Background: Informed consent can be obtained by various methods, by various people, and with use of various types of consent forms. Persistent effort is necessary to reveal the practical realities of informed consent to improve ethical and legal standards. Objective: To determine the ethical challenges of obtaining informed consent from surgical patients. Methods: The present study was a descriptive cross-sectional study using two researcher-made questionnaires and a checklist for data collection. Data were collected from nursing personnel ( n = 95) (...) and surgical patients ( n = 203) on the surgical wards of three university hospitals in Isfahan, Iran. Data were analyzed using descriptive statistics, Spearman’s rank correlation, Pearson’s correlation coefficient, and the t-test. Ethical considerations: The study was approved by the Ethics Committee of Isfahan University of Medical Sciences (No: 396478). Results: The mean scores (maximum 100) of awareness, competency, and authority were 36.3, 67.7, and 57.6, respectively. The overall quality of the informed consent was poor (score 53.9 of 100). The higher educational level in patients was correlated with lower awareness of and less authority to give informed consent. Only 12.6% of the nurses stated that patients were given sufficient information to assure informed consent. In 89.2% of the consent forms, the risks of the treatment were mentioned. However, alternative methods and risks and advantages of rejecting the treatment were not mentioned in any of the forms. Conclusion: Ethical challenges to obtaining informed consent include patients’ poor awareness of their rights, a failure to provide adequate information to patients, absence of consideration of patients’ educational level, an unclear definition of who is responsible for obtaining informed consent from the patients, time constraints, and use of unclear language and medical jargon. Constructing an ethical framework may guide nursing staff in dealing with the ethical challenges involved in obtaining informed consent. (shrink)

The article proposes a formal semantics of happiness and sadness modalities in the imperfect information setting. It shows that these modalities are not definable through each other and gives a sound and complete axiomatization of their properties.

Betweenness as a relation between three individual points has been widely studied in geometry and axiomatized by several authors in different contexts. The article proposes a more general notion of betweenness as a relation between three sets of points. The main technical result is a sound and complete logical system describing universal properties of this relation between sets of vertices of a graph.

Background: Conscience is a guiding factor in nursing practice for delivering the ultimate care. In order to expand the concept of conscience-based care, factors affecting conscience in nursing practice need to be identified. Objectives: The current study assessed nurses’ experiences to explore factors affecting conscience in nursing practice. Research design: This qualitative content analysis study employed purposive sampling to reach 14 nurses working at educational hospitals in Tabriz and Urmia, Iran. Data were analyzed using inductive and conventional analysis. Ethical considerations: (...) This research was approved by the Ethics Committee of Urmia University of Medical Science. Voluntary participation, anonymity, and confidentiality were considered. Finding: Two themes emerged from our analysis for enhancing conscience in nursing practices, including environment of professional performance and personal factors. Discussion: The two important factors for enhancing conscience in nursing practice are environment and personal factors. Conclusion: It is necessary to emphasize on religious beliefs, professional commitment, and communication skills in educational training structure. Also, establishing appropriate management systems will help nurses to provide moral care. (shrink)

In the last decades, researchers have been considering some fundamental issues such as energy saving, global warming, greenhouse emissions, and non-renewable energy to make models of house environmental standards to achieve a suitable consumption pattern for saving energy. In architecture, using natural energy is one of the essential pillars of design because it was one of the criteria of designing, which was considered on climate and geography, and it has been a high performance of climate adaptation in the modeling of (...) traditional houses. In this research, Azerbaijan is selected to evaluate the practical features of traditional Iranian houses designed in the cold climate, and criteria for developing sensible solutions to achieve a suitable design model for energy saving are provided. The primary purpose of this paper is to evaluate and identify the features of climate design in traditional houses in a cold climate, which are suitable residential buildings for energy management, and to identify the components affecting energy saving. The data collection method is based on checklists, observation, considering the orientation, density, solar radiation angle in the region, documentary, analysis of maps, and adaptation of the architectural plan of the studied houses with the pattern of solar radiation in the area. This research discusses the design criteria for future structures and their adaptable measures based on the obtained results. Finally, it is declared that the traditional architectural design model follows the region’s climatic conditions, and considering the current climate and energies, traditional houses were designed; therefore, the best model for maximum use of available energy is climatic design. As a result, suggestions are made regarding residential architecture design to save energy. (shrink)