had a significant correlation with only 3 items out of 11 for the attitude toward spiritual practices. There was no correlation between spiritual attitude and the attitude toward spiritual practices.

Conclusion

In spite of the positive attitude, nurses did not perform half of the spiritual interventions which most of them were in line with fulfilling the patients’ religious needs. Establishment of in-service education program regarding spiritual care practice by role play and modeling methods are recommended.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Socioeconomic inequalities in metastasis, recurrence, stage and grade of breast cancer: a hospital-based retrospective cohort study

Introduction

This study aims to estimate the Socio-Economic Status (SES) inequality on the metastasis, recurrence, stage and grade in Breast Cancer (BC).

Methods

This retrospective cohort study conducted on 411 BC patients in Arak, Iran. Asset-based questionnaire used to estimate the household SES. For calculate of SES inequality was used from Concentration Index (C). Moreover for investigate the association between recurrence and metastasis with other variables were used from multilevel logistic regression and analysis of variance were used to investigate the relationship between SES and other variables. The data were analyzed with Stata (v.13) software.

Results

Results of analysis of variance showed statistical significant relationship between SES with, insurance, surgery, grade, stage, recurrence and metastasis (p-value < 0.05). Moreover the Odds Ratio (OR) were significant of recurrence with age, academic level of education, supplementary insurance history of BC in first-degree relatives, stage and grade, also, metastasis with age of > 80 years, insurance, supplementary insurance, history of BC in first-degree relatives, chemotherapy, radiotherapy, stage and grade four. The total C index obtained 0.015 (0.002, 0.026), 0.011 (0.003, 0.031), – 0.014 (– 0.034, – 0.001) and – 0.042 (– 0.061, – 0.002) for metastasis, recurrence, stage and grade of BC respectively.

Conclusions

Our results showed evidence of inequality in the metastasis, recurrence, stage and grade in BC patients.

Improved diagnostic accuracy for myocardial perfusion imaging using artificial neural networks on different input variables including clinical and quantification data

OBJECTIVE

Diagnostic accuracy of myocardial perfusion imaging (MPI) is not optimal to predict the result of angiography. The current study aimed at investigating the application of artificial neural network (ANN) to integrate the clinical data with the result and quantification of MPI.

METHODS

Out of 923 patients with MPI, 93 who underwent angiography were recruited. The clinical data including the cardiac risk factors were collected and the results of MPI and coronary angiography were recorded. The quantification of MPI polar plots (i.e. the counts of 20 segments of each stress and rest polar plots) and the Gensini score of angiographies were calculated. Feed-forward ANN was designed integrating clinical and quantification data to predict the result of angiography (normal vs. abnormal), non-obstructive or obstructive coronary artery disease (CAD), and Gensini score (≥10 and <10). The ANNs were designed to predict the results of angiography using different combinations of data as follows: reports of MPI, the counts of 40 segments of stress and rest polar plots, and the count of these 40 segments in addition to age, gender, and the number of risk factors. The diagnostic performance of MPI with different ANNs was compared.

RESULTS

The accuracy of MPI to predict the result of angiography, obstructive CAD, and Gensini score increased from 81.7% to 92.9%, 65.0% to 85.7%, and 50.5% to 92.9%, respectively by ANN using counts and clinical risk factors.

CONCLUSION

The diagnostic accuracy of MPI could be improved by ANN, using clinical and quantification data.

Low Temperature Oxidation of Cyclohexane: Uncertainty of Important Thermo-Chemical Properties

The study of the standard formation enthalpy, entropy, and heat capacity for key species relevant to the low-temperature combustion of cyclohexane has been performed by applying the group additivity method of Benson. The properties of 18 Benson groups (8 of them for the first time), and 10 ring correction factors for cyclic species were estimated through different empirical and semi-empirical methods. The method validation proceeded through comparison of predicted values for certain number of newly estimated groups and available literature data derived from quantum chemistry estimations. Further validations of the estimated properties of groups have been provided by comparing estimated properties of test species with data in literature and kinetic databases. Also the standard deviation between prediction and reported values has been evaluated for each validation case. A similar approach has been applied for validation of the estimated ring correction groups. For selected well-studied cyclic molecules the predicted values and the literature data have been compared with each other, and the standard deviations have been also reported. The evaluated properties of the cyclohexane relevant species were also compared with similar ones available in other kinetic models and in databases. At the end the estimated properties have been presented in a tabulated form of NASA polynomial coefficients with extrapolation up to 3500 K.

An ethical framework for evaluation of public health plans: a systematic process for legitimate and fair decision-making

OBJECTIVES

Given the increasing threats of communicable and non-communicable diseases, it is necessary for policy-makers and public health (PH) professionals to address ethical issues in health policies and plans. This study aimed to develop a practical framework for the ethical evaluation of PH programs.

STUDY DESIGN

A multidisciplinary team developed an ethical framework to evaluate PH plans from 2015 to 2017.

METHODS

In this study, the multi-method approach was used. First, a list of moral norms in PH policy and practice was drafted and completed in two interactive sessions. Then, the Delphi method was used for consensus about the structural components to be adopted in the framework. After developing the framework, its efficiency was assessed by evaluating Iran's Fourth Strategic Plan for HIV/AIDS Prevention and Control.

RESULTS

The framework was developed in the following three sections: (i) determination of the general moral norms in PH practice and policy; (ii) five steps of evaluation; and (iii) a procedural evaluation step to ensure fair decision-making. The ratio of the ethical points of the PH plan increased by 46% after implementation of the framework, and the frequency of ethical points increased significantly after applying the framework (P = 0.001).

CONCLUSION

The application of the framework for the ethical evaluation of various PH programs ensures a comprehensive and scientific-deliberative decision-making process, while also contributing to the development of the framework.

Uncertainty Quantification in Chemical Modeling

A module of PrIMe automated data-centric infrastructure, Bound-to-Bound Data Collaboration (B2BDC), was used for the analysis of systematic uncertainty and data consistency of the H2/CO reaction model (73/17). In order to achieve this purpose, a dataset of 167 experimental targets (ignition delay time and laminar flame speed) and 55 active model parameters (pre-exponent factors in the Arrhenius form of the reaction rate coefficients) was constructed. Consistency analysis of experimental data from the composed dataset revealed disagreement between models and data. Two consistency measures were applied to identify the quality of experimental targets (Quantities of Interest, QoI): scalar consistency measure, which quantifies the tightening index of the constraints while still ensuring the existence of a set of the model parameter values whose associated modeling output predicts the experimental QoIs within the uncertainty bounds; and a newly-developed method of computing the vector consistency measure (VCM), which determines the minimal bound changes for QoIs initially identified as inconsistent, each bound by its own extent, while still ensuring the existence of a set of the model parameter values whose associated modeling output predicts the experimental QoIs within the uncertainty bounds. The consistency analysis suggested that elimination of 45 experimental targets, 8 of which were self- inconsistent, would lead to a consistent dataset. After that the feasible parameter set was constructed through decrease uncertainty parameters for several reaction rate coefficients. This dataset was subjected for the B2BDC framework model optimization and analysis on. Forth methods of parameter optimization were applied, including those unique in the B2BDC framework. The optimized models showed improved agreement with experimental values, as compared to the initially-assembled model. Moreover, predictions for experiments not included in the initial dataset were investigated. The results demonstrate benefits of applying the B2BDC methodology for development of predictive kinetic models.

Prevalence and Barriers to Lung Cancer Screening in Karachi, Pakistan: A Cross-Sectional Survey of Smokers and Physicians

Background

Early detection of lung cancer using low-dose computed tomography (LDCT) can potentially reduce morbidity and mortality. However, LDCT for lung cancer screening, especially in low income countries, has been underutilized. The objective of this study was to evaluate the prevalence and the potential personal, social, and economic barriers of lung cancer screening using LDCT.

Methods

A total sample of 156 smokers and 200 general physicians was collected during December 2016-February 2017 from community settings in Karachi, Pakistan. Two separate questionnaires were constructed to characterize participants’ knowledge, attitudes, and practices regarding lung cancer screening. Screening-eligible smokers and physicians were asked to identify patient barriers to screening and were asked their opinion regarding most effective approach for increasing awareness of screening guidelines.

Results

The majority of smokers' (n=91, 58.3%) and physicians' (n=131, 65.7%) beliefs about the US Preventive Services Task Force (USPSTF) eligibility criteria were inconsistent with the actual recommendations. Major barriers to screening included financial cost, lack of patient counseling and health anxiety related to screening. Over two-thirds (n=105, 67.3%) of smokers were receptive to further information about LDCT screening, and half (n=78, 50.0%) favored one-on-one counseling by their physician, compared to other media. Only one-third (n=65, 33.3%) of physicians reported use of LDCT screening, although 54.5% (n=108) felt that screening implementation would be very effective in their practice.

Conclusion

LDCT screening is currently an uncommon practice in Pakistan. Financial cost, inadequate doctor-patient communication, and lack of awareness of guidelines among both patients and physicians are the major barriers in the utilization of LDCT screening.

Cu-Catalyzed first direct access towards 3-sulfenylindoles from aryl halides

The copper-catalyzed cross-coupling of indole derivatives with aryl halides in the presence of thiourea proceeds to give 3-sulfenylindoles in DMSO at 120 °C.

Epidemiological trends of dermatophytosis in Tehran, Iran: A five-year retrospective study

OBJECTIVE

Dermatophytosis is the most frequent fungal infection all over the world and its frequency is constantly increasing. The aim of this study was to evaluate clinical features and epidemiological trends of dermatophytosis over the years 2010 to 2014 in Tehran, Iran.

PATIENTS AND METHODS

A total of 13,312 patients clinically suspected of cutaneous fungal infections were examined. Skin scales, plucked hairs, nail clippings and sub-ungual debris were examined by direct microscopy and culture. Dermatophyte species were identified at the species level by a combination of morphological and physiological criteria.

RESULTS

Direct microscopy confirmed a contamination rate of 19.7% (2622/13,312 cases) of which 1535 cases (58.5%) were culture positive distributed in male (1022 cases) and female (513 cases). The most commonly infected age group was the 30-39 years old. Tinea pedis (30.4%) was the most prevalent type of dermatophytosis followed by tinea cruris (29.8%) and tinea corporis (15.8%). Epidermophyton floccosum (31%) was the most prevalent causative agent, followed by Trichophyton rubrum (26.2%) and Trichophyton mentagrophytes (20.3%).

CONCLUSION

Our results showed considerable distribution of dermatophytosis from zoophilic, anthropophilic and geophilic species among population with diverse age groups. Although anthropophilic fungi such as T. mentagrophytes, E. floccosum, and T. rubrum were the main etiologic agents of dermatophytosis, the prevalence of T. verrucosum showed a meaningful increase over the years, which highlights the importance of rural dermatophytosis mainly transmitted from large animals. This noticeable information improves our current knowledge about dermatophytosis and assists to establish effective prevention and therapeutic strategies to overcome the disease.