Co-constructed interaction underscored the value of the nursing presence as an integral component of caring with humanistic and patient-centered approaches. The findings could help clinical nurses have a better understanding of the nursing presence. Findings also can improve educators' and managers' knowledge for developing and conducting appropriate education strategies and caring activities to facilitate the promotion of nursing presence.

Knowing the perspectives of patients is important as the evaluation of nursing care quality should rely on outcome indicators that are sensitive to patients. For instance, client satisfaction and health status acceptance, especially as it relates to coping, comfort level, hope, and participation in decision-making, are included in the nursing outcomes' classification system. Thus, the findings of this study may facilitate improvement in the quality of care by continuous improvement in knowledge, attitudes and abilities of nurses. It is therefore recommended that managers and clinical nurses, by relying on these findings, design the caring activities so that nurses' presence can act as a facilitating factor for improving quality assurance.

Aims:To promote the nurses' organizational commitment by their participation in the improvement of the performance appraisal process.Background: Organizational commitment is one of the factors that secures safe and high-quality care of patients. It also enhances motivation among nurses, which affected by various factors such as performance appraisal. Method: A participatory action research study was undertaken (March 2015 toFebruary 2018) with 39 intensive critical care nurses and nurse managers in Social Security Hospital in Iran, using a complete enumeration sampling method. The data were collected using organizational commitment and job satisfaction questionnaires, focus groups, semi-structured interviews and Delphi technique.Results: Three major themes emerged including inappropriate performance appraisal system, inefficient instruments and unskilled evaluators. There were significant differences between organizational commitment and job satisfaction with performance appraisal process before and after the change in appraisal process. Conclusions:Nurses' involvement in revising and improving the process of their performance appraisal leads to higher commitment. Implications for Nursing Management: Maintaining a committed nursing workforceis vital for high-quality health care. Nurse Managers can improve the process of nurses' appraisal to make more motivation among them and prevent some problems such as job dissatisfaction.

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Currently, metabolic syndrome has become a global health problem. Alterations in neurocognitive functions among patients with metabolic syndrome are important issues in this disorder. In this paper, studies on metabolic syndrome were reviewed and their importance emphasized for the benefit of experts and policy makers. Metabolic syndrome activates inflammatory mediators that disrupt brain metabolism. These mediators can be activated by metabolic inflammation and microvascular disorders and may further cause damage to the white matter and impair cognitive function. These alterations can result in serious changes in cognitive abilities. The association between cognitive changes and metabolic syndrome has been independently evaluated in several studies. In addition, some areas of research in the field of metabolic syndrome include the effectiveness of neurocognitive interventions to enhance normal behaviors or reduce risky behaviors in patients. Structural brain correlates of health-related behaviors provide a basis for designing more effective behavioral interventions by identifying the corresponding brain regions and using behavioral interventions.

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.

Ethics and integrity constitute the heart of leadership and must be taken seriously for the long-term survival of an organisation (Ahmad et al., 2017). Ethical leaders play a pivotal role in organisations. Their behaviour has a significant impact on the work behaviour, performance and well-being of employees (Nogueira et al., 2019). Health care systems invest significant resources in optimizing nurse performance outcomes. Reducing the rate of nursing shortages by relying on human resource policy, workplace optimization and leadership empowerment have become a global priority in the last decade (Lee et al., 2019). Psychological empowerment has been recognized as a tool for improving employee performance

Background: Polymeric nanomaterials with size ranging from 10 to 1000 nm are one of the most widely used types of nanoparticles with ideal properties in the drug delivery systems. Here, we decided to systematically review the antihypertensive effects of polymeric nanomaterials in vitro, in vivo, and clinical trials. Methods: The present review was conducted based on the 06- PRISMA guideline; whereas five English databases, including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation were used for searching the publications related to antihypertensive effects of natural and synthetic polymeric nanoparticles. Results: The results demonstrated that among 1701 papers, 25 papers including 11 in vitro (44%), 6 in vivo (24%), 7 in vitro / in vivo (28%), and 1 in vitro / ex vivo (4%) up to 2020, met the inclusion criteria for discussion in this systematic review. The most used nanoparticles poly-(lactic-co-glycolic) acid nanoparticle (PLGANPs) (7, 29.2%), chitosan based nanoparticles (6, 25%), followed by polylactide acid nanoparticles (5, 20.8%). Conclusion: We concluded that the high potency of polymeric nanoparticles in the drug delivery system for hypertension treatment. Although the accurate mechanisms are not fully understood; however, some mechanisms such as sustained release forms with increased bioavailability, increasing oral bioavailability and improve the oral and non-oral absorption, counteracting excessive superoxide and decreasing blood pressure, etc can be related these nanoparticles.