Investigating the Effect of ADDIE Model on the Effectiveness of Clinical Education of Operating Room Students

AbstractIntroduction: As a clinical setting, the operating room (OR) is also a complicated system; there are a lot of contrasts and complexities between the OR environment and other clinical areas regarding the teaching and learning process. Effective teaching in the operating room is clearly one of the most important and yet most challenging and difficult-to-define tasks for any educator. There is no instructional model for operating room students. This study was aimed at developing a clinical education model for OR students, in accordance with ADDIE model.Methods: The ADDIE model was used to guide the development of clinical education in five University of Medical Sciences. The ADDIE model includes five steps of Analysis, Design, Development, Implementation, and Evaluation. Qualitative method, literature review and curriculum assessment was used to generate five step ADDIE model.Results: Conceptual model “gaining of clinical competence and approval” was appeared in analysis step ADDIE model. Presenting educational objectives, learning communication skills and teamwork, performing objective evaluation, administering a comprehensive test, as well as learning from surgical team members and peers were also specified.Conclusions: The findings of the research, in relation to the clinical training of students in the operating room field, indicated the uniqueness of the clinical environment of the operating room and how the student copes with the different conditions of the environment and teamwork in the operating room. The present research led to the design of a model based on the general pattern of educational design(ADDIE model). ADDIE provides a model for common understanding of teamwork to increase aptitude and professional competence of operation room students. It also provides evidence the usefulness of ADDIE model on clinical education for OR students

A Comprehensive Review of the Development of Carbohydrate Macromolecules and Copper Oxide Nanocomposite Films in Food Nanopackaging

Background. Food nanopackaging helps maintain food quality against physical, chemical, and storage instability factors. Copper oxide nanoparticles (CuONPs) can improve biopolymers' mechanical features and barrier properties. This will lead to antimicrobial and antioxidant activities in food packaging to extend the shelf life. Scope and Approach. Edible coatings based on carbohydrate biopolymers have improved the quality of packaging. Several studies have addressed the role of carbohydrate biopolymers and incorporated nanoparticles to enhance food packets' quality as active nanopackaging. Combined with nanoparticles, these biopolymers create film coatings with an excellent barrier property against transmissions of gases such as O2 and CO2. Key Findings and Conclusions. This review describes the CuO-biopolymer composites, including chitosan, agar, cellulose, carboxymethylcellulose, cellulose nanowhiskers, carrageenan, alginate, starch, and polylactic acid, as food packaging films. Here, we reviewed different fabrication techniques of CuO biocomposites and the impact of CuONPs on the physical, mechanical, barrier, thermal stability, antioxidant, and antimicrobial properties of carbohydrate-based films

Clinical investigation of the acute effects of pomegranate juice on blood pressure and endothelial function in hypertensive individuals

BACKGROUND: Pomegranate juice (PJ) is rich in bioactive phytochemicals with antioxidant, and anti-inflammatory and cardioprotective functions. The present trial investigated the acute effects of PJ consumption on blood pressure and markers of endothelial function. METHODS: In this single-arm study, thirteen hypertensive men aged 39-68 years were recruited. Included subjects were assigned to natural PJ (150 ml/day) following a 12 hour fast. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and flow-mediated dilation (FMD), along with serum concentrations of C-reactive protein (CRP), intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), E-selectin and interleukin-6 (IL-6) were measured at baseline and 4-6 hours after PJ consumption. RESULTS: Comparison of pre- vs. post-trial values revealed a significant reduction in both SBP (7; P = 0.013) and DBP (6; P < 0.010). However, changes in FMD (20) as well as circulating levels of CRP, ICAM-1, VCAM-1, E-selectin, and IL-6 did not reach statistical significance (P = 0.172). CONCLUSION: PJ has promising acute hypotensive properties. Consumption of PJ could be considered in the context of both dietary and pharmacological interventions for hypertension

The role of magnesium sulfate in the intensive care unit

Magnesium (Mg) has been developed as a drug with various clinical uses. Mg is a key cation in physiological processes, and the homeostasis of this cation is crucial for the normal function of body organs. Magnesium sulfate (MgSO4) is a mineral pharmaceutical preparation of magnesium that is used as a neuroprotective agent. One rationale for the frequent use of MgSO4 in critical care is the high incidence of hypomagnesaemia in intensive care unit (ICU) patients. Correction of hypomagnesaemia along with the neuroprotective properties of MgSO4 has generated a wide application for MgSO4 in ICU

Oral health status among Iranian veterans exposed to sulfur mustard: a case-control study

Background: Sulfur mustard (SM) is a chemical warfare agent that has been repeatedly used since World War I. SM has chronic and deleterious effects on different body organs such as lungs, skin and eyes. Objectives: To determine dental and oral health status of chemical victims of SM who were exposed to SM during the Iraqi-Iran war. Material and Methods: In this case-control study, 100 male subjects exposed to SM were chosen as cases, and 100 non-exposed volunteers were chosen as controls. These groups were selected randomly according to their referral number, and were matched regarding age. Collection of information was performed using Oral Health Assessment Form designed by the World Health Organization. Quantitative and qualitative data were compared between the groups using independent samples t-test and Chi-square test, respectively. Results: There was a significant difference between the case and control groups with respect to the frequencies of oral candidiasis, pharyngeal erythema and/or hyperplasia, hairy tongue and reflux disease, being higher in the former group. There was also a positive association between the frequency of candidiasis and the percentage of disability; pharyngeal erythema and/or hyperplasia and use of salmeterol spray; and between hairy tongue and antibiotic use in the case group. Conclusions: Exposure to SM and the use of drugs for controlling long-term complications does not increase the risk of tooth decay, tooth loss, and intra and/or extra oral lesions in patients, but may be associated with increased incidence of oral candidiasis, pharyngeal erythema and/or hyperplasia, hairy tongue and reflux disease

Clinical Evaluation of Blood Pressure Lowering, Endothelial Function Improving, Hypolipidemic and Anti-Inflammatory Effects of Pomegranate Juice in Hypertensive Subjects

Pomegranate (Punica granatum L.) juice (PJ) contains different types of antioxidants and bioactive polyphenols and has been reported to promote cardiovascular health through several mechanisms. The present study aimed to examine the effects of 2-week intake of fresh PJ on blood pressure, flow-mediated dilatation (FMD), serum lipid profile and concentrations of inflammatory and endothelial function biomarkers. Twenty-one hypertensive patients (aged 30-67years) were recruited into the trial and assigned to receive either PJ (150ml/day in a single occasion between lunch and dinner; n=11) or the same amount of water (n=10) for a period of 2weeks. Systolic (SBP) and diastolic (DBP) pressures together with FMD and serum concentrations of lipid profile parameters, apolipoproteins A and B, intracellular adhesion molecule-1 (ICAM-1), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin, high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured at baseline and at the end of trial. PJ consumption was associated with significant reductions in SBP (p=0.002) and DBP (p=0.038) but not FMD (p>0.05). Serum levels of VCAM-1 (p=0.008) were significantly reduced by PJ while those of E-selectin were elevated (p=0.039). However, no significant effect was observed from PJ on serum levels of ICAM-1, hs-CRP, lipid profile parameters, apolipoproteins and IL-6 in any of the study groups (p>0.05). Consumption of PJ for 2weeks has effective hypotensive effects, and may improve endothelial function by decreasing serum concentrations of VCAM-1. These findings suggest PJ as a beneficial cardioprotective supplement for hypertensive subjects. Copyright (c) 2013 John Wiley & Sons, Ltd

The relationship between serum levels of fibroblast growth factor 21 and diabetic retinopathy

Fibroblast growth factor 21 (FGF21) is a major metabolic regulator that has been shown to be elevated in a number of metabolic disturbances including type 2 diabetes mellitus (T2DM) and the metabolic syndrome, but few studies about the relationship between serum FGF21 and the complications of diabetes have been done. Since the association between FGF21 and diabetic retinopathy is not clear, this study was conducted to investi- gate this relationship. In this cross-sectional study, 61 subjects (14 healthy controls, 22 diabetic patients without retinopathy, and 25 patients with diabetic retinopathy) were evaluated. All patients in the study were examined for the presence of diabetic retinopathy. Various clinical and biochemical parameters including FGF21 were evaluated and analyzed and compared between the study groups. Serum levels of FGF21 showed a significant difference between the three groups (P=0.003) but the difference between diabetic patients with and without ret- inopathy was not significant (P=0.122). Regression model was used to evaluate the role of FGF21 in predicting diabetic retinopathy. In the multivariate logistic regression model after adjustment of systolic blood pressure and fasting blood glucose, the level of FGF21 was not associated with diabetic retinopathy. In the multivariate mod- el, only fasting blood glucose was associated with diabetic retinopathy (P=0.009). According to the results of this study, serum levels of FGF21 in diabetic patients was higher than the control group but these raised levels could not predict the presence of diabetic retinopathy

Response to commentary on 'zinc supplementation is associated with a reduction in serum markers of inflammation and oxidative stress in adults: a systematic review and meta-analysis of randomized controlled trials'

No description supplie

Zinc supplementation is associated with a reduction in serum markers of inflammation and oxidative stress in adults: a systematic review and meta-analysis of randomized controlled trials

Background: Zinc (Zn) is a trace metal that is considered to have an impact on chronic inflammation. However, findings of clinical trials have been inconsistent. The present systematic review and meta-analysis aimed to provide a more robust examination of the evidence on the effectiveness of Zn supplements on markers of inflammation and oxidative stress. Methods: A systematic search in PubMed, Scopus, Web of Science and Cochrane Library was undertaken to identify relevant randomized controlled trials (RCTs) assessing the impact of Zn on inflammation and oxidative stress until 17 August 2020. We applied a random-effects method to obtain effect sizes (ES) and 95 % confidence intervals (CIs). Meta-regression was used to detect the potential source of between-study heterogeneity. Results: Twenty-one eligible RCTs comprising 1321 participants were included in the meta-analysis. In comparison with the control groups, serum C-reactive protein (CRP) (ES = -0.92 mg/L, 95 % CI = [-1.36, -0.48], P < 0.001, I2 = 90.2 %), tumor necrosis factor-alpha (TNF-α) (ES = -0.49 pg/mL, 95 % CI = [-084, -0.14], P = 0.006, I2 = 34.6 %) and malondialdehyde (MDA) (ES = -0.42, 95 % CI = [-083, -0.01], P = 0.04, I2 = 76.1 %) were significantly reduced in the groups receiving Zn. Serum interleukin 6 (ES = -1.02 pg/mL, 95 % CI = [-2.06, 0.02], P = 0.05, I2 = 92.3 %) was marginally reduced following Zn supplementation. Moreover, treatment duration was found as the source of inter-study heterogeneity. Conclusion: This meta-analysis suggests that Zn supplements reduce serum concentrations of markers of inflammation and oxidation: CRP, TNF-α and MDA

The relationship between serology of hepatitis E virus with liver and kidney function in kidney transplant patients

Although hepatitis E virus (HEV) is well known to cause acute hepatitis, there are reports showing that HEV may also be responsible for progression of acute to chronic hepatitis and liver cirrhosis in patients receiving organ transplantation. In this study, we aimed to evaluate the prevalence of HEV in patients with kidney transplantation. In this study, 110 patients with kidney transplantation were recruited, and anti-HEV IgG, creatinine, alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and estimated glomerular filtration rate (eGFR) in the first, third and sixth months after renal transplantation were measured. The mean serum anti-HEV IgG titers in the study participants was 1.36 (range 0.23 to 6.3). Twenty-three patients were found to be seropositive for HEV Ab defined as anti-HEV IgG titer > 1.1. The difference in liver and renal function tests (creatinine, eGFR, AST, ALT and ALP) at different intervals was not significant between patients with HEV Ab titers higher and lower than 1.1 (p > 0.05). However, an inverse correlation was observed between HEV Ab and eGFR values in the first (p = 0.047, r = -0.21), third (p = 0.04, r = -0.20) and sixth (p = 0.04, r = -0.22) months after renal transplantation in patients with HEV Ab 1.1. Also, a significant correlation between age and HEV Ab levels was found in the entire study population (p =0.001, r = 0.33). Our findings showed a high prevalence of seropositivity for anti-HEV IgG in patients receiving renal transplants. However, liver and renal functions were not found to be significantly different seropositive and seronegative patients by up to 6 months post-transplantation