The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study.

INTRODUCTION: Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students. METHOD: This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students' Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests. RESULTS: The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05). CONCLUSION: The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.

Serum microRNA-33 levels in pre-diabetic and diabetic patients.

Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and abnormal insulin secretion. MicroRNAs are small, non-coding RNAs that are able to affect cell biological functions and act as biomarkers for some diseases such as DM. In current study, we measured serum miR-33 in three groups (n = 15) as follows; non-diabetic control, pre-diabetic, and DM patients. Real-time PCR method was used to quantify miR-33 expression. miR-33 expression was significantly increased in pre-diabetic subjects compared to other two groups (p < 0.001). FBS (p < 0.001), insulin (p < 0.001), HOMA-IR (p < 0.001), and TG (p = 0.026) were higher in diabetic subjects than the other two groups. In people that had high physical activity, the number of diabetic subjects were zero and most of them were in pre-diabetic group (p = 0.019). Serum miR-33 level significantly and positively correlated with pre-diabetic state (B = 2.67, p = 0.000), Sex (B = 1.03, p = 0.025), and FBS (B = 0.04, p = 0.036) and also miR-33 was significantly and negatively correlated with HOMA-IR (B = - 1.58, p = 0.04). These findings support the possible role of miR-33 to monitor pre-diabetes onset and progression. It needs to be evaluated in future studies with high number of participants to clarify its mechanism and diagnostic viability.

Psychometric properties of the Persian version of the Patient Measure of Safety (PMOS).

Background: Patient safety practice reduces the adverse events that may occur in the health care system during procedures, diseases, and diagnoses. Failure and negligence in identifying and resolving health care system errors may result in financial and physical harm. Thus, this study aimed to investigate the psychometric properties of the Patient Measure of Safety in Hospitals (PMOS). Methods: This study was conducted on 264 patients in 4 hospitals. The patient measure of safety questionnaire has 44 items and 9 domains. To translate the PMOS questionnaire, standardized forward-backward procedure was used, and a panel of experts assessed the face and content validity of the Persian version. Internal consistency, confirmatory factor analysis (CFA), and test-retest method were used to test the validity and reliability of the instrument. Also, AMOS (version 23) and SPSS (version 16) software were used for data analysis and modeling. Results: The average CVI score was 0.85, indicating well results in the Persian context. CVR score was 0.65. The indices of goodness of fit were acceptable for Iranian sample (CFI=0.91, TLI=0.89, RMSEA=0.063, relative/normal Chi-Square Statistic (X2/df)=2.85). All items were significantly loaded on the domains, except the 33rd and 38th items that were related to the eighth domain. Thus, the final Persian version was developed with 8 domains and 42 items. Internal consistency was acceptable for these domains, and test-retest method showed a good reliability (r=0.984). Conclusions: The Persian version of PMOS is an appropriate instrument to assess the safety of patients in Persian language communities. Also, PMOS is an optimal tool to identify and avoid preventable errors.

Boosting decision-making in rat models of early-life adversity with environmental enrichment and intranasal oxytocin.

Impaired decision-making constitutes a fundamental issue in numerous psychiatric disorders. Extensive research has established that early life adversity (ELA) increases vulnerability to psychiatric disorders later in life. ELA in human neonates is associated with changes in cognitive, emotional, as well as reward-related processing. Maternal separation (MS) is an established animal model of ELA and has been shown to be associated with decision-making deficits. On the other hand, enriched environment (EE) and intranasal oxytocin (OT) administration have been demonstrated to have beneficial effects on decision-making in humans or animals. Given these considerations, our investigation sought to explore the impact of brief exposure to EE and intranasal OT administration on the decision-making abilities of adolescent rats that had experienced MS during infancy. The experimental protocol involved subjecting rat pups to the MS regimen for 180 min per day from postnatal day (PND) 1 to PND 21. Then, from PND 22 to PND 34, the rats were exposed to EE and/or received intranasal OT (2 µg/µl) for seven days. The assessment of decision-making abilities, using a rat gambling task (RGT), commenced during adolescence. Our findings revealed that MS led to impaired decision-making and a decreased percentage of advantageous choices. However, exposure to brief EE or intranasal OT administration mitigated the deficits induced by MS and improved the decision-making skills of maternally-separated rats. Furthermore, combination of these treatments did not yield additional benefits. These results suggest that EE and OT may hold promise as therapeutic interventions to enhance certain aspects of cognitive performance.

Long-Term Survival of Patient with End-Stage Renal Disease Using Bayesian Mixture Cure Rate Frailty Models.

Background: Along with the increasing prevalence of ESRD in developing countries, the use of more up-to-date statistical models is highly recommended. It is crucial to control potential cure pattern and heterogenicity among patients. Methods: In this longitudinal study, the data of 170 hemodialysis patients who visited the dialysis department of Shafa Hospital in Kerman from 2006 to 2016 were collected. To provides robust estimates the time to event data (death) were analyzed with a gamma frailty mixed cure Weibull model (MC-WG) using Bayesian inference. Results: About 49% of patients experienced the death and median survival time was 37.5 months. Older patients (0.264), female patients (0.269), and patients with higher mean serum urea levels (0.186) had a higher risk of death. Moreover, we observe a decrease in death with increase in Creatine (Cr). Conclusion: In the MC-WG Bayesian model, the diabetes, AST, calcium, phosphorus and uric acid variables had a significant effect on the survival of hemodialysis patients, while they were not significant in the Cox PH model. The results of MC-WG Bayesian model are more consistent with other studies.

The effect of regular nursing rounds on patients' comfort and satisfaction, and violence against nurses in surgical ward.

Background: Patients' satisfaction and comfort are known as the quality indicators of nursing care. Nowadays, violence against nurses has an increasing trend. Regular nursing rounds are one of the caring programs that help improve these indicators. This study aimed to examine the effect of regular nursing rounds on patients' comfort, satisfaction, and violence against nurses. Materials and methods: This quasi-experimental study was conducted in two groups consisting of 100 patients and 35 nurses in a surgery ward in the northwest of Iran. The satisfaction with nursing care quality questionnaire, Kolcaba's general comfort questionnaire, and work environment violence were used for data collection. In the present study, the control and intervention groups were selected using a simple sampling method. The control group received routine care only; however, the intervention group received a regular nursing round program every 2 h from the second day of their admission for three days. The satisfaction questionnaire and comfort scale were completed on the second and fifth days of admission, and the evaluation of violence against nurses was performed from the second to the fourth day. The results were analyzed using chi-square, Fisher, independent t, and paired t tests. Results: Before the intervention, no statistically significant difference was observed between the two groups in terms of demographic and dependent variables (p > 0/05). After the intervention, statistically significant differences were observed among the mean scores of satisfaction with nursing care (p < 0/001), comfort (p < 0.001), and violence against nurses (p = 0.041) between the two study groups, so that in the intervention group, the patients' satisfaction and comfort increased and violence against nurses reduced during the intervention period. Conclusions: The use of regular nursing rounds had a positive effect on the study results. Therefore, it is recommended that nurse managers design, implement, encourage, and evaluate regular nursing rounds to improve nursing care.

Demographic and anthropometric characteristics and their effect on the concentration of heavy metals (arsenic, lead, chromium, zinc) in children and adolescents.

Background: Biomonitoring is a well-established method for assessing people's exposure to contaminants in the environment. Many non-communicable diseases can be prevented or aggravated by physiologically monitoring heavy metals in biological matrices such as urine, evaluating their association with non-communicable diseases, and attempting to limit exposure to them. The focus of this research was to determine the association between potentially toxic elements (PTE) such as arsenic (As), lead (Pb), chromium (Cr), and zinc (Zn) urine concentrations and anthropometric indices and demographic data in children and adolescents aged 6-18 years in Kerman, Iran. Methods: 106 children and adolescents aged 6-18 years in Kerman were randomly selected. A questionnaire was used to acquire demographic information from the participants' parents. Height, weight, and waist circumference (WC) were all assessed, as well as body mass index (BMI) and BMI Z-score. Induced Coupled Plasma Mass Spectrometry (ICP/MS) was used to quantify As, Pb, Cr, and Zn concentrations in participants' urine. Results: The geometric mean concentrations were As (38.72 ± 39.30), Pb (19.58 ± 22.91), Cr (1.06 ± 0.28), and Zn (344.72 ± 288.16) µg/creatinine. Boys aged 12-18 years old had higher mean concentration of As than boys aged 6-11 years old (p = 0.019) according to two measurement standards, µg/L, and µg/creatinine, whereas girls had no significant difference. In general, there was a strong association between parental education and metal concentrations of As, Pb, and Cr. As, Pb, and Zn (µg/creatinine) had a significant positive association with BMI z-score and BMI. As, Pb, and Zn metals were shown to have a substantial positive association (p < 0.001). There was no evidence of an association between the metals evaluated and WC. Conclusions: The findings of this study generally showed that there was a significant association between demographic characteristics and exposure to these metals in children and adolescents, indicating that these people were exposed to these metals, which can harm their health. As a result, the pathways of exposure to metals must be limited.

Association of As, Pb, Cr, and Zn urinary heavy metals levels with predictive indicators of cardiovascular disease and obesity in children and adolescents.

BACKGROUND: Although the basic causes of obesity and cardiovascular illness have been extensively researched, little is known about the influence of environmental variables such as heavy metals on obesity development and cardiovascular disease in children and adolescents. The assumption that arsenic (As), lead (Pb), chromium (Cr), and zinc (Zn) exposure impact obesity and predictors of cardiovascular disease was explored in this study. METHOD: A questionnaire was used to gather demographic information as well as certain determinants of exposure to As, Pb, Cr, and Zn from 106 children and adolescents aged 6 to 18. Physical tests (height, weight, waist circumference (WC), BMI, BMI Z-score, Systolic blood pressure (SBP), Diastolic blood pressure (DBP)), blood samples for clinical trials (Fasting Blood Sugar (FBS), Total Cholesterol (TC), Triglyceride (TG), Low-Density Lipoprotein (LDL), High-Density Lipoprotein (HDL) (, and urine samples for urinary creatinine measurement and measures of As, Pb, Cr, and Zn in urine were obtained using the Inductively coupled plasma mass spectrometry (ICP/MS). RESULTS: The average age of the participants in the research was 11.42 ± 3.68. The majority of the participants in the research were boys (56 people). As, Pb, and Zn mean concentrations (µg/L) were greater in obese adults (42.60 ± 22.59, 20.63 ± 14.64, 326 ± 164.82), respectively. After adjusting for possible confounding factors, the data revealed that adolescents aged 12-18 years had higher levels of As and Pb (8.69 and 5.02 µg/L) than children aged 6 to 11. As and Zn metals had significant association with FBS and lipid profile (TC, TG, LDL, HDL), lead had significant correlations with lipid profile, while Cr had significant correlations with WC, SBP, FBS, LDL, TC. CONCLUSION: Childhood and adolescent exposure to As, Pb, Cr, and Zn can impact obesity and cardiovascular disease markers. The current research was a cross-sectional study, which necessitates group studies and case studies to evaluate causal relationships.

The Application of Non-Parametric Count Models for the Modeling of Female's Accident Rates in Hamadan Province from 2009 to 2016.

BACKGROUND: Accidents were just one of the general health problems. According to WHO forecasts (2013), deaths from road accidents will become the fifth-highest cause of death in the world by 2030. Therefore, we have attempted the application of non-parametric count models for modeling female's accident rates. METHODS: All accidents in Hamadan Province, western Iran are referred to as one of the emergency centers located in the hospitals. Data regarding the accidents were obtained from 21 emergency centers across Hamadan for the period 2009-2016. To assess the trend and pattern of the accidents, the Generalized Additive Model for the accident rate has been utilized. RESULTS: The Mean±SD age of the females in study was 31.23±12.88 yr old. For each of the three kinds of road accidents (car accidents, motor accidents and pedestrian crashes), the accident rates in the "residential urban" areas are lesser than in the "non-residential" area (P=<0.001) and in "public and sports grounds" and "great roads, avenues and streets" are more than in "others". For the three kinds of accidents, the functional effect in the monthly trend of the accidents was signification (P=<0.001). CONCLUSION: The rates for all three kinds of accidents decreased. The increase in accident rates from the beginning of 2014 to Mar 2016 maybe due to the generalization of insurances in Iran and the increase in the number of accident victims being referred to the hospitals, which was the same with the results of other studies.