The impact of mentorship program on the level of anxiety and pre-internship exam scores among Iranian senior nursing students.

BACKGROUND: Mentorship involves a voluntary, collaborative, and non-hierarchical relationship where an experienced individual shares knowledge with a less-experienced individual. This study aimed to evaluate the effects of a mentorship program on anxiety levels and pre-internship exam scores among senior nursing students. METHODS: This quasi-experimental research was conducted on 37 nursing students in the sixth semester of the School of Medical Sciences in Saveh in the year 2023. Participants were selected based on initial criteria using a census method and were then randomly assigned to two groups: the control group (19 participants) and the intervention group (17 participants). The mentoring program for the intervention group was implemented one month before the pre-internship exam and consisted of six sessions, each lasting two hours, over two weeks (three sessions per week). Data collection tools included a demographic questionnaire, the Sarason Anxiety Questionnaire, and pre-internship exam scores. SPSS software version 23 was utilized for data analysis. RESULTS: The mean anxiety exam scores in the two control and intervention groups did not exhibit a statistically significant difference before the intervention (P = 0.34). However, the mean anxiety exam score of the intervention group students after the intervention (5.89 ± 15.11) was significantly lower than that of the control group students (7.04 ± 21.42) (P = 0.007). Additionally, the results showed that the mean anxiety exam scores of the intervention group students before (5.77 ± 17.53) and after the intervention (5.89 ± 15.11) had a statistically significant difference (P = 0.013). Furthermore, the mean pre-internship exam scores of the intervention group students (1.71 ± 17.72) were significantly higher than those of the control group students (1.15 ± 16.46) (P = 0.014). CONCLUSION: The mentorship program resulted in a reduction of exam anxiety in nursing students and improved their performance in the pre-internship exam to the extent that the exam scores of the participating students were higher than those of other students.

A five-day-old child with lipid hemihypertrophy: A case report.

Key Clinical Message: Lipid hemihypertrophy should be considered in the differential diagnosis of neonatal asymmetry. Early recognition and further evaluation for associated disorders are important for appropriate management and surveillance of potential complications. Abstract: We present the case of a 5-day-old female neonate who presented with a visibly enlarged right thigh, right labia majora, and below the right mandible. This case report highlights the importance of early identification, comprehensive evaluation, and multidisciplinary management in neonates with lipid hemihypertrophy to optimize their long-term outcomes and quality of life.

A Comparative Study of EEG and aEEG in Seizure Diagnosis in Infants Admitted to the NICU.

Objectives: Seizure is a common sign in neonates hospitalized in the neonatal intensive care units (NICU) that may lead to morbidity and mortality. Most neonatal seizures are subclinical. Conventional EEG (cEEG) is the gold standard for detecting and monitoring seizures but is not widely available. Amplitude-integrated electroencephalography (aEEG) has been used for over a decade to evaluate infants with seizures. In this study, we tried to determine the efficacy of aEEG as a widely available diagnostic tool in diagnosing seizures. Materials & Methods: All cases with seizures or suspicious seizures were admitted to the NICU of the Children's Medical Center for one year. cEEG and aEEG were performed for these infants. aEEG was recorded for at least six hours with a description of the tracing. Clinical information, outcomes, and questionnaires (patient information) were recorded in detail. The obtained data were analyzed with the SPSS version 24 software. Results: Eleven out of twenty-five aEEG recordings were abnormal; other patients showed normal aEEGs. The most common clinical and neurological manifestations were seizure (68%) and hypotonia (28%); the mortality rate was 12%. No significant correlation was observed between aEEG findings and gender, age, familial relation, outcome, ultrasound result, type of seizure, and underlying disease. Conclusion: Studies showed variable sensitivity and specificity values for aEEG. aEEG cannot be recommended as the only way to diagnose and manage seizures in neonates. However, Good accessibility and ease of working with aEEG promote a tendency to use this procedure as a screening tool.

The impacts of head trauma management education on the clinical decision-making of pre-hospital emergency staff.

BACKGROUND: The aim of this study was to compare the effectiveness of head trauma management education by the scenario method versus lecturing on clinical decision-making by pre-hospital emergency staff. MATERIALS AND METHODS: This was an educational trial on 60 pre-hospital emergency staff, performed in Saveh in 2020-2021. The participants fulfilling inclusion criteria entered the study and were randomly allocated to two groups: scenario (n = 30) and lecture (n = 30). Clinical decision-making scores for head trauma patient management were determined at the beginning and end of the study using a researcher-made questionnaire. Data were analyzed using descriptive and inferential statistics and SPSS software version 16. RESULTS: At post-intervention, the mean score of clinical decision-making was 75.28 ± 11.7 in the scenario group and 68.55 ± 11.91 in the lecture group. The results of the independent t-test showed that the mean score of clinical decision-making was significantly higher in the scenario group compared with the lecture group (p = 0.04). The results of paired t-test showed a significant increase in the mean score of clinical decision-making in both groups after the intervention (p < 0.05); however, the mean of increment was higher in the scenario group (9.77 ± 7.63) than in the lecture group (1.79 ± 3). CONCLUSION: Regarding the impact of scenario-based education on learners' intellectual abilities and creativity, it seems that this type of education can be an appropriate alternative to traditional educational methods. Therefore, it is suggested to incorporate this method in the training programs of pre-hospital emergency staff.

Correlation between COVID-19-related health anxiety and coping styles among frontline nurses.

BACKGROUND: The long-term epidemic of COVID-19 and its recurrence has exposed frontline nurses to mental disorders such as stress and health anxiety. High levels of health anxiety associated with COVID-19 may lead to maladaptive behaviors. There is no agreement on which coping styles are most effective against stress. Therefore, more evidence is required to find better adaptive behaviors. The present study was conducted to investigate the correlation between the level of health anxiety and the type of coping strategies used by frontline nurses fighting COVID-19. METHODS: This is a cross-sectional study that was performed on a convenience sample of 386 nurses who are working in the COVID department from October to December 2020, coinciding with the outbreak of the third COVID-19 peak in Iran. Data were collected through a demographic questionnaire, the short version of the health anxiety questionnaire, and coping inventory for stressful situations. Data were analyzed using independent T-test, U-Mann-Whitney, and Kruskal-Wallis statistical tests with SPSS version 23 software. RESULTS: The mean score of nurses' health anxiety was 17.61 ± 9.26 which was more than the cut-off point for health anxiety and 59.1% of nurses had COVID-19-related health anxiety. The mean score of problem coping style (26.85 ± 5.19), was higher than emotion (18.48 ± 5.63) and avoidance (19.64 ± 5.88) coping styles and nurses mostly used problem-coping strategies to deal with anxiety caused by COVID-19. There was a positive significant correlation between the scores of health anxiety and emotion coping style (r = 0.54; P < 0.001). CONCLUSION: Based on the findings of this study, COVID-19-related health anxiety was high in front-line nurses and those with high health anxiety were more likely to use emotion-based coping strategies, which are ineffective. Therefore, considering strategies to reduce nurses' health anxiety and holding training programs on effective coping methods in epidemic conditions are recommended.

The Effect of Distance Empowerment Program on Self-efficacy Among Multiple Sclerosis Patients.

ABSTRACT: BACKGROUND: Multiple sclerosis (MS) is the most common nontraumatic debilitating disease in young adults. This study aimed to determine the effect of distance empowerment programs on self-efficacy in MS patients. METHODS: Sixty-four MS patients participated in this quasi-experimental study. Patients were first entered into the study using the convenience sampling method and then were randomly allocated to control (32) and intervention (32) groups. The intervention group underwent a distance empowerment program (via WhatsApp, Telegram, and blog) and weekly telephone follow-up for 2 months. Self-efficacy was evaluated before, and immediately after, the empowerment program using the MS Self-Efficacy Scale. RESULTS : Data from 59 participants were analyzed. Before implementation of the empowerment program, the mean scores of self-efficacy in the intervention and control groups were not significantly different. After implementing the empowerment program, the mean score of self-efficacy in the intervention group was higher than that of the control group ( P < .05). CONCLUSION : Distance empowerment has an effect on the self-efficacy of patients with MS and may lead to an increase in self-efficacy scores after implementing an empowerment program.

Stress coping strategies of Iranian healthcare staff during the COVID-19 pandemic: A cross-sectional study.

The COVID-19 pandemic has exposed healthcare staff to mental distress. Given the importance of applying effective strategies to cope with stress caused by COVID-19, this study aimed to assess the stress-coping strategies of Iranian healthcare providers. This cross-sectional study was performed through a web-based survey. Data collection was done online using a demographic data questionnaire and the short form of Endler and Parker's coping inventory. The mean scores of task-oriented strategies (27.06 ± 5.13) were higher than avoidance-oriented (19.42 ± 5.77) and emotion-oriented strategies (18.45 ± 5.76), and the healthcare workers mainly used task-oriented styles to cope with COVID-19-related stress. There was a significant difference between the score of task-oriented strategy in terms of age groups (P < 0.001), work experience (P = 0.018), level of education (P < 0.001), having children (P = 0.002), and type of hospital (P = 0.028). The score of task-oriented strategies was lower in employees who were in the age group of 20-30 years and had less than 10 years of work experience, and it was higher in employees who had children, worked in private hospitals, and had a master's degree or higher. The score of emotion-oriented strategies in the age group of 51-60 years was significantly lower than other age groups (P < 0.01) and was significantly higher in employees with a bachelor's degree than those with a master's degree or higher (P = 0.017). There was no significant difference between the scores of avoidance-oriented strategies and any socio-demographic variables. According to the findings of this study, young and less experienced employees were more inclined to utilize emotion-oriented coping styles. Therefore, considering appropriate training programs for these employees to apply effective coping strategies is extremely important.

Posterior reversible encephalopathy syndrome in SARS-CoV-2 infection: A case report and review of literature.

Consider PRES in SARS-CoV-2 infected patients who develop encephalopathy, seizures or impaired vision; especially if the disease is complicated by respiratory distress and need for mechanical ventilation.

Comparing the Efficacy and Safety of Levetiracetam Versus Phenytoin for Treating the Acute Phase of Neonatal Seizures.

Objectives: Neonatal seizure is a significant problem in this life course, and its timely and effective treatment is crucial. In this study, we compared the efficacy of levetiracetam versus phenytoin for treating the acute phase of neonatal seizures. Materials & Methods: In this single-blind case-control study, 60 consecutive children with neonatal seizures referred to the Children's medical center in Tehran, Iran, in 2018 were studied. Those neonates who had at least 30 minutes of seizure after Phenobarbital treatment were assigned to receive either phenytoin (20 mg/kg) or levetiracetam (initial dose of 40-60 mg/kg) through block randomization. The efficacy and safety of the two drugs were compared between the groups. Results: The response rate was 83.3% and 86.7% in phenytoin and Levetiracetam groups, respectively, which was not significantly different between groups (P=1.000). Adverse effects were nearly similar between groups (6.7% in the phenytoin group and 3.3% in the Levetiracetam group, P=1.000). Conclusion: Levetiracetam and phenytoin are both practical and safe for treating neonatal seizures.

Developing a Culture of Civility in Nursing Students.

ABSTRACT: Incivility is a significant problem in nursing education. The purpose of the study was to determine the impact of culture management on incivility in nursing students. Nursing faculty and students participated in a quasi-experimental study. The program included the formation of a committee, development of codes of conduct, giving positive scores for civil behaviors, and setting a vision. Behavioral changes were assessed before and after the intervention. There were significant differences between the two groups for perceived level and occurrence rate of incivility ( p < .05).

Weaning and extubation from neonatal mechanical ventilation: an evidenced-based review.

Mechanical ventilation is a lifesaving treatment used to treat critical neonatal patients. It facilitates gas exchange, oxygenation, and CO2 removal. Despite advances in non-invasive ventilatory support methods in neonates, invasive ventilation (i.e., ventilation via an endotracheal tube) is still a standard treatment in NICUs. This ventilation approach may cause injury despite its advantages, especially in preterm neonates. Therefore, it is recommended that neonatologists consider weaning neonates from invasive mechanical ventilation as soon as possible. This review examines the steps required for the neonate's appropriate weaning and safe extubation from mechanical ventilation.

Predictors of COVID-19-related health anxiety among health care workers: a cross-sectional study.

BACKGROUND: One of the psychological issues that may affect health care workers (HCWs) during the outbreak of COVID-19 is health anxiety. Health anxiety disorder goes beyond normal health concerns and can seriously affect occupational and interpersonal performance. The present study was designed to determine the level of COVID-19-related health anxiety and its predictors in Iranian HCWs. METHODS: This is a cross-sectional study. Data were collected online through a demographic information questionnaire and the short version of the Health Anxiety Questionnaire. The online questionnaires were created via Google Form and the URL link was sent to HCWs via email or social networking applications. In total, questionnaires were sent to more than 1,500 HCWs throughout Iran. Data were analyzed with SPSS software version 23. RESULTS: Five hundred and fifty-two HCWs completed and sent the questionnaires. The mean scores of health anxiety of HCWs were higher than the cutoff point of health anxiety (17.28 ± 8.84) and 58.1% of HCWs had health anxiety. There was a significant inverse relationship between health anxiety score and age (r = - 0.13; P = 0.002), work experience (r = - 0.16; P < 0.001) and income level (r = - 0.097; P = 0.03). The rate of health anxiety was significantly higher in females (P = 0.03). Based on regression results, age and hospital category were significant risk factors for health anxiety. CONCLUSION: Based on the results of this study, employees working in health centers in Iran had high health anxiety. Due to the high level of health anxiety in HCWs, it is important to consider strategies to reduce their health anxiety in the current situation.

Psychometric evaluation of the perceived nursing student's Incivility questionnaire.

AIM: Student's uncivil behaviour is one of the most common problems in the educational setting, including nursing schools. It is essential to develop tools for measuring the uncivil behaviour of nursing students to solve this problem. Therefore, this study aimed to evaluate psychometric properties of perceived nursing student's incivility questionnaire among the Iranian community. DESIGN: In this methodological study, perceived nursing student's incivility questionnaire was completed by 360 nursing students and 121 nursing faculty members. METHODS: Sampling was done from October 2019-November 2019. Content and construct validity of the questionnaire were evaluated. Reliability was estimated using Cronbach's alpha and McDonald's omega coefficients and composite reliability. The construct validity of nursing student's perceived incivility was investigated by exploratory and confirmatory factor analyses. RESULTS: Content validity index 0.88 for the whole instrument. The three factors of violent behaviours, irresponsible behaviours and unsound behaviours explained more than 51.485% of the variance. Factor structure extracted using model fit indices (PCFI = 0.763, PNFI = 0.732, CMIN/DF = 2.501, RMSEA = 0.056, GFI = 0.941, AGFI = 0.918, CFI = 0.935) and convergent validity were also confirmed. Internal consistency and composite reliability were estimated to be more than 0.7. The results showed that Iranian perceived nursing student's incivility questionnaire is a three-dimensional construct with good validity and reliability.

The psychometric properties of the Persian version of the MUSIC Model of Academic Motivation Inventory among nursing students.

AIM: To determine the psychometric properties of the Persian version of the MUSIC Inventory in nursing students. DESIGN: Cross-sectional psychometric study. METHODS: Transcultural adaptation of the MUSIC Model of Academic Motivation Inventory was carried out using translation to Persian and back-translation. Then, the qualitative and quantitative face and content validity of the inventory were evaluated. Construct validity was assessed by exploratory factor analysis. To perform construct validity and reliability, a convenience sample of 360 undergraduate nursing students was recruited. Cronbach's alpha was used to assess internal consistency reliability. RESULTS: Cronbach's alpha for all items of the MUSIC inventory was .94, and each factor was between .72-.93. Exploratory factor analysis supported the 5-factor structure of the MUSIC inventory. These 5 factors explain 66.59% of the overall extracted variance. Three items of the MUSIC inventory, which were related to the empowerment component, were deleted. CONCLUSION: Based on the findings of this study, the Persian version of the MUSIC Model of Academic Motivation Inventory is a valid and reliable tool for Persian language nursing students.

Factor Analysis of Iranian Version of Nursing Students' Incivility Questionnaire.

BACKGROUND: Uncivil student behavior is one of the challenging issues in the nursing schools that disrupts the learning process and teacher-student interactions. Planning to control student's incivility requires knowing the condition using valid tools. The purpose of this study was to investigate the validity and reliability of the incivility occurrence's questionnaire among Iranian students. MATERIALS AND METHODS: This methodological study was conducted on 358 nursing students and 122 nursing faculty members. The samples were selected from the nursing students of second to fourth year from September to October 2019. McDonald's omega, Cronbach's alpha coefficients and composite reliability were calculated. Exploratory and confirmatory factor analysis were used to investigate the construct validity of tool. RESULTS: Content validity index was 0.94 for the whole instrument. In factor analysis, three factors of irresponsible, violent, and unsound behaviors were identified. These factors explained more than 50.52% of the variance. Model fit indices Parsimonious Normed Fit Index) = 0.74, Root Mean Square Error of Approximation = 0.05, Parsimonious Comparative Fit Index = 0.78, Goodness-of-Fit Index = 0.92, Comparative Fit Index ( CFI) = 0.92, Adjusted Goodness-of-Fit Index) = 0.89, CIMN=2.58) indicated the proportion of factors. Internal consistency was 0.77 to 0.89. CONCLUSIONS: This questionnaire is a three-dimensional tool with appropriate validity and reliability that can be used to evaluate occurrence rate of nursing student incivility in Iran.

The effects of teaching methods on academic motivation in nursing students: A systematic review.

Motivation is one of the key factors in educational achievement. Like any other field of study, motivation in nursing is highly critical. The instructor's knowledge about the teaching methods that are effective in academic motivation of students enables them to adopt proper measures to improve the teaching efficiency. The present paper is a systemic review of the efficiency of instructional interventions in improvement of academic motivation in nursing students. The published papers related to the study from 2000 to February 2020 were searched at different databases such as PubMed, Scopus, Web of Science, PsycInfo, and ERIC. To examine the quality of the articles, critical appraisal instrument for reports of educational interventions was used. Totally, 18 articles entered the study for structured review. The majority of the articles reported that educational interventions improved academic motivation in nursing students. The effective teaching methods described in the reviewed articles that led to an improvement in academic motivation were simulation, case-based learning, cooperative learning, learning contract, peer assessment, and self-assessment using video typing. As the findings showed, implementation of applied and participatory methods in teaching process improved the academic motivation of nursing students. Therefore, using such methods, nursing instructors can improve the academic motivation of their students.

The effect of the Verbascum Thapsus on episiotomy wound healing in nulliparous women: a randomized controlled trial.

BACKGROUND: The pain and discomfort caused by episiotomy affect the quality of life of the mothers, so rapid and complete repair of the episiotomy is very important. Due to the effective ingredients of Verbascum Thapsus, it has been used since ancient times to treat wounds. Therefore, this study aimed to evaluate the effect of Verbascum Thapsus on episiotomy wound healing. METHODS: The study was designed as a randomized, double-blind, controlled clinical trial. Ninety-three primiparous women who were referred to Fatemeh Zahra Hospital in Saveh in 2015 were randomly divided into two groups of intervention (Verbascum Thapsus) and control (placebo). Both groups covered the episiotomy wound twice a day for 10 days with 2 cm of prescribed creams. Wound healing was assessed using the REEDA scale before the intervention and on days 1,3 and 10 after the intervention. RESULTS: Before the intervention, there was no statistically significant difference in terms of demographic characteristics, obstetrics, and REEDA scores between the two groups (p < 0.05). The mean scores of REEDA on days 1 and 3 in the intervention group were better than the control group but were not statistically significant. However, on the tenth day after the intervention, the mean scores of REEDA were significantly better in the Verbascum group than the placebo (p = 0.01). CONCLUSIONS: According to the results of this study, it seems that Verbascum Thapsus is effective in repairing episiotomy wounds. The researchers hope that the results of this study can provide clinical evidence for the use of this herbal medicine in the wound healing process. TRIAL REGISTRATION: This study was registered in the Iranian Registry of Clinical Trials (IRCT) with the code " IRCT201404073106N15 " on 02/12/2015.

Major depressive disorder diagnosis based on effective connectivity in EEG signals: a convolutional neural network and long short-term memory approach.

Deep learning techniques have recently made considerable advances in the field of artificial intelligence. These methodologies can assist psychologists in early diagnosis of mental disorders and preventing severe trauma. Major Depression Disorder (MDD) is a common and serious medical condition whose exact manifestations are not fully understood. So, early discovery of MDD patients helps to cure or limit the adverse effects. Electroencephalogram (EEG) is prominently used to study brain diseases such as MDD due to having high temporal resolution information, and being a noninvasive, inexpensive and portable method. This paper has proposed an EEG-based deep learning framework that automatically discriminates MDD patients from healthy controls. First, the relationships among EEG channels in the form of effective brain connectivity analysis are extracted by Generalized Partial Directed Coherence (GPDC) and Direct directed transfer function (dDTF) methods. A novel combination of sixteen connectivity methods (GPDC and dDTF in eight frequency bands) was used to construct an image for each individual. Finally, the constructed images of EEG signals are applied to the five different deep learning architectures. The first and second algorithms were based on one and two-dimensional convolutional neural network (1DCNN-2DCNN). The third method is based on long short-term memory (LSTM) model, while the fourth and fifth algorithms utilized a combination of CNN with LSTM model namely, 1DCNN-LSTM and 2DCNN-LSTM. The proposed deep learning architectures automatically learn patterns in the constructed image of the EEG signals. The efficiency of the proposed algorithms is evaluated on resting state EEG data obtained from 30 healthy subjects and 34 MDD patients. The experiments show that the 1DCNN-LSTM applied on constructed image of effective connectivity achieves best results with accuracy of 99.24% due to specific architecture which captures the presence of spatial and temporal relations in the brain connectivity. The proposed method as a diagnostic tool is able to help clinicians for diagnosing the MDD patients for early diagnosis and treatment.

Increasing prevalence of gestational diabetes mellitus when implementing the IADPSG criteria: A systematic review and meta-analysis.

AIMS: Quantify the proportional increase in gestational diabetes (GDM) prevalence when implementing the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria compared to prior GDM criteria, and to assess risk factors that might affect the change in prevalence. METHODS: A systematic review and meta-analysis was performed of cohort and cross-sectional studies between January 1, 2010 to December 31, 2018 among pregnant women with GDM using IADPSG criteria compared to, and stratified by, old GDM criteria. Web of science, PubMed, EMBASE, Cochrane, Open Grey and Grey literature reports were included. The relative risk for each study was calculated. Subgroup analyses were performed by maternal age, body mass index, study design, country of publication, screening method, sampling method and data stratified according to diagnostic criteria. RESULTS: Thirty-one cohort and cross-sectional studies with 136 705 women were included. Implementing the IADPSG criteria was associated with a 75% (RR 1.75, 95% CI 1.53-2.01) increase in number of women with GDM with evidence of heterogeneity. CONCLUSIONS: The IADPSG criteria increase the prevalence of GDM, but allow movement towards more homogeneity. More studies are needed of the benefits, harms, psychological effects and health costs of implementing the IADPSG criteria.

Major depressive disorder assessment via enhanced k-nearest neighbor method and EEG signals.

The aim of this paper is to introduce a novel method using short-term EEG signals to separate depressed patients from healthy controls. Five common frequency bands (delta, theta, alpha, beta and gamma) were extracted from the signals as linear features, as well as, wavelet packet decomposition to break down signals into certain frequency bands. Afterwards, two entropy measures, namely sample entropy and approximate entropy were applied on the wavelet packet coefficients as nonlinear features, and significant features were selected via genetic algorithm (GA). Three machine-learning algorithms were used for classification; including support vector machine (SVM), multilayer perceptron (MLP) a novel enhanced K-nearest neighbors (E-KNN), which uses GA to optimize the feature-space distances and provides a feature importance index. The highest accuracy obtained by using frequency-based features was from gamma oscillations which resulted in 91.38%. Performance of nonlinear features were better compared to the frequency-based features and the results showed 94.28% accuracy. The combination of the features showed 98.44% accuracy with the new proposed E-KNN classifier.