Journal of Rafsanjan University of Medical Sciences
Year:2022 | Volume:21 | Issue:2|Papers Count:8

Background and Objectives: The rapid and accurate triage of patients is the key to success in patient care and to enable the identification of patients in need of emergency care. Therefore, this study was conducted to determine the effect of smart triage training on nurses' knowledge and decision making. Materials and Methods: This quasi-experimental study was conducted with a pre-test and post-test group in 2020 which 25 triage nurses of the emergency department of Khoy University of Medical Sciences hospitals were selected. The training method was via smart phone. A questionnaire containing demographic information and a triage form based on the triage algorithm were used to collect data. In order to diagnose triage error, 350 patient records were reviewed by the researcher before and after the training. Then, the level of triage was determined and the amount of triage error was assessed. The knowledge of emergency nurses was also examined before and one year after the intervention. The data were analyzed using chi-square, McNemar, and paired t-test. Results: The results showed that the triage error decreased from 28% before the intervention to 19. 1%, and McNemar test showed a statistically significant difference (p<0. 001). Regarding the knowledge of triage nurses, paired t-test showed that the knowledge of nurses increased after the intervention (p<0. 001). Conclusion: The results of the present study showed that improving the skills and knowledge of nurses can increase the accuracy of emergency nurses in the correct triage of patients. Therefore, planning based on proper triage training is strongly recommended for emergency nurses.

Background and Objectives: The corona crisis has led to an increase in working children who have poor psychological well-being. Therefore, the aim of this study was to determine the factor structure and validation of the Ryff's Psychological Well-being Scale in working children. Materials and Methods: This research was a descriptive study performed by structural equation modeling. The statistical population included all working children in Bandar Abbas in 2021. The sample size was determined based on psychometric criteria to be 80 for the predictive validity section and 100 for the convergence validity section. Samples were selected by random sampling method. Research data were collected through three questionnaires of Ryff's Psychological Well-Being (1989), Oxford Happiness (1990), and Positive Psychology Characteristics Questionnaire (2008) in the printed and electronic forms by sending the questionnaire link to the participants' mobile phones. To evaluate the validity of the scale, content validity, convergence, and factor analysis methods were used. The reliability of the scale was assessed by internal consistency methods and the split-half reliability (halving). Results: The results of exploratory factor analysis showed that the researcher-made questionnaire consists of six factors and has a good validity and reliability. Confirmatory factor analysis also confirmed the six-factor model. This questionnaire was administered along with the Oxford Happiness Questionnaire and the Positive Psychological Characteristics Questionnaire, which had a good reliability and validity with 18 items (p<0. 001). Conclusion: The 18-item Ryff's Psychological Well-Being Scale can be used to assess psychological well-being in working children.

Background and Objectives: Heart-kidney disorders affect on each other. Exercise training can control heart and kidney cell damages. The aim of this study is to determine the effect of exercise training and warfarin administration on cardiac matrix Gla protein (MGP) and indices of renal injury in rats of myocardial infarction model. Materials and Methods: In this experimental study, 42 male Sprague-Dawley rats (180-220 grams) were randomly divided into 7 groups of healthy control, myocardial infarction or ischemia (ISC), ISC+interval training, ISC+ continuous training, ISC+warfarin, ISC+interval training+warfarin, and ISC+continuous training+warfarin. The duration of interval and continuous training was eight weeks, five sessions per week. Induction of myocardial infarction was performed with subcutaneous injection of isoproterenol. Cardiac MGP was measured by western blotting, creatinine and blood urea nitrogen (BUN) by photometric method, and cystatin C by Turbidimetry. Glomerular filtration rate (GFR) was calculated according to cystatin C consideration. Independent t-test and twofactor analysis of variance were used to analyze the data. Results: Myocardial infraction decreased MGP protein (p=0. 001), increased creatinine (p=0. 001), BUN (p=0. 002), and cystatin C (p=0. 001), and decreased GFR (p=0. 001) compared to the control group. The main effect of exercise type on all variables, the main effect of warfarin on MGP and BUN, and also interaction of warfarin and exercise type on MGP were significant. Conclusion: Exercise training had a better effect on cardiac MGP and control of renal injury markers compared to warfarin. Therefore, in heart and kidney diseases with warfarin therapy, exercise training should be carefully planned.

Background and Objectives: Caring of elderly with Alzheimer's disease and communicating with them is a chronic stressful process that has a negative effect on caregivers’,psychological well-being and quality of life. Therefore, considering the importance of this issue, the aim of this study was to investigate the effectiveness of mindfulness-based cognitive therapy on psychological well-being and quality of life in caregivers of the elderly with Alzheimer’, s disease in Isfahan city. Materials and Methods: This quasi-experimental study was conducted with a pretest-posttest design with control group. The statistical population was caregivers of the elderly with Alzheimer's disease in Isfahan in year 2021. At first, 30 people were selected by available sampling method and then randomly divided into two groups of 15 people. For the people in the experimental group, the mindfulness-based cognitive therapy was implemented in 8 sessions, each session lasting 90 minutes, but the control group received no training and remained in the waiting list. Data was collected using Ryff’, s Psychological Well-Being Scale and World Health Organization Quality of Life in two stages, pre-test and post-test. Data was analyzed using multivariate analysis of covariance (MANCOVA). Results: The results indicated that mindfulness-based cognitive therapy significantly improved psychological wellbeing and quality of life in caregivers of the elderly (p<0. 05). Conclusion: Since mindfulness-based cognitive therapy was effective on psychological well-being and quality of life, it can be concluded that this intervention can be used by counseling centers and psychological services to improve the psychological well-being and quality of life of caregivers of the elderly with Alzheimer's.

Background and Objectives: Control processes in osteoblastic differentiation of mesenchymal stem cells are not yet fully understood. Epigenetic mechanisms, especially the methylation of CpG Islands in the promoter of genes, are considered as one of the most important control mechanisms in stem cell differentiation. In the process of differentiation, it is debated whether only the methylation of specific genes changes or the methylation of global DNA. Therefore, in the present study, the state of global DNA methylation was evaluated during osteoblastic differentiation of mesenchymal stem cells by differentiation medium and also in treatment by zoledronic acid. Materials and Methods: In this laboratory study, after isolation and proliferation of mesenchymal stem cells, induction of osteoblastic differentiation was done using differentiating medium and zoledronic acid. DNA extraction was performed at differentiation weeks 1, 2, and 3 as well as from undifferentiated mesenchymal stem cells. Global DNA methylation status was assessed by antibodies against 5-methyl cytosine. Repeated measurement design test was used to analyze the data. Results: Global DNA methylation status of the genome did not change during osteoblastic differentiation of mesenchymal stem cells (p=0. 093). Also, treatment with zoledronic acid had no effect on global DNA methylation (p=0. 057). Conclusion: Osteoblastic differentiation of mesenchymal stem cells by differentiation medium and also in treatment with zoledronic acid is not associated with altered global methylation of the genome. Therefore, the differentiation process of mesenchymal stem cells to osteoblasts is a unique pathway, and possibly other genetic and epigenetic mechanisms play a role in controlling it.

Background and Objectives: Exposure to lead and its effects on children's health is one of the most important and widespread concerns of human societies today. Therefore, the purpose of this systematic study was to evaluate blood lead levels in Iranian children. Materials and Methods: In this systematic review, PubMed, Scopus, Science Direct, Scientific Information Database (SID), and Iran Medex databases were comprehensively searched for papers published from 2005 to the end of October 2021. Studies that reported blood lead levels in Iranian children were collected. Then the articles were evaluated according to a pre-prepared checklist. Results: Of a total of 143 articles found in the initial search, 13 studies were included in our systematic review. The lowest and highest mean blood lead levels were 0. 65 micrograms per deciliter in Abadan and 57. 1 micrograms per deciliter in Mashhad, respectively. In three studies conducted in Mashhad and Isfahan, blood lead levels were reported to be higher than 5 Micrograms per deciliter in all children studied. The level of education of the father, the use of canned food, the habit of eating soil by the child, damage to the paint of the house, and the reduction of blood iron levels were the effective factors in increasing the blood lead levels in Iranian children. Conclusion: Due to the high prevalence of blood lead samples above 5 micrograms per deciliter in some studies, reducing the exposure to lead should be seriously pursued by health policy makers and health systems.

Background and Objectives: Different dimensions of nursing care as a component of health care services are very important in satisfying the patient. This study was conducted to investigate the patients satisfaction with nursing services in Imam Reza hospital of Lar City during the Covid-19 pandemic. Materials and Methods: In this descriptive study conducted in 2020, 190 hospitalized patients were selected by convenience sampling. Data were collected using a standard patient satisfaction questionnaire by interview. Pearson’, s and Spearmen’, s correlation coefficient tests and one-way analysis of variance were used to determine the relationship between the variables. Results: The mean and standard deviation of patients 39,age was 47. 63±, 14. 58 years. Out of 190 respondents (patients), 110 were men (58%) and 80 were women (42%). Also, 63 people (33. 2%) had undergraduate education, 28 (14. 7%) had a diploma, 19 (10. 0%) had an associate degree, 48 (25. 3%) had a bachelor’, s degree, and 32 (16. 8%) had a master', s degree. 24 people (12. 6%) were dissatisfied with their opinion on the components of satisfaction, 49 (25. 8%) were somewhat satisfied, and 111 (58. 4%) were completely satisfied with their opinion on these components. Conclusion: The findings of this study showed that the majority of patients had full satisfaction with nursing services. It is recommended to improve the quality of nursing care by implementing educational programs and assessing the reasons for patient dissatisfaction to increase patient satisfaction.

Background and Objectives: Calcium deposition and ossification may be seen in tissues such as arteries, lymph nodes, glands, and ligaments which in some cases, it causes inflammation and pressure on adjacent tissues, including nerves. According to the passing of the nerve under the superior transverse scapular ligament, the ossification of this ligament can lead to pressure on the relevant nerve, resulting in pain in the scapular region, which in severe cases, arthroscopic surgery and removal of the pressure on the nerve is necessary for the patient. The aim of this study was to describe a case of ossification of the superior transverse scapular ligament. Case report: At the time of evaluation of the scapulae in the Anatomy Museum, an unusual case involving ossification of the superior transverse ligament of the right scapula was observed. This ossification led to the formation of an oval hole on the superior border with a large diameter of 9 mm and a small diameter of 6 mm. The circumference of this complete ossified ligament was 14 mm and its thickness in the middle part was 4 mm. Conclusion: This study described a case of ossification of the superior transverse scapular ligament. In order to determine the frequency of this case in the Iranian population and to determine the various aspects of its clinical significance, more comprehensive studies are needed. This report is also significant as the ossification of this ligament in the Iranian population has not been documented.