HP mouthwash was found more effective than NS in reducing VAP. HP mouthwash can therefore be used in routine nursing care for reducing VAP.

Introduction: Diabetes is among the common diseases in the elderly which results in depression, anxiety, and emotional distress in the elderly and impacts the disease control by the individual. This study was conducted with the aim of exploring the effectiveness of acceptance and commitment therapy (ACT) in the improvement of emotional distress in the elderly with type 2 diabetes. Materials and methods: In this randomized control trial, 80 elderly with type 2 diabetes aged ≥60 years were randomly selected among the individuals visiting Yazd Diabetes Research Center. Then, the patients were randomly divided into two 40 individual groups, ie, the intervention group and the control group. The intervention group underwent group ACT during eight 90-min sessions. The diabetes-related emotional distress questionnaire was completed before the intervention, after the end of the group sessions and 2 months after that. The statistical software SPSS version 21 was used for data analysis. Results: The emotional mean scores in the intervention and control groups were not significantly different before the intervention. However, the mean score of the intervention group was lower than of the control group immediately after the intervention (p=0.02) and 2 months after the intervention (p=0.02). Conclusion: ACT results in the improvement of diabetes-related emotional distress in the intervention group. Considering the effectiveness of ACT, this therapeutic method is recommended to be used for the amelioration of emotional distress in the elderly with type 2 diabetes.

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One of the most common risks after a heart transplant is bleeding. In this study, the effect of desmopressin administration on the amount of bleeding and transfusion requirements after heart transplant surgery was investigated. In a double-blind clinical trial, 48 patients who were candidates for heart transplant surgery were randomly assigned to two groups. In the intervention group, patients received desmopressin of 0.3 μg/kg, 30 min. before surgery. Patients in the control group received normal saline at the same amount and time. Homeostasis was evaluated using activated clotting time (ACT), PT, PTT and PLT before, 12 and 24 hr after surgery, and also, chest tube drainage, blood products transfusion requirements during the first day in both groups. No significant differences were found between the groups in terms of ACT, PT, PTT and PLT at all times. Transfusion of packed red blood cells and the mean drainages of chest tube during the first 24 hr after surgery were significantly lower in the desmopressin group compared to the saline group. Desmopressin may reduce post-operative bleeding in patients undergoing heart transplant surgery. Further studies are required to confirm the potential effect of desmopressin on establishing haemostasis after heart transplantation.

Nanophotocatalysts are applied for different applications, and their usage has been enhanced remarkably since a decade. On the other hand, cross-coupling reactions of C−N bonds have found increasing popularity for coupling derivatives of organic compounds such as aniline using diverse catalysts. Nanoheterogeneous photocatalysts can offer suitable platforms for the C−N coupling of aniline derivatives. However, the design of a photocatalyst on the nanoscale with remarkable activity and selectivity, made of noble-free elements, is highly welcome. In this study, the half-filled electronic configuration and shallow trapping properties of Fe were employed to reduce the energy band gap of the system. Moreover, the large ionic radius of lanthanide leads to large surface activity. Thus, bi-and trinuclear nano-oxide nanophotocatalysts were synthesized based on the titanium, iron, and lanthanide elements (Ti x Fe y O z , Ti x Fe y La m O z ) to obtain logically designed photocatalysts with high selectivity, durability, and operation speed under visible light. In addition, designing photocatalysts in the nanoscale was the ultimate target of this study to use the highest benefit of the nanoscale, which is high surface activity. The developed nanophotocatalysts were used for coupling aniline and its 10 derivatives under visible light. The mechanism of the migration of electrons and the C−N reaction was also investigated in detail. In addition, both obtained nanophotocatalysts were applied in five different solvents and eight different conditions so the best condition for the reaction could be determined. Furthermore, the photocatalytic mechanism was studied in detail. The final nanocomposites were characterized by X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), energy-dispersive X-ray analysis (EDX), inductively coupled plasma mass spectrometry (ICP-MS), Brunauer−Emmett−Teller (BET) surface activity, Barrett−Joyner− Halenda (BJH) method, UV−vis spectroscopy, photoluminescence emission spectra, X-ray photoelectron spectroscopy (XPS), cyclic voltammetry (CV), NMR spectra, mass spectra, and CHN elemental analysis. Both nanocomposites exhibited high photocatalytic activities in coupling aniline and its derivatives under visible light. However, the Ti x Fe y La m O z nanophotocatalyst showed a higher activity (90% conversion to obtain 2,4 dinitro-n-phenylaniline) than the Ti x Fe y O z nanophotocatalyst (68% conversion to obtain 2,4 dinitro-n-phenylaniline), which is mainly due to its higher surface activity because of its lanthanide content.

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Healthcare providers agree that promoting spirituality among older adults while caring for them increases their quality of life. However, there is little knowledge about the spiritual needs of the elderly, especially in the Muslim community. This qualitative study attempted to explore the spiritual needs of Muslim older adults. Fifteen non-hospitalized Muslim older adults from Hamadan City, Iran, were interviewed. The semi-structured interviews were analyzed using conventional content analysis. After identifying semantic units from the text, related codes were extracted and placed in subcategories and categories based on their similarities. Once the data were analyzed, one theme was formed. The study's findings showed that the spiritual needs of older adults fell into three main categories: religious needs, the need for transcendence, and the need for connection. Religious needs included subcategories of religious practices and beliefs, and the need for transcendence included the search for meaning and purpose in life, and the need for peace and stability and balance. Also, the need for connection included the need to connect with nature and connect with others. Healthcare professionals and family caregivers should be trained in the specific competence of recognizing older people's unmet spiritual needs and fulfilling them.

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