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

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

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

Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran

OBJECTIVES: The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran. METHODS: This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student's t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test. RESULTS: The prevalence of LTBIs according to both the QFT and the TST was 17 (95 confidence interval CI, 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34). CONCLUSIONS: Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs

Correction: The Effects of Melatonin Supplementation on Glycemic Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

his systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to clarify the effect of melatonin supplementation on glycemic control. Databases including PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched until July 30th, 2018. Two reviewers independently assessed study eligibility, extracted data, and evaluated the risk of bias for included trials. Heterogeneity among included studies was assessed using Cochran’s Q test and I-square (I2) statistic. Data were pooled using random-effect models and mean difference (MD) was considered as the overall effect size. Twelve trials out of 292 selected reports were identified eligible to be included in current meta-analysis. The pooled findings indicated that melatonin supplementation significantly reduced fasting glucose (MD=–6.34; 95% CI, –12.28, –0.40; p=0.04; I2: 65.0) and increased the quantitative insulin sensitivity check index (QUICKI) (MD=0.01; 95% CI, 0.00, 0.02; p=0.01; I2: 0.0). However, melatonin administration did not significantly influence insulin levels (MD=–1.03; 95% CI, –3.82, 1.77; p=0.47; I2: 0.53), homeostasis model assessment of insulin resistance (HOMA-IR) (MD=–0.34; 95% CI, –1.25, 0.58; p=0.37; I2: 0.37) or HbA1c levels (MD=–0.22; 95% CI, –0.47, 0.03; p=0.08; I2: 0.0). In summary, the current meta-analysis showed a promising effect of melatonin supplementation on glycemic control through reducing fasting glucose and increasing QUICKI, yet additional prospective studies are recommended, using higher supplementation doses and longer intervention period, to confirm the impact of melatonin on insulin levels, HOMA-IR and HbA1c. Key words: melatonin - glycemic control - insulin resistance - meta-analysi

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

The effects of vitamin D supplementation on expanded disability status scale in people with multiple sclerosis: A critical, systematic review and metaanalysis of randomized controlled trials

In this meta-analysis of randomized controlled trials (RCTs), the effects of vitamin D supplementation on the scores for the expanded disability status scale (EDSS) in people with multiple sclerosis (MS) are assessed. The following databases were search up to January 2018: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The quality of the relevant extracted data was assessed according to the Cochrane risk of bias tool. Data were pooled by the use of the inverse variance method and expressed as mean difference with 95 Confidence Intervals (95 CI). Six studies were included in this meta-analysis. The findings demonstrated that supplementation with vitamin D alone and vitamin D plus calcium did not affect the EDSS score (WMD -0.11 (-0.33, 0.11); P = 0.32). In addition, subgroup analysis showed that vitamin D supplementation alone, when compared to the use of a placebo, and vitamin D plus calcium supplementation compared with the control did not affect EDSS (WMD -0.13 (-0.30, 0.11); P = 0.29) and (WMD -0.08 (-0.57, 0.41); P = 0.29), respectively. Overall, this meta-analysis indicated that taking vitamin D in people with MS had no significant effect on EDSS. © 2019 Elsevier B.V

Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran

OBJECTIVES: The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran. METHODS: This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student's t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test. RESULTS: The prevalence of LTBIs according to both the QFT and the TST was 17 (95 confidence interval CI, 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34). CONCLUSIONS: Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs. © 2016, Korean Society of Epidemiolog