A cinenurducation activity using Call the Midwife to teach about sexually transmitted infections and preeclampsia: design, implementation, and assessment.

BACKGROUND: Nursing students need to learn about sexually transmitted infections and preeclampsia. Cinenureducation is a rigorous method that uses materials from commercial movies or television series to teach health sciences students. OBJECTIVES: Using content analysis of the television series Call the Midwife, design a cinenureducation activity teaching nursing students about sexually transmitted infections and preeclampsia. Evaluate its effectiveness in knowledge acquisition. DESIGN, IMPLEMENTATION, AND PRE-POST ASSESSMENT OF KNOWLEDGE GAIN FOR TEACHING ACTIVITIES: The study comprised three main steps: designing the teaching activity, implementing it, and analyzing its pedagogical effectiveness through a pre-and-post study to assess knowledge acquisition resulting from the teaching activity. PARTICIPANTS: A six-member panel assessed the suitability of materials for the teaching goals. All second-year undergraduate nursing students in the course "Nursing management and leadership" at a nursing school in the 2022-2023 academic year were invited to participate (N = 160). METHODS: The panel conducted a content analysis of the first two seasons of the series to determine the usefulness of each episode for teaching the chosen topics. Students were randomly assigned to groups watching episodes emphasizing either sexually transmitted infections or preeclampsia, followed by discussion. Learning was gauged through a pre-post viewing 20-question multiple-choice test. Additionally, students' satisfaction was evaluated. RESULTS: A total of 142 nursing students participated. Significant differences between mean scores before and after intervention were found [6.90 vs. 6.42 on the preintervention assessment, p < 0.05; mean gain, 0.49 (95 % CI: 0.22-0.76)]. Most students were satisfied with the activity. CONCLUSIONS: The activity was useful for teaching about sexually transmitted infections and preeclampsia. The use of a television series portraying nurses enables the exploration of these critical topics. This has potential implications for integrating similar methods into nurse education curricula, emphasizing the broader impact of the research on pedagogical practices in healthcare education.

Telling the story of the opioid crisis: A narrative analysis of the TV series Dopesick.

Dopesick (2021) is the first TV series whose plot deals exclusively with the opioid crisis in the United States. The current study uses narrative analysis and framing theory to explore this series, discussing its portrayal of the people and themes involved in the opioid crisis. Our analysis found that although Dopesick attempts to portray multiple dimensions of the opioid crisis, its narrative oversimplifies the story in attributing the cause of the problem almost exclusively to Purdue Pharma and its director Richard Sackler, while downplaying other factors that contributed to the opioid crisis. Thus, the narrative in this TV series tends to offer simple explanations to a complex problem for which simple solutions are likely to be inadequate.

Competencias Transversales: Una Revisión de las Mallas Curriculares de la Carrera de Odontología en Chile

RESUMEN: El desarrollo de competencias transversales es un aspecto relevante en el currículum de pregrado de Odontología, sin embargo, existe escasa evidencia sobre su presencia en los planes de estudio nacionales. El objetivo de esta investigación fue conocer la presencia de asignaturas centradas en competencias transversales en la carrera de Odontología de las universidades chilenas. Se realizó un estudio descriptivo de diseño transversal, revisando las mallas curriculares publicadas en la web por cada universidad que dictó el pregrado de Odontología el año 2020, con proceso de admisión abierto. De las 19 universidades consultadas, todas exhibieron en sus mallas curriculares asignaturas asociadas a competencias transversales y distribuidas a lo largo de los seis años del plan de estudios. Al utilizar la agrupación de competencias transversales propuesta por el Proyecto Tuning América Latina, se observó que las asignaturas relacionadas con los procesos cognitivos asociados al aprendizaje eran las más numerosas y suponían el 41 % del total; las vinculadas con los valores sociales correspondieron al 34 %; las asociadas al contexto tecnológico e internacional representaron el 20 %; mientras que las relacionadas con las habilidades interpersonales, solo alcanzaron un 5 %. Debido a su escasa presencia, es posible concluir que gran parte de los aprendizajes relacionados con el entrenamiento en habilidades interpersonales se encuentren resguardados en el currículum oculto y que probablemente estén a cargo del modelaje docente que se realiza diariamente en la práctica clínica. Como propuesta de futuro, el estudio sugiere mejorar la formación en competencias transversales de los egresados de odontología de las universidades chilenas.

ABSTRACT: The development of transversal competencies is a relevant aspect in the dental undergraduate curriculum. However, there is insufficient evidence about its implementation in national curriculums. The aim of this research was to know whether or not the courses are focused on transversal competencies in dental programs of Chilean universities. To accomplish this, a descriptive, cross-sectional study was carried out. This research was based on the review of the curriculums published on the websites of each university that awarded undergraduate degrees in dentistry in 2020, and facilitated an open admission process. Of the 19 universities studied, all had courses associated with transversal competencies in their dental curriculum. These were distributed throughout the six years of the curriculum. Using the grouping of transversal competencies, as proposed by the Latin America Tuning Project, it was shown that courses related to cognitive learning processes were the most represented of the subjects, corresponding to 41 % of all courses studied. Those related to social values corresponded to 34 %; courses associated with informational technology and those within the international context represented 20 %; while the courses related to interpersonal skills only reached 5 %. Due to the fact that the courses related to interpersonal skills were scarce, it could be concluded that a large part of this learning is included in the hidden curriculum and is probably achieved via instructional modeling as part of the daily clinical practice. As a proposal for the future, this research suggests that we need to improve the training in transversal competencies for the dental graduates of Chilean universities.

TV medical dramas: health sciences students' viewing habits and potential for teaching issues related to bioethics and professionalism.

BACKGROUND: Medical dramas have been popular since their inception, especially among medical students. We hypothesized that the recent increase in the availability of TV medical series through online streaming platforms has probably changed health science students' viewing habits as well as the representation of bioethical conflicts and health professionals. METHODS: We invited undergraduate students of medicine, nursing, and human biology to complete a self-administered questionnaire about their viewing habits and perceptions of the depictions of bioethical issues and professionalism in TV medical series. RESULTS: Of the 355 respondents, 98.6 % had watched TV in the last year, 93.5 % watched TV series, and 49.6 % watched medical dramas more than once a week. The most-viewed medical dramas were The Good Doctor, House MD, and Grey's Anatomy. The most-remembered bioethical topics were medical errors, inappropriate professional behaviors, and death. Most students considered that ideals of professionalism were depicted positively and professionals were portrayed as intelligent, professionally qualified, and competent. CONCLUSIONS: Medical dramas are very popular with health science students and are potentially useful as teaching tools for discussing issues related to bioethics and professionalism.

Health Care Professionals' Assessment of Patient Discomfort After Abdominal Surgery.

PURPOSE: The purpose of this study was to classify elements of patients' discomfort in the resuscitation room after open or laparoscopic abdominal surgery as per health care professionals' perceptions. DESIGN: A prospective cross-sectional study at a tertiary hospital in Spain. METHODS: Resuscitation room nurses administered the Postoperative Discomfort Inventory to physicians and nurses with >1 year experience working closely with patients who had undergone abdominal surgery, asking them to score nine items related to patients' discomfort in the first 8 hours after surgery on an 11-point scale (0 = absent to 10 = very severe). Interobserver agreement among proxy reporters was measured with the Spearman's ρ; correlations >0.35 was considered adequate agreement. FINDINGS: Of 125 eligible professionals, 116 (93%) participated (63 [54%] nurses and 53 [46%] physicians; mean age, 38 ± 12 years; 86 [74%] women). Professionals' perception of discomfort differed significantly between patients undergoing open surgery and those undergoing laparoscopic surgery; after open surgery, the most common types were pain (7.1 ± 1.8), movement restriction (7 ± 1.75), and dry mouth (6.6 ± 2.6), whereas after laparoscopic surgery, the most common types were dry mouth (5.85 ± 2.8), abdominal bloating (5.3 ± 2.5), and pain (5 ± 2.2). The Spearman's ρ correlations were inadequate for all items except for dry mouth in open surgery (r = 0.40). CONCLUSIONS: Pain, movement restriction, abdominal bloating, and dry mouth were the main causes of discomfort. Our findings highlight the need to be vigilant for all manifestations of discomfort after abdominal surgery to enable timely treatment.

Frankenstein; or, the modern Prometheus: a classic novel to stimulate the analysis of complex contemporary issues in biomedical sciences.

BACKGROUND: Advances in biomedicine can substantially change human life. However, progress is not always followed by ethical reflection on its consequences or scientists' responsibility for their creations. The humanities can help health sciences students learn to critically analyse these issues; in particular, literature can aid discussions about ethical principles in biomedical research. Mary Shelley's Frankenstein; or, the modern Prometheus (1818) is an example of a classic novel presenting complex scenarios that could be used to stimulate discussion. MAIN TEXT: Within the framework of the 200th anniversary of the novel, we searched PubMed to identify works that explore and discuss its value in teaching health sciences. Our search yielded 56 articles, but only two of these reported empirical findings. Our analysis of these articles identified three main approaches to using Frankenstein in teaching health sciences: discussing the relationship between literature and science, analysing ethical issues in biomedical research, and examining the importance of empathy and compassion in healthcare and research. After a critical discussion of the articles, we propose using Frankenstein as a teaching tool to prompt students to critically analyse ethical aspects of scientific and technological progress, the need for compassion and empathy in medical research, and scientists' responsibility for their discoveries. CONCLUSION: Frankenstein can help students reflect on the personal and social limits of science, the connection between curiosity and scientific progress, and scientists' responsibilities. Its potential usefulness in teaching derives from the interconnectedness of science, ethics, and compassion. Frankenstein can be a useful tool for analysing bioethical issues related to scientific and technological advances, such as artificial intelligence, genetic engineering, and cloning. Empirical studies measuring learning outcomes are necessary to confirm the usefulness of this approach.

Cinemeducation in clinical pharmacology: using cinema to help students learn about pharmacovigilance and adverse drug reactions.

PURPOSE: Feature films are increasingly being used in teaching health sciences. However, few publications address the effectiveness of this approach. We hypothesized that using feature films could help students learn. We aimed to assess the effectiveness of using a feature film to teach students about adverse drug reactions and pharmacovigilance. METHODS: The study population comprised third-, fifth-, and sixth-year undergraduate students of medicine, third-year undergraduate students of human biology, and graduate students in a master's degree program about the pharmaceutical and biotechnology industry. Students watched clips from the film 150 Miligrams (La fille de Brest) and discussed them afterward. To measure learning, we administered a 10-question multiple-choice test about pharmacovigilance concepts. We assessed students' satisfaction with the activity through a questionnaire. An exploratory comparative analysis was performed. RESULTS: A total of 237 students participated. Postintervention assessment scores were significantly higher than preintervention scores for the entire population and for all subgroups. The mean number of correct answers was 4.41 on the preintervention assessment and 5.78 on the postintervention assessment (mean gain: 1.37; 95% CI: 1.10-1.65). Similar results were found when analyzing groups of students from each group. Student satisfaction with this teaching activity was high in all groups. CONCLUSIONS: Cinemeducation is a useful tool for teaching about adverse drug reactions and pharmacovigilance processes. Most students were highly satisfied.

The Ethical Interest of Frankenstein; Or, the Modern Prometheus: A Literature Review 200 Years After Its Publication.

Two hundred years after it was first published, Mary Shelley's Frankenstein; or, the modern Prometheus remains relevant. This novel has endured because of its literary merits and because its themes lend themselves to analysis from multiple viewpoints. Scholars from many disciplines have examined this work in relation to controversial scientific research. In this paper, we review the academic literature where Frankenstein is used to discuss ethics, bioethics, science, technology and medicine. We searched the academic literature and carried out a content analysis of articles discussing the novel and films derived from it, analyzing the findings qualitatively and quantitatively. We recorded the following variables: year and language of publication, whether it referred to the novel or to a film, the academic discipline in which it was published, and the topics addressed in the analysis. Our findings indicate that the scientific literature on Frankenstein focuses mainly on science and the personality of the scientist rather than on the creature the scientist created or ethical aspects of his research. The scientist's responsibility is central to the ethical interest of Frankenstein; this issue entails both the motivation underlying the scientist's acts and the consequences of these acts.

Mu and delta opioid receptors play opposite nociceptive and behavioural roles on nerve-injured mice.

BACKGROUND AND PURPOSE: Mu and delta opioid receptors(MOP, DOP) contribution to the manifestations of pathological pain is not understood. We used genetic approaches to investigate the opioid mechanisms modulating neuropathic pain and its comorbid manifestations. EXPERIMENTAL APPROACH: We generated conditional knockout mice with MOP or DOP deletion in sensoryNav1.8-positive neurons (Nav1.8), in GABAergic forebrain neurons (DLX5/6) orconstitutively (CMV). Mutant mice and wild-type littermates were subjected topartial sciatic nerve ligation (PSNL) or sham surgery and their nociception wascompared. Anxiety-, depressivelike behaviour and cognitive performance were also measured. Opioid receptor mRNA expression, microgliosis and astrocytosis were assessed in the dorsalroot ganglia (DRG) and/or the spinal cord (SC). KEY RESULTS: Constitutive CMV-MOP knockouts after PSNL displayed reduced mechanical allodynia and enhanced heat hyperalgesia. This phenotype was accompanied by increased DOP expression in DRG and SC, and reduced microgliosis and astrocytosis in deep dorsal horn laminae. Conditional MOP knockouts and control mice developed similar hypersensitivity after PSNL, except for anenhanced heat hyperalgesia by DLX5/6-MOP male mice. Neuropathic pain-induced anxiety was aggravated in CMV-MOP and DLX5/6-MOP knockouts. Nerve-injured CMV-DOP mice showed increased mechanical allodynia, whereas Nav1.8-DOP and DLX5/8-DOP mice had partial nociceptive enhancement. CMV-DOP and DLX5/6-DOP mutants showed increased depressive-like behaviour after PSNL. CONCLUSIONS AND IMPLICATIONS: MOP activity after nerve injury increased anxiety-like responses involving forebrain GABAergic neurons and enhanced mechanical pain sensitivity along with repression of DOP expression and spinal cord gliosis. In contrast, DOP shows a protective function limiting nociceptive and affective manifestations of neuropathic pain.

Pain, Anxiety, Depression, and Quality of Life in Patients with Vulvodynia.

BACKGROUND/AIMS: The term vulvodynia refers to vulvar pain of unknown origin lasting at least 3 months. Psychiatric comorbidities are a common feature and, along with pain, may severely affect patients' wellbeing. We aimed to determine the characteristics of pain in vulvodynia, to correlate characteristics with symptoms of anxiety and depression, and to analyse the impact of these factors on patients' quality of life. METHODS: This cross-sectional observational study analysed pain, anxiety, and depression and the effects of these factors on quality of life. Pain, anxiety, and depression were assessed using validated tools in 110 women. RESULTS: Statistical analyses found correlations between pain and anxiety and between anxiety and worsened quality of life. Patients often reported stinging, burning, pain, itching, and dyspareunia, pointing to the importance of temporal, localisation, punctate pressure, thermal, tactile sensitivity, and emotional tension characteristics. Most patients had severe pain related to psychiatric comorbidities and decreased quality of life. CONCLUSION: Using descriptors of pain quality and assessing anxiety and depression might help to define subgroups of patients that may benefit from different therapeutic approaches and thus enable treatments to be tailored to individual patients.

Developing creative and research skills through an open and interprofessional inquiry-based learning course.

BACKGROUND: Biomedicine needs innovative professionals. Inquiry-based learning (IBL) aims to develop higher order thinking skills, such as creativity and research. Stimulatory techniques and interprofessional education, which requires students from different fields to collaborate, also enhances creativity. In this study, the effectiveness of an interprofessional IBL course that introduces a creativity workshop based on stimulatory techniques to develop creative and research skills is examined. METHODS: 529 undergraduate human biology and medical students performed the interprofessional IBL course, 198 with the creativity workshop and 331 without. Students' perceptions of learning processes and outcomes were assessed in surveys and focus groups by the authors of this study. As well, the final learning results from both groups of students were analyzed by the teachers of the course and the researchers. RESULTS: The results show that the open IBL approach promoted the development of these skills, interprofessionality acted as a creativity enhancer and stimulatory techniques contributed to improve the learning outcomes. CONCLUSIONS: This study provides insight into how open interprofessional IBL fosters acquisition of complex skills and knowledge, pointing out the benefits and limitations of this approach in health sciences studies.

Why mu-opioid agonists have less analgesic efficacy in neuropathic pain?

Injury to peripheral nerves often leads to abnormal pain states (hyperalgesia, allodynia and spontaneous pain), which can remain long after the injury heals. Although opioid agonists remain the gold standard for the treatment of moderate to severe pain, they show reduced efficacy against neuropathic pain. In addition to analgesia, opioid use is also associated with hyperalgesia and analgesia tolerance, whose underlying mechanisms share some commonalities with nerve injury-induced hypersensitivity. Here, we reviewed up-to-day research exploring the contribution of mu-opioid receptor (MOR) on the pathophysiology of neuropathic pain and on analgesic opioid actions under these conditions. We focused on the specific contributions of MOR populations at peripheral, spinal and supraspinal level. Moreover, evidences of neuroplastic changes that may underlie the low efficacy of MOR agonists under neuropathic pain conditions are reviewed and discussed. Sensitization processes leading to pain hypersensitivity, molecular changes in signalling pathways triggered by MOR and glial activation are some of these mechanisms elicited by both nerve injury and opioid exposure. Nerve injury-induced pain hypersensitivity might be masking the initial analgesic effects of opioid agonists, and alternatively, sustained opioid treatment to individuals already suffering from neuropathic pain could aggravate their pathophysiological state. Finally, some combined therapies that can increase opioid analgesic effectiveness in neuropathic pain treatment are highlighted. SIGNIFICANCE: This review provides evidence of the low benefit of opioid monotherapy in neuropathic pain and analyses the reasons of this reduced effectiveness. Opioid agonists along with drugs targeted to block the sensitization processes induced by MOR stimulation might result in a better management of neuropathic pain.

Fentanyl as pre-emptive treatment of pain associated with turning mechanically ventilated patients: a randomized controlled feasibility study.

PURPOSE: To compare pain incidence and changes in pain scores with fentanyl versus placebo as pre-emptive treatment during turning and 30 min post-turning in mechanically ventilated critically ill patients. METHODS: We performed a randomized, double-blind, parallel-group, placebo-controlled clinical trial in the intensive care unit of a university hospital. Seventy-five mechanically ventilated patients were randomized to an intervention group (fentanyl) or a control group (placebo). Patients in the intervention group received 1 µg/kg (medical patients) or 1.5 µg/kg (surgical patients) of fentanyl 10 min before turning. Pain indicators were assessed using the behavioral pain scale. Safety was assessed by determining the frequency and severity of pre-defined adverse events. Pain was evaluated at rest (T0), at turn start and end (T1 and T2) and at 5, 15 and 30 min post-turning (T3, T4 and T5). RESULTS: The two groups had similar baseline characteristics. The area under the curve for BPS values was significantly smaller in the fentanyl group than in the control group [median and interquartile range (IQR): 132 (108-150) vs. 147 (125-180); p = 0.016, respectively]. Nineteen non-serious adverse events were recorded in 14 patients, with no significant between-group differences (23 % fentanyl group vs. 14 % control group; p = 0.381). CONCLUSIONS: These results suggest an intravenous bolus of fentanyl of 1 µg/kg for medical patients or 1.5 µg/kg for surgical patients reduces the incidence of turning-associated pain in critically ill patients on mechanical ventilation. ClinicalTrials.gov: NCT 01950000.

Postoperative Discomfort After Abdominal Surgery: An Observational Study.

PURPOSE: Patients who have surgery may experience distress in the following days. Although postoperative distress is a common experience, few studies have analyzed these patient complaints in-depth. The purpose of the present study was to analyze the potential causes of patients' discomfort after abdominal surgery. DESIGN: This was a prospective and observational study. METHODS: Patients (N = 131) were asked to rate their discomfort twice using a list of nine items in the first 6 to 8 hours after surgery and at 24 hours after its completion. Participants were asked to score intensity from 0 (absent) to 10 (unbearable). FINDINGS: The main causes of discomfort at 24 hours were pain (82%), movement restriction (79%), and dry mouth (70%). These items also had the highest scores (by gender, women scored higher than did men in insomnia, dry mouth, and abdominal distension). No significant differences were observed between patients who had undergone open or laparoscopic surgery. CONCLUSION: It was concluded that pain, movement restriction, and dry mouth were the most disturbing causes of discomfort. Therefore, symptoms other than pain should be considered to improve the well-being of patients after abdominal surgery.

A randomized controlled trial of fentanyl in the pre-emptive treatment of pain associated with turning in patients under mechanical ventilation: research protocol.

AIM: To compare the effectiveness and safety of fentanyl with placebo as pre-emptive treatment for pain associated with turning in patients in intensive care units. BACKGROUND: Turning is frequently a painful procedure in this setting. Pre-emptive administration of supplementary analgesia may help decrease this pain. However, medical literature on pre-emptive analgesia in these patients is scarce. DESIGN: A randomized, double-blind, controlled clinical trial. METHODS: This study will assess the benefits and risks of pre-emptive analgesia with fentanyl compared with placebo on turning-associated pain. Eighty patients will be recruited from among those older than 18 years and needing mechanical ventilation for at least 24 hours. Pain intensity will be assessed using the Behavioral Pain Scale. Primary outcome will be pain intensity between the baseline and 30 minutes after turning, measured by the area under the curve of the pain scale scores. Secondary outcomes will be the usefulness of physiological parameters and the Bispectral Index to measure pain and the safety of pre-emptive fentanyl in turning. The study protocol was approved in February 2011. DISCUSSION: If pre-emptive fentanyl is more effective than placebo and reasonably safe, the results of the current study may change nursing attitude in managing turning in critically ill patients. As a consequence, pain may be decreased during this nursing procedure.

Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery.

OBJECTIVES: To analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: Observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: The prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: Preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery.