Development of a curriculum for endoscopy nurse education in Iran

Abstract Introduction: Nursing as a discipline and a profession is following to meet the needs of clients in clinical settings. The nurse participation and cooperation in the programs of diagnostic and therapeutic endoscopy has not been recorded in Iran. On the other hand, health care system needs to provide specialized care for patients under endoscopy. The aim of this study was to develop a professional curriculum for endoscopy nurse education in Iran. Method: This was a study to approve the content and curriculum for endoscopy nurse education in Iran using the Delphi method. This study carried out in three phases; a review of the literature on endoscopy nursing courses and training program in the world; assessment of expert groups and individuals associated with gastrointestinal endoscopy; and finally, a consensus on the curriculum of nursing endoscopy and its implementation. Results: Based on the endoscopy nurse training needs, eight priorities for education endoscopy nurse including theory, practical, and clinical professional was determined. Total hours of training were 210 hours, including 140 hours for theoretical and practical courses and 70 hours of clinical training. Different strategies were used to teach the theoretical and practical subjects. For theoretical teaching, lectures, group work, and self-learning were applied. Role Playing and simulation were used for practical training; and for clinical training, endoscopy clinical practice settings were determined. Conclusion: This training program was based on a participant survey on the digestive endoscopy and educational needs. This educational curriculum involved learning different areas of knowledge, attitudes, and skills for nurses to train caring of patients undergoing gastrointestinal endoscopy through an inter-professional education program. These special nursing educational programs can be contributed to the professional development of Iranian nurses

Gene cloning and evaluation of the Acinetobacter baumannii nlpD gene expression in human dermal fibroblast cells using RT-PCR

Background: Acinetobacter baumannii is one of the highly antibiotic-resistant bacteria in the world. This bacterium is a cause of endemic and epidemic nosocomial infections and despite many efforts, there is still no effective vaccine agains it. NlpD is one of the important antigenic agents that stimulate the immune system. So, the aim of this study was to examine gene cloning and expression of the nlpD gene of A. baumannii in human dermal fibroblast (HDF) cells. Materials and Methods: In this experimental study, the nlpD gene was amplified from A. baumannii genome using polymerase chain reaction (PCR). Then, the nlpD gene was cloned and sub-cloned in pTZ57R/T and pIRES2-EGFP vectors, respectively. Confirmation of gene cloning was performed by PCR, restriction endonuclease and sequencing methods. The final pIRES2-EGFP-nlpD recombinant vector was transformed into HDF cells using electroporation and the expression of target gene was evaluated by RT-PCR. Results: In this study, the 831 bp nlpD gene of A. baumannii was amplified successfully. Also, the results of the study showed that the recombinant pIRES2-EGFP-nlpD final construct was produced. Observation of the 831 bp band on agarose gel in transformed cells compared to control cells confirmed the nlpD gene expression in HDF cells. Conclusion: The final construct that generates in this study can express the nlpD gene of A. baumannii in eukaryotic cells. Successful expression of the target gene can be used as a new recombinant vaccine in animal model. The pIRES2-EGFP-nlpD recombinant vector has also the potential as a gene vaccine for future research

Epidemiology of urinary tract infection and antibiotic resistance pattern of E. coli in patients referred to Imam Ali hospital in Farokhshahr, Chaharmahal va Bakhtiari, Iran

زمینه و هدف: عفونت دستگاه ادراری یکی از شایع ترین عفونت های بیمارستانی است که الگوی مقاومت آنتی بیوتیکی آن در مناطق گوناگون متفاوت است. هدف این مطالعه تعیین فراوانی عوامل باکتریال ایجاد کننده عفونت ادراری و الگوی حساسیت و مقاومت آنتی بیوتیکی اشرشیاکلی (E. coli) در مراجعین سرپایی به مجتمع بیمارستانی امام علی(ع) فرخشهر بود. روش بررسی: در این مطالعه توصیفی تحلیلی، در یک مدت 5 ماهه (بهمن1390 تا خرداد 1391) از تعداد 848 نفر بیمار مشکوک به عفونت ادراری مراجعه کننده به بیمارستان امام علی(ع)، نمونه ادرار جمع آوری شد. پس از جدا سازی عامل عفونت، با روش Clinical and Laboratory Standards Institute آزمون حساسیت به آنتی بیوتیک انجام شد. داده ها با استفاده از آزمون آماری مجذور کای تجزیه و تحلیل شدند. یافته ها: از میان 848 نمونه واجد شرایط، نتیجه آزمایش کشت ادرار 74 نفر (72/8) مثبت بود. باکتری E.coli با 52 مورد (27/70) و باکتری استافیلوکوکوس با 15 مورد (27/20) شایع ترین باکتری‌های جداسازی شده بودند. از 52 نفر آلوده به باکتری E.coli 34 نفر (38/65) زن و 18 نفر (62/34) مرد بودند. بر اساس نتایج آنتی بیوگرام بیشترین موارد مقاومت، به ترتیب مربوط به آنتی بیوتیک آمپی سیلین (71/85)، نالیدیسیک اسید (78/78) و سیپروفلاکسین (51/46) بود. از سوی دیگر، بیشترین حساسیت مربوط به آنتی بیوتیک های نیتروفورانتوئین (30/92)، آمیکاسین (67/66) و جنتامایسین (50/62) بود. بیشترین موارد عفونت در رده ی سنی بالاتر از 47 سال مشاهده گردید. نتیجه گیری: آمپی سیلین و نیتروفورانتوئین به ترتیب دارای بیشترین میزان مقاومت و حساسیت آنتی بیوتیکی بوده اند و براساس نتایج بدست آمده، درمان تجربی با آمپی سیلین در اکثر بیماران مبتلا به عفونت ادراری مناسب نیست

Application of Learning Theories in Clinical Education

Introduction: The purpose of education is learning. Several theories have been raised about learning, which have tried to explain how learning occurs. They help teachers to choose teaching methods, prepare learning environment and determine students' activities. Given the importance of learning theories in education, this study aimed to review application of learning theories in nursing education. Methods: In this study, some related published literatures during 2000-2010 were selected using key words including learning, theory and nursing education. Then the selected materials were reviewed for extracting application of learning theories in nursing education. Application of behavioral learning theories, cognitive theories (including Gestalt theory, information processing, Ausubel meaningful learning, constructivism, Bandura's social learning) and adult learning theory in nursing education were discussed in this article. Results: Some applications of behavioral theories are teaching in a sequential, simple to complex pattern teaching the skills using behavioral objectives for determining learning outcomes and assessment and providing teaching plan using the nursing process and nursing care plans and positive reinforcement. Principles of Gestalt theory have been used in mental organization towards simplicity, directed balance and equilibrium, and selective stimulus perception. Writing narratives and portfolio are samples of the application of constructive theory. Role models have been used in social cognitive theory. Based on adult learning theory, learners should be active and taught material should be applicable for them. Conclusion: Each learning theory has the particular application. Nursing educators must apply proper learning theories regarding students' experience and target material

Occupational risk factors among Iranian farmworkers: a review of the available evidence.

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors

Comparing Strengths and Weaknesses of Learning Theories

چكيده مقدمه: آموزش در علوم پزشكي در حال تغيير است. بنابراين نياز است كه مدرسان عملكردهاي خود را ارزيابي و براي به حداكثر رساندن يادگيري تلاش كنند. تئوريهاي يادگيري ميتواند ديدگاه هايي در مورد يادگيري فراهم كنند. هدف از اين مطالعه بررسي نقاط قوت و ضعف هر يك از تئوريهاي يادگيري شامل تئوريهاي رفتاري، شناختي و انسانگرايانه با مرور متون مرتبط است. روشها: در اين مطالعه برخي از متون مرتبط با تئوريهاي يادگيري شامل كتب و مقالات انتخاب شدند. سپس متون انتخاب شده از نظر نقاط قوت و ضعف تئوريهاي يادگيري مورد بررسي قرار گرفتند. يافتهها: نتايج نشان داد كه تئوريهاي رفتاري ساده هستند، كاربرد آنها آسان است و فراگير بر يك هدف واضح و مشخص متمركز ميشود. تئوريهاي يادگيري شناختي نظير خبرپردازي، گشتالت و سازندهگرايي موجب ارتقاي تفكر انتقادي و حل مسأله در فراگير ميشوند و فراگير ميتواند بهتر با موقعيتهاي واقعي زندگي روبرو شود. در تئوري انسانگرايانه تمركز يادگيري مربوط به نيازهاي فرد است كه نياز غايي آن خود شكوفايي و خوديابي است. يادگيري خود-راهبر يكي از مهمترين و مشهورترين اصول آموزشي اين رويكرد است كه نهايتاً منجر به خود هدايتي در فراگير ميشود. نتيجهگيري: هر تئوري به يك جنبه از يادگيري ميپردازد و بنابراين هر كدام داراي نقاط قوت و ضعف خاصي هستند. لازم است مدرسان و طراحان آموزشي به اين موارد جهت استفاده بهتر از تئوريها توجه كنند

Kappa-casein gene polymorphism in Holstein and Iranian native cattle by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP)

Caseins amount to nearly 80% of the protein output in cow milk. Caseins are biologically important proteins and they are also a raw material for the cheese making industry. The aim of this study was to identify kappa-casein genotype in Holstein and Iranian native cattle. DNA was extracted from 457 blood samples of 247 Holstein and 210 native cattle for identification and genotyping of kappa-casein gene by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) assay using HindIII and TaqI restriction endonucleases. The PCR product of the specific primer K-F and K-R gives the 379 bp specific band. Digestion of 379 bp fragment by restriction endonuclease HindIII generated two fragments of 156 and 223 bp. Result of the cut with this enzyme indicate there genotypes AA, AB and BB in the samples. Also, the amplified DNA (379 bp) from the samples remained undigested by TaqI restriction enzyme. These findings suggest that BB genotype could be a good factor for increase of fat and protein content of milk.Key words: Polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP), kappa-casein gene, genotyping, Holstein, native cattle

Molecular assessment of clarithromycin resistant Helicobacter pylori strains using rapid and accurate PCR-RFLP method in gastric specimens in Iran

Currently, a seven-day, triple-drug regimen has been recommended as one of the first-line therapies for Helicobacter pylori management in which clarithromycin is a key component. Development of clarithromycin resistance leads to the long term assessment of the efficacy of clarithromycin in the triple-drug regimen. The aim of this study was to rapidly and directly assess clarithromycin resistance point mutations on gastric biopsy specimens by using PCR-RFLP method. Biopsy samples were obtained over a 6-months period of 2009, from 200 dyspeptic patients referred to Shahrekord University of Medical Sciences, Iran. Initially, rapid urease test was performed and then DNA was isolated from each tissue and used for molecular analysis such as PCR (for H. pylori diagnostic) and PCR-RFLP (for Cla resistance determination). RUT and PCR results showed that 164 (82%) of the patients were H. pylori-positive. Resistance was evaluated in 164 samples by using enzymes BsaI and MboII. Thirty nine (39) (23/78%) clarithromycin-resistant strains were detected which were identified as 15 (9.15%) A2143G, 15 (9.15%) A2142G and 9 (5.49%) mix strains. The results showed that PCR-RFLP method had a high accuracy to detect A2142G and A2143G mutations associated with resistance to clarithromycin in the minimum possible time.Key words: Helicobacter pylori, clarithromycin resistance, polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)

Survival rate of patients with bladder cancer in Yazd, central province of Iran

Abstract Background: Bladder cancer is the ninth most commonly diagnosed malignancy worldwide. The trend of bladder cancer incidence and mortality is rising in Iran. This study was aimed to evaluate the survival rate of patients with bladder cancer in Yazd province, Iran. Methods: In this retrospective cohort study, data were collected from 340 patients suffering from bladder cancer referred to Shahid Rahnemon and Shohada-Kargar Hospitals in Yazd province, Iran between April, 2001 and March, 2012. Variables included age, gender, stage of cancer, place of residence and type of treatment. The Kaplan-Meier and Cox regression analyses were used to evaluate the relationship between each variable and survival time. A P value less than 0.05 was considered significant. Results: The mean age of total patients was 65.8 ± 13.6 years, and their mean survival time was 68.55 ± 6.05 months. Cumulative survival rates at the end of 1, 3, and 5 years in bladder cancer patients were 91%, 58%, and 51.4%, respectively. A statistically significant association was found between age (P = 0.005), stage of disease (P = 0.0003), type of treatment (P = 0.0003) and survival time of patients. Data showed no significant correlation between age, gender, place of residence and patients’ survival. Conclusions: The survival of patients suffering from bladder cancer in this study was less than other reports. Patients’age and cancer stage were the effective factors in survival time. Continuous screening of older people for cancer diagnosis in early stages is seemed to improve survival in patients. Keywords: Bladder; Cancer; Survival Rate; Ira