The authors of this article discuss the challenges that nurses in Iran face as they seek to advance the profession and healthcare in Iran. The challenges they face are shared by nurses in other nations in the region and to some degree globally, that is to say a significant nursing and nurse educator shortage, the aging of the nursing work force, and inadequate resources committed to the recruitment, education, and retention of a sufficient number of competent nurses to deal with the information explosion and rapidly changing workplace. Nurses in Iran have historically suffered from a low social status that has limited their voice in the country, despite having the BSN (Bachelor of Science in Nursing) as the entry to practice, and fine graduate and doctoral programs in the country. Efforts to address these challenges are discussed.

Dengue fever is a dangerous infectious endemic disease that affects over 100 nations worldwide, from Africa to the Western Pacific, and is caused by the dengue virus, which is transmitted to humans by an insect bite of Aedes aegypti. Millions of citizens have died as a result of dengue fever and dengue hemorrhagic fever across the globe. Envelope (E), serine protease (NS3), RNA-directed RNA polymerase (NS5), and non-structural protein 1 (NS1) are mostly required for cell proliferation and survival. Some of the diterpenoids and their derivatives produced by nature possess anti-dengue viral properties. The goal of the computational study was to scrutinize the effectiveness of diterpenoids and their derivatives against dengue viral proteins through in silico study. Methods: molecular docking was performed to analyze the binding affinity of compounds against four viral proteins: the envelope (E) protein, the NS1 protein, the NS3 protein, and the NS5 protein. Results: among the selected drug candidates, triptolide, stevioside, alepterolic acid, sphaeropsidin A, methyl dodovisate A, andrographolide, caesalacetal, and pyrimethamine have demonstrated moderate to good binding affinities (−8.0 to −9.4 kcal/mol) toward the selected proteins: E protein, NS3, NS5, and NS1 whereas pyrimethamine exerts −7.5, −6.3, −7.8, and −6.6 kcal/mol with viral proteins, respectively. Interestingly, the binding affinities of these lead compounds were better than those of an FDA-approved anti-viral medication (pyrimethamine), which is underused in dengue fever. Conclusion: we can conclude that diterpenoids can be considered as a possible anti-dengue medication option. However, in vivo investigation is recommended to back up the conclusions of this study.

Simone de Beauvoir (1947/1948) defined freedom as the ability to "surpass the given toward an open future" (p. 91). She also appreciated that the freedom of others was a condition of her freedom. An open future that is explored in this paper is the ability to overcome barriers that prevent the implementation of Watson's (2012) human caring science (HCS) in Iran and elsewhere. Nursing theory and nursing knowledge distinguish nurses from other members of the healthcare team, including physicians, and enhance the nursing profession. The use of a problem-solving model is also useful in eliminating barriers. The IDEAL Problem-Solving Model The IDEAL (identify the problem, define and represent the problem, explore possible strategies or solutions, act on a selected strategy or solution, and look back and evaluate) is a problem-solving model, a way to overcome barriers to the use of nursing theory, like HCS in practice (Saif, 2005). The first step is to identify the barriers. The authors started with reviewing the literature found in PubMed, Elsevier, Science Direct, Ovid, ProQuest, Web of science, and Google Scholar between 1991 and 2018 using the following search terms, separately and in combination: Watson's theory, clinical nursing, nursing theory, barriers to using theory, and carative factors or processes. After discussing Watson's HCS, in particular the carative processes (see Table 1 for Watson's carative processes), the barriers to implementing her theory are discussed. The barriers found in the literature are here divided into three domains or levels: organizational-(workplace environmental-management) level barriers, practitioner-level barriers, and educational barriers. Watson's Human Caring Science Watson (1979) discussed the assumptions of her theory and included what she originally referred to as the carative factors. She said, "My conception of life and personhood is tied to notions that one's soul possesses a body that is not confined by objective space and time" (Watson, 2012, p. 57). She defined health as a "subjective experience that can refer to the unity and harmony with mind-body-soul" (Watson, 2012, p. 60). Therefore, the goal of nursing from her perspective is to help people gain a higher level of harmony.

‫يح‬ ‫ي‬ ‫محمدي‬ ‫ي‬ 2 ‫پرست‬ ‫يسدان‬ ‫الىبز‬ 3 * ‫چىبري‬ ‫احمدي‬ ‫َبدي‬ 4 ‫اسالمي‬ ‫حسه‬ 5 ‫رجبي‬ ‫راحلٍ‬ 6 ‫جسمي‬ ‫اصغر‬ ‫علي‬ 7 ‫شمبرٌ‬ ‫تمبس:‬ 69356768462 Email:Ahmadi.h@bums.ac.ir 5 AbstractBackground & Aim: Overweight and its consequences are the most important complications in hemodialysis patients. Weight Control is an important educational need in hemodialysis patient. Multimedia technology provides easy and stable learning by various forms of interaction. The present study carried out to determine the effect of multimedia training method to weight management in hemodialysis patients. Material & Methods:In a quasi-experimental research 30 hemodialysis patients were divided based on random allocation in two intervention and control groups. Data were collected by demographic data form and standardized weighing scale. In the intervention group training were given about methods of weight control. Weight measurement of patients performed before and after training. Data were analyzed using SPSS software ver. 18.0 while descriptive statistics and independent t-test were applied. Results: Comparison of means demonstrated that change in the body weight in intervention group is more than control group (1.63±1.55 VS 0.43±1.07).The average weight change between intervention and control group was significant (P<0.05). Conclusion: Multimedia training method was effective on weight loss in hemodialysis patients as a result this method may improve the weight management of hemodialysis patients.