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

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

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

Efficacy of tenofovir disoproxil fumarate therapy in nucleoside-analogue naive Iranian patients treated for chronic hepatitis B

Background: Tenofovir disoproxil fumarate (TDF) is a new effective treatment option for patients with chronic hepatitis B (CHB). Objectives: To evaluate TDF efficacy in nucleos(t)ide analogues (NAs)-naive Iranian patients with CHB. Patients and Methods: The NA-naive patients received TDF for at least six months. The primary endpoint was the proportion of patients achieving a complete virological response (CVR) during the treatment. Multivariate Cox regression analysis determined predictive factors independently associated with the time to CVR. The secondary endpoints were biochemical and serological responses, frequency of virological breakthrough, genotypic resistance development, safety and tolerability. Results: In all, 93 patients (64.5 hepatitis B e antigen HBeAg-negative) were eligible. Of these, 70 patients completed 24 months of treatment. The cumulative CVR rates in HBeAg-negative and HBeAg-positive patients were 87% versus 53% at 24 months, respectively. The multivariate Cox regression model showed only HBeAg positivity at baseline and a high baseline HBV DNA level were independent factors predicting a CVR. No patient achieved hepatitis B surface antigen (HBsAg) and HBeAg loss or seroconversion and no virologic breakthrough occurred. A new amino acid substitution (rtD263E) was observed to develop in 60% of patients with viremia. Conclusions: The cumulative CVR rates showed that patients with HBeAg-negative have better virologic respond than those with HBeAg-positive during the same period. The rtD263E mutation might be associated with partial resistance to TDF. © 2015, Kowsar Corp

Multiple functions of microfluidic platforms: Characterization and applications in tissue engineering and diagnosis of cancer

Microfluidic system, or lab-on-a-chip, has grown explosively. This system has been used in research for the first time and then entered in the clinical section. Due to economic reasons, this technique has been used for screening of laboratory and clinical indices. The microfluidic system solves some difficulties accompanied by clinical and biological applications. In this review, the interpretation and analysis of some recent developments in microfluidic systems in biomedical applications with more emphasis on tissue engineering and cancer will be discussed. Moreover, we try to discuss the features and functions of microfluidic systems. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinhei

Limb-Girdle Muscular Dystrophy Type 2B (LGMD2B) caused by Pathogenic Splice and Missense Variants of DYSF Gene among Iranians with Muscular Dystrophy.

BACKGROUND: The phenotypic range of limb-girdle muscular dystrophies (LGMDs) varies significantly because of genetic heterogeneity ranging from very mild to severe forms. Molecular analysis of the DYSF gene is challenging due to the wide range of mutations and associated complications in interpretations of novel DYSF variants with uncertain significance. Thus, in the current study, we performed the NGS analysis and its results are confirmed with Sanger sequencing to find the plausible disease-causing variants in patients with muscular dystrophy and their relatives via segregation analysis. MATERIALS AND METHODS: Nine patients with LGMD type 2B (LGMD2B) characteristics were screened for putative mutations by the whole-exome sequencing (WES) test. Either the patients themselves or their parents and first relatives were investigated in the segregation analysis through Sanger sequencing. The majority of variants were classified as pathogenic through American College of Medical Genetics and Genomics (ACMG) guidelines, segregation results, and in silico predictions. RESULTS: Results revealed eight variants in DYSF gene, including three splicing (c.1149+4A>G, c.2864+1G>A, and c.5785-7G>A), two nonsense (p.Gln112Ter and p.Trp2084Ter), two missense (p.Thr1546Pro and p.Tyr1032Cys), and one frameshift (p.Asp1067Ilefs), among nine Iranian families. One of the eight identified variants was novel, including p.Asp1067Ilefs, which was predicted to be likely pathogenic based on the ACMG guidelines. Notably, prediction tools suggested the damaging effects of studied variants on dysferlin structure. CONCLUSION: Conclusively, the current report introduced eight variants including a novel frameshift in DYSF gene with noticeable pathogenic effects. This study significantly can broaden the diagnostic spectrum of LGMD2B in combination with previous reports about DYSF mutations and may pave the way for a rapidly high-ranked identification of the accurate type of dysferlinopathy

Biallelic MFSD2A variants associated with congenital microcephaly, developmental delay, and recognizable neuroimaging features

Major Facilitator Superfamily Domain containing 2a (MFSD2A) is an essential endothelial lipid transporter at the blood-brain barrier. Biallelic variants affecting function in MFSD2A cause autosomal recessive primary microcephaly 15 (MCPH15, OMIM# 616486). We sought to expand our knowledge of the phenotypic spectrum of MCPH15 and demonstrate the underlying mechanism of inactivation of the MFSD2A transporter. We carried out detailed analysis of the clinical and neuroradiological features of a series of 27 MCPH15 cases, including eight new individuals from seven unrelated families. Genetic investigation was performed through exome sequencing (ES). Structural insights on the human Mfsd2a model and in-vitro biochemical assays were used to investigate the functional impact of the identified variants. All patients had primary microcephaly and severe developmental delay. Brain MRI showed variable degrees of white matter reduction, ventricular enlargement, callosal hypodysgenesis, and pontine and vermian hypoplasia. ES led to the identification of six novel biallelic MFSD2A variants (NG_053084.1, NM_032793.5: c.556+1G>A, c.748G>T; p.(Val250Phe), c.750_753del; p.(Cys251SerfsTer3), c.977G>A; p.(Arg326His), c.1386_1435del; p.(Gln462HisfsTer17), and c.1478C>T; p.(Pro493Leu)) and two recurrent variants (NM_032793.5: c.593C>T; p.(Thr198Met) and c.476C>T; p.(Thr159Met)). All these variants and the previously reported NM_032793.5: c.490C>A; p.(Pro164Thr) resulted in either reduced MFSD2A expression and/or transport activity. Our study further delineates the phenotypic spectrum of MCPH15, refining its clinical and neuroradiological characterization and supporting that MFSD2A deficiency causes early prenatal brain developmental disruption. We also show that poor MFSD2A expression despite normal transporter activity is a relevant pathomechanism in MCPH15