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The effectiveness of acceptance and commitment therapy on posttraumatic cognitions and psychological inflexibility among students with trauma exposure
Full text linkBackground: Posttraumatic stress disorder has a negative impact on the individual, family, and community due to disturbance in social functioning, increased stress, and life-threatening health status. Therefore, effective and useful therapeutic interventions in this area are very important. This study aimed at examining the effectiveness of acceptance and commitment therapy (ACT) on the posttraumatic cognitions of students with trauma exposure. Methods: In this quasi- experimental study, population included all students of Islamic Azad University in Roudehen, Tehran, Iran, during the academic year of 2018-2019. After administering trauma questionnaire, the second version of acceptance and action questionnaire (AAQ-II), and posttraumatic cognitions inventory (PTCI) to 500 people, 113 people who experienced trauma and had high scores in PTCI and low scores in AAQ-II were identified. Of whom 40 people were selected randomly. After the clinical interview, the subjects were randomly placed in the experimental group (who received ACT, n = 20) and placebo group (n = 20). Both groups were pre- and posttested using the PTCI and AAQ-II. Then, the obtained data were analyzed using covariance analysis. Results: The results showed that there was a significant difference in posttraumatic cognitions (negative cognitions about self, negative cognitions about the world, and self-blame) between the two groups. In addition, the results of posttest related to ACT had a significant impact on psychological inflexibility. In other words, ACT reduced posttraumatic cognitions and increased psychological flexibility of these students. Conclusion: The findings of the present study reveal that despite posttraumatic cognitions of students with trauma exposure, ACT increases value-based behaviors through increasing psychological flexibility and decreasing experiential avoidance
Promotion of knowledge, skill, and performance of emergency medical technicians in prehospital care of traumatic patients: An action-research study
Full text linkBackground: Annually, there is a high rate of mortality due to trauma. Prehospital emergency personnel are the first caregivers present beside trauma patients, and their dexterity to take care of trauma patients is of great significance in the vast majority of patients' survival. Materials and Methods: This study was action research with the participation of 125 prehospital emergency personnel from May 2016 to December 2018 in five stages (observation, reflection, planning, action, and evaluation) in Iran. Knowledge, skills, and performance of personnel were assessed before and after the action. Data collection tools included knowledge questionnaire and PERFECT skill assessment checklist by Objective Structured Clinical Examination method and researcher-made checklist for performance. Data were analyzed using SPSS-21 software. Results: The findings indicated that 67.82 and 84.4 of prehospital emergency staff have median to low knowledge and expertise in respect to trauma care, respectively. Their performance of necessary measurements for trauma patients was poor prior to training. There was a significant difference between the mean knowledge, skills, and performance of medical emergency technicians before and after the training course (P = 0.00). Conclusions: Participation of beneficiaries in planning for trauma patient's care is helpful. Establishment of prehospital trauma life support training in the medical emergency, training curriculum, and its instruction to prehospital emergency personnel while serving in trauma care will be of great benefit
Hospitalization due to traffic accidents among the elderly, Shiraz, 2018; mortality, severity, and injury pattern
Full text linkBackground: Aging results in declined function, which leads to loss of capacity and respond to injury. Hence, the duration of treatment after traffic accident increases in these patients. The present study aimed to identify the factors affecting the elderly hospitalization. Study Design: This was a cross-sectional study. Materials and Methods: This cross-sectional study was conducted on 768 trauma patients aged 65 years and more due to traffic injuries, referred to Rajaee (Emtiaz) hospital trauma referral center, Shiraz, Iran, in 2018. Data were collected through the hospital's health information system, as well as readings and encoding patient's clinical records. Poisson regression was performed to evaluate the partial effects of each covariate on geriatric trauma patients. Results: The mean age of injured patients was 73.27 ± 6.88 years, of which 7.29 expired. Extremities and externals (58.20) and head and neck (18.36) were the most commonly injured regions of the body. Each year after 65 led to 0.03 times increase in the length of hospitalization. The male's hospital stay was 1.15 times more than females. Conclusion: According to the results, length of hospitalization had a direct correlation with aging among elderly trauma patients. Since the elderly population is on the rise, it is necessary for the policymakers to come up with preventive measures to reduce the number of accidents and casualties
An epidemiologic study of Wednesday Eve Festival of Charshanbe-Soori in Iran, 2017
Full text linkBackground and Purpose: Wednesday Eve Festival Charshanbe-Soori is one of the famous Iranian festivals that is held on the last Wednesday of each Solar Hijri year. The ceremony is accompanied by lighting fires and fireworks. The purpose of this study was the epidemiologic investigation of incidents of Wednesday Eve Festival in 2017. Materials and Methods: This ecological study was conducted to evaluate the epidemiological features of the Wednesday Eve Festival in 2017. The research population included all patients referred to all hospitals in Iran on the last Wednesday night of the year. Two-part questionnaire containing demographic information and burns-related factors were used for data collection. To analyze the data, the incidents in different provinces were calculated based on factors such as age, sex, occupation, and education. Results: A total of 3285 incidents related to the Persian Wednesday Eve Festival were reported from March 2 to March 15, 2017,. The injury rate in 2017 was 4.2/100000. The highest incidence rate was found in Qazvin (15.92) and Kurdistan (13.7) cities, and the lowest incidence rate was reported in Kerman (0.13) Sistan and Balochestan and Yazd (0.23)/100,000. Conclusion: Fireworks in Wednesday Eve Festival have become serious trouble, not only because nowadays principles and its traditional aspects are ignored but also it inflicts considerable harm and damage on families and our country by using destructive incendiary equipment. To prevent upcoming incidents, educating the community, especially the youth and teenagers, are necessary
Development and psychometric evaluation of the Hospital Nurse Interpersonal Empathy Questionnaire
Full text linkObjective: This study aimed to develop the Hospital Nurse Interpersonal Empathy Questionnaire (HNIEQ) and evaluate its psychometric properties. Methods: The primary version of HNIEQ was deductively developed through reviewing the literature, and then, its face and content validity were assessed. For construct validity assessment, 250 hospital nurses were randomly selected from hospitals of Kashan, Iran. Their data were used for exploratory factor analysis. Internal consistency was assessed through Cronbach's α coefficient and questionnaire stability was assessed through test-retest intraclass correlation coefficient. Ceiling and floor effects were also assessed. Data analysis was done via the SPSS program (v. 16.0). Results: The final version of HNIEQ contained 45 items. Exploratory factor analysis revealed a six-factor structure (empathetic and ethical attention, perspective adoption, emotional affectability, altruism, emotion identification and responsivity, and reflection forecasting) for the questionnaire which explained 52.7 of the total variance of its total score. The Cronbach's α coefficient and the intraclass correlation coefficient of HNIEQ were 0.953 and 0.972, respectively. Conclusion: HNIEQ is a valid and reliable instrument for empathy assessment among nurses. © 2020 Chinese Nursing Associatio
Quercetin as an anticancer agent: Focus on esophageal cancer
No full textEsophageal cancer (EC) is regarded as the sixth highest contributor to all cancer-related mortality, worldwide. In spite of advances in the treatment of EC, currently used methods remain ineffective. Quercetin, as a dietary antioxidant, is a plant flavonol from the flavonoid group of polyphenols, and can be found in numerous vegetables, fruits, and herbs. Quercetin can affect the processes of cancer-related diseases via cell proliferation inhibitory effects, potential apoptosis effects, and antioxidant properties. Of the various types of cancer, the use of quercetin has now become prominent in the treatment of EC. In this review, we discuss how quercetin may be an important supplement for the prevention, treatment, and management of EC, owing to its natural origin, and low-cost relative to synthetic cancer drugs. However, most findings cited in the current study are based on in vitro and in vivo studies, and thus, further human-based research is necessitated. Practical applications: In spite of advances in the treatment of esophageal cancer, currently used methods remain ineffective, therefore, an alternative or complementary therapy is required. Quercetin, as a dietary antioxidant, can affect the processes of cancer-related diseases via cell proliferation inhibitory effects, potential proapoptotic functions, and antioxidant properties. Quercetin may be an important supplement for the prevention, treatment, and management of EC, owing to its natural origin. The low cost of quercetin as supplement or dietary intake, relative to synthetic cancer drugs, is an advantage of the compound which should be considered. © 2020 Wiley Periodicals LL
The effect of surgical preference card on the clinical self-efficacy of operating room students
Full text linkBackground & Aim: A wide range of clinical education of operating room students is done in the operating room. One of the problems in students' clinical education is the lack of appropriate learning tools in the operating room. The use of educational tools that improve students' performance affects students' self-efficacy in the operating room. So, the purpose of this study was to investigate the influence of the surgical preference card as an educational aid tool on the self-efficacy of the operating room students. Methods & Materials: This quasi-experimental study was carried out on 64 operating room students of Isfahan University of Medical Sciences at AL-Zahra Hospital in the year 2018. Participates were selected through convenience sampling and were divided into experimental (n=32) and control (n=32) groups. The students in the intervention group performed surgical care with using the surgical preference card. The data collection tool was a clinical self-efficacy questionnaire. Data were analyzed with SPSS-21 software using the independent-t, paired t-test, and chi-square test. Results: The findings of this study showed that there was no significant difference between the average self-efficacy score of the control group before and after the intervention (p>0.05). while the average self-efficacy score of the experimental group increased significantly after the intervention as compared with before the intervention (p <0.001). Conclusion: The surgical preference card as an educational aid tool improved the students' self-efficacy. Therefore, it is recommended to use this tool for the clinical education of other operating room students. © 2020, Tehran University of Medical Sciences. All rights reserved
Melatonin and morphine: potential beneficial effects of co-use
No full textMorphine is a potent analgesic agent used to control acute or chronic pain. Chronic administration of morphine results in analgesic tolerance, hyperalgesia, and other side effects including dependence, addiction, respiratory depression, and constipation, which limit its clinical usage. Therefore, identifying the new analgesics with fewer side effects which could increase the effect of morphine and reduce its side effects is crucial. Melatonin, a multifunctional molecule produced in the body, is known to play an important role in pain regulation. The strong anti-inflammatory effect of melatonin is suggested to be involved in the attenuation of the pain associated with inflammation. Melatonin also increases the anti-nociceptive actions of opioids, such as morphine, and reverses their tolerance through regulating several cellular signaling pathways. In this review, published articles evaluating the effect of the co-consumption of melatonin and morphine in different conditions were investigated. Our results show that melatonin has pain-killing properties when administered alone or in combination with other anti-nociceptive drugs. Melatonin decreases morphine consumption in different pathologies. Furthermore, attenuation of morphine intake can be accompanied by reduction of morphine-associated side-effects, including physical dependence, morphine tolerance, and morphine-related hyperalgesia. Therefore, it is reasonable to believe that the combination of melatonin with morphine could reduce morphine-induced tolerance and hyperalgesia, which may result from anti-inflammatory and antioxidant properties of melatonin. Overall, we underscore that, to further ameliorate patients' life quality and control their pain in various pathological conditions, melatonin deserves to be used with morphine by anesthesiologists in clinical practice. © 2020 Société Française de Pharmacologie et de Thérapeutique
A novel silica supported chitosan/glutaraldehyde as an efficient sorbent in solid phase extraction coupling with HPLC for the determination of Penicillin G from water and wastewater samples
Full text linkIn this study, silica@chitosan-glutaraldehyde (Si@Cs-G) was synthesized as a novel adsorbent for extraction of Penicillin G (PG) from the synthetic and real samples followed by HPLC determination. The synthesized adsorbents were characterized by the scanning electron microscopy (SEM), X-ray diffraction (XRD), fourier transform infrared (FTIR), dynamic light scattering (DLS), transmission electron microscopy (TEM) and nitrogen adsorption–desorption techniques. The factors influencing the extraction efficiency including pH, sorbent dose, extraction time, extraction solvent type and its volume were investigated and optimized. Under the optimal conditions (sorbent dosage: 25 mg, desorption solvent (acetonitrile) with volume of 0.75 mL; pH: 6 and extraction time: 50 min), the Si@Cs-G demonstrated high efficiency and linearity (R2 > 0.999) with the concentration of penicillin G ranging from 1 to 300 μg L−1. Extraction recovery in synthetic samples was 98.977, with LOD = 0.493 μg L−1, LOQ = 1.638 μg L−1 and RSD < 1.953. The method was successfully applied for determination of PG in real water samples (tap, river, lake and well water) and wastewater samples (SH and SHB hospital effluent). The obtained relative recoveries were in the range of 91.31 -123.27 with RSD less than 6.34 for all the real samples. The dominant mechanism in the PG adsorption process was involved in the π-π interaction, hydrogen bonding, and electrostatic interaction. © 202
Potential drugs used in the antibody–drug conjugate (ADC) architecture for cancer therapy
Full text linkCytotoxic small-molecule drugs have a major influence on the fate of antibody–drug conjugates (ADCs). An ideal cytotoxic agent should be highly potent, remain stable while linked to ADCs, kill the targeted tumor cell upon internalization and release from the ADCs, and maintain its activity in multidrug-resistant tumor cells. Lessons learned from successful and failed experiences in ADC development resulted in remarkable progress in the discovery and development of novel highly potent small molecules. A better understanding of such small-molecule drugs is important for development of effective ADCs. The present review discusses requirements making a payload appropriate for antitumor ADCs and focuses on the main characteristics of commonly-used cytotoxic payloads that showed acceptable results in clinical trials. In addition, the present study represents emerging trends and recent advances of payloads used in ADCs currently under clinical trials. © 2019 Wiley Periodicals, Inc