Predicting the Incidence and Trend of Breast Cancer Using Time Series Analysis for 2007-2016 in Qazvin

Introduction: Breast cancer is the most common cancer and the second leading cause of death in women worldwide. The aim of this study was to analyze the trend and predict the incidence of breast cancer using time series analysis. Methods: In this study, data on breast cancer incidence in Qazvin province between 2007 and 2016 were analyzed using time series analysis with autoregressive integrated moving average (ARIMA) modeling to forecast the future pattern. The Box-Jenkins time series model and its diagnosis and evaluation methods were used to show the trend and forecasting the next year new cancers. To describe and fit the appropriate models, R statistical software version 3.6.3 was used. Results: Between 2007 and 2016, a total number of 1229 new patients had been registered (monthly mean [SD]: 10.24 [1.03]). Although the overall trend in the raw number of new breast cancer cases has been increasing over time, the change in observations over time has been increasing and decreasing. According to Bartlett test results, the variances of the data were not constant. Also, according to the results of Kolmogorov-Smirnov test, breast cancer series data were not normal. Among the studied models, ARIMA (1, 1, 1) was selected due to lower AIC criteria than other models, and this model was selected as the final model for predicting breast cancer for the next year. The confidence interval of the predicted values was relatively narrow, which indicates the appropriateness of the final model in the prediction. Conclusion: Time series analysis is an efficient tool to model the past and future data on the raw number of new cancer cases, and the goodness-of-fit indicators of the model showed that the Box-Jenkins model is a reliable model for fitting similar data. Keywords: Breast Cancer, Seasonal Trend, Time Series Analysis, Ira

The Elixir of Visiting: A Qualitative Study on the Experiences of Conscious Mechanically Ventilated Patients in Intensive Care Units Regarding Visiting Family Members

Background: Visiting family members is one of the basic human needs; however, there is contradictory evidence about the advantages and disadvantages of the existing visiting systems.  Therefore, the investigation of patients’ preferences for the visiting strategies, and achievement of their authentic experiences can significantly contribute to decision-making about the type of acceptable and approved policies in this domain. Aim: The aim of this study was to explain the experiences of conscious patients undergoing mechanical ventilation in Intensive Care Units regarding their visits with their family members. Method: This qualitative study was conducted on 15 conscious mechanically ventilated patients admitted to the Intensive Care Unit in Iran in 2017. The data were collected using semi-structured interviews and observations. The sampling was performed through purposive sampling technique, which was continued until data saturation to select the individuals with rich experiences about the subject under investigation. The data were analyzed through the conventional type of qualitative content analysis. Results: Out of the initial 385 codes, 11 subthemes and 5 main themes were extracted during the analysis process, all of which were placed under the general concept of “the elixir of visiting”. The five main themes included visiting as a healing agent, visiting as an agent for the enhancement of perceived support, visiting as an agent for gaining hope, visiting as the patient’s urgent need, and preference for planed visiting. Implications for Practice: The results of the present study showed that visiting was like an elixir for the conscious patients undergoing mechanical ventilation in the Intensive Care Units. This practice could allay lots of their pains and lead to numerous valuable effects, such as elimination of loneliness and sadness, increased hope for survival and recovery, and enhancement of a sense of support. Therefore, nursing authorities and managers are required to take steps in terms of redefining visiting rules and regulations in line with patients’ preferences, and thereby move towards the promotion of patient care

Enclosed in the synergistic rings of suffering: The experience of conscious patients under mechanical ventilation in the intensive care unit of the causes of suffering

Background: Patients undergoing mechanical ventilation in intensive care units are in a special position of suffering, and discovering their experiences in the painful situations of the intensive care unit can contribute greatly to improve the quality of nursing care for them. Objective: The present study was performed aiming to explain the experience of conscious patients receiving mechanical ventilation in the intensive care units of the causes of suffering. Methods: This is a qualitative content analysis study conducted in Iran in 2017. Participants of this study included 15 conscious mechanically ventilated patients in the intensive care unit. Semi-structured interviews and observations were used to collect data. For sampling, first, the purposeful and then theoretical methods (guided by the created categories) were used and the procedure continued until saturation of the data. The text of the handwritten notes of recorded interviews were analyzed using conventional qualitative content analysis. Results: Four subclasses of "unpleasant consequences of disease", "bitter elixir of therapy", "an inconvenient environment" and "understanding the threat to family safety and comfort" all under the general category "enclosed in the synergistic rings of suffering" were extracted from the profound descriptions of contributors. Conclusion: Mechanically ventilated patients in the intensive care unit are enclosed in the rings of suffering, so that each of these rings imposes a great deal of pain and suffering on the patient and have a synergic and intensifying effect on each other. Therefore, design and application of strategies and nursing care is essential to reduce the severity of the suffering and discomfort of these patients

The Effect of Direct Observation of Procedural Skills (DOPS) Evaluation Method on Learning Clinical Skills among Emergency Medicine Students

Introduction: Despite the fact that evaluation is the most important part of effectiveness of clinical education, evidences show the inefficiency of current evaluation methods. Common evaluation methods are restricted in subjective information and in addition to failure in evaluating students’ clinical skills precisely, they are not considered as learning instruments. Therefore, this study was conducted to determine the effect of DOPS evaluation method on learning clinical skills of emergency medicine students. Methods: This two group quasi experimental study of before and after design was carried out in surgery wards of Ghaem & Emam Reza hospitals of Mashhad University of Medical Sciences within 2008 and 2009 academic years. Study population included all emergency medicine students of the second semester that were divided into two groups (n=25 in experiment and n=21 in control group). Data collection method included observation and completion of a researcher made checklist before and after clinical course. Tool credibility was confirmed using content validity and its reliability was approved through inter-rater reliability (r=0/89). Data were analyzed using descriptive statistics, independent t-test, and paired t-test. Results: There was no significant difference between groups regarding demographic variables. The mean of pretest in two groups showed no significant difference before intervention (p=0.18 and t=-1.3). This is while case group showed higher mean scores compared to control group after intervention (via DOPS evaluation) and this difference was significant (p=0.0001, t=4.9). Conclusion: It seems that employing new methods of evaluation such as DOPS as an objective, valid, and highly applicable method in clinical evaluation solely or along with other common methods, can result in the improvement of clinical skills and more effective learning among students

Comparing the Effect of Continuous and Intermittent Irrigation Techniques on Complications of Arterial Catheter and Partial Thromboplastin Time in Patients Following Coronary Artery Bypass Grafting Surgery

Background: Different approaches are available to irrigate the arterial catheter, such as continuous and intermittent techniques. However, there is a disagreement regarding the most appropriate method. Aim: this study aimed to compare the effect of two continuous and intermittent irrigation methods on complications of arterial catheter and partial thromboplastin time (PTT) in patients with coronary artery bypass (CABG) surgery. Method: This randomized clinical trial was conducted on 60 participants undergoing coronary artery bypass grafting surgery in open-heart surgery ICU at Imam Reza hospital in Mashhad, Iran, in 2016. In continuous group, the arterial catheter was continuously irrigated with heparin solution at the rate of 2cc/h, and in the intermittent group with a syringe containing 5cc heparin solution every 3 hours. In both groups, catheter was monitored and recorded every 3 hours (until 48 hours and 3 times from enrollment) in terms of complications of partial thromboplastin time. Data were analyzed using SPSS version 16. Results: The findingsof independent t-test showed that the two groups are homogeneous in age (P =0.48). The result of Fisher's exact test revealed no significant difference between the two groups in terms of average incidence of complications during the first 24 hours (P=0.55) and second 24 hours (P=0.55) after catheterization. Also during the 48 hours after surgery, independent t-test results showed no statistically significant difference in partial thromboplastin time (P=0.53) between the two groups. Implications for Practice: According to the results of the research based on the lack of difference between continuous and intermittent irrigation methods up to 48 hours after catheter replacement in terms of arterial catheter complications, further long-term follow-up researches are recommended

The Effect of Motivational Abdominal Breathing Device on Breathing Patterns and Shortness of Breath in Patients with Chronic Obstructive Pulmonary Disease

Background and purpose: Despite the high prevalence of chronic obstructive pulmonary disease, There haven,t been definite curative treatment for the disease and focus of treatment has directed towards pulmonary rehabilitation as an effective non-drug treatments. this study were performed to determine the effect of motivational abdominal breathing device on breathing pattern and dyspnea of chronic obstructive pulmonary disease Materials and methods: This study is a clinical trial done in 2015 on 70 patients with chronic obstructive pulmonary disease admitted to Samen alaeme hospital, CHENARAN city. Patients were assigned to two groups of 35 persons, Intervention and control. groups did exercises at home twice a day for two weeks. The dyspnea, respiratory rate and depth of breathing, before, seventh day and after the intervention was measured by spirometry and dyspnea NRS scale. Data analysis was performed by SPSS version 11.5 using t-test, Mann-Whitney and repeated measures analysis. Results: The results showed that difference in respiratory rate before and after intervention (P=0/78) did not change significantly between two groups. But difference before and after the intervention, depth of breathing and before and after intervention of dyspnea were significantly changed in both groups (

Isolation Compliance and Associated Factors Among COVID-19 Patients in North-West Iran: A Cross-Sectional Study

Introduction: Coronavirus disease 2019 (COVID-19) has now turned into a public health emergency. Isolation of patients is a possible solution for controlling epidemic infectious diseases. We assessed the compliance of isolation and associated factors among patients with COVID-19. Methods: This cross-sectional study was conducted on 320 COVID-19 patients discharged from hospitals of Qazvin province. Patients’ isolation, self-care health behaviors, reference to public health services and possible related factors were assessed. Data were analyzed using multiple logistic regression. Results: In this study, 320 patients were enrolled, including 175 men (54.7%). Two hundred and eighty-six patients (89.4%) had complete isolation. Factors such as phone tracking by health center (OR = 1.30; 95% CI: 1.01 to 1.75) and dry cough (OR = 2.36; 95% CI: 1.09 to 5.09) increased odds of complete isolation in COVID-19 patients, but having a COVID-19 patient in the family (OR = 0.32; 95% CI: 0.15 to 0.71) and symptoms of disease like shortness of breath(OR = 0.39; 95% CI: 0.18 to 0.85) and muscle pain (OR = 0.43; 95% CI: 0.20 to 0.95) decreased odds ratio for these patients. Conclusion: Phone tracking by the health center was the most important factor to increase the odds of patient isolation. Thus, the health system should consider improving health workers’ knowledge and skills through education Keywords: COVID-19, isolation, self-care, compliance, Ira

Comparison of Nursing Students’ Professional Behavior to Nurses Employed in Mashhad University of Medical Sciences

Introduction: An important part of nurse’s professional behavior forms during academic education and develops throughout professional career. Therefore comparing professional behavior of freshmen and seniors at graduation with that of nurses can illustrate the formation and development of professional behavior at the time of formal and informal nursing education. This study was conducted to compare professional behavior of nursing students to that of nurses employed in Mashhad University of Medical Sciences. Methods: In this descriptive cross-sectional study of trend type, study population included all freshmen and senior nursing students of school of nursing and midwifery in Mashhad University of Medical Sciences as well as nurses employed in hospitals affiliated to this university in year 2011 (n=322). Professional behavior of these students and nurses was assessed using modified “nursing student professional behavior” questionnaire of Goze. The validity of the questionnaire was confirmed using content validity index and its reliability was confirmed using Cronbach's alpha coefficient. Data was analyzed using descriptive statistics, Kruscall-Wallis, and Spearman correlation coefficient. Results: 72 freshman students of clinical nursing (64%), 40 senior nursing students (35%), and 322 nurses formed the sample. The mean score of professional behavior of freshman students was 110/3±17.3 out of total score of 135 and this mean score was 107±12/8 for senior nursing students and 109±12/6 for clinical nurses. The result of Kruscall-Wallis test showed no significant difference among these three groups (p=0.2). Conclusion: Although basic nursing educations prior to clinical education has lead to development of a desirable level of professional behavior in junior nursing students, development of these behaviors did not have an appropriate trend among senior students and employed nurses. Further studies using other ways of assessment are needed to assess nursing students and clinical nurses' professional behavior considering factors promoting professional behavior

Impact of the Internet of Things on Psychology: A Survey

The Internet of things (IoT) continues to “smartify” human life while influencing areas such as industry, education, economy, business, medicine, and psychology. The introduction of the IoT in psychology has resulted in various intelligent systems that aim to help people—particularly those with special needs, such as the elderly, disabled, and children. This paper proposes a framework to investigate the role and impact of the IoT in psychology from two perspectives: (1) the goals of using the IoT in this area, and (2) the computational technologies used towards this purpose. To this end, existing studies are reviewed from these viewpoints. The results show that the goals of using the IoT can be identified as morale improvement, diagnosis, and monitoring. Moreover, the main technical contributions of the related papers are system design, data mining, or hardware invention and signal processing. Subsequently, unique features of state-of-the-art research in this area are discussed, including the type and diversity of sensors, crowdsourcing, context awareness, fog and cloud platforms, and inference. Our concluding remarks indicate that this area is in its infancy and, consequently, the next steps of this research are discussed