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The Origins of Perceived Discrimination in e-Learning in Nursing Students: A Qualitative Study
No full textIntroduction Discrimination in education is commonly associated with face-to-face interactions between teachers and students. However, e-learning environments can also foster discrimination. Despite existing research on discrimination in traditional education, limited studies address this issue in virtual education, particularly in nursing education.Objectives This study aimed to explore the factors contributing to perceived discrimination in e-learning among nursing and midwifery students, focusing on the underlying causes and conditions that shape these experiences.Methods A qualitative design was employed at the nursing and midwifery school of Isfahan University of Medical Sciences. Thirteen nursing and midwifery students were selected using purposeful and convenient sampling. Data were collected through semi-structured, in-depth interviews, and analyzed using content analysis.Results Factors contributing to perceived discrimination in e-learning were categorized into four themes: (1) the nature of e-learning (e.g., limited teacher availability, reduced interaction); (2) professor-related factors (e.g., experience, age, technology skills, and inattention to feedback); (3) student-related factors (e.g., gender, financial issues, and varying technology skills); and (4) inadequate resources (e.g., internet connectivity and limited access to study materials).Conclusions This study highlights multiple factors influencing students' perceptions of discrimination in e-learning. Addressing these issues can improve virtual education quality in nursing programs. Further research is needed to explore these factors in broader educational context
Evaluation of the Health-Related Quality of Life in Non-Syndromic Persian Toddlers with Orofacial Clefts Undergoing Team Care and Compared with a Control Group
No full textObjectives Maintaining and enhancing patients' quality of life (QoL) are considered the most significant objectives in healthcare systems. These objectives are directly associated with the intervention of healthcare providers across the globe. This study aimed to evaluate the health-related quality of life (HRQoL) of toddlers who have undergone interventions for oral clefts and compare it with a healthy control group. Materials & Methods The present study is cross-sectional. Thirty-six toddlers aged 18 to 36 months with oral clefts undergoing team care were recruited from a pediatric hospital and matched with healthy peers based on inclusion criteria. Demographic characteristics were collected before the TNO-AZL preschool children's quality of life (TAPQoL) questionnaire was completed. Results The QoL was compared to an overall score and the average score of items and domains on the TAPQoL questionnaire between the groups. The results showed a significant difference between the two groups in social functioning (t=2.96, p = 0.004), cognitive functioning (t=2.21, p = 0.03), emotional functioning (t=3.99, p<0.01), and the total score (p<0.001). However, no significant difference was observed in physical functioning (t= 0.78, p=0.43), and toddlers with oral clefts had more reasonable scores. Conclusion The QoL of toddlers with oral clefts who received care from a multidisciplinary team was slightly better than that of the healthy group. Therefore, participating in these teams could lead these children to a similar QoL as their peers. Medical systems can provide easy accessibility to cleft care teams for patients and their families
A Scoping Review of 20 Years Breast Cancer Screening Programs in Iran
No full textBackground: Breast cancer (BC) is the leading cancer among women globally. Early detection through screening is vital for reducing mortality, complementing advancements in treatment. Methods: We aimed to overview BC screening practices in Iran over two-decades to inform policymakers for future research directions and prompt timely diagnoses. A scoping review was conducted on BC studies in Iran from 2000 to 2023, following PRISMA guidelines. Results: We analyzed 129 articles on BC in Iranian women, and finding six main areas. Conclusion: Iran's health system lacks an organized BC screening initiative, facing challenges like inadequate infrastructure, sociocultural barriers, unintegrated health insurance packages, and limited research on key indicators
Effect of flood on the cutaneous leishmaniasis incidence in northeast of Iran: an interrupted time series study
No full textIntroductionCutaneous Leishmaniasis (CL) is a zoonosis infection which is endemic in more than 100 countries in Asia, Africa, Europe and America. It was estimated that nearly 20 thousand of new cases are reported in Iran annually. This study aimed to investigate the impact of floods on the incidence of leishmaniasis in Golestan province (northeast of Iran) over nine years, from 2015 to 2023.MethodsInterrupted Time Series Analysis (ITSA) is a study design used to study the effects of an intervention, disaster, or natural event on occurrence of a disease over time. In March 2019, a major flood occurred in Golestan Province, and it had a particularly strong effect on the Gonbad Kavous county (region 1). The trend of CL incidence before and after the flood was assessed using ITSA. In addition, the flood impact on CL incidence was compared between Gonbad Kavous county (region 1) with other counties (13 counties, as the region 2).ResultsThroughout the study, a total of 8953 cases were identified with 2148 (24) infected with leishmaniasis before the flood and 6805 (76) after that. A comparison of leishmaniasis between the two regions before and after the flood revealed a significant increase in Gonbad Kavous County following the flood. Also, in the multivariate regression analysis, the average difference in the baseline occurrence level before the flood in regions 1 and 2 was 30.3 per 105 population, which was statistically significant. Additionally, the average difference in the occurrence of leishmaniasis after the flood between the two regions was 37.3 cases per 105 population. The difference in trend of incidence between the two regions increased to 30.4 per 105 population after the flood, compared to 5.5 per 105 before the flood. Also, the long-term trend difference after the flood between the two regions has reached 27.3 per 105 population.DiscussionNatural disasters such as floods, earthquakes, and climate change can increase the spread of diseases such as leishmaniasis. Some interventional strategies are needed to decrease the risk of leishmaniasis outbreaks in flooded areas. Besides informing the community, allocating more financial resources for healthcare activities is essential. Environmental and individual protective activities, regular waste collection and disposal, and combating reservoirs and vectors are particularly crucial
Drug prescription patterns and compliance with WHO and beers criteria in older patients
No full textBackgroundAs the population ages, the prevalence of chronic diseases increases, leading to greater reliance on multiple medications that are conducted to increase the risk of adverse drug reactions (ADR) that may cause higher morbidity and mortality rates. This study aims to evaluate medication prescribing patterns in the older adults and assess compliance with the World Health Organization (WHO) guidelines and Beers Criteria.MethodsA cross-sectional study was conducted over six months in 2022, collecting prescriptions for patients aged 65 and above from a 24-hour community pharmacy in Iran. The prescriptions were analyzed according to the WHO prescribing guidelines, including the mean number of prescribed drugs, the number of injectable drugs and antibiotics per prescription, and also the prescription of drugs with generic names and from the list of Essential Drug List (EDL). In addition, the prescriptions were assessed according to the Beers Criteria for the frequency of prescription of potentially inappropriate medications (PIMs). Also, polypharmacy, which is defined as the prescription of more than five drugs per prescription, has been investigated based on the number of drugs prescribed per prescription.Results1,053 older patient prescriptions were assessed, whose average age was 72.3 +/- 6.7 years, with 36.2 of prescriptions involving polypharmacy (five or more drugs). The most frequent medical discipline of prescribers was general practice (30.3). The average number of drugs per prescription was 4.1 +/- 2.1, which exceeded the WHO recommendation. Additionally, 47.3 of prescriptions contained at least one PIM according to the Beers Criteria, with non-steroidal anti-inflammatory drugs (NSAIDs) being the most common (17.9). The relative frequency of injectable drugs and antibiotics used per prescription was 20.8 and 18.9, respectively, while 7.6 of prescriptions did not use generic names.ConclusionsThe study highlights concern about levels of polypharmacy and PIM use in older patients. While the low rate of antibiotic prescribing and relatively high use of generic drugs indicate some positive adherence to WHO guidelines, the frequent prescription of PIMs and the high average number of drugs per prescription point to substantial room for improvement
The pringle maneuver for Budd-Chiari syndrome-related orthotopic liver transplantation: an experience from a large referral center
No full textBackgroundOrthotopic liver transplantation (OLT) in Budd-Chiari Syndrome (BCS)-related liver cirrhosis is quite technically challenging due to the difficult handling of an enlarged and congested liver along with the risk of massive intraoperative bleeding. Therefore, we aimed to evaluate the efficacy of occluding the hepatic blood inflow tract by the Pringle maneuver (PM) at the beginning of the hepatectomy phase of BCS-related OLT procedure.MethodsThe current retrospective study of prospectively collected data was conducted between 2010 and 2022 in our referral center for OLT. Patients were divided into PM (after 2018) and non-PM (NPM, before 2018) groups. Intraoperative blood loss, packed red blood cell (PC) transfusion, operation time, 30-day mortality, and liver and renal function indexes were collected retrospectively.ResultsFrom a total of 3539 records, a total of 55 patients included in this study; the PM and NPM groups consisted of 17 and 38 patients, respectively. The mean intraoperative blood loss (1418 +/- 621 vs. 2240 +/- 1591 ml, p = 0.04) and amount of PC transfusion (418 +/- 423 vs. 1263 +/- 1557 ml, p = 0.03) were significantly lower in the PM group. In the NPM group, duration of operation (282 +/- 52 vs. 257 +/- 32 min) and 30-day mortality rate (16 vs. 0) were higher, which are statistically nonsignificant but clinically noteworthy.ConclusionUsing the PM can be an effective approach to reducing intraoperative bleeding, PC transfusion, and the length of surgery during OLT for BCS. It decreases the incoming blood to the congested liver, helps porta hepatis collaterals to shrink, and eases the division of hepatic ligaments and diaphragmatic attachments during the hepatectomy phase. These factors potentially facilitate the procedure for surgeons
Chemical Composition, Molecular Docking Analysis, and Biological Properties of Salvia Mirzayanii
No full textBackground:Diabetes is a dangerous metabolic disorder that is becoming more common worldwide. In the present research, we aimed to analyze the chemical composition, in silico molecular docking, and evaluate the biological features of Salvia mirzayanii.Materials and Methods:The constituents found in the aqueous extract of S. mirzayanii leaves were identified using gas chromatography-mass spectrometry (GC-MS). The major compounds of S. mirzayanii extract were subjected to molecular docking analysis. Screening for potential antioxidant abilities was conducted using radical scavenging assays. Alpha-amylase and alpha-glucosidase inhibitory kinetic studies were performed to evaluate the in vitro antihyperglycemic potential of S. mirzayanii. The in vivo function of S. mirzayanii extract was evaluated by examining the gene expression of phosphoenolpyruvate carboxykinase (PEPCK), glucose 6-phosphatase (G6Pase), and glucose transporter-4 (GLUT4) in diabetic rats.Results:The major compounds in aqueous extract of S. mirzayanii were 1,8-cineole (51.6 + 2.7), linalool acetate (22.0 + 1.9), a-terpinyl acetate (9.3 + 0.7), and aromadendrene (5.6 + 0.6). In silico studies indicated that 1,8-cineole was a more potent inhibitor of alpha-amylase and alpha-glucosidase enzymes. The liquid extract of S. mirzayanii showed considerable radical scavenging activity against 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and effective inhibition of alpha-amylase (IC50 = 0.01 +/- 0.02) and alpha-glucosidase (IC50 = 0.11 +/- 0.01). The highest antihyperglycemic activity was observed with a 600 mg/kg dose of the plant's aqueous extract.Conclusions:Altogether, our findings show the possibility of applying the aqueous extract of S. mirzayani leaves as a potential therapeutic compound
Development of the Persian Listening in Spatialized Noise Sentence Test: A Preliminary Study
No full textBackground and Aim: Listening in Spatialized Noise Sentence (LiSN-S) is one of the auditory processing disorder test battery that specifically diagnose spatial processing disorders. This research aimed to develop The Persian version of the LiSN-S, for assessing auditory processing disorders in the Persian speakers' population. Methods: The PLiSN-S test was developed based on its original Australian version. The speech stimuli were convolved with Head-Related Transfer Functions (HRTFs) to generate speech in the presence of spatialized noise. In total, 120 target sentences (consisting of five 1-3-syllable words) and competing stories were presented in four conditions. These included the Same Voice co-located condition (SV0 degrees), Different Voice co-located condition (DV0 degrees), Same Voice separated condition (SVf90 degrees), and Different Voice separated condition (DVf90 degrees). Then, data from 30 adults aged 18-23 with normal hearing were obtained. Results: The results from the normal-hearing subjects showed that the Speech Reception Threshold (SRT) scores, expressed as Signal to Noise Ratios (SNR), varied across the four conditions (SV0 degrees, DV0 degrees SVf90 degrees, DVf90 degrees) the highest and lowest SRTs belonged to the first and last conditions, respectively. The amount of advantage in all conditions was lower than in the previously published English versions. Conclusion: Considering the impact of spatial separation on the SRTs, PLiSN-S appears to be an effective tool for measuring spatial processing skills
Evaluation of the immunogenicity of a DNA vaccine for Leishmania major based on the Leishmania-activated C kinase antigen using calcium phosphate and chitosan adjuvants
No full textBackground Leishmaniasis represents a significant parasitic disease with global health implications, and the development of an affordable and effective vaccine could provide a valuable solution. This study aimed to evaluate the immunogenicity of a DNA vaccine targeting Leishmania major specifically based on the Leishmania-activated C kinase (LACK) antigen, utilizing calcium phosphate nanoparticles (CaPNs) and chitosan nanoparticles (ChitNs) as adjuvants.Methods Seventy female BALB/c mice, aged 4-6 wk and weighing 20-22 g, were selected and divided into five groups, each consisting of 14 mice. The first group received the plasmid LACK vaccine (pcDN3+LACK), the second group received the pcDN3+LACK vaccine with the CaPN adjuvant (pcDN3+LACK+CaPN), the third group received the pcDN3+LACK vaccine with the ChitN adjuvant (pcDN3+LACK+ChitN), the fourth group was administered phosphate-buffered saline as a negative control and the fifth group did not receive any vaccine, serving as a positive control. The vaccination program involved two intramuscular injections at 3-wk intervals. Three weeks following the final vaccination, the mice were challenged with wild-type L. major promastigotes via intradermal injection at the base of their tails. Clinical signs and lesion sizes were evaluated biweekly using Vernier calipers. Immune responses, including levels of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4), were assessed using ELISA.Results The groups receiving pcDN3+LACK+ChitN, pcDN3+LACK+CaPN and pcDN3+LACK exhibited the highest increases in IFN-gamma titers and the most significant reductions in IL-4 titers. Furthermore, lesion sizes associated with Leishmania infection were reduced in the vaccinated groups, with the most favorable outcomes observed in the pcDN3+LACK+ChitN group.Conclusions These findings suggest that vaccination utilizing the LACK antigen in conjunction with CaPN and ChitN adjuvants may represent an effective strategy for the control of cutaneous leishmaniasis