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AIM: This study aimed to examine the effectiveness of an educational board game in improving nursing students' medication knowledge. BACKGROUND: Maintaining patient safety is a core practice for nurses. Medication management is a central principle of patient safety. Nurses acquire pharmacology knowledge and medication safety skills in the classroom training. Thus, solidifying and strengthening nursing students' medication knowledge are crucial tasks for nursing faculty members. In recent years, board games, which offer both entertainment and competitive play, have been employed to educate students in a variety of disciplines and settings. Through board game play, students can learn in an enjoyable and fun atmosphere. DESIGN: A randomized controlled trial design. METHODS: A convenience sample of 69 nursing students was obtained from a university in Taiwan. Participants were randomly assigned either to an experimental (board game) group (n = 35) or a comparison group (n = 34) using block randomization. The experimental group engaged in board game play to learn about medications, whereas the comparison group attended a one-hour didactic lecture. Using questionnaires, data were collected before the intervention, immediately post intervention and one month post intervention. RESULTS: Following the intervention, regardless of the learning method, both groups showed significant improvements in their immediate recall of medication information. However, when retested after one month, the experimental group obtained significantly higher scores than the comparison group. Moreover, students in the experimental group reported more satisfaction with the learning method than those in the comparison group. CONCLUSIONS: The study results suggest that learning through board games could enhance nursing students' retention of knowledge. Students reported favorable reactions to using a board game learning method for increasing knowledge of medication. With respect to this finding, faculty members may consider employing board games as teaching tools in nursing and other health science courses. Moreover, the findings of this study can also provide additional information for nursing managers in hospital wards or long-term care facilities where nurses are trained to familiarize themselves with frequently administered medications. TWEETABLE ABSTRACT: Board game play can enhance nursing students' retention of knowledge; students reported positive reactions to game-based learning for medication training.
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Estudantes de Enfermagem , Humanos , Aprendizagem , Segurança do Paciente , Inquéritos e Questionários , TaiwanRESUMO
Angiogenesis occurs during ovarian follicle development and luteinization. Pituitary secreted FSH was reported to stimulate the expression of endothelial mitogen VEGF in granulosa cells. And, intraovarian cytokine transforming growth factor (TGF)ß1 is known to facilitate FSH-induced differentiation of ovarian granulosa cells. This intrigues us to investigate the potential role of FSH and TGFß1 regulation of granulosa cell function in relation to ovarian angiogenesis. Granulosa cells were isolated from gonadotropin-primed immature rats and treated once with FSH and/or TGFß1 for 48 h, and the angiogenic potential of conditioned media (granulosa cell culture conditioned media; GCCM) was determined using an in vitro assay with aortic ring embedded in collagen gel and immunoblotting. FSH and TGFß1 increased the secreted angiogenic activity in granulosa cells (FSH + TGFß1 > FSH ≈ TGFß1 >control) that was partly attributed to the increased secretion of pro-angiogenic factors VEGF and PDGF-B. This is further supported by the evidence that pre-treatment with inhibitor of VEGF receptor-2 (Ki8751) or PDGF receptor (AG1296) throughout or only during the first 2-day aortic ring culture period suppressed microvessel growth in GCCM-treated groups, and also inhibited the FSH + TGFß1-GCCM-stimulated release of matrix remodeling-associated gelatinase activities. Interestingly, pre-treatment of AG1296 at late stage suppressed GCCM-induced microvessel growth and stability with demise of endothelial and mural cells. Together, we provide original findings that both FSH and TGFß1 increased the secretion of VEGF and PDGF-B, and that in turn up-regulated the angiogenic activity in rat ovarian granulosa cells. This implicates that FSH and TGFß1 play important roles in regulation of ovarian angiogenesis during follicle development.
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Hormônio Foliculoestimulante/farmacologia , Neovascularização Fisiológica/efeitos dos fármacos , Ovário/irrigação sanguínea , Ovário/efeitos dos fármacos , Fator de Crescimento Transformador beta1/farmacologia , Indutores da Angiogênese/metabolismo , Animais , Feminino , Células da Granulosa/citologia , Células da Granulosa/efeitos dos fármacos , Células da Granulosa/metabolismo , Humanos , Técnicas In Vitro , Microvasos/citologia , Microvasos/efeitos dos fármacos , Microvasos/metabolismo , Ovário/citologia , Fator de Crescimento Derivado de Plaquetas/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores do Fator de Crescimento Derivado de Plaquetas/antagonistas & inibidores , Receptores do Fator de Crescimento Derivado de Plaquetas/metabolismo , Ovinos , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/metabolismoRESUMO
BACKGROUND: Treatment of oral cavity cancer may require variable extent of mandibular resection. Marginal mandibulectomy is a controversial technique in providing oncologic resection margin. This study analyzes the efficacy of local oncologic control and the morbidity of marginal mandibulectomy in oral cavity carcinoma. Nononcologic complication of osteoradionecrosis is discussed. METHODS: A retrospective cohort study analyzed clinicopathologic features of 43 patients with oral cavity cancer who underwent marginal mandibulectomy. Histologic mandibular invasion was examined as a function of local control and contribution to osteoradionecrosis. RESULTS: Bone invasion was present in 16.3% of patients with marginal mandibulectomy. Local control rates were 85.7% in the bone invasion group and 77.8% in the no bone invasion group (p = .7). Osteoradionecrosis rates were 16.7% and 17.6%, respectively (p = .96). There was no significant difference between the 2 groups. CONCLUSIONS: Marginal mandibulectomy is oncologically sound in providing a safe resection margin in oral cavity cancer abutting or superficially invading the mandible.
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Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Mandíbula/patologia , Mandíbula/cirurgia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/cirurgia , Invasividade Neoplásica , Recidiva Local de Neoplasia , Osteorradionecrose/patologia , Prognóstico , Estudos Retrospectivos , Terapia de Salvação , Retalhos CirúrgicosRESUMO
Metastatic head and neck squamous cell carcinoma (HNSCC) is a rare cause of cardiac tamponade. We report on a 62-year-old male who presented with metastatic squamous cell carcinoma (SCC) that caused cardiac tamponade secondary to a primary SCC originating from the retromolar trigone of the oral cavity. The clinical diagnosis was confirmed by physical examination, echocardiography and complete resolution of symptoms after pericardial fluid drainage. Cytologic examination of the pericardial fluid was the only investigational tool able to render a definitive evidence of malignant pericardial effusion. However, evidence of a hemorrhagic pericardial effusion must raise the suspicion of a malignant etiology regardless of the result of the cytologic examination. Metastatic HNSCC may involve multiple organ systems including the heart. We report this rare clinical presentation of cardiac tamponade as the initial location of distant metastasis. Otolaryngologists should keep a high index of suspicion and pay special attention to the symptoms arising on the non-head and neck sites to establish an early diagnosis and prompt management of the disease process.
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Carcinoma de Células Escamosas/secundário , Tamponamento Cardíaco/etiologia , Neoplasias Cardíacas/secundário , Neoplasias Bucais/complicações , Neoplasias Bucais/diagnóstico , Derrame Pericárdico/etiologia , Pericárdio , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/cirurgia , Tamponamento Cardíaco/diagnóstico , Diagnóstico Diferencial , Neoplasias Cardíacas/complicações , Neoplasias Cardíacas/diagnóstico , Humanos , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Neoplasias Bucais/cirurgia , Esvaziamento Cervical , Derrame Pericárdico/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologiaRESUMO
OBJECTIVE: This study investigated whether audiovestibular function tests, namely auditory brain stem response (ABR) and vestibular-evoked myogenic potential (VEMP) tests were correlated to hearing outcomes after controlling the effects of other potential confounding factors in severe to profound sudden sensorineural hearing loss (SSHL). DESIGN: Eighty-eight patients with severe to profound SSHL were enrolled in this study. Pretreatment hearing levels, results of audiovestibular function tests, and final hearing outcomes were recorded from retrospective chart reviews. Other factors, including age, gender, delay of treatment, vertigo, diabetes mellitus, and hypertension, were collected as well. Comparative analysis between multiple variables and hearing outcomes was conducted using the cumulative logits model in overall subjects. Further, multivariate analysis of prognostic factors was conducted in the stratified groups of severe (70 dB HL
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Potenciais Evocados Auditivos do Tronco Encefálico , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/fisiopatologia , Testes Auditivos , Audição , Testes de Função Vestibular , Adolescente , Adulto , Idoso , Criança , Feminino , Perda Auditiva Neurossensorial/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recuperação de Função Fisiológica , Estudos Retrospectivos , Índice de Gravidade de Doença , Vertigem/complicações , Adulto JovemAssuntos
Doenças do Nervo Facial/patologia , Neuroma/patologia , Neoplasias do Sistema Nervoso Periférico/patologia , Lobo Temporal/patologia , Cerebelo/diagnóstico por imagem , Cerebelo/patologia , Neoplasias da Orelha/diagnóstico por imagem , Neoplasias da Orelha/patologia , Doenças do Nervo Facial/diagnóstico por imagem , Imageamento por Ressonância Magnética , Neuroma/diagnóstico por imagem , Neoplasias do Sistema Nervoso Periférico/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. METHODS: From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. RESULTS: At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. CONCLUSIONS: Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks.
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Potencial Evocado Motor/fisiologia , Doença de Meniere/fisiopatologia , Músculos do Pescoço/fisiologia , Vestíbulo do Labirinto/fisiopatologia , Adolescente , Adulto , Idoso , Eletromiografia , Eletronistagmografia/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Processamento de Sinais Assistido por Computador , Gravação em VídeoRESUMO
The aim of this study was to investigate the side-difference of vestibular evoked myogenic potentials (VEMPs) in relation to the provocation rates, latencies and amplitudes using binaural acoustic stimulation with bilateral recording. Fourteen healthy volunteers underwent a serial VEMP testings elicited binaurally by a sequence of alternating stimulus intensities, that is, 95-95 (right-left), 85-95, 95-85, and 85-85 dBHL tone burst, respectively. The provocation rates as well as the mean latencies of p13 and n23 for the VEMPs demonstrated no significant side-difference despite using 95-95, 85-95, 95-85 and 85-85 dBHL binaural acoustic stimulation. In contrast, nine (64%) of the 14 subjects showed side-difference of absolute p13-n23 amplitude, including right side dominant in five subjects, and left side dominant in four subjects. However, there was no significant side-difference in terms of relative amplitude despite using 95-95, 85-95, 95-85 and 85-85 dBHL binaural acoustic stimulation. Furthermore, the relative amplitude or interaural amplitude difference (IAD) ratios between those with and without side-difference of p13-n23 amplitude did not differ significantly. Hence, this study provides a potentially important method for adjusting the side difference of p13-n23 amplitudes by using a relative amplitude or IAD ratio adjustment. It also adds confidence to the successful use of binaural stimulation and recording of VEMPs under conditions of bilateral SCM muscular contractions.