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Background: Confidence in ethical decision‐making is a critical factor for the success of nurse leaders. This confidence impacts the quality of nurse care and influences the work environment and the morality of health workers as a team. Aims: This study aimed to determine the relationship between the ethical decision‐making confidence of nursing managers and the ethical behavior of nurses. Methods: This study used a cross‐sectional and correlational design. In total, 532 nurses and 178 nursing managers from 12 hospitals affiliated with Ardabil University of Medical Sciences in Northwestern Iran participated in the study. The measuring tools used were Birkholz et al.’s Ethical Decision‐making Scale and Orathai’s Ethical Behavior Scale. Results: The mean values of ethical decision‐making confidence in nurse managers and ethical behavior in nurses were 75.51 ± 7.27 and 130.56 ± 29.16, respectively. Additionally, 62.4% of nursing managers and 74.1% of nurses reported their ability to make ethical decisions and ethical behavior at a high or average level. There was a significant positive relationship between managers’ ethical decision‐making confidence and nurses’ ethical behavior ( r = 0.9, p = 0.001). The regression model indicated that the managers’ ethical decision‐making confidence could predict 81% of nurses’ ethical behavior variance. Furthermore, female nurses and participants in an ethics workshop demonstrated higher ethical decision‐making confidence and behavior ( p < 0.001). Conclusion: The confidence of nursing managers in their ethical decision‐making significantly influences the ethical behavior of nurses on these managers’ respective units. Continuous training in ethical strategies is essential for managers, as decisions in true ethical dilemmas require a team approach. Managers should serve as role models and not make independent decisions when the choices lack clear right and wrong options.

Background Female-headed households are one of the most vulnerable groups of society that confront many problems and challenges. Therefore, the present study aimed to explore the challenges and opportunities confronting female-headed households in Iran. Methods This qualitative study was conducted among female-headed households in Kermanshah, West of Iran, in 2019. The data were collected through Semi-structured interviews with 26 female-headed households who were selected by purposeful and theoretical sampling. Data analysis was done through conventional qualitative content analysis, and the software MAXQDA-12 was used for the management of data. The four criteria of Goba and Lincon, including credibility, confirmability, dependability, and transferability, were observed to evaluate the quality of research results. Results After analyzing the data, 4 main categories and 13 subcategories were obtained as follows: individual problems (role overload, role conflict, end of love, psychological problems), intra-family problems (declined independence, intra-family tension, poverty reproduction and family disability), social problems (stigma of being unattended, social insecurity, social isolation, social exclusion), positive outcomes (positive self-concept, social maturity). Conclusion Female-headed households face many challenges that can become a big threat or an opportunity. Therefore, their health improvement can be achieved through training and helping them to adapt to new and multifaceted roles, providing more economic support and helping them raise their social status.

There are many barriers for condom use, which was one of the most important methods to prevent the transmission of HIV among female sex workers. Therefore, the aim of the present study was to identify the barriers to condom use among female sex workers in Tehran, Iran. This study was conducted with a qualitative approach and conventional content analysis among female sex workers in Tehran. Twenty-two female sex workers were selected through snowball sampling and purposive sampling. The data gathering method was a semi-structured interview and the data were analyzed using Graneheim and Lundman method. Guba and Lincoln criteria were used for evaluating research transferability. The results of data analysis were categorized in three categories and seven sub-categories included 1) individual factors (not knowing HIV/AIDS properly, anti-loyalty and love, and personality traits), 2) structural factors (partner's desire, problems with condom availability), and 3) cultural factors (cultural taboos, following the models). The results showed that lack of condom use is the consequence of different individual, structural, and cultural factors. So, it can be useful to take some initiatives at the individual level by raising awareness and understanding of female sex workers about HIV at the structural level by lowering the price of condoms and providing them extensively and at the societal level, by changing the beliefs and taboos about condoms.

In this study, experimental reactors for cathodic nitrogen plasma electrolysis were designed by the composition of galvanic (voltaic) and electrolytic cells with wide and narrow connectors filled with tap water and agar solutions. The designed reactor can be used to simultaneously perform and manage nitrification in acidic and alkaline environments. According to the reactor’s performance, it can be installed on the irrigation system and used depending on the soil pH of the fields for delivering water and nitrogen species that are effective in growth. The nitrification process was investigated by choosing the optimal reactor with a wide connector based on different changes in oxidation-reduction potential and pH on the anode and cathode sides. The nitrite concentration changed directly with ammonium and nitrate concentrations on the cathode side. It changed inversely and directly with ammonium and nitrate concentrations on the anode side respectively. Nitrite concentration decreased from 5.387 ppm with water connector, to 0.326 ppm with 20% agar solution, and 0.314 ppm with 30% agar solution connectors on the anode side. It increased from 0 ppm to 0.191 ppm with a water connector, 0.405 ppm with 20% agar solution, and 7.454 ppm with 30% agar solution connectors on the cathode side.

Health services utilization, as one of the mechanisms of the health system, guarantees a healthy life and improves well-being for everyone. The aim of this study was to identify factors affecting the use of outpatient health services among women. This scoping review examined the studies related to outpatient health services utilization (OHSU) and its determinants among women. This review was conducted on English language studies published between 2010 and 2023 (All searches were conducted on 20 January 2023). Studies available in databases such as Web of Science, MEDLINE (PubMed), Scopus, Wiley library, Proquest, and Google Scholar were searched manually. Selected keywords and their equivalents were used to search for related articles in each database. A total of 18 795 articles were identified, of which 37 met the inclusion criteria. Findings showed that age, marital status, level of education, employment status, income level, socioeconomic status, rape experience, health insurance, health status, ethnicity, living in rural areas, quality of services, area of residence, having a purpose in life and access to health services affect OHSU among women. The results of the present review showed that in order to achieve the universal goals of health services coverage and health service utilization, it is necessary for countries to provide insurance coverage to the maximum number of people. Also, policies should change in favor of the elderly, poor and low-income, low-educated, rural, ethnic minority, and chronically ill women and provide them with free preventive health services.

This study investigated the influence of various treatments on the autofluorescence properties of Bacillus subtilis . Our results demonstrate that autofluorescence is not a static property but is significantly modulated by environmental and nutritional factors. Glucose limitation markedly reduced autofluorescence, highlighting its crucial role in maintaining cellular components involved in fluorescence. Environmental stressors exerted diverse effects: oxidative stress induced by hydrogen peroxide altered fluorescence patterns, while ethanol exposure enhanced fluorescence intensity. Heat and cold stress induced subtle changes, suggesting a degree of bacterial resilience. Lysis methods, such as autoclaving and sonication, significantly impacted fluorescence intensity and spectral profiles, revealing insights into the cellular localization and nature of fluorophores. Microscopy analysis confirmed the presence of wavelength-specific autofluorescence in Bacillus subtilis . These findings underscore the sensitivity of bacterial autofluorescence to cellular and environmental perturbations and highlight its potential as a valuable tool for monitoring bacterial health and stress responses.

Ebstein's anomaly (EA) is a congenital heart disorder characterized by abnormal function of the tricuspid valve. There are several ways to study tissue composition using magnetic resonance imaging (MRI). One of the most accurate methods is strain calculation using the feature tracking (FT) technique. Due to the novelty of the FT technique in cardiac magnetic resonance (CMR) imaging, there is a lack of comprehensive guidelines to conduct FT-MRI and to present a quantitative report. The current study is aimed to evaluate the FT technique in EA patients and to compare the obtained numerical values with those of healthy individuals. A total of 33 individuals were enrolled in a study conducted in 2018-2019 at Shahid Rajaei Hospital, Tehran, Iran. Radial, longitudinal, and circumferential strain patterns of the left and right ventricles were determined in both the patients and the controls using the FT technique. Data were analyzed using SPSS software, version 22.0. The results showed a significantly lower left ventricular (LV) radial strain in EA patients compared to the control group (P=0.002). In addition, the right ventricular (RV) global longitudinal strain (GLS) in EA patients was significantly lower than in the controls (P=0.001). Other parameters (LV global longitudinal strain, RV radial strain, LV circumferential strain, and RV circumferential strain) did not differ significantly between the two groups. Determination of strain patterns using cardiac MRI is a promising method for the diagnosis of EA. Markers such as LV longitudinal strain and RV-GLS are the most suitable parameters for the early diagnosis of heart dysfunction.

BACKGROUND: Social resources help to adapt to stress and might positively affect the well-being of individuals with severe conditions like human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The present study investigates the effect of social support, social capital, and coping in a positive state of mind of Iranian older people with HIV/AIDS. MATERIALS AND METHODS: This cross-sectional study was conducted on 160 older people with HIV referred to AIDS clinics in Tehran in 2019. Samples were randomly selected from patients aged 50 years and older. Data were collected using a questionnaire, a positive state of mind, social capital, coping, social support, and a checklist of demographical variables. Data analysis was performed using SPSS software version 21. RESULTS: A significant positive correlation was found between social support, social capital, coping, education, and a positive state of mind. A significant negative correlation was also found between age, several chronic diseases of the patient, and a positive state of mind. The linear regression results showed that social support, social capital, coping, and education improved the positive state of mind. CONCLUSIONS: Based on our findings, we believe that social and psychological interventions effectively enhance patients' positive state of mind with HIV and ultimately, improve their quality of life.

Background: Snails of the genus Galba are the intermediate hosts of Fasciola species, the etiological agents of liver fluke disease, fascioliasis. A genetically different but morphologically very similar species in the genus, G. schirazensis, is sympatrically distributed with G. truncatula in some regions of the world. We aimed to investigate the occurrence of G. schirazensis in Kerman province, Iran and to characterize genetically G. schirazensis specimens from southeast Iran. Methods: Field-collected snails from four localities in Jiroft, Bam and Faryab, Kerman province, southeastern Iran were studied. Hydrological variables including temperature and pH were recorded for each habitat. Each specimen was identified using morphological as well as conchological characteristics. Genetic characterization was performed using PCR-sequencing followed by phylogenetic analyses on nuclear ITS2 as well as mitochondrial cox1 gene fragments. MaxEnt software was used to predict the most appropriate ecological niches for the targeted species. Results: G. schirazensis was found in 4 out of 28 locations. One ITS2 and two cox1 haplotypes were detected among G. schirazensis populations from the four localities. Habitat study showed that G. schirazensis thrives in habitats with alkaline pH. G.schirazensis from South America were clustered with specimens from Bam, Kerman, Iran; however, north Iranian isolates of G. schirazensis were strongly correlated with specimens from Jiroft and Faryab. MaxEnt model for the most appropriate ecological niches of the targeted species predicted environmental suitability for this species in western Africa as well as coastal areas in north and southwestern Africa. Conclusion: G. schirazensis is frequently present in southern areas of Kerman Province. At least two genetically different haplotypes are present in southeastern Iran.

BACKGROUND: Breast cancer is the most common type of cancer among women. Mammography is the most sensitive and important method for screening and early diagnosis of breast cancer. Considering the importance of using mammography in breast cancer screening, this study was performed to evaluate mammographic determinants. MATERIALS AND METHODS: In the cross-sectional study, we surveyed 985 women over 40 years in Tehran concerning demographic characteristics: age, socioeconomic status, a problem in the breast, alcohol use, drug use, and health belief model. Logistic regression was used to identify determinant factors associated with mammography performance. RESULTS: The results of this study showed that 42.1% (95% confidence interval [CI]: 38, 45) participant performed mammography at least once during their lifetime. Age (odds ratio [OR] = 4.252; 95% CI = 2.041-8.857); housing situation (OR = 1.706; 95% CI = 1.178-2.469); having breast problems (OR = 5.224; 95% CI = 3.501-7.795); socioeconomic status (OR = 1.855; 95% CI = 1.035-3.325); family income level (OR = 1.998; 95% CI = 1.028-3.884); alcohol consumption (OR = 2.676; 95% CI = 1.344-5.328); smoking (OR = 2.824; 95% CI = 1.418-5.623); self-efficacy (OR = 1.935; 95% CI = 1.242-3.015); perceived barriers (OR = 2.017; 95% CI = 1.348-3.019); self-care (OR = 4.901; 95% CI = 3.152-7.620); perceived susceptibility (OR = 1.971; 95% CI = 1.271-3.057) and perceived severity (OR = 1.830; 95% CI = 1.170-2.860) were mammography behaviors determinants. CONCLUSION: The findings indicated that the rate of mammography screening among Tehranian women is low and highlights the need for developing a comprehensive national breast cancer control program, which should be considered as the priority for health-care providers. Furthermore, the identification of these factors can help to design an appropriate educational intervention that focuses on the benefits of mammography screening.