Prognosis and Complications of Attempted Suicidal Hanging

Background: Hanging is a form of strangulation, in which the body is suspended through the neck and the weight of the body acts as a constricting force. This study assessed various factors on the outcome of hanging and identification of prognostic factors related to the outcomes.Methods: Ninety-nine hanging victims from 1995 to 2015 in Iran were evaluated; then, variables such as the cause of death, distribution of mortality, duration of hospitalization, substance abuse consumption, respiratory distress, and cerebral edema were studied in these people. Finally, the data were analyzed.Results: Major cases of suicide by hanging were men. In connection with prognosis, about 12% of the deaths occurred in men and about 21% were represented in women. More importantly, in the matter of suspension, the model was largely incomplete to complete. Also, the outcomes of pulmonary stress and cerebral edema were recognized in association with the type of hanging and mortality prognosis.Conclusion: Only two risk factors, including loss of consciousness at the time of entry into the medical center, as well as the complete suspension, would be predictive operations of death and unsuccessful revival

University Teachers’ Point of View about Educational Environment in Major Clinical Wards in Educational Hospitals of Iran University of Medical Sciences, Based on Modified DREEM Model

Background & Objective : Educational institutions use different tools for evaluating their own activities. In this study, DREEM (Dundee Ready Education Environment Measure) model was used as a diagnostic tool to evaluate curriculum problems and efficacy of change in education. Methods : This cross-sectional study was conducted in four major clinical wards including internal medicine, pediatrics, obstetrics &gynecology and general surgery in four educational hospitals of Iran University of Medical Sciences. A questionnaire including 35 questions concerning three domains of students’ learning, teachers, and educational atmosphere was distributed amongst 53 clinical teachers in the aforementioned wards. Results : The mean score was 116 out of 140 which was interpreted as very satisfactory. Regarding all three domains of learning, teachers, and educational environment, the highest mean score belonged to pediatrics ward whereas the least belonged to internal medicine ward. There was a significant difference between clinical wards concerning educational environment (P=0.042). The internal medicine ward’s score was 39.3 while pediatrics ward got 46.2. Conclusion : According to the mean score, it seems that the university teachers consider learning and teaching to be suitable. As for the least score which was given to educational environment in internal medicine ward, it seems that problems in appropriate communication between teachers and learners in this ward have led to a stressful environment. Since DREEM model is suitable for educational changes, comparing teachers and learners’ points of view and planning to solve problems in internal ward could be useful. Keywords: Educational environment, Clinical wards, Educational evaluation, Teaching and learning, DREEM model

Epidemiology of Completed Suicides Referred to Forensic Pathology Organization of Tehran, Iran, During March 2011 to March 2016

Background: Completed or successful suicide is the worst outcome of suicide attempts. This study is an epidemiologic investigation of successful suicides in Tehran, Iran.Methods: In this routine-data-based study, the records of successful suicides in Forensic Pathology Organization of Tehran were investigated with respect to confidentiality of information during March 2011 to March 2016. The obtained data were analyzed by SPSS 11.5. Statistically significant level was considered at less than 0.05.Results: A total of 1773 cases with mean (SD) age of 33.19(13.11) years and male-to-female ratio of 3.1 were included in the study. The mean age of male victims was greater than that of female ones (P=0.01). Of victims, 821(46.3%) were single and 807(45.5%) were unemployed/housewife. Methods of suicide were hanging in 962(54.6%), poisoning in 640(35.8%), falling in 88(5%), burning in 35(2%), shooting in 29(1.6%) and others in 19(1%) cases. Of poisoned cases, 283(44%) were victims of aluminum phosphide ingestion. Generally, frequency of married victims was greater than single ones but by comparing genders, relative frequency of single victims was greater among males (P<0.001). There was statistically significant association between suicide methods and age (P=0.001), gender (P<0.001), and occupation (P<0.001) of victims. Among different methods, shooting and poisoning were used by the youngest cases. Relative frequency of females was greatest in victims of burning and poisoning. Regarding occupational categories, poisoning was most frequent in students.Conclusion: In this study, the majority of successful suicides happened in people with occupational uncertainty, thus preventive measures should prioritize this issue. It seems that women with marital problems are also prone to suicide and social support programs should target this group, too. Association between the method of suicide and demography of victims will help us to recognize common methods in various groups of the society and establish appropriate preventive measures. While limiting access to supplies of suicide (like legislation on distribution of drugs for prevention of poisoning) is valuable, fundamental interventions at community level will be more effective in prevention of all kinds of suicide

The Experiences of Healthcare Professional Students about the Educational Impacts of Mobile Learning

The role of mobile devices in learning processes is growing rapidly and it is imperative to assess the effect of this technology. This paper explores the experience of healthcare professional students with regard to the educational impacts of mobile learning. We conducted a qualitative study using a conventional qualitative content analysis based on Graneheim and Lundman (2004) method to collect and analyze the experiences of 23 healthcare professional students. Two themes, each with subthemes, emerged from the findings: (1) perceived benefit in learning process, and (2) reflective self-assessment. The results revealed that mobile learning has a positive impact on both the process and the outcome of learning in healthcare professional students. Therefore, creating a supportive condition to promote mobile learning is recommended

Assessing the Evaluation Domain of Ambulatory Care Training in Firoozgar Hospital, Iran, Based on Iranian National Standards of Undergraduate Medical Education in 2013

Background & Objective: In the present study, the evaluation domain of ambulatory care training in Firoozgar Hospital, Tehran, Iran, was assessed based on the Iranian national standards of undergraduate medical education related to ambulatory education using the Baldrige scoring matrix. It also offered some suggestions for the promotion of education quality by use of the gap analysis method between the current condition and these standards. Methods: This descriptive analytic study was a kind of evaluation research performed using the standard checklist published by the undergraduate medical education council. Document evaluation, survey, and observation were performed based on the Baldrige excellence model. After the confirmation of validity and reliability of the checklist, the establishment level of national standards was evaluated in the clinics of Firoozgar Hospital in the evaluation domain. Data were analyzed according to the national standards of the domain of ambulatory education and the Baldrige scoring matrix. Finally, the quality of the current condition was determined as very satisfactory, satisfactory, medium, weak, and very weak. Results: In the clinics of Firoozgar Hospital, 25.50% of the national standards related to ambulatory education in the evaluation domain were observed and this domain was at a medium level. Conclusion: Due to the medium level of the evaluation domain, it is suggested that ambulatory education authorities provide the necessary facilities and reformations by considering the national standards of ambulatory education in the domains that were determined as weak and need quality promotion. Keywords: Quality; Ambulatory training; Evaluation; Iranian national standard

Research Paper: Gender Identification With Knee Bicondylar Width and Vertical Diameter of the Femur Head Based on Radiography Assessment

Background: Some skeletal criteria especially for bones of lower limbs are considerably different between men and women that may help in identifying the gender. We studied two lower limbs parameters, i.e. bicondylar width and vertical diameter of the femoral head based on radiographic assessment in gender identification.Methods: Bicondylar width and vertical diameter of the femoral head of 280 radiographs taken from people aged 30 to 75 years were measured. Additionally, gender and age subgroups were recorded and added to the measured anthropometric parameters in the checklist of the study.Results: The mean width of both left and right bicondylar bones as well as vertical diameter of both left and right femoral heads were significantly different between men and women. Considering two parameters of bicondylar width and vertical diameter of femoral head, the measurements could differentiate gender, with 96.7% sensitivity, 72.2% specificity, and 96.0% accuracy.Conclusion: By measuring bicondylar width and vertical diameter of the femur head, it is possible to determine gender with a high discriminative capability

Sensorless Control of a Single-Phase AC-DC Boost Converter without Measuring Input Voltage and Current

It is well-known that the accurate measurement of input voltage and current, as the feedforward and feedback terms, plays a crucial role in the nonlinear controller design for power factor compensation of an AC-DC boost converter. This paper addresses the problem of the simultaneous estimation of the input voltage and current from the output voltage in a full-bridge AC-DC boost converter. In the lossless model of the system, those variables are unobservable from the output voltage when the control input is zero. To overcome this, the system dynamics are immersed in a proper form by a new filtered transformation. The phase and amplitude of the input voltage, along with the input current, are globally estimated from the output voltage by a fifth-dimensional estimator. Unlike some existing results, the stability of the proposed estimator does not rely on a priori knowledge about the parasitic resistances and is guaranteed exponentially under the persistence of excitation conditions on the control signal. An application of the proposed estimator is presented in conjunction with a dynamic controller to form a sensorless control algorithm that does not require any sensor on the input side and controls the system only by the feedback from the output voltage. Processor-in-the-loop (PIL) studies conducted by OPAL-RT OP 5700 are used to assess the performances of the proposed estimator and controller

Investigating Emergency Nurses’ Awareness on the Differentiation Between Acute Methanol and Ethanol Intoxication

Background: Alcohol intoxication is among the leading and preventable causes of death, disability, and injury in numerous societies. Ethanol and methanol are the most commonly used types of alcohol. Increasing nurses’ awareness about the difference between intoxication with these two alcohol types will prevent the occurrence of dangerous and deadly complications of intoxication. We investigated the awareness of the nurses respecting the difference between acute methanol and ethanol intoxication in clinical manifestations, diagnosis, and treatment.Methods: A cross-sectional study was performed in 2020 on the emergency nurses from two educational hospitals. A total of 100 nurses participated in this study. The data collection tool was a researcher-made questionnaire, including demographic characteristics and questions concerning the identification and differentiation of acute methanol from ethanol intoxication. Moreover, the obtained data were analyzed using SPSS v. 20 at the significance level of P<0.05. Results: The present research results suggested that 21% of the examined nurses had a low level of awareness (<7) and 79% had a moderate level of awareness (8-13). The mean score of awareness was measured as 8.71 (range: 2-12). Nurses’ awareness was not related to age, gender, the duration of working experience, and educational level (P>0.05).Conclusion: The awareness of nurses regarding alcohol poisoning is moderate. Due to the importance of differentiating ethanol from methanol toxicity, considering the outcomes of the patients, nurses’ awareness should be increased