Evaluation of Awareness and Attitude of Telemedicine among Primary Healthcare Workers in Deprived Area Health Centers.

Background: Telemedicine has the potential to make healthcare more efficient, organized, and available and is a more beneficial technology that can ease preventive treatment and improve long-term health management. This is especially essential for those who face financial or regional reasons to get quality treatment. Telemedicine in Iran is a new medical field and a noble way to access medical facilities for populations living in deprived areas, and the primary healthcare workers in these deprived medical centers are the implementers of telemedicine in those areas; we aimed to investigate the awareness and attitude towards telemedicine among all the healthcare workers in these centers. Method: This is a descriptive cross-sectional study at the Health Centers of Raz County in North Khorasan Province, Iran, and 149 healthcare workers were included. For collecting information, we used a questionnaire that consisted of two parts. The first part contains the demographic data of health care workers, and the second part includes the 5-point Likert scale questionnaire (questions on telemedicine awareness, attitude, and self-report readiness). Result: Most participants (51%) were male, and 69.8% were married. The most frequent sources of information about telemedicine are colleagues (40.3%), continuing education (24.7%), and social media and the internet (10.1%). Awareness did not significantly relate to gender, age, marital status, or work experience, but awareness of physicians and midwives is higher than other groups (p < 0.05). The awareness of healthcare workers using continuing education, articles, workshops, or conferences was significantly higher (p < 0.05). The attitude scores for most questions are above 3.4 and reflect a positive attitude about telemedicine. Attitudes did not show a significant relation to gender, age, marital status, or work experience. Conclusion: Using telemedicine in developing countries, rural or urban areas have a high potential to improve epidemiological investigations, disease control, and clinical case management. Providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help get a more realistic picture of their perceptions.

Comparison of the Quality of Life of Physically Active and Inactive Grandmothers Caring and Non-caring for Grandchildren: A Cross-Sectional Study.

Background: Nowadays, grandparents have a major role in taking care of their grandchildren. Also, caring for grandchildren is a common and normative experience for many Iranian grandparents. The present study aimed to compare the quality of life of physically active and inactive grandmothers caring and non-caring for grandchildren. Methods: This analytical cross-sectional study was conducted on 300 grandmothers at the age range of 50 to 70 years old, who lived in Bojnurd, northeastern Iran (2018). Data were collected using the questionnaires of 36-Item Short Form Health Survey (SF-36) and Baecke Physical Activity, and demographic information. Results: The total scores of quality of life in caring physically active, physically inactive, non-caring physically active and non-caring physically inactive grandmothers were 76.95±6.33, 71.74±9.41, 75.56±5.9, and 56.06±11.23, respectively. There was a significant difference in the comparison of the quality of life score in caring grandmothers in two active and inactive groups (P<0.001). In addition, the quality of life score of non-caring grandmothers indicated a significant difference in physically active and inactive grandmothers (P<0.001). Conclusion: According to the results of this study, it seems that caring physically active grandmothers have higher quality of life. It can be suggested that the grandmothers who care for their grandchildren may improve their health and quality of life by incorporating the programs to increase physical activities in their daily life.

Evaluating the academic advisors' communication skills according to the students living in dormitory.

BACKGROUND: As revealed by previous research studies, stress, lack of problem-solving ability, and weakness may influence the academic performance of students who study medicine or relevant fields. It is necessary to provide students with consultation and academic advising to ensure their support and welfare. OBJECTIVES: The present study was carried out to evaluate the academic advisors' communication abilities and skills based on the views of the students living in the dormitory of North Khorasan University of Medical Sciences, Bojnurd, Iran. METHODS: The present analytical cross-sectional study was carried out on 155 dormitory-living students who were majoring in medicine, nursing and midwifery, and health. The required data were collected using a 17-item research-made questionnaire which evaluated the academic advisors' communication skills in "oral and written," "accepting and giving feedback," "understanding others," "being a good listener," and "effectiveness" fields. Descriptive statistics and Pearson's correlation coefficient test were utilized to analyze the collected data. RESULTS: In the students' opinion, as revealed by the results of the present study, the academic advisors gained the lowest scores in "oral and written" (8.33 ± 1.58) field and the highest scores in "accepting and giving feedback" (20.78 ± 9.36) and "understanding others" (22.73 ± 9.8) fields. CONCLUSION: The students believed that the academic advisors had the lowest ability in "oral and written" field; therefore, paid more attention should be paid to their communication skills, and their "oral and written" skills should be evaluated.

Locked nucleic acid -anti- let-7a induces apoptosis and necrosis in macrophages infected with Leishmania major.

BACKGROUND: Protozoan parasites of the genus Leishmania are etiologic agents which are intracellular pathogens of vertebrates and replicate inside infected macrophages. Leishmania have developed complex strategies to reverse host immune responses in favor of it. One of the major species causing cutaneous involvements is Leishmania major. MicroRNAs (miRNA) are non-coding small RNAs encoding 22-nucleotide (nt) long RNAs. miRNAs affect diverse biological processes, including cell cycle, proliferation, differentiation, growth and development, metabolism, aging, apoptosis, gene expression and immune regulation. This study aimed at evaluating apoptosis and necrosis after transfection locked nucleic acid (LNA) inhibitor of let-7a in the human macrophages miRNAs upon infectionwith L. major. MATERIALS AND METHODS: Inhibition of let-7a in macrophages was derived originally from the human monocytes (MDM), using locked nucleic acid (LNA) antagomir. The total cellular RNA was extracted 24 and 48 h post transfection. The levels o Let-7a expression was measured by qPCR Real Time using specific primer. Annexin-V/Propidium Iodide staining method was performed to detect apoptosis and necrosis in the MDM cells. Data were analyzed using the Kruskal-Wallis and Mann-Whitney tests. RESULTS: Let-7a inhibition increased the MDM cells apoptosis and necrosis using flow cytometry method. CONCLUSIONS: The results suggested that inhibition of let-7a could be a new approach in treatment of leishmaniasis.

The effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model.

BACKGROUND: Clinical experience associated with the fear and anxiety of nursing students in the psychiatric unit. Mental health nursing instructors find it challenging to teach nursing students to deal with patients with mental disorders in an environment where they need to provide patient teaching and clinical decision-making based on evidence and new technology. OBJECTIVE: To measure the effectiveness of clinical teaching of mental health courses in nursing using clinical supervision and Kirkpatrick's model evaluation in the psychiatry unit of Imam Reza Hospital, Bojnurd, Iran. METHODS: This cross-sectional study was carried out from 2011 to 2016 on 76 nursing students from a university as part of a clinical mental health course in two semesters. The students were selected by a non-probable convenient sampling method. After completing their clinical education, each student responded to checklist questions based on the four-level Kirkpatrick's model evaluation and open questions relating to clinical supervision. Finally, all data was analyzed using the SPSS version 16. RESULTS: The students have evaluated clinical supervision as a useful approach, and appreciated the instructor's supportive behavior during teaching and imparting clinical skills. This has made them feel relaxed at the end of the clinical teaching course. In addition, in the evaluation through Kirkpatrick's model, more than 70% of the students have been satisfied with the method of conducting the teaching and average score of nursing students' attitude toward mental health students: Their mean self-confidence score was 18.33±1.69, and the mean score of their performance in the study was evaluated to be 93.74±5.3 from 100 points. CONCLUSION: The results of clinical mental health teaching through clinical supervision and Kirkpatrick's model evaluation show that the satisfaction, self-esteem, attitude, and skill of nursing students are excellent, thereby portraying the effectiveness of clinical teaching. But this program still needs to be reformed. To establish long-term goals and obtain knowledge and clinical skills of nursing, it is recommended to develop a curriculum and evaluate it appropriately.

Evaluation of the disruptive behaviors among treatment teams and its reflection on the therapy process of patients in the operating room: The impact of personal conflicts.

INTRODUCTION: Understanding the development and distribution of disruptive behaviour among members of a health-care team is critical to the safety and quality of patient care in high-risk environments such as operating rooms. The present study identified disruptive behaviour and its effect on the treatment of patients in the operating room environment. SUBJECTS AND METHODS: This cross-sectional study used the convenience sampling method to select 144 operating room physicians and nurses (91 women and 53 men). The study was conducted in the operating rooms of four academic hospitals with different specialties in North Khorasan province in Iran from December 2013 to September 2014. The data were collected using a translated, modified, and validated questionnaire to investigate the prevalence and consequences of disruptive behaviour, the response of the health care system to the behaviour, factors affecting the creation of conflict and the spread of disruptive behaviour. Statistical analysis of the data was performed using SPSS 18. RESULTS: Disruptive behaviour was reported by 82.95% physicians and nurses. On average, 39% of physicians and 21% of operating room nurses exhibited disruptive behaviour. Disruptive behaviour is associated with psychological and clinical consequences. Factors such as fear of retaliation (8%), lack of change (43.8%), lack of security (18.1%) and attitude of the organization (14.6%) are significant reasons for the failure to report these behaviours. CONCLUSIONS: The findings suggest that disruptive behaviour occurs and affects treatment and workflow of treatment teams in the operating room. Interpersonal conflict contributes to the growth of such behaviour; thus, more research should focus on this subject in the future.