bluuebunny/crossref_metadata_2025 huggingface dataset:
Bridging the Policy Gap: Examining Physical Education in Colorado
Authors: Fan Xiaoping , McMullen Jaimie M. , Dauenhauer Brian , Krause Jennifer M.
Published: May 2024

Purpose: Using the social ecological model as a guiding framework, the purpose of this study was to examine the status of physical education in Colorado. Method: A sequential explanatory mixed-method approach was employed to acquire a snapshot of the status of physical education. Participants completed an initial survey followed by semistructured interviews. The quantitative survey data were analyzed with descriptive statistics, and the qualitative data were analyzed using open and axial coding. Results: The results of this study are presented in two parts: an overview of the status of physical education, followed by a detailed analysis of each component of physical education. Discussion/Conclusion: This study demonstrates a comprehensive approach to examining physical education, providing a holistic view of physical education, and serving as a valuable resource for policymakers and stakeholders.
Remote proton elimination: C–H activation enabled by distal acidification
Authors: Grant Phillip S. , Vavrík Miloš , Porte Vincent , Meyrelles Ricardo , Maulide Nuno
Published: May 2024

Generally, the acidity of carbon-hydrogen bonds is most sensitive to functionality just one or two bonds away. Here, we present an approach to the formation of carbon-carbon σ bonds by remote proton elimination, a distinct mode of carbon-hydrogen activation enabled by distal acidification through five carbon-carbon bonds. Application of remote proton elimination to cyclodecyl cations unveiled an appealing method for the synthesis of decalins. The transformation is regioconvergent, proceeds without the need for a directing group or precious metal, and demonstrates exquisite site selectivity. An in-depth computational study illuminated the reaction mechanism. Additionally, we describe the complete stereoisomeric enrichment of the decalin products through epimerization mediated by hydrogen atom transfer.
How power shapes behavior: Evidence from physicians
Authors: Schwab Stephen D. , Singh Manasvini
Published: May 2024

Power—the asymmetric control of valued resources—affects most human interactions. Although power is challenging to study with real-world data, a distinctive dataset allowed us to do so within the critical context of doctor-patient relationships. Using 1.5 million quasi-random assignments in US military emergency departments, we examined how power differentials between doctor and patient (measured by using differences in military ranks) affect physician behavior. Our findings indicate that power confers nontrivial advantages: “High-power” patients (who outrank their physician) receive more resources and have better outcomes than equivalently ranked “low-power” patients. Patient promotions even increase physician effort. Furthermore, low-power patients suffer if their physician concurrently cares for a high-power patient. Doctor-patient concordance on race and sex also matters. Overall, power-driven variation in behavior can harm the most vulnerable populations in health care settings.
Quantum interference in atom-exchange reactions
Authors: Liu Yi-Xiang , Zhu Lingbang , Luke Jeshurun , Houwman J. J. Arfor , Babin Mark C. , Hu Ming-Guang , Ni Kang-Kuen
Published: May 2024

Chemical reactions, in which bonds break and form, are highly dynamic quantum processes. A fundamental question is whether coherence can be preserved in chemical reactions and then harnessed to generate entangled products. Here we investigated this question by studying the 2KRb

→

K
2

+ Rb
2
reaction at 500 nanokelvins, focusing on the nuclear spin degrees of freedom. We prepared the initial nuclear spins in KRb (potassium-rubidium) in an entangled state by lowering the magnetic field to where the spin-spin interaction dominates and characterized the preserved coherence in nuclear spin wave function after the reaction. We observed an interference pattern that is consistent with full coherence at the end of the reaction, suggesting that entanglement prepared within the reactants could be redistributed through the atom-exchange process.
AI-driven robots discover record-setting laser compound
Authors: Service Robert F.
Published: May 2024

Automated labs spread across the globe create, test, and assemble materials—no humans required
Heterologous prime-boost vaccination drives early maturation of HIV broadly neutralizing antibody precursors in humanized mice
Authors: Cottrell Christopher A. , Hu Xiaozhen , Lee Jeong Hyun , Skog Patrick , Luo Sai , Flynn Claudia T. , McKenney Katherine R. , Hurtado Jonathan , Kalyuzhniy Oleksandr , Liguori Alessia , Willis Jordan R. , Landais Elise , Raemisch Sebastian , Chen Xuejun , Baboo Sabyasachi , Himansu Sunny , Diedrich Jolene K. , Duan Hongying , Cheng Cheng , Schiffner Torben , Bader Daniel L. V. , Kulp Daniel W. , Tingle Ryan , Georgeson Erik , Eskandarzadeh Saman , Alavi Nushin , Lu Danny , Sincomb Troy , Kubitz Michael , Mullen Tina-Marie , Yates John R. , Paulson James C. , Mascola John R. , Alt Frederick W. , Briney Bryan , Sok Devin , Schief William R.
Published: May 2024

A protective HIV vaccine will likely need to induce broadly neutralizing antibodies (bnAbs). Vaccination with the germline-targeting immunogen eOD-GT8 60mer adjuvanted with AS01
B
was found to induce VRC01-class bnAb precursors in 97% of vaccine recipients in the IAVI G001 phase 1 clinical trial; however, heterologous boost immunizations with antigens more similar to the native glycoprotein will be required to induce bnAbs. Therefore, we designed core-g28v2 60mer, a nanoparticle immunogen to be used as a first boost after eOD-GT8 60mer priming. We found, using a humanized mouse model approximating human conditions of VRC01-class precursor B cell diversity, affinity, and frequency, that both protein- and mRNA-based heterologous prime-boost regimens induced VRC01-class antibodies that gained key mutations and bound to near-native HIV envelope trimers lacking the N276 glycan. We further showed that VRC01-class antibodies induced by mRNA-based regimens could neutralize pseudoviruses lacking the N276 glycan. These results demonstrated that heterologous boosting can drive maturation toward VRC01-class bnAb development and supported the initiation of the IAVI G002 phase 1 trial testing mRNA-encoded nanoparticle prime-boost regimens.
1: A CONTENT ANALYSIS OF PEDIATRIC INFORMATION IN IRANIAN NEWSPAPERS
Authors: Farashbandi Firoozeh Zare , Amini Faezeh , Kelishadi Roya , Rahimi Alireza
Published: May 2024

Background and aims:

Newspapers along with other mass media have a significant role in increasing health literacy of the general public. Pediatrics related information is one of the most important issues of newspapers. The goal of this study is to perform a content analysis of the newspaper in Iran for pediatrics information in year 2014.

Methods:

This is an applied survey performed by using content analysis method. The data gathering tool is a checklist designed by the researchers. The statistical population consisted of all of the messages printed in 694 volumes in five most widely circulated Iranian newspapers, published during a six-month span. The sample size calculated using non-probability– purposive sampling was 3019 messages from 426 newspaper articles.

Results:

Findings showed that “Mental disorders” (19.6%) and “Nutrition” (19.27%) had the highest and “Pathophysiology of body fluids and fluid therapy” and “Gynecological problems in childhood” had the lowest (0%) frequency in the messages. there is little attention to “Human Genetics”, “metabolic disorders” and “children with special needs.” The author of 52.58% of articles was identified and among these 157 (36.85%) articles had authors with unknown Specialty. It is discovered that 295 (60.79%) articles had citations and among them 59.62% had in-text citations.

Conclusion:

The findings of this study show that pediatric is well covered in examined newspapers. But authorities should pay more attention to subjects like Pathophysiology of body fluids and fluid therapy, Gynecological problems in childhood, Human Genetics, metabolic disorders and children with special needs. Finally, since the audience of newspapers consists of public people the scientific credibility of the claims made in these messages should be regarded.
111: SET UP A REFERRAL SYSTEM WITH EVIDENCE-BASED APPROACH IN TABRIZ ASADABADI HOSPITAL
Authors: Bakhshian Fariba , Beirami Hossein Jabbari , Beirami Saba Jabbari , Fatollahi Seiied Yaaghoob
Published: May 2024

Background and Aims:

Evidence-based management and evidence-based medicine plays an important role in providing health care services. This study describes the referral system has been set up in Tabriz's northwest.

Methods:

Following the appointment of the new director of the center Asadabadi, the data was analyzed, Interviews were conducted with physicians and employees and upstream managers, referral Committee was formed at the center. By the committee set up referral system was a priority. By reviewing the scientific literature and experiences from the different solutions proposed in the discussion group. Finally, communicate with health centers, staff training, to encourage doctors, as well as strategies and action items were chosen priority. Now, we passed the next few months and will evaluate its progress.

Results:

After reviewing the evidence and formulate action plan, we have attempted to identify peripheral units Then, six health centers with a population of about 500,000 people and a few regional and multi- city contract was signed. Hotline to prioritize queue and at reception to referral patients was assigned. By encouraging physicians to write feedback, We managed, the number of referral patients will increase from less than one percent (40 cases in month) to about 7 percent (1900 cases in month). Also, we were able to improve patient satisfaction from 50 percent to 80 percent.

Conclusion:

Set up a referral system with evidence-based approach in small area, to identify bottlenecks and interventions to expand it at a national level will be great help. The results of this study, firstly confirmed the feasibility of setting up a referral system. Secondly, the need to expand the vision and systemic action than ever before that was appeared. The center, with the launch of electronic queue system and other measures tries to increase the quantity and quality of the referral system but changing attitudes and structures at high levels in the control lever is vital to the success of the referral system.
115: STRATEGIES OF INTEGRATION OF EVIDENCE-BASED PRACTICE IN THE CLINICAL SETTINGS
Authors: Farokhzadian Jamileh , Poorchangizi Batool
Published: May 2024

Background and aims:

The pace of change in the delivery of health care along with professional responsibilities of clinical staff to provide high quality services, wants to the necessity of incorporating of research evidence in decision-making. Implementation of EBP has positive implications for clinical staff, patients, and organizations. Implementation of EBP in clinical settings is a long-term process and requires multiple strategies such as individual and organizational factors as well as factors related to the patients. This study was conducted to evaluate strategies of integration of EBP in clinical practice.

Methods:

This review study was performed on the articles related to facilitators and barriers of implementation of EBP.

Results:

The literature review indicated that multiple strategies can be used to integrate EBP in clinical settings, including:

– Creation of a learning environment and designing and delivering training programs such as EBP journal clubs.

– Enjoying from EBP experts and faculty members for advice on implementation of EBP.

– Research consulting and creation of further interaction between clinicians and research centers.

–  The discussion meetings of inter-professional and inter-wards.

–  Promotion of the culture of evidence-based decision making in the clinical arena.

– The increasing use of clinical guidelines, development of health care standards.

– Providing conditions and accessing resources to research results (time, resources of human, financial and equipment).

– Providing resources and free access to EBP database and centers and knowledge management units.

– Encourage and support employees interested in EBP.

– Identify barriers of EBP implementation and strategies to overcome these barriers.

– Monitoring and evaluation of EBP in the organization and providing appropriate solutions.

Conclusion:

Transformational managers and policy makers can determine a strategic planning according to the barriers and facilitators of EBP, and then can provide the culture and the necessary infrastructure to help clinical staff to develop EBP competencies and a professional environment which resulted in personal and professional growth of staff and improvement of quality of care.
125: THE EFFECT OF EDUCATIONAL PACKAGE ON MATERNAL SELF-CONFIDENCE OF PRIMIPAROUS WOMEN IN POSTPARTUM PERIOD: A RANDOMIZED CONTROLLED CLINICAL TRIAL
Authors: Shafaie Fahimeh Sehati , Mirghafourvand Mojgan , Bagherinia Marzieh
Published: May 2024

Background and aims:

Transition to motherhood is a stressful and challenging process in the postpartum period, so that mothers not only face with new maternal tasks but also with significant changes in their bodies. The aim of this study was to determine the effect of training packages on maternal self-confidence in the postpartum period.

Methods:

This randomized controlled clinical trial was conducted on 136 primiparous women who were referred to health centers in Tabriz, Iran, for their second postpartum care (10–15 days after delivery). Primiparous women aged 18–35 with singleton pregnancy and term birth (37–42 weeks) were randomly assigned to training (n=68) and control (n=68) groups. The education group was provided with a face to face training session, three phone sessions, and a booklet. The control group received the routine postpartum care in days 1–3, 10–15, and 42–60. Participants completed the Lips maternal self-confidence questionnaire before the intervention and eight weeks postpartum. ANCOVA with adjustments for baseline score was used for analysis.

Results:

No statistically significant difference was found between the two groups in terms of socio-demographic characteristics except for infant's gender (p>0.05). At 6 weeks after the intervention and by adjusting for baseline scores, mean scores of maternal self-confidence (Adjusted mean difference: 16.6; CI 95%:13.8 to 19.3, p<0.001) in educational group were significantly higher than the control.

Conclusion:

Results showed that training women have a positive effect in increasing their self-confidence.
127: THE EFFECT OF EVIDENCE BASED CARE TO TYPE-2 DIABETIC PATIENTS ON CONTROLLING BLOOD GLUCOSE IN PATIENTS ADMITTED TO THE DIABETES RESEARCH CENTER OF HAMADAN
Authors: Omidi Afsar , Khodaveisi Masoud , Karami Manuchehr
Published: May 2024

Background and aims:

One of the most challenges in diabetic patients is learning how to glycemic control. Evidence based care is proper, correct and intellectual use of the best evidence in clinical decision making for every single patient care. This study aimed to determine the effect of evidence based care on glycemic control in type 2 diabetes patients.

Methods:

This study was a clinical randomized controlled trial which conducted on sixty diabetic type 2 patients. Patients were divided in two groups of intervention and control. Nursing interventions based (exercise & nutrition) on a review of the literature. Data were collected using questionnaire and checklist before and three months after the intervention. Data were analyzed using SPSS/20.

Results:

The results showed that after evidence based care, fasting plasma glucose test in the intervention group than in control group, the difference was statistically significant (P<0.05)

Conclusion:

With designing evidence-based nursing care instructions for type-2 diabetic patients, the need of clinical nurses in confronting these patients was removed. It also leads to improve the quality of care and reduce complications in duration of the hospital stay.
134: THE EFFECTIVENESS OF CXL IN THE TREATMENT OF KERATOCONUS
Authors: Esmaeilnezhad Mahdieh , Seyyedrasooli Alehe
Published: May 2024

Background and aims:

Keratoconus is characterized by corneal ectasia and irregular astigmatism, which can lead to diminished vision and corneal scarring. Keratoconus is a condition that causes corneal ectasia and reduced vision in young adults. A proportion of these patients have progressive disease requiring corneal transplantation.

Methods:

The databases searched included OVID MEDLINE, MEDLINE IN-Process and other Non-Indexed Citations such as EMBASE with keyword Keratoconus and Corneal cross-linking.

Results:

Rocha KM andet al.(2014) funded that Epithelial thickness standard deviations were significantly lower 3 months after CXL, compared to ranges before CXL in both the vertical and horizontal meridians for keratoconus and ectasia (P=0.048). No significant differences were found between epithelial remodeling in keratoconus and corneal ectasia (P=0.98). No significant or consistent stromal changes were found for either group. Cınar andet al.(2013) funded that Flat keratometry, steep keratometry, mean keratometry and maximum keratometry were significantly reduced at the 6th month after CXL (p=0.025, p<0.001, p=0.004 and p=0.03, respectively). Thinnest corneal thickness (TCT) and endothelial cell density (ECD) were not changed significantly the 6th month after CXL (p=0.135 and p=0.082, respectively).Brooks NO andet al.(2012) funded that After CXL, patients noted subjective improvement in visual symptoms, specifically night driving, difficulty reading, diplopia, glare, halo, starbursts, and foreign-body sensation.

Conclusion:

Significantly fewer corneal transplants were performed for treating keratoconus following the nationwide introduction of CXL. This reduction suggests that corneal cross-linking can significantly reduce the need for corneal transplantation. CXL represents a new treatment that uniquely allows the halt of progression of keratoconus, thus preventing visual loss and the need for surgical intervention.
139: THE EVALUATION OF NEWLY-ARRIVED RESIDENTS' SATISFACTION OF PATIENT-PHYSICIAN COMMUNICATION WORKSHOPS IN TABRIZ UNIVERSITY OF MEDICAL SCIENCES IN 1394
Authors: Begi Hamid Reza Morteza , Abdollahi Fariba , Khoshmaram Nahid , Noriasl Fatemeh
Published: May 2024

Background and aims:

The ability to communicate is a basic skill for human beings and some people in this area are more capable than the others. That's why communication skills training is one of the medical education issues that have been emphasized in recent years. These skills are taught, measured and evaluated with different methods. This study aimed to investigate the Tabriz University of Medical Sciences newly-arrived residents' satisfaction of patient-physician communication workshops conducted in 1394.

Methods:

A cross-sectional study was conducted on 150 newly-arrived residents in all clinical training subjects. Data was collected using researcher-made questionnaire for satisfaction of environment and training facilities, teachers teaching and presentations and course content. The validity and reliability of questionnaires were assessed in good level, through conducting a pilot study. The data was analyzed using SPSS.

Results:

The results showed that all newly-arrived residents' satisfaction of patient-physician communication workshops is above the cutoff point (m=4.26±.49). Of the variables studied the greatest satisfaction were teaching methods (4.52±0.26), presentations (m=4.32±.36) and environment and training facilities (m=4.22±0.23). The survey of satisfaction showed no significant statistical difference between the assistants by different fields (p=0.1).

Conclusion:

The residents' satisfaction of patient-physician communication workshops is highly desirable which is the reason for this workshop to be hold annually.
146: THE PREVALENCE OF HUMAN PAPILLOMA VIRUS AND ITS HIGH RISK GENOTYPES AMONG IRANIAN HEALTHY WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Malary Mina , Moosazadeh Mahmood , Hamzehgardeshi Zeinab , Afshari Mahdi , Moghaddasifar Iman , Afsharimoghadam Amin
Published: May 2024

Background and aims:

Human papilloma virus (HPV) is the most common sexual transmitted infection worldwide among women and plays a key role in the development of genital cancers. Different studies in Iran, reported various prevalences and combining their results could be important for health policy makers. The aim of this study is to estimate the prevalence of HPV and its high risk genotypes among Iranian healthy women.

Methods:

Using national and international databases and excluding duplicates and irrelevant evidences followed by applying exclusion criteria and quality assessment, eligible articles were selected. Standard error of the prevalence was calculated based on binomial distribution. Random effects model was used because of the high heterogeneity among the results.

Results:

Of 14 studies entered into the systematic review, 24 evidences reported the HPV prevalence among 7655 healthy and non-cancerous women in different provinces of Iran. Total prevalence of HPV, 9.4% (95% CI: 6.8–12.02), HPV 16, 2.03% (95% CI: 1.3–2.8), HPV 18, 1.7% (95% CI: 0.9–2.5) and other genotypes of HPV, 5.3% (95% CI: 3.6–6.9) were estimated.

Conclusion:

Our meta- analysis showed that the total prevalence of HPV and its high- risk genotypes (16 and 18) among healthy non- cancerous Iranian women was very high.
16: ARNEBIA EUCHROMA (ROYLE) JOHST ROOT EXTRACT AND ITS EFFECT ON BURN WOUND HEALING
Authors: Dehkordi Akram Karami , Tahmasbi Sara Hoseini
Published: May 2024

Background and aims:

One of the major causes of death and disability in the world is burning, that from past to present the proper treatment of burns has been considered by physicians. Properties of medicine plants in burn wound healing have been proven in various studies. Arnebia euchroma is rich sources of antioxidants. Therefore, this work was carried out to investigate the effect of Arnebia euchroma on second-degree burn wound healing in Balb c.

Methods:

In an experimental study burn wounds were made by placing a hot plate with a surface area of 1 cm2 for 10s on the back of 30 balb c mice animals. Five groups of mice Vaseline, silver, without intervention, Arnebia euchroma 1% and 10% were treated topically for 21 days. Wound size at day 0, 7, 14 and 21 was measured. Data were analyzed by using Kruskal-Wallis statistical tests and mean.

Results:

Results showed that the most recovery was observed in Silver groups, without intervention, Vaseline, Arnebia euchroma 1% and Arnebia euchroma 10%respectively.Silver group showed the best healing effects between other study groups.

Conclusion:

Evidence show that Arnebia euchroma root did not have any effect on healing of second degree burn wounds in balb c. More studies were recommended for evaluating the effects of other dose and extracts of the plant on burn healing.
162: BRISBANE EVIDENCE-BASED LANGUAGE TEST, BRISBANE EBLT: A NEW DIAGNOSTIC TEST FOR THE IDENTIFICATION OF ACUTE POST-STROKE LANGUAGE DISORDERS
Authors: Alexia Rohde , Linda Worrall , Robyn O'Halloran , Erin Godecke , Anna Farrell
Published: May 2024

Background and aims:

Stroke clinical guidelines recommend that “All patients should be screened for communication deficits using a screening tool that is valid and reliable” (p.90). Current speech pathology practice does not meet this recommendation instead relying on clinical experience or informal language screeners which have not undergone validation by clinical research. This research involves the development of the Brisbane Evidence-Based Language Test (Brisbane EBLT), a reliable, valid diagnostic test for the identification of acute post-stroke language disorders.

Methods:

Brisbane EBLT diagnostic accuracy was determined in a prospective blinded cross-sectional study (n=100 patients) comparing acute stroke patient (<2 months post-stroke) performance on the Brisbane EBLT with performance on a gold-standard language reference measure. Intra-rater and inter-rater reliability was concurrently analysed using a repeated measures study design. Acute stroke patient/family and clinician feedback was also obtained on test items.

Results:

Diagnostic accuracy analysis revealed test sensitivity of 97.62% (95%CI: 87.4%–99.9%) and specificity of 84% (95%CI: 63.9%–95.5%). Test sensitivity/specificity was determined by calculating Brisbane EBLT total score while controlling for patient age and education level. Patient/family self-report of a new-onset language deficit was also included within the diagnostic accuracy analysis. Data collection was completed at the hospital bedside demonstrating the feasibility of Brisbane EBLT for use in acute contexts. Intra-rater reliability intra-class correlation coefficients (ICC) demonstrated almost perfect agreement (0.994; 95% CI: 0.989–0.997) between two speech pathologists' scores of 35 patients when they re-assessed the same patient video after a 2 week interval. Inter-rater reliability also demonstrated almost perfect agreement (0.995; 95% CI: 0.990 – 0.998) when comparing fifteen speech pathologists' scores of fifteen patients completing the new test, as per a priori sample size requirements.

Conclusion:

The Brisbane EBLT is a new reliable, valid, acute post-stroke diagnostic language test. Test development has been guided by EBP principles to ensure it meets sound psychometric standards, meets patient and clinician needs and is suitable for use in the acute hospital environment. This research will directly contribute to the evidence-base of acute stroke care and assist in bringing practice in line with stroke clinical guideline recommendations.
163: CLINICAL STATUS INDEXES FOLLOWING THE SELF-MANAGEMENT PROGRAM BASED ON 5A MODEL IN COPD PATIENTS
Authors: Heidari Maryam , Moradbeygi Khadijeh , Nassaji Neda Akbari , Elhami Saeedeh
Published: May 2024

Background and aims:

Chronic obstructive pulmonary disease (COPD) is a progressive process that leading to major clinical problems in patients. There is no highly effective treatment for these patients and therapists only try to relieve the symptoms. But, there are interventions such as self-management program for improvement of health level in patients. 5A model, known as behavior change counseling model is an evidence-based approach for behavior change and self-management. Thus this study was performed to investigate the effects of self-management program based on 5A model on some of clinical parameters in COPD patients.

Methods:

this clinical trial was performed on 50 COPD patients that referred to Apadana sub-special clinic in Ahvaz. Patients were randomly assigned to control and intervention groups. The control group received usual care and the intervention group received usual care plus a self-management program based on the 5A model (includes: Assess Advise, Agree, Assist and Arrange stage). Patients were assessed by six-minute walking test and the Borg scale for exercise tolerance level and dyspnea severity at baseline and after 3 months. Chi-square and t-test in the SPSS software were used to data analysis.

Results:

There was no significant difference between the groups in exercise tolerance at base line; but, they were significantly different at the end of 3 months (P=0.007). In addition, a significant reduction was found in patients' dyspnea in the intervention group, compared with the control group after 3 months (P<0.0001).

Conclusion:

with attention to effectiveness of self-management program based on 5A model on increase of exercise tolerance and decrease of dyspnea in COPD patients, use of this program is recommended as benefit method for decline major difficult of disease without spend cost for frequent refer to medical center.
170: DEVELOPMENT OF PELVIC ORGAN PROLAPSE GUIDELINES
Authors: Bastani Parvin , Hajebrahimi Sakineh , Mallah Fatima , Ghaderi Fariba , Rasouli Leili
Published: May 2024

Background and aims:

Pelvic organ prolapse (POP) is a common disease which is presented as symptomatic descent of the anterior, posterior vaginal wall or apical prolapse. Since, social and cultural factors have impact on interval between symptoms incidence and seek for medical care, diagnosis method and treatment process, it was important to prepare a guideline for management of the Iranian women with POP.

Methods:

This guideline has drawn on the evidence based search strategy developed for study goals to provide a native guideline. Therefore, during a systematic search, all clinical guidelines relevant to the subject extracted. Of 85 study, 35 study with evidences grades, systematic reviews or high quality clinical trials selected and further grading performed. Current recommendations presented with attention to best data available in the literature or based on a mixture of clinical experience and experts' panels decisions.

Results:

Pelvic floor muscle training recommended as the first line treatment in patients with urinary incontinence or POP (Grade A). Physicians should recommend pessaries to all women seeking treatment for their prolapse (Grade A). Subtotal hysterectomy is not recommended to prevent further prolapse (Grade A). in term of recurrence, dyspareunia and stress urine incontinency (SUI), abdominal sacropexy is better than vaginal suspension, however, these results cannot be extended to reoperation rate and patients' satisfaction (Grade: A). Since graft using fascia increases rate of recurrence, it should not be used during abdominal sacrocolpopexy (Grade: A). in patients who underwent first time anterior colporaphy, local tissue should be repaired instead of mesh as a graft (Grade: B). In women who suffer concurrent POP and SUI, both should be repaired at the same time (Grade A).

Conclusion:

The present guideline is based on high quality evidences and can be used for management of patients suffering POP problems.
173: EFFECTIVENESS OF COMMUNITY AND SCHOOL- BASED INTERVENTIONS ON CONTROL AND PREVENTION OF TOBACCO USE IN ADOLESCENTS: A RANDOMIZED COMMUNITY INTERVENTION TRIAL
Authors: Khayyati Fariba , Rahmani Khaled
Published: May 2024

Background and aims:

Most consumers of tobacco begin to consume it before age 18. The aim of this study was to determine the effect of community and school-based interventions to reduce tobacco consumption in high school students.

Methods:

This was a randomized community intervention trial. We first selected two economically and culturally similar cities including Ajabshir and Malekan in East Azerbaijan province, Iran, then one city, Ajabshir, was randomly selected for intervention. The intervention included educational activities and community-based environmental policies. Final year high school students including 1965 and 2457 were participants of the study in the intervention and control group, respectively. The outcome was reduction in the prevalence of tobacco use. All analysis conducted in SPSS version 19 using paired t test, analysis of covariance, independent t-test and chi square.

Results:

Finally 1885 and 2302 participants in intervention and control groups (cities) were analyzed, respectively. Intervention significantly increased the awareness and prevented the adverse changes in attitude and attention to tobacco use (P<0.001). After the intervention, onset of cigarette and hookah smoking in control group was more than in intervention group (P<0.001). Cigarette and hookah smoking at 1 and 6 months in both groups increased, but consumption in the past 30 days was higher in the intervention group (P<0.001). Attempting to quit cigarette increased in the intervention group and reduced in the control group (P<0.001). Attempting to quit the hookah declined in both groups. In intervention group, there was significant increased attempt to quit cigarette smoking in families (P<0.001). Teachers were cited as the most effective educational resource by students.

Conclusion:

In control group, onset of tobacco smoking in the last six months has been impressive. It shows a new wave of consumers that need to serious and urgent attention to prevent adolescent's tobacco use. Our experience showed that teacher's existence in the program, face-to-face explanation the tobacco importance for the authorities and participation as well as inter-sectorial coordination can be effective methods to tobacco prevention and control.
190: PATIENT PERSPECTIVES ON CONSISTENCY OF MEDICAL CARE WITH RECOMMENDED CARE IN ASTHMA
Authors: Tabrizi Jafar sadegh , Farahsa Sahar , Taghizadieh Ali , Mostafanejad Madineh
Published: May 2024

Background and aims:

Technical quality (TQ) in health care refers to clinical or disease-specific aspects of care and largely reflecting issues related to health care providers. In relation to TQ Global Initiative of National Asthma (GINA) introduce guidelines for the Management of Asthma and define a minimal standard of care that can be used to assess health care quality for patients with asthma. This study aimed to assess technical quality for people with asthma from the patients' perspective.

Methods:

A cross-sectional study was conducted with 180 people with asthma who were received care from specialist clinics of Tabriz University of medical sciences in 2013. Technical Quality was measured using questionnaire. The questionnaire set based on issued guidelines internationally which considered as proxy measure of technical quality. Validity of the study questionnaire was reviewed by 11 experts and its reliability was confirmed according to Cronbach's alpha index (α=0.86), based on a pilot study by participate of 30 patients. Data analyzed using the SPSS-17 statistical package.

Results:

Technical Quality score for people with asthma from the patient perspective had the range between 0% and 77%. The lowest scores were for the items: Asthma Control Test, written asthma action plan, measuring peak expiratory flow and assessing patient's self-care program. The highest scores belonged to visit by specialist and education about quit smoking. Asthma control status had significant relationship with continuity of care (patients who receives continuous care, expressed better asthma status) (P=0.012) and patients with complications reported higher TQ score than who haven't complications (P<0.001).

Conclusion:

According to study findings, overall technical quality for people with asthma from the patient perspective was relatively low. The largest gap in medical care, related to self-care program and management standards, suggests that new systems and new ways of improving such aspects of care need to be considered. The importance of multidisciplinary care for asthma and active engagement of the patient in their asthma management have been repeatedly emphasized. Potential changes include wider measurement of asthma Control and peak expiratory flow, having specific written asthma action plan, clinician and patient incentives to increase the relevant activities and a patient reminder system.
199: THE EFFECT OF INTERACTIVE EDUCATIONAL WORKSHOPS WITH OR WITHOUT STANDARDIZED PATIENTS ON THE SELF-EFFICACY OF MIDWIFERY STUDENTS IN SEXUAL HEALTH COUNSELING
Authors: Khadivzadeh Talat , Ardaghi Mina , Mirzaii Khadijeh , Mazloum Seyed Reza
Published: May 2024

Background and aims:

Modifications in learning systems based on the concepts of self-efficacy and self-esteem are among the suggested strategies to bridge the gap between knowledge and practice. The aim of this study was to compare the effect of two interactive educational workshops with or without standardized patients (SPs) on midwifery students' self-efficacy in providing sexual health counseling at Mashhad University of Medical Sciences, Mashhad, Iran in 2014.

Methods:

In this quasi-experimental study, 92 B.Sc. and M.Sc. students of midwifery at Mashhad School of Nursing and Midwifery were randomly divided into two groups. The groups were trained, using one of two interactive educational workshops (with or without SPs) on sexual health counseling (10 hours). Data were collected, using a demographic questionnaire and a self-efficacy assessment tool. For data analysis, paired and independent t-tests were performed, using SPSS version 16.

Results:

Two weeks after the intervention, the scores were significantly higher in students who participated in SP-based workshops (76.0±10.9 vs. 66.7±5.9, P<.0001). Two weeks after the intervention, the mean scores of students' self-efficacy in providing sexual health counseling in the two groups were significantly higher compared to their scores at the beginning of the study.

Conclusion:

Although both methods could promote students' self-efficacy, the impact of workshops with SPs was more significant. Therefore, integration of this training method in midwifery educational curricula is recommended.
20: ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICAL SKILLS REQUIRED FOR MEDICAL INTERNS TO LEARN DURING THE 7-DAY RHEUMATOLOGY OUTPATIENT (CLINICS) PERIOD IN TABRIZ UNIVERSITY OF MEDICAL SCIENCES
Authors: Najafi Maryam , Kolahi Sousan , Mokhtarkhani Mohaddeseh
Published: May 2024

Background and Aims:

Medical students are responsible to learn and practice in the internal wards (including rheumatology) according to the designed evidence based standard of Tabriz University of Medical Sciences. It is Important to assess how much they have learnt. The aim of this study was to assess the interns' knowledge, attitude and the skills during their 7-day rheumatology clinics education period.

Methods:

The current study is a cross sectional one conducted since 2014 to 2016, among interns of the Imam Reza Teaching hospital of Tabriz University of Medical Sciences. The students were to answer to the questions “What Did You Learn during Your rheumatology Period?” and “What Issue Was More Interesting and Useful?” Their writings were classified according to the national standard guideline of educational program, which contained 24 items; 9 for knowledge, 7 for skills, 4 for attitude and 4 major issues of rheumatology. The data were transferred to the analysis software of SPSS.

Results:

The statistics indicated that the interns' knowledge was scored forclinical findings, history, psychological effects and treatment of patientsas 70.58%, 0%, 35.29% and 52.94%, respectively. Also their skills inphysical examination, diagnosis and diagnostic arrangementswere scored as 88.23%, 82.35%, and 58.82% respectively. For the attitude assessments, 47.05% and 58.82% of the interns had learntactive listening (patient value) and ethical behavingduring their 7-day ward period. According to the assumed program for the major issues of rheumatology,arthritis and back painwas learned as well in 21.44% and 41.17% of interns.

Conclusion:

The findings indicated that this strategy can be an effective way for medical students' assessment. They assess themselves while reviewing their learning and writing them down. It can also be useful for the professors. Assessments should be according to the evidence based logbook; to consider how it is being taught. Through the current strategy, the common cases of the rheumatology ward and clinic get distinguished. Thus, if any change is needed to be conducted on the content of the evidence based logbook, it can be done.
208: TRANSLATION AND VALIDATION OF THE PELVIC FLOOR DISTRESS INVENTORY SHORT FORM (PFDI-20), IRANIAN VERSION
Authors: Hakimi Sevil , Hajebrahimi Sakineh , Bastani Parvin , Aminian Elham , Ghana Samieh , Mohammadi Marzieh
Published: May 2024

Background and aims:

The Pelvic Floor Distress Inventory (PFDI) was developed and validated to measure symptom distress and impact on Health related quality of life (RQOL), focusing on pelvic organ pelvic organ prolapse (POP), urinary incontinence (UI) and fecal incontinence (FI). The purpose of this study was assessment of translation, cultural adaptation and psychometric validation of PFDI-20 and PFIQ-7.

Methods:

The study was a cross sectional research. The sampling method was multi stage sampling. Out of 33 urban health centers in Tabriz, half of them were selected randomly. In the second phase using quota sampling method from each center, middle age women who attended the health centers for giving medical care and diagnosed with PDF were included in the study.

Signs of genital prolapse were recorded during the pelvic examination in dorsal lithotomy position. Diagnosis of POP was performed according to the modified pelvic organ prolapse (POP-Q).

Inclusion criteria were menopausal women aged 45 years and older with at least one symptom of PFD including UI, FI or POP existing for at the minimum 3 last months. Exclusion criteria were previous pelvic surgery, any malignant tumor, mental retardation and dementia. UI, FI and POP were defined with using of International Continence Society criteria.

Construct validity of questionnaire was assessed by ceiling and floor effect. Ceiling or ﬂoor effects were given when more than 15% of the responses get the best or worst possible score respectively.

The questionnaires internal consistency were assessed by calculation of Cronbach's alpha. Reliability of the questionnaires was estimated by test retest reliability. The questionnaires were re-administered to 30 individuals 2 weeks after the first administration.

Results:

A total of 150 women with PFD were recruited in this study. The mean age (SD) was 52.3 (4.0). Translation and cultural adaptation of PFDI-20 to Persian language had a good value with regards of meaning, idiomatic and content. The results of test- retest reliability and internal consistency were shown in Table 1.

Conclusion:

The results of this study were demonstrated that Iranian version of PFDI-20 has acceptable validity and reliability.Table 1

Results of analysis for internal consistency and test- re test reliability for the PFDI-20

PFDI-20Test retest reliability
N=30Internal consistency
N=150POPDI0.680.67CRADI0.710.69UDI0.690.70

The PFIQ-7 Iranian version showed a ﬂoor effect (29.6%).
21: ASSESSMENT OF SERUM LEVEL OF ANTI-PSEUDOMONAS AERUGINOSA IMMUNOGLOBULIN IGG IN CHILDREN WITH CYSTIC FIBROSIS ADMITTED TO MOFID CHILDREN'S HOSPITAL IN 2013–2014
Authors: Mostafavi Sina , Asgharzade Ali Zhiani , Zare M , Abbasi F , Karimi M , Shahkar L
Published: May 2024

Background and aims:

One of the most common reasons of mortality in patients with cystic fibrosis (CF) is lung infection; and Pseudomonas aeruginosa (PA) has the highest share. In children above 6 and adults with CF, cultures can be well-recognized due to the presence of expectorated sputum; but children under 6 years have not reliable sputum, so serological tests for PA sensitive antigens can be helpful. The aim of this study was to evaluate serum levels of IgG through PA infection in children and adolescent with CF; and to replace the sputum culture tests with this method.

Methods:

In this cross-sectional study, Blood and sputum or throat samples were taken from 68 patients with CF. PA existence was studied in the samples. The variables including age, sex, and lung function tests were obtained. Then 3 serum antigens levels were determined by enzyme-linked immune sorbent assay (ELISA).

Results:

The mean age of children was 7.4±5.6 (ranging 23 to 0.5) years. Generally in CF patients, the percentage of PA infection increased in higher ages. Meaningful relationship was observed between the level of serum IgG in children with CF and positive sputum culture for PA.

Conclusion:

Anti-PA antibodies can be early markers for diagnosis of PA infection, especially in young children who cannot expectorate. Due to the impact of age on CF patients with PA infection, PA early diagnosis can prevent lung damage and increases longevity and quality of life in this group of patients.
23: ASSOCIATION OF HEALTH-RELATED QUALITY OF LIFE WITH RESILIENCE AMONG MOTHERS OF CHILDREN WITH CANCER: A CROSS-SECTIONAL STUDY
Authors: Salimi Sedigeh , Pakpour Vahid , Ghafourifard Mansour
Published: May 2024

Background and aims:

Childhood cancer as a life-threatening illness has negative consequences for both the patients and their family. The aim of this study was to examine the impact of child cancer on their mother's quality of life and to assess the association of quality of life with resilience among mothers of children with cancer.

Methods:

In this cross-sectional study, a total of 145 mothers of children with cancer participated. Data were collected by two questionnaires: (a) PedsQL™ Family Impact Module, (b) Connor- Davidson Resilience Scale. Data were analyzed using SPSS version 13. Pearson correlation test was run for the analysis.

Results:

The result showed that total scale score, HRQOL Summary score, and the Family Functioning Summary Score were 41.68±20.62, 43.10±22.40, and 45.06±24.30, respectively. The mean score of resilience among mothers of children with cancer was 86.80±19.08. There was a positive association between resilience and all dimensions of life quality (p<0.05).

Conclusion:

Measuring HRQOL and resilience in a preventive strategy would help to address vulnerable mothers and to present psychosocial support for them. Designing and implementing family-oriented and parent focused intervention strategies in health care systems are recommended for improving the quality of life of families with cancer children.
29: CEILIAC DISEASE AND BONE MASS DENSITY
Authors: Parast Vida Mohammd , Paknahad Zamzam
Published: May 2024

Background and aims:

Celiac disease (CD), an autoimmune disease initiated by the ingestion of food containing gluten. Constant intolerance to gluten cause damages of the small intestinal mucosa. One of reasons malabsorption in children and infants is Celiac disease. About 75% of newly identified patients with celiac disease have low bone mineral density (BMD). Many factors have role in metabolic bone disease such as disturbance in calcium absorption, consume of endogenous calcium, fecal loss, damaged to vitamin D absorption and inflammatory mediators. The gluten free diet (GFD) is only efficacious treatment for celiac disease. Low bone mineral density (BMD) which is a prevalent problem of untreated CD may be restored by gluten free diet.

Methods:

We searched the following databases: PubMed, ISI web of science, Google scholar and EMBASE databases by using celiac disease & gluten free diet, celiac disease & bone mineral density & gluten free diet& children to July 2016.

Results:

Most of children with CD before treatment with gluten-free diet have reduced low bone mass density. Gluten-free diet caused normal bone mineral density in most of celiac children and adolescent. The duration treatment for restore bone mass has not been obviously. There are not similar time points for all patients; therefore duration of treatment is different. There is relation between age of intervention and recovery bone mineral density. In older children may have slower grades of improvement.

Conclusion:

Gluten free diet have important role on bone health. If the diagnosis and management done before adolescence may children with celiac disease achieve normal bone mass.