Ethical care in patients with Covid-19: A grounded theory

BACKGROUND

Providing ethical care during the Covid-19 pandemic has become an inevitable challenge due to facing limitations such as fear of contracting the disease, lack of equipment and emergence of ethical conflicts; So that there is no clear picture of how to provide ethical care for patients with Covid-19. The study aimed to explain the ethical care process of patients with Covid-19.

METHOD

This qualitative study was conducted in 2021-2023 using the grounded theory research method. Data were collected through conducting 21 semi-structured interviews with 19 participants (16 staff nurses, and 3 supervisor). Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin.

RESULTS

The results indicated that starting the process with a problem means a challenge of how to do the right or correct thing for the patient. This process is driven by the feeling of duty and inner commitment to do the right thing. The sense of responsibility or commitment is directly related to the degree of faith in a person. The actions that a nurse takes to fulfill her sense of commitment is called the faith-based behavior process. The process of behavior based on faith is done through two steps. Attaining the satisfaction of God and as well as the satisfaction of one's conscience is the nurses' ultimate goal of doing the right work and being committed.

CONCLUSION

The process of ethical care of patients with Covid-19 can be different according to the degree of faith and environmental conditions. A higher level of faith and more helpful environmental conditions, the greater the nurse's inner commitments in the first and second steps, as a result, the satisfaction of God and conscience will be greater.

Human Placental Mesenchymal Stem Cell-derived Exosomes in Combination with Hyperbaric Oxygen Synergistically Promote Recovery after Spinal Cord Injury in Rats

Spinal cord injury (SCI) is a critical medical condition during which sensorimotor function is lost. Current treatments are still unable to effectively improve these conditions, so it is important to pay attention to other effective approaches. Currently, we investigated the combined effects of human placenta mesenchymal stem cells (hPMSCs)-derived exosomes along with hyperbaric oxygen (HBO) in the recovery of SCI in rats. Ninety male mature Sprague-Dawley (SD) rats were allocated into five equal groups, including; sham group, SCI group, Exo group (underwent SCI and received hPMSCs-derived exosomes), HBO group (underwent SCI and received HBO), and Exo+HBO group (underwent SCI and received hPMSCs-derived exosomes plus HBO). Tissue samples at the lesion site were obtained for the evaluation of stereological, immunohistochemical, biochemical, molecular, and behavioral characteristics. Findings showed a significant increase in stereological parameters, biochemical factors (GSH, SOD, and CAT), IL-10 gene expression and behavioral functions (BBB and EMG Latency) in treatment groups, especially Exo+HBO group, compared to SCI group. In addition, MDA levels, the density of apoptotic cells and gliosis, as well as expression of inflammatory genes (TNF-α and IL-1β) were considerably reduced in treatment groups, especially Exo+HBO group, compared to SCI group. We conclude that co-administration of hPMSCs-derived exosomes and HBO has synergistic neuroprotective effects in animals undergoing SCI.

Assessment of Nurses' Caring Behaviors from the Perspective of Covid-19 Patients

Caring behaviors are an important focus of nurses' physical and technical aspects of caring. By identifying and comprehending the nurses' caring behaviors from the perspective of the patients, as well as taking into account the elements influencing caring behaviors during the Covid-19 pandemic, we may plan to offer nursing care and caring behaviors based on the needs of the patients. In this cross-sectional study, purposive sampling was used to collect data from both the Demographic Questionnaire and the Nurses' Caring Behavior Questionnaire. The results showed that the respectful relationship field had an average score of 33.57, the professional knowledge and skill field at 15.35, and the overall mean score for the questionnaire was 43.92, with the mean score from the questionnaire being higher than the real mean score. It may be concluded that this component of nurses' behavior is seen favorably by patients in the Covid-19 ward. Additionally, the patients in the Covid-19 ward thought the mean score from the questionnaire on professional knowledge and skills was good because it was higher than the real mean score. The questionnaire's overall score was likewise greater than its mean overall score. Overall, it can be concluded that patients in the Covid-19 ward have a positive opinion of the nurses' level of caring behaviors. These results indicate that it is possible to achieve ideal caring and full patient satisfaction by planning and considering future outlook in order to educate and empower nurses in terms of correct caring behaviors, and to provide quality caretaking.

The Effects of Aroma on Apnea Attacks and Oxygen Saturation Among Preterm Infants: A Systematic Review and Meta-Analysis:

Researchers and clinicians need to be aware of procedures that are more adaptable to new and different environments in premature infants; therefore, it is important to conduct a comprehensive review of the effect of aromatherapy on apnea attacks and oxygen saturation (SpO2 ) in premature newborns. In this review, databases such as PubMed, Scopus, Web of Science, and Cochrane Library were systematically searched without language and time limitations up to November 1, 2022. Initially, 153 studies were founded, and after duplicate removal, title as well as full-text review, seven studies were enrolled in the final analysis. Studies indicated that aromatherapy with Rosa damascena, vanilla, and breast milk odors could significantly reduce apneas in preterm infants and improve SpO2 levels. Hence, aromatherapy could consider as an effective adjuvant treatment for the reduction of apnea attacks among preterm infants.

The effects of Feijoa sellowiana fruit extract on wound healing in rats: a stereological and molecular study

OBJECTIVE

The aim of this study was to evaluate the anti-inflammatory and wound-healing potential of Feijoa sellowiana fruit extract using stereological and molecular methods in experimental rat models.

MATERIALS

Male Wistar rats were divided into four equal groups: non-treated, vehicle, Feijoa sellowiana fruit extract ointment (5% weight/weight) and the reference drug (madecassol). All animals were treated topically once per day. At the end of the study, wound samples were harvested for histological, stereological, immunohistochemical and molecular assessments to determine the in vivo healing potential and anti-inflammatory activity. A high-performance liquid chromatography (HPLC) analysis was performed for the characterisation of the phenolic acids in the extract.

RESULTS

The study included 64 rats in total. Our results showed that the wound closure, volume of new epidermis and dermis, density of fibroblasts and blood vessels, and the deposition of collagen were significantly higher in both extract and madecassol groups compared to the non-treated and vehicle groups, with superior healing in the extract group. The transcript for the transforming growth factor (TGF)-β gene was significantly upregulated in both extract and madecassol groups compared to non-treated and vehicle groups and was highest for the extract group. The density of inflammatory cells and expression levels of the cyclooxygenase (COX)-2 protein and tumour necrosis factor (TNF)-α gene in the extract and madecassol groups, especially in the extract group, were significantly reduced compared to non-treated and vehicle groups.

CONCLUSION

Our results confirm that the Feijoa sellowiana fruit extract is a valuable source of antioxidant and anti-inflammatory activities and can allow for damaged tissue in wounds to recover markedly.