The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients

Introduction: COVID-19 is currently a global pandemic, and coagulation-related mortality has been widely reported in patients suffering from it. Objective: this article aimed to investigate the coagulation profile of COVID-19 patients. Methods: This was a cross-sectional study conducted using a retrospective research design. We recruited patients with COVID-19 admitted to a hospital from June 15th to July 7th, 2020. Upon patients' entering a blood sample was drawn from each patient for assessing patient’s coagulation profile (PT, PTT, INR, Platelet count); and a chest high-resolution computed tomography (HRCT) scan was performed for each patient. The study patients were divided in to sever group (CO-RADS score 5) and non-sever group (CO-RADS score <5). Results: Thirty-six patients (20 males and 16 females) with a mean age of 54.7±17.5 years were studied. Of them, 11 cases (30.56%) had severe pulmonary involvement. Also, the coagulation profiles were longer in the severe group than non-sever group. As well, the means of platelet count that were 232.440 per microliter in the non-severe group and 289.180 per microliter in the severe and non-sever groups, respectively; but still not statistically significant (p>0.05). The Area under the ROC Curve (AUC) for PT and INR was 0.615 and 0.611, respectively. The AUC for platelet count was 0.680 (95% CI: 0.501 to 0.859) and had an acceptable discriminating power. Conclusions: In this study, we did not find any statistically significant relationship between the results of coagulation tests and the severity of pulmonary involvement according to HRCT scan findings in COVID-19 patients. But further analyses suggest that, except PTT, the other coagulation tests (PT, INR, and platelet count) may discriminate severe COVID-19 patients

Explicando el estado de la educación en enfermería clínica: un estudio de análisis de contenido en Irán

Introduction: Challenges and problems of clinical nursing education are the most important factor in determining the quality of nursing students' education. Frequent assessment of the quality of nursing education without considering the existing challenges is an ineffective activity in analyzing the situation of nursing education. Objective This study aimed to explain the status of clinical nursing education at Jahrom University of Medical Sciences in Iran. Methodology: A qualitative design based on the conventional content analysis approach was used. This study was conducted at the X University of Medical Sciences in 2018-2019. Data were drawn from 10 semi-structured focus group interviews with 110 nurses, head nurses, instructors, and students. Purposeful sampling was performed. The time and place of the interviews were chosen according to the participants. The interviews were analyzed by Graneheim and Lundman method by MAXQDA software. Results: 626 in-vivo codes, 46 primary codes, 8 subcategories (lack of attention to the evaluation process, non-participative evaluation, low staff educational cooperation, ineffective instructors, non-educational clinical space, student educational deficits, student drown in the clinic, non-participatory planning), and 3 main categories (planning challenges, implementing challenges and evaluation challenges) were obtained. Conclusion: Educational leaders must shift to three areas; democratic planning, wise implementation with frequent monitoring, and the use of modern clinical evaluation methods (Based on the participation of learners and other stakeholders).Introducción: Los desafíos y problemas de la educación clínica en enfermería son el factor más importante para determinar la calidad de la educación de los estudiantes de enfermería. La evaluación frecuente de la calidad de la educación en enfermería sin considerar los desafíos existentes es una actividad ineficaz en el análisis de la situación de la educación en enfermería. Objetivo Este estudio tuvo como objetivo explicar el estado de la educación en enfermería clínica en la Universidad de Ciencias Médicas Jahrom en Irán. Metodología: Se utilizó un diseño cualitativo basado en el enfoque de análisis de contenido convencional. Este estudio se realizó en la X Universidad de Ciencias Médicas en 2018-2019. Los datos se obtuvieron de 10 entrevistas de grupos focales semiestructurados con 110 enfermeras, enfermeras jefes, instructores y estudiantes. Se realizó un muestreo intencional. La hora y el lugar de las entrevistas se eligieron según los participantes. Las entrevistas fueron analizadas por el método de Graneheim y Lundman por el software MAXQDA. Resultados: 626 códigos in-vivo, 46 ​​códigos primarios, 8 subcategorías (falta de atención al proceso de evaluación, evaluación no participativa, escasa cooperación educativa del personal, instructores ineficaces, espacio clínico no educativo, déficits educativos de los estudiantes, estudiante ahogado en la clínica, planificación no participativa) y 3 categorías principales (desafíos de planificación, desafíos de implementación y desafíos de evaluación). Conclusión: Los líderes educativos deben cambiar a tres áreas; planificación democrática, implementación inteligente con monitoreo frecuente y el uso de métodos modernos de evaluación clínica (basado en la participación de los estudiantes y otras partes interesadas)