Decellularized peripheral nerve grafts by a modified protocol for repair of rat sciatic nerve injury.

Studies have shown that acellular nerve xenografts do not require immunosuppression and use of acellular nerve xenografts for repair of peripheral nerve injury is safe and effective. However, there is currently no widely accepted standard chemical decellularization method. The purpose of this study is to investigate the efficiency of bovine-derived nerves decellularized by the modified Hudson's protocol in the repair of rat sciatic nerve injury. In the modified Hudson's protocol, Triton X-200 was replaced by Triton X-100, and DNase and RNase were used to prepare accelular nerve xenografts. The efficiency of bovine-derived nerves decellularized by the modified Hudson's protocol was tested in vitro by hematoxylin & eosin, Alcian blue, Masson's trichrome, and Luxol fast blue staining, immunohistochemistry, and biochemical assays. The decellularization approach excluded cells, myelin, and axons of nerve xenografts, without affecting the organization of nerve xenografts. The decellularized nerve xenograft was used to bridge a 7 mm-long sciatic nerve defect to evaluate its efficiency in the repair of peripheral nerve injury. At 8 weeks after transplantation, sciatic function index in rats subjected to transplantation of acellular nerve xenograft was similar to that in rats undergoing transplantation of nerve allograft. Morphological analysis revealed that there were a large amount of regenerated myelinated axons in acellular nerve xenograft; the number of Schwann cells in the acellular nerve xenograft was similar to that in the nerve allograft. These findings suggest that acellular nerve xenografts prepared by the modified Hudson's protocol can be used for repair of peripheral nerve injury. This study was approved by the Research Ethics Committee, Research and Technology Chancellor of Guilan University of Medical Sciences, Iran (approval No. IR.GUMS.REC.1395.332) on February 11, 2017.

Cinnamaldehyde Enhanced Functional Recovery after Sciatic Nerve Crush Injury in Rats.

Peripheral nerve injury is a common clinical issue induced by trauma, tumor, and damage caused by treatment. Such factors create chemical and inflammatory alterations at the injury site, which increase nerve deterioration. Thus, minimizing these modifications can lead to nerve protection after injury. The present study sought to evaluate the possible improvement in nerve regeneration and enhancement of functional outcomes by cinnamaldehyde (Cin) administration following sciatic nerve crush in a rat model. Rats (n = 48) were distributed into 6 groups, including sham, injury, DMSO (vehicle group), and Cin groups (10, 30, and 90 mg/kg/day). Using small hemostatic forceps, crush injury was induced in the left sciatic nerve. Thereafter, Cin was administered for 28 successive days. Weekly records were taken for sciatic functional index (SFI) measurements. Further assessments including electrophysiological and histomorphometric evaluations, gastrocnemius muscle wet weight measurements, and estimation of the serum total oxidant status were performed. According to the results, Cin could accelerate sciatic nerve recovery after crush injury, and the dose of 30 mg/kg/day of Cin had better impacts on SFI recovery, muscle mass ratio, and myelin content. The current research demonstrated that Cin positively affects peripheral nerve restoration. Therefore, Cin therapy could be considered as a potential treatment method for peripheral nerve regeneration and its functional recovery. However, more investigations are required to further validate the study results and evaluate the optimal dose of Cin.

Comparison of melatonin and curcumin effect at the light and dark periods on regeneration of sciatic nerve crush injury in rats.

Being one of the acute clinical problems, peripheral nerve injury can bring about a number of consequences including severe disability, reduced Quality of life (QOL) and immense costs. Currently, melatonin and curcumin are widely applied because of their immunomodulatory, anti-inflammatory, neuro-protective and antioxidant properties. The present study aims to compare the effects of melatonin and curcumin during light and dark periods on sciatic nerve crush injury repair. Accordingly, rats received IP injections of curcumin (100 mg/kg) and melatonin (10 mg/kg) over two periods of light (9:00 a.m.) and dark (9:00 p.m.) for 4 weeks. In order to evaluate rats, functional (walking track analysis and electrophysiological measurements), histomorphometric and gastrocnemius muscle mass investigations were administered. No statistically significant difference was identified between dark and light curcumin groups while curcumin groups displayed better results than did melatonin groups. In addition, dark melatonin group displayed better results than the light melatonin. On the whole, this study found that melatonin and curcumin can be used to quicken neural recovery and help treat nerve injury. It was also found that better neuroregeneration or nerve regeneration was induced when rats were treated by melatonin during the dark period while effects and injection time did not correlate in curcumin application.

The effect of web quest and team-based learning on students' self-regulation.

INTRODUCTION: In this study, the authors aimed to examine the effects of cooperative learning methods using Web Quest and team-based learning on students' self-direction, self-regulation, and academic achievement. METHOD: This is a comparative study of students taking a course in mental health and psychiatric disorders. In two consecutive years, a group of students were trained using the WebQuest approach as a teaching strategy (n = 38), while the other group was taught using team-based learning (n=39). Data gathering was based on Guglielmino's self-directed learning readiness scale (SDLRS) and Buford's self-regulation questionnaire. The data were analyzed by descriptive test using M (IQR), Wilcoxon signed-rank test, and the Mann-Whitney U-test in SPSS software, version 13. p<0.05 was considered as the significance level. RESULTS: The results of the Mann-Whitney U test showed that the participants' self- directed (self-management) and self-regulated learning differed between the two groups (p=0.04 and p=0.01, respectively). Wilcoxon test revealed that self-directed learning indices (self-control and self-management) were differed between the two strategies before and after the intervention. However, the scores related to learning (students' final scores) were higher in the WebQuest approach than in team-based learning. CONCLUSION: By employing modern educational approaches, students are not only more successful in their studies but also acquire the necessary professional skills for future performance. Further research to compare the effects of new methods of teaching is required.

A Study of the Relationship Between Nurses' Professional Self-Concept and Professional Ethics in Hospitals Affiliated to Jahrom University of Medical Sciences, Iran.

BACKGROUND: Commitment to ethics usually results in nurses' better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses' professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. METHODS: This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses' self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. RESULTS: The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). CONCLUSION: In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses' self-concept, which can boost their commitment to ethics, be given more consideration.

Iranian Nurses' Views on Barriers and Facilitators in Patient Education: A Cross-Sectional Study.

BACKGROUND: As a major factor in patient-centered care, patient education has a great impact on the quality of care provided by nurses; however, clinical nurses' performance with regard to patient education is not satisfactory. This study is an attempt to investigate barriers and facilitators in patient education from nurses' point of view. METHODS: 122 nurses at Jahrom University of Medical Sciences participated in this descriptive-cross sectional study. Sampling was based on the census method. The questionnaire used to collect data included questions about nurses' demography, barriers (10 questions), and facilitators (10 questions) in patient education. The questionnaire was designed to be completed independently. To analyze the data, the researchers used descriptive statistics, including frequency, mean and standard deviation. RESULTS: The highest scores related to barriers to patient education were: nurses' insufficient knowledge, patients' physical and emotional unpreparedness, and lack of a proper environment for education. The most important facilitators, on the other hand, were: enhancement of instructing nurses' knowledge and skills, motivating nurses, and a step-by-step approach to patient education. CONCLUSION: It is important that nurses be prepared and motivated to train their patients. By satisfactory patient education on the part of nurses, patients will be more willing to cooperate in the treatment process.

Integrated method of teaching in Web Quest activity and its impact on undergraduate students' cognition and learning behaviors: a future trend in medical education.

INTRODUCTION: Web Quest is one of the new ways of teaching and learning that is based on research, and includes the principles of learning and cognitive activities, such as collaborative learning, social and cognitive learning, and active learning, and increases motivation. The aim of this study is to evaluate the Web Quest influence on students' learning behaviors. MATERIALS & METHODS: In this quasi-experimental study, which was performed on undergraduates taking a psychiatric course at Jahrom University of Medical Sciences, simple sampling was used to select the cases to be studied; the students entered the study through census and were trained according to Web Quest methodology. The procedure was to present the course as a case study and team work. Each topic included discussing concepts and then patient's treatment and the communicative principles for two weeks. Active participation of the students in response to the scenario and introduced problem was equal to preparing scientific videos about the disease and collecting the latest medical treatment for the disease from the Internet.Three questionnaires, including the self-directed learning Questionnaire, teamwork evaluation Questionnaire (value of team), and Buffard self-regulated Questionnaire, were the data gathering tools. RESULTS: The results showed that the average of self-regulated learning and self-directed learning (SDL) increased after the educational intervention. However, the increase was not significant. On the other hand, problem solving (P=0.001) and the value of teamwork (P=0.002), apart from increasing the average, had significant statistical values. CONCLUSIONS: In view of Web Quest's positive impacts on students' learning behaviors, problem solving and teamwork, the effective use of active learning and teaching practices and use of technology in medical education are recommended.

Effect of Self-Care Education by Face-to-Face Method on the Quality of Life in Hemodialysis Patients (Relying on Ferrans and Powers Questionnaire).

INTRODUTION: One of the most common methods to control chronic renal failure, Hemodialysis creates numerous changes in the style and the quality of life in patients. Educating patients is one of effective factors to improve the quality of life. The present study aims to investigate influences of self-care education by face-to-face method on determining quality of life in hemodialysis patients in Jahrom, Iran, during 2014-2015. METHODS: This is a quasi-experimental, single-blind study in which 50 patients undergoing hemodialysis at Shahaid Mottahari Hospital, Jahrom. The patients were placed in two groups of 25 individuals: the face to face educational group and the control group. The control group received only routine care in hemodialysis unit. The face to face educational group received 8 instruction sessions of 60 minutes before starting dialysis and received an instruction booklet. Data collection tools were a questionnaire consisting of demographic characteristics, a checklist of needs assessment for hemodialysis patients and a quality of life questionnaire, whose reliability and validity were previously approved. The questionnaires were completed face to face, before and after the intervention. RESULTS: The results show that the research units did not have any significant difference in terms of demographic variables. Also increase in various aspects of the quality of life compared with the control group is observed after the intervention in the face to face educational group (p<0.001). DISCUSSION & CONCLUSION: Given the results, representation of adequate training in hemodialysis ward can cause improve in physical function, mental health and thus increase the quality of life in hemodialysis patients, through raising the awareness level.

The Effect of Stress Management Training on Hope in Hemodialysis Patients.

INTRODUCTION: Chronic renal failure exposes patients to the risk of several complications, which will affect every aspect of patient's life, and eventually his hope. This study aims to determine the effect of stress management group training on hope in hemodialysis patients. METHOD: In this quasi-experimental single-blind study, 50 patients with renal failure undergoing hemodialysis at Motahari Hospital in Jahrom were randomly divided into stress management training and control groups. Sampling was purposive, and patients in stress management training group received 60-minute in-person training by the researcher (in groups of 5 to 8 patients) before dialysis, over 5 sessions, lasting 8 weeks, and a researcher-made training booklet was made available to them in the first session. Patients in the control group received routine training given to all patients in hemodialysis department. Patients' hope was recorded before and after intervention. Data collection tools included demographic details form, checklist of problems of hemodialysis patients and Miller hope scale (MHS). Data were analyzed in SPSS-18, using Chi-square, one-way analysis of variance, and paired t-test. RESULTS: Fifty patients were studied in two groups of 25 each. No significant difference was observed between the two groups in terms of age, gender, or hope before intervention. After 8 weeks of training, hope reduced from 95.92±12.63 to 91.16±11.06 (P=0.404) in the control group, and increased from 97.24±11.16 to 170.96±7.99 (P=0.001) in the stress management training group. Significant differences were observed between the two groups in hope scores after the intervention. CONCLUSION: Stress management training by nurses significantly increased hope in hemodialysis patients. This low cost intervention can be used to improve hope in hemodialysis patients.

Investigating factors associated with not reporting medical errors from the medical team's point of view in Jahrom, Iran.

BACKGROUND: medical errors as a problematic fact in healthcare systems can increase patient's safety if reported. This article tried to determine several factors associated with not reporting medical errors from medical team's points of view. METHODS: 300 staff working in different parts of educational hospitals affiliated to Jahrom University of Medical Sciences including nursing, midwifery, paramedical and medical groups participated in this descriptive study using census method (2013). Data collection was performed using a researcher-made questionnaire including 31 items regarding four areas: medical teams, managers, errors and patients. RESULTS: The mean score of factors related to errors, mangers, medical teams, and patients' scope was 2.68 ± 0.79, 2.63 ± 0.72, 2.53 ± 0.66, 2.41 ± 0.87, respectively. In medical teams' points of view, errors and managers were among the important factors for not reporting professional errors. The most important factors in professional errors were related to severity and emergency of errors (2.73 ± 0.97), and managers' focus on wrongdoers instead of noticing systematic factors of errors (3.00 ± 1.01). In medical teams, fear of legal prosecution by patients or their relatives (2.87 ± .97), and in patients, unawareness of errors (2.67 ± 1.08) was reported as the most effective factors. CONCLUSION: Factors related to errors and managers were more important than other reasons. Therefore, educating medical teams on recognizing errors and managers' proper reactions in case of occurring or reporting errors seem to be necessary.