A Standardized Shift Handover Protocol: Improving Nurses’ Safe Practice in Intensive Care Units

Introduction: For maintaining the continuity of care and improving the quality of care, effective inter-shift information communication is necessary. Any handover error can endanger patient safety. Despite the importance of shift handover, there is no standard handover protocol in our healthcare settings. Methods In this one-group pretest-posttest quasi-experimental study conducted in spring and summer of 2011, we recruited a convenience sample of 56 ICU nurses. The Nurses’ Safe Practice Evaluation Checklist was used for data collection. The Content Validity Index and the inter-rater correlation coefficient of the checklist was 0.92 and 89, respectively. We employed the SPSS 11.5 software and the Mc Nemar and paired-samples t test for data analysis. Results: Study findings revealed that nurses’ mean score on the Safe Practice Evaluation Checklist increased significantly from 11.6 (2.7) to 17.0 (1.8) (P < 0.001). Conclusion: using a standard handover protocol for communicating patient’s needs and information improves nurses’ safe practice in the area of basic nursing care

Investigating the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility: A cross-sectional study

Background: Infertility affects individual’s and couples’ adjustment. The defense mechanism and marital adjustment are mental processes that play a key role in infertile couples’ life. Objective: This study aims to investigate the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility. Materials and Methods: This cross-sectional study was conducted on 400 infertile couples at Royan Institute (A referral center for infertility, Tehran, Iran). Infertile couples were divided into 4 groups based on the cause of infertility (female, male, both, and unknown). Demographic questionnaire, revised dyadic adjustment scale, and defense styles questionnaire were used for data collection. Results: Results showed that the mean score of marital adjustment of men based on the cause of infertility (female, male, and both) was significantly higher in comparison with their wives (p = 0.04, p ≤ 0.001, p ≤ 0.001, respectively). However, no difference was observed between the mean score of women, men, and couples (women and husbands) in defense mechanisms. But marital adjustment has a significant positive correlation with mature defense mechanisms and a negative correlation with immature ones (p &lt; 0.05). Conclusion: The mean score of marital adjustment is higher in men than in their wives in all groups. So, counseling infertile couples in the field of marital adjustment and training in the use of mature defense mechanisms is recommended especially in women. Key words: Defense mechanism, Marital relationship, Infertility

The Application of Palatal Rugae for Sex Discrimination in Forensic Medicine in a Selected Iranian Population

Background: Palatal rugae have been shown to be associated with racial and geographical variations and are known to be useful in sex identification. The present study aimed to assess palatal rugae patterns in a sample Iranian population and to compare the results with those from other studied populations. Methods: During summer 2017, 130 pre-orthodontic plaster casts from patients aged 17-25 years (65 males and 65 females) were obtained from the Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. The castes were evaluated using the classification given by Thomas and Kotze followed by recording the rugae lengths and shapes. The data were analyzed with the SPSS statistical software package (version 15.0) using the unpaired t test and Chi-square test. P<0.05 were considered statistically significant. Additionally, discriminant function analysis was applied to determine the applicability of palatal rugae patterns as a tool to aid sex identification. Results: The rugae count showed an insignificant difference between the Iranian males and females. The primary rugae were most common in both sexes followed by the secondary and fragmentary. Significant differences were observed between the sexes and the number of primary rugae in males (P=0.03) and fragmentary rugae in females (P=0.04) on the left side of the palate. A significant difference in the straight and diverging unification types was observed, which was highest in males (P=0.01) and females (P=0.03), respectively. Discriminant function analysis enabled sex identification with an accuracy of 70%. Conclusion: Palatal rugae is shown to be an appropriate tool for sex identification in an Iranian population. Further studies with a larger sample size are required for a comprehensive outcome

Characteristics of Palatal Rugae Patterns as a Potential Tool for Sex Discrimination in a Sample of Iranian Children

Statement of the Problem: Palatal rugae have been considered equivalent to fingerprints, as they are unique to each individual. It has been shown that palatal rugae are associated with specific racial groups and are known to aid sex identification. Due to the lack of any published data on palatal rugae morphology on Iranian children, the present study was performed. Purpose: The present study aimed to investigate differences in the morphology of individual palatal in a sample of Iranian children. Additionally, it is intended to develop discriminant function to identify sex, based on rugae morphology. Materials and Method: A total of 120 pre-orthodontic casts were evaluated for different rugae patterns using the Thomas and Kotze classification. The casts were equally distributed between sexes with an age range of 6-12 years. Rugae length, shape, and associated morphology were recorded and the independent t-test and Chi-square test were used to compare the mean and relationship between the attributes. The discriminant function analysis was applied to the data in order to determine the applicability of palatal rugae patterns as an aid for sex identification. Results: While the total rugae count showed an insignificant difference between the males and females, the rugae count on the right side of the palates showed a significant difference (p= 0.046). The primary rugae were most common in both sexes, followed by the secondary and fragmentary rugae. The most prevalent rugae shape between both sexes was the wavy rugae followed by the curve and straight shapes in males and the straight and curve shapes in females. A significant difference was observed in the number of the curve rugae between the sexes. Discriminant function analysis allowed sex differentiation with an accuracy of 60.8%. Conclusion: Palatal rugae shapes are unique to each individual and could be used as a potential tool for sex identification. Further research on a larger sample is required to fully confirm the application of this method (e.g. in forensic medicine) as a complementary technique for sex identification

Sensor Fault Detection and Compensation with Performance Prescription for Robotic Manipulators

This paper focuses on sensor fault detection and compensation for robotic manipulators. The proposed method features a new adaptive observer and a new terminal sliding mode control law established on a second-order integral sliding surface. The method enables sensor fault detection without the need to impose known bounds on fault value and/or its derivative. It also enables fast and fixed-time fault-tolerant control whose performance can be prescribed beforehand by defining funnel bounds on the tracking error. The ultimate boundedness of the estimation errors for the proposed observer and the fixed-time stability of the control system are shown using Lyapunov stability analysis. The effectiveness of the proposed method is verified using numerical simulations on two different robotic manipulators, and the results are compared with existing methods. Our results demonstrate performance gains obtained by the proposed method compared to the existing results

Beneficial effect of high energy intake at lunch rather than dinner on weight loss in healthy obese women in a weight-loss program: a randomized clinical trial

ABSTRACT Background: The association between the time of nutrient intake and health has been described in a few studies. To our knowledge, no study has evaluated the relation between high energy intakes at lunch compared with at dinner on weight loss in overweight and obese subjects. Objective: We compared the effect of high energy intake at lunch with that at dinner on weight loss and cardiometabolic risk factors in women during a weight-loss program. Design: Overweight and obese women [n = 80; body mass index (BMI; in kg/m2): 27–35; age: 18–45 y] were asked to eat either a main meal at lunch (LM) or a main meal at dinner (DM) for 12 wk while in a weight-loss program. Results: A total of 80 participants were randomly assigned to one of 2 intervention groups. Sixty-nine subjects (86%) completed the trial (34 subjects in the DM group, and 35 subjects in the LM group). Baseline variables were not significantly different between groups. A significant reduction in anthropometric measurements and significant improvements in cardiometabolic risk characteristics were observed over 12 wk in both groups. Compared with the DM group, the LM group had greater mean 6 SD reductions in weight (LM: 25.85 6 1.96 kg; DM: 24.35 6 1.98 kg; P = 0.003), BMI (LM: 2.276 0.76; DM: 1.68 6 0.76; P = 0.003), homeostasis model assessment of insulin resistance (LM: 20.66 6 0.33; DM: 20.46 6 0.24; P = 0.001), and fasting insulin (LM: 22.01 6 1.10 mIU/mL; DM: 21.16 6 0.72 mIU/mL; P , 0.001) after 12 wk. However, there were no significant differences for fasting plasma glucose and lipid profiles within both groups after 12 wk. Conclusions: The consumption of higher energy intake at lunch compared with at dinner may result in favorable changes in weight loss in overweight and obese women after a weight-loss program of 12 wk. The consumption may also offer clinical benefits to improve insulin resistance. This trial was registered at clinicaltrials.gov as NCT02399280. Am J Clin Nutr doi: 10.3945/ajcn.116.134163

Effect of a long bout versus short bouts of walking on weight loss during a weight loss diet: a randomized trial

Objective: To evaluate the effect of different daily physical activity (PA) frequencies while maintaining the same daily volume of PA on weight loss, carbohydrate and lipid metabolism, in women with overweight/obesity throughout a 24- week intervention.Methods: 65 women [BMI = 27- 35 kg/m²; age= 18-40 y] who had a sedentary lifestyle were randomly allocated to include either a longer-bout of PA (LBP), 50 min/d moderate-intensity PA, or two shorter-bouts of PA (SBP), two 25 min/d moderate intensity PA, 6 d/week during their weight loss plan. Anthropometric and blood measurements were taken at baseline and 24 weeks.Results: Compared with the LBP group, the SBP group had a greater decrease in weight (SBP: -8.08 ± 2.20 kg; LBP: -6.39 ± 2.28 kg; P = 0.019), BMI (SBP: -3.11 ± 0.87 kg/m²; LBP: -2.47 ± 0.86 kg/m², P=0.027) and waist circumference (SBP: -8.78 ± 2.62 cm; LBP: -5.76 ± 2.03 cm; P = 0.026). No significant differences were seen in carbohydrate and lipid metabolism characteristics after the 24 weeks.Conclusion: PA undertaken in 2 shorter-bouts per day could be more effective for weight loss than when undertaken in a daily long-bout in adult women on a 24 wk weight loss program

Simultaneous Underexpression of let-7a-5p and let-7f-5p microRNAs in Plasma and Stool Samples from Early Stage Colorectal Carcinoma: Supplementary Issue: Biomarkers for Colon Cancer

Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer death worldwide. Early detection of CRC can improve patient survival rates; thus, the identification of noninvasive diagnostic markers is urgently needed. MicroRNAs (miRNAs) have extensive potential to diagnose several diseases, including cancer. In this study, we compared the expression pattern of miRNAs from plasma and stool samples of patients with early stages of CRC (I, II) with that of healthy subjects. We performed miRNA profiling using microarrays on plasma and stool samples of eight patients with CRC and four healthy subjects. Seven miRNAs were found to be underexpressed in both plasma and stool samples of patients with CRC versus healthy subjects. Then, we aimed to verify two out of these seven differentially expressed miRNAs (let-7a-5p and let-7f-5p) by quantitative reverse transcriptase polymerase chain reaction on a larger set of plasma and stool samples of 51 patients with CRC and 26 healthy subjects. We confirmed the results of microarray analysis since their expression was significantly lower in stool and plasma samples of patients with CRC. Moreover, receiver operating characteristic curve analysis demonstrated that fecal let-7f expression levels have significant sensitivity and specificity to distinguish between patients with CRC and healthy subjects. In conclusion, if the results are confirmed in larger series of patients, underexpressed let-7a-5p and let-7f-5p miRNAs in both plasma and stool samples of patients with CRC may serve potentially as noninvasive molecular biomarkers for the early detection of CRC.Peer reviewe