Enhancing residents' neonatal resuscitation competency through team-based simulation training: an intervention educational study.

BACKGROUND: Neonatal resuscitation training in a simulated delivery room environment is a new paradigm in pediatric medical education. The purpose of this research is to highlight team-based simulation as an effective method of teaching neonatal resuscitation to senior pediatric residents. METHODS: In an intervention educational study, we evaluated the impact of team-based simulation training in the development of neonatal resuscitation. A team consisting of a three-person group of senior pediatric residents performed neonatal resuscitation on a low-fidelity newborn simulator based on the stated scenario. Video-based structured debriefing was performed and followed by the second cycle of scenario and debriefing to evaluate the feasibility of conducting team-based simulation training in a lesser-resourced environment. Evaluation criteria included megacode scores which is a simulation performance checklist, pre-and post-test scores to evaluate residents' knowledge and confidence, the survey checklist as a previously developed questionnaire assessing residents' satisfaction, and debriefing from live and videotaped performances. Four months after the end of the training course, we measured the behavioral changes of the residents by conducting an OSCE test to evaluate post-training knowledge retention. Mean ± SD was calculated for megacode, satisfaction (survey checklist), and OSCE scores. Pre- and post-program gains were statistically compared. The first three levels of Kirkpatrick's training effectiveness model were used to evaluate the progress of the program. RESULTS: Twenty-one senior residents participated in the team-based simulation. The mean ± SD of the megacode score was 35.6 ± 2.2. The mean ± SD of the overall satisfaction score for the evaluation of the first level of the Kirkpatrick model was 96.3 ± 3.7. For the evaluation of the second level of the Kirkpatrick model, the pre-posttest gain in overall confidence score had a statistically significant difference (P = 0.001). All residents obtained a passing grade in OSCE as an evaluation of the third level. CONCLUSIONS: Team-based simulation training in neonatal resuscitation improves the knowledge, skills, and performance of pediatric residents and has a positive effect on their self-confidence and leadership skills. There is still a need to investigate the transfer of learning and abilities to real-life practice, and further research on cost-effectiveness and impact on patient outcomes is warranted.

The Effectiveness of Kangaroo Mother Care (KMC) on attachment of mothers with premature infants.

Objective: Attachment is a socio-emotional relationship between the mother and infant that increases the probability of a preterm infant's survival. This study aimed to evaluate the effectiveness of Kangaroo Mother Care (KMC) on maternal attachments of mothers with premature infants. Study design: This quasi-experimental study was performed on 100 mothers of premature infants who were admitted to neonatal intensive care units. A questionnaire comprising demographic information and the Maternal Attachment Scale were used as data collection tools. All data analysis was performed using SPSS software version 25. Significant level is considered P < 0.05. Results: After the intervention, the levels of maternal attachment of mothers in the intervention group were significantly higher than in the control group (47.7 ± 2.9vs. 40.4 ± 5.4, P = 0.003). After the intervention, the infants in the intervention group has a significantly higher number of breastfeeding than the control group (10.6 ± 1.8 vs. 8.2 ± 1.6, P = 0.000). Moreover, the infant of the intervention group had a statistically significant higher weight at discharge time (2164.4 ± 481.1 vs. 1965.2 ± 372, P = 0.042). Conclusion: The results of the present study showed that Kangaroo Mother Care can be used to improve the maternal attachments in mothers with premature infants. It improves the breastfeeding and weight gain status in infants as well.

The effect of eight weeks of moderate and high intensity aerobic training on the gene expression of Mir-145, Wnt3a and Dab2 in the heart tissue of type 2 diabetic rats.

PURPOSE: Pathological hypertrophy of heart tissue has been attributed to changes in some microRNAs and their target genes in heart tissue. This study intended to study the effects of eight weeks of moderate and high intensity aerobic training (MIT&HIT) on the mRNA of Mir-145, Wnt3a, and Dab2 in heart tissue of type 2 diabetic rats. METHODS: To implement this experimental research, 60 male Wistar rats were randomly divided into 6 groups, including Healthy-control (HC), Diabetic-control (DC), Moderate intensity training (MIT), Diabetes-MIT (DMIT), high intensity training (HIT) and Diabetes-HIT (DHIT). The aerobic training was conducted with moderate (50-60% VO2max) and high (85-90% VO2max) intensity, 5 days a week, for 8 weeks. The Mir-145, Wnt3a and Dab2 gene expression in the heart tissue samples was measured by Real Time PCR. Data were analyzed by one-way ANOVA and Tukey post hoc test at the P < 0.05. RESULTS: Moderate and high intensity aerobic training was associated with non-significant increase in Mir-145 mRNA of Heart tissue in type 2 diabetic rats than the diabetic control group(P < 0.05). Moderate and high intensity aerobic training was associated with significant increase in Wnt3a mRNA (P = 0.001) and significant decrease in Dab-2 mRNA (P = 0.001) of Heart tissue in type 2 diabetic rats than the diabetic control group. The Dab-2 mRNA was significantly lower of heart tissue in the diabetes- high intensity training group than the diabetes- moderate intensity training group (P = 0.001). CONCLUSION: It seems that moderate and high intensity aerobic exercise can help regulate the genes of the physiological hypertrophy pathway of the heart tissue in diabetes.

Lipid-Lowering Effects of Concurrent Training and Green Tea Consumption in Overweight Women.

BACKGROUND: Exercise conducted simultaneously with the consumption of herbal supplements is one of the suggested methods for controlling obesity and its complications. The present study sought to investigate the lipid-lowering effects of concurrent training and green tea (GT) consumption in overweight women. METHODS: In this quasi-experimental study, 40 overweight women were selected and stratified into four groups: control (C), GT, concurrent training+placebo (TP), and concurrent training+GT (three tablets containing 500 mg of GT per week; T+GT) groups. Both the TP and T+GT groups performed exercise three sessions per week for 8 weeks. Fasting blood samples were collected before and 48 hours after the last training session. RESULTS: Low-density lipoprotein cholesterol levels in the T+GT (P=0.03) and TP (P=0.001) groups were significantly decreased relative to in the GT group and were significantly decreased in the T+GT group relative to in the TP group (P=0.001). Meanwhile, high-density lipoprotein cholesterol levels in the T+GT group were significantly increased as compared with in the GT (P=0.01), TP (P=0.03), and C (P=0.04) groups. Finally, total cholesterol levels in the T+GT group were decreased significantly as compared with in the TP, GT, and C groups (P=0.001) and triglyceride levels in the T+GT, TP, and GT groups were significantly increased as compared with in the C group (P=0.001). CONCLUSION: Exercise performed simultaneously with GT consumption in comparison with either alone has a greater effect on improving the lipid profile in overweight women.