Extracting virtual modules of diabetes courses for training primary health care professionals: a scoping review.

Purpose: There is plenty of evidence on the interventions that can improve outcomes of diabetes. Thus, there is an urgent need to innovate and provide cost-effective ways to optimize the best care for diabetes. The aim was to examine the components of diabetes courses to extract training virtual modules for training primary health care professionals (PHCPs) (i.e. general practitioners, nurses and nutritionists). Methods: In this scoping review, a systematic approach based on the Arksey and O'Malley method was used. In order to develop the modules for diabetes courses, search strategy was developed using main keywords. Also, databases including PubMed, Web of Science, Scopus, CINAHL, ERIC and Embase, and Google search engine were searched up to April 10th 2021. Two researchers independently screened the retrieved courses. After removing duplicates, and according to the eligibility criteria, the components of each retrieved course were extracted. Results: Diabetes training courses have been selected to examine their components to extract training modules. Initially, we found 120 courses related to the training of PHCPs. All information about 44 courses were available online. The researchers reviewed the courses according to tool approved by panel of experts, inclusion criteria, and purpose of the study. Thus, we first extracted 23 eligible programs and 15 final programs were considered for extracting the modules. According to the tool developed by the panel of experts, we extracted 9 virtual modules for diabetes courses including principles, prevention or delay, management, complications, education, special conditions, information technology, referral system of diabetes for training PHCPs. Conclusion: Education is an important part of diabetes and needs of PHCPs should be addressed in educational programs in the future. The design of the diabetes training course based on extracted modules in this research for the training of PHCPs can help in this field.

Preparation, Characterization, and Wound Healing Assessment of Curcumin-Loaded M-MOF (M = Cu, Zn)@Polycaprolactone Nanocomposite Sponges.

The fabrication of multifunctional scaffolds has attracted much attention in biological fields. In this research, some novel composites of Cu(II) or Zn(II) metal-organic framework (M-MOF) and polycaprolactone (PCL), M-MOF@PCL, have been fabricated as multifunctional scaffolds for application in the tissue engineering (TE) field. The porous three-dimensional sponges were prepared by the salt leaching method. Then, the M-MOF@PCL composite sponges have been prepared by in situ synthesis of M-MOF in the presence of the as-obtained PCL sponge to gain a new compound with proper features for biological applications. Finally, curcumin was attached to the M-MOF@PCL as a bioactive compound that can act as a wound-healing agent, anti-oxidant, and anti-inflammatory. The presence of the M-MOF in final composites was investigated by different methods such as FTIR (Fourier-transform infrared), XRD (X-ray diffraction), SEM (scanning electron microscope), EDS (energy-dispersive X-ray spectroscopy), and TEM (transmission electron microscope). SEM images confirmed the porous structure of the as-obtained composites. According to the EDS and TEM images, M-MOFs were uniformly incorporated throughout the PCL sponges. The water sorption capacities of the blank PCL, Cu-MOF@PCL, and Zn-MOF@PCL were determined as 56%, 155%, and 119%, respectively. In vivo investigation on a third-degree burn model in adult male Wistar rats exhibited an accelerated wound healing for Cu-MOF@PCL compared to with Zn-MOF@PCL and the control group.

Challenges of Type 2 Diabetes Mellitus Management From the Perspective of Patients: Conventional Content Analysis.

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) face significant challenges in the treatment process, which can have a negative impact on disease management. Proper management of the disease can reduce symptoms and complications, improve glycemic indices, and reduce mortality and readmission. OBJECTIVE: Given the influential role of patients in prevention and self-care, this study was conducted to explore the challenges of diabetes management from the perspective of patients. METHODS: Two rounds of focus group discussions with T2DM patients were conducted. The principal investigator of the study and a research assistant compiled a list of volunteer patients with names and contact information and selected participants based on their medical information. Participants were chosen via a purposive sampling technique. The questions were designed to encourage patients to share their views on how the treatment team communicates and participates in treatment, how they are trained, and the health care system. The discussion continued until data saturation. During 2 rounds of focus group discussions, the voices of the participants were recorded by 2 voice recorders, and one of the team members was a transcriber. After discussion, participant views were transcribed, and common issues were identified, sorted, and reported as categories and subcategories. RESULTS: According to the conventional content analysis, 88 primary codes were extracted from the detailed and in-depth description of the participants. The codes were summarized after repeated readings and classified based on their similarities and semantic relevance. Through analysis and comparison, 4 categories and 7 subcategories were identified: communication challenges (poor medical staff communication, lack of psychological support), challenges to participation in treatment (lack of patient participation), educational challenges (training program bugs, inadequate training), and challenges of the health care system (inefficiency of the care system, caregiver inefficiency). CONCLUSIONS: This study showed that the treatment team members should pay more attention to the challenges of care and treatment from the perspective of patients with T2DM. Therefore, recommendations for future policies to overcome these obstacles include establishing a multidisciplinary health care team; using trained health care workers to provide organized treatment and care services; holding individual counseling sessions with patients in need of counseling; and providing counseling services, involving patients in the treatment and self-care process, and designing a comprehensive diabetes education program with an emphasis on education. Necessary information should be provided to the patients, and effective communicate should address patient concerns.

The effect of exercise on quality of life in postmenopausal women referred to the Bone densitometry centers of Iran University of Medical Sciences.

BACKGROUND: One of the most critical stages of women's lives is menopause and one of the aims of health for all in the 21st century is the improvement of the quality of life. AIM AND OBJECTIVE: The aim of this study was to determine the effect of exercise on quality of life in postmenopausal women. MATERIALS AND METHODS: This study was designed by a randomized-controlled trial. Eighty volunteer postmenopausal women who experienced the menopause period naturally and have been taking hormone replacement treatment (HRT) were divided into two groups randomly (exercise group n = 40, control group n = 40). The Nottingham Health Profile (NHP) was used to assess quality of life in both groups before and after 8 weeks. The exercise group participated in an exercise program, which was composed of sub-maximal aerobic exercises for an 8-week period 5 times a week. Quality of life in two groups was compared at the end of 8 weeks. RESULTS: The results showed that there was a statistically significant difference in the exercise group for the NHP indicating an improvement in the quality of life (P < 0.05). CONCLUSION: We concluded that quality of life on postmenopausal women could be improved with a regular and controlled exercise program of 8 weeks. Thus, implementing appropriate educational programs to promote the quality of life in postmenopausal women is recommended.

Sleep quality and associated factors among patients with chronic heart failure in Iran.

BACKGROUND: Sleep disorders are common among patients with chronic heart failure (HF), and it can have a significant effect on patients' daily activities as well as their health. The purpose of this study was to assess sleep quality and its predictors in Iranian patients with chronic HF. METHODS: This cross-sectional study was conducted on a sample of 200 patients with HF in two hospitals of Tehran University of Medical Sciences from June to November 2009. These patients completed a demographic questionnaire, and their sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). One-way analysis of variance (ANOVA), Kruskal-Wallis test, t-test and Linear regression were used for data analysis. RESULTS: Seventy-nine percent of patients (n = 158) reported poor sleep quality (PSQI > 5). The range of global PSQI scores was 3-20. Also, a significant relationship was found between PSQI scores and patients' age (p<0.004), gender (p< 0.042), educational level (p< 0.001), occupational status (p< 0.038), number of hospitalizations (p< 0.005), type of referral (p< 0.001), non-cardiac diseases (p< 0.001), diuretic use (p< 0.021) and left ventricular ejection fraction (p< 0.015). Three predictors were identified using regression analyses with stepwise methods, and included age, type of referral and educational level. CONCLUSION: The high prevalence of poor sleep quality highlighted the importance of sleep disorders in HF patients. There are many factors associated with sleep quality and sleep disorders that health providers should recognize for improved and effective management.

Mobile Phone Short Message Service (SMS) for Weight Management in Iranian Overweight and Obese Women: A Pilot Study.

We conducted a text message-based intervention for weight management over three months by two months intervention and one month wash-out period. In a quasi-experimental study with control (n = 40) and experimental group (n = 40), 80 overweight and obese employed women were entered. Participants were recruited via announcement. All subjects attended a face-to-face information session and received a booklet that contained food calorie chart and strategies and recommendations for weight management. The experimental group received text messages (SMS) about weight management twice a day for two months, in addition to the information and the booklet which they had received in the information session. Also, the experimental group was instructed to weekly self-weight and to send the data to the principle researcher. All subjects were measured for baseline and secondary weight in a standardized manner by a nurse, and the data were compared between the two groups. Experimental group lost more weight than the control group (1.5 kg difference, P = 0.018). Text messaging seems to be an effective channel of communication for weight management in Iranian overweight and obese women. The clinical trial registration number is IRCT201204029360N1.