Evaluation of the nursing students' skills by DOPS

Background and purpose: Student assessment is an important issue in medical education. It is necessary to use objective, valid and reliable assessment methods that are appropriate to the learning objectives and domain.The objectives of this study were 1- Development of the DOPS test [Direct Observation Procedural Skills] and identification of its validity, reliability and acceptability. 2- Evaluation of the nursing students' skills by the DOPS test

Methods: First, the DOPS test was developed by reviewing the literatures and other related tools. Its validity was determined by computing the Content Validity Ratio [CVR] and Content Validity Index [CVI], based on the experts' panel opinions. Then, the clinical skills of the students in doing special procedures were evaluated by the DOPS test. The Cronbach Alpha coefficient was used to determine the DOPS reliability. To explore the satisfaction with the DOPS test, a questionnaire and VAS were used

Results: Based on the results, the DOPS test showed high content validity with CVR=1 and CVI=0.94. The reliability of the DOPS test confirmed alpha>0.7. The respondents held a positive attitude toward the DOPS test with mean satisfaction greater than 8. The performance of the majority of students in doing special procedures was good based on the DOPS scores

Conclusions: The DOPS test is a suitable evaluation method to assess the students' procedural skills objectively because of its high validity, reliability and acceptability. To evaluate all aspects of the students' performance the DOPS test should be combined with other clinical performance tests

[ effect of L-Carnitine and 10 weeks of aerobic exercise on serum levels of CRP in streptozotocin-induced diabetic rats]

Introduction: Cardiovascular complications are considered as the main cause of morbidity and mortality in patients with diabetes mellitus. The role of increased serum concentrations of inflammatory markers, particularly C Reactive Protein [CRP], in the prediction and the pathogenesis of cardiovascular complications of type 1 diabetes has been established. The aim of the present study was to evaluate the effect of 10 weeks of L-carnitine supplementation and aerobic exercise training on serum levels of CRP in streptozotocin-induced diabetic rats

Materials and Methods: Male wistar rats [n=36], weighing 230 +/- 10 [grams] were randomly divided into 6 groups [n=6 each], including the healthy group, and the remaining [after the induction of diabetes mellitus by injection of streptozotocin], into the diabetic pre-test, diabetic control, diabetic aerobic training, diabetic oral L-carnitine treatment, and the diabetic aerobic training plus oral L-carnitine treatment groups. At the end of the interventions, blood samples were collected to determine serum levels of CRP. Data were analyzed with one-way ANOVA and Tukey's post hoc test using SPSS version 20; P values<0.05 were considered significant

Results: Althought L-carnitine supplementation in diabetic oral L-carnitine treatment group did not significantly reduce serum levels of CRP, compared with the diabetic control group [p=0.078], it however reduced the rate of its progressive increase. Also significant reductions in CRP levels in both the aerobic training [p=0.00021] and the aerobic training plus L-carnitine supplementation groups [p<0.0001] were observed. However, the percentage changes of CRP level in the latter group was higher

Conclusion: Results of the current study show that, aerobic training can reduce serum CRP levels in streptozotocin-induced diabetic rats, and the simultaneous use of L-carnitine supplementation, can lead to more beneficial effects

[ effects of static cock up c-bar splint on strength, spasticity, ROM, and dominant hand function in spastic diplegic children]

Cerebral Palsy [CP] children are the most clients referred to occupational therapy settings. Hand function is important in Activities of Daily living. There is a hand dysfunction in most cerebral palsy children. Orthosis and splints are commonly used to improve the position, range of motion, quality of movement and function of a personrm or hand. The aim of this study was to investigate the effects of static cock up c-bar splint on strength, spasticity, range of motion, and dominant hand function in spastic diplegic children with 8 to 12 years old. This interventional study is in a before-after design. Thirteen spastic diplegic cerebral palsy children with 8 to 12 years old were selected through students who studied in physical disabled schools in Tehran city and had the inclusion criteria. Patients used a static cock up c-bar splint [wrist in 10 degrees of extension and thumb in palmar abduction and opposition] for two months, 2 hours daily and 4-6 hours at night. In this study the Jebsen Taylor test was used to evaluate hand function, the Modified Ashworth Scale was used to assess spasticity of thumb, wrist and elbow, ROM of thumb, wrist and elbow were tested with goniometer and power grip was evaluated with dynamometer. Results showed a significant improvement in hand function [p<0.001], in wrist's spasticity [p<0.001], elbow's spasticity [p<0.008], palmar abduction of thumb spasticity [p<0.002], wrist's ROM [p<0.001], Palmar abduction of thumb ROM [p<0.001] and power grip [p<0.001]. The data did not show significant improvement on elbow's joint ROM. Information from present research shows that using static cock up c-bar splint for 2 months, 2 hours a day and 4 to 6 hours nightly, can be an effective method to improve power grip, hand function, thumb, wrist and elbow spasticity and range of motion of thumb and wrist of spastic diplegic CP children

[ effect of C-bar Splint on hand function in 8-12 years old spastic diplegic children]

Cerebral palsy [CP] is a neurodevelopmental disorder caused by nonprogressive lesions. This disorder produces motor impairment deficits in early infancy. Hand function is essential in performing activities of daily living for everyone, including individuals with cerebral palsy. Adequate first web space is essential for web space expansion, thumb abduction, and a wide range of thumb mobility and hand function. The purpose of this study was to determine the effects of C-bar splint on hand function and strength and also wrist and thumb range of motion [ROM] of dominant hand of 8-12 years old children with spastic diplegic cerebral palsy. The design of this study was before- after and quasi-experimental. According with inclusion criteria, 8 to 12 years old children with spastic diplegia from physical - motor special school at Tehran [8 boys and 5 girls], were studied. They used a C-bar splint [40 degree of palmer abduction of thumb] for 8 weeks [6-8 hours during day and 4-6 hours at night]. In this study, hand function was evaluated by Jebsen Taylor Hand Function Test, hand strength by MIE dynamometer and thumb and wrist ROM by Goniometer. During intervention, they received routine occupational therapy program. The results of this study showed significant improvement in hand function [P=0.001], and thumb range of motion [P=0.02]. The data did not show any significant improvement in wrist ROM and hand strength. According to the result of this study, it seems that using C-bar splint can be an effective method in improvement of hand function and thumb ROM in 8-12 years old children with spastic diplegia

[ study of the effect of progressive resistance training on functional balance of 8-12 years old children with Down syndrome]

Rehabilitation interventions have significant role in reducing the disabilities of Down syndrome. Due to great role of balance in the function of individuals particularly in Activity of Daily Living and the effect of strength on balance, the aim of this study was to investigate the effects of Progressive Resistive Exercise on functional balance in children with Down syndrome. Fifteen girls children aged between 8 and 12 years, with Down syndrome participated in this study by available sampling method. The subjects participated three times per week in a six-week progressive strengthening program. During intervention, 3 of them excluded. Balance were measured by Berg Balance Scale and right/left hip abductor and flexor, knee extensor and flexor muscles isometric strengths were measured by Nickolas hand-held dynamometer. Paired-sampled T-Test was used for data analysis. The results of this study showed that the mean of functional balance and muscles isometric strengths were significantly increased after intervention [P<0.001]. It seems that the results of this study confirm the effect of progressive resistance training on progressing functional balance, and 8-12 years old children with Down syndrome can benefit from these exercises

[Nursing students' clinical evaluation in students and teachers views]

Evaluation is an important part of educational process. To reach evaluation's objectives, we need an accurate and effective evaluation method. The aim of this study was review of nursing students' and their teachers' view about clinical evaluation method. This descriptive study was done in one of universities in Tehran at 2010-2011. All nursing students in bachelor course which studying in 8-2 semester [217] and, their clinical instructors [41] were population of the study. Sample size in students' and instructors' group was 197 and 29 participants, respectively. Data collection tool was a questionnaire and satisfaction form which their content validity was confirmed by experts. Data were analyzed by SPSS version 16. The results showed the majority of students [73.6%] and teachers [75.9%] are object with current clinical evaluation method and think this is inappropriate. Also, according to the results 59.9% of students and 37.9% were unsatisfied with the current evaluation method. Most of the students [96.4%] told in this method of evaluation they do not receive any feedback. 79.6% of them believed current evaluation is based on teachers' idea about students, not student performance. According to the results, both students and teacher believed an evaluation method is insufficient when it is just one global form that is completed based on teacher idea without any rules. So, it is necessary to change the current evaluation method and apply other clinical evaluation methods to have more accurate and precise judgment about clinical performance of students

[ effect of constraint -induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke]

Constraint-induce movement therapy is one of the treatment methods to treat those who have stroke disorders. The aim of this study was to determine the effect of constraint-induced movement therapy [CIMT] on quality of life, function and range of motion of upper extremity of patients with stroke. This study was conducted in 15 patients in accordance to random clinical trial during the treatment operation, the patients were asked to restrict their upper extremity movement with orthopedics sling for 3 days per week and each day for 8 hours. They were asked to practice on affected upper extremity for 2 hours while their hands were restricted. Additionally, the present study was conducted for 6 weeks. The statistical analysis illustrated that quality of life was significantly changed which measured by SF36 test [p=0.008]. Furthermore, the upper extremity function which was assessed by Box and Black test was statistically analyzed by t-coupled; in this regard, it showed a significant change when the treatment ended up [p=0.009]. However, active range of motions in wrist extension and elbow extension did not significantly changed [p=0.227]. Based on the results, it can be implied that constraint-induce movement therapy is an effective method for improvement of life quality and the upper extremity function .Three mechanisms are discussed: involvement of non used affected limbs, neural plasticity in CNS, and amelioration of mental and physical health of patients can be resulted in life quality and patients' hand improvement

effects of palmar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic cerebral palsy children

Upper limb dysfunction is a common and disabling consequence of cerebral palsy. Any functional disorder in the hand can cause a person's independence to be disrupted and therefore his or her social independence is threatened. The purpose of this study was to determine the effects of volar static splint on hand function, spasticity and wrist and elbow range of motion of 8 to 12 years old spastic children. The design of this study was clinical trial and before after. Fourteen 8 to 12 spastic cerebral palsy children that have the inclusion criteria of study were selected from rehabilitation clinics of Tehran. The patient used a volar static splint [10 degree of wrist extension, full extension of fingers and abduction and opposition of thumb] for 2 mounts [2 hours during day and 4 to 6 hours at night]. In this study Jebsen Taylor Hand Function Test was used to evaluate hand function. Modified Ashworth Scale was used to evaluate spasticity. A Goniometer was used to measure range of motion. The results of this study showed significant improvement in hand function [P<0/001] Significant reduction in wrist spasticity [P<0/001] and elbow spasticity [P<0/009] and significant increase in wrist range of motion [P<0/001] The data did not show any significance in elbow range of motion [P<0/336]. Our findings suggested that 2 months using of volar static splint in children with spastic cerebral palsy can improve hand function, wrist and elbow spasticity and wrist range of motion

Immediate effect of lateral-wedged insole on postural control in children with hemiplegic cerebral palsy

Cerebral palsy [CP] is the most common motor impairment in childhood and affects 2 in 1000 live births, in which postural and motor control involved. In hemiplegic type, two sides of the body have differences in postural tone that cause weight shift to the intact side. In these children postural disorders appear as postural stability disorder. The aim of this study is to assess the effect of lateral wedge insole on postural control in cerebral palsy children. Sixteen hemiplegic children attended in this program and stood in two conditions on the force plate with and without lateral wedge on the hard plate. Center of pressure displacement measured for medio-lateral and antro-posterio directions. Every test took 20 seconds. It was repeated 3 times. Range of sideways decreased significantly with use of 5° wedge. Also a shoe wedge of 5° provided symmetrical weight distribution. The results represent that a 5° lateral wedge applied to the unaffected limb, can improve factors of postural control and gain the symmetry in hemiplegic children

Anaerobic removal of COD from high strength fresh and partially stabilized leachates and applications of multi stage Kinetic model

High strength fresh leachates generated at a new disposal trench, compost plant and partially stabilized leachate of an older trench were characterized in terms of anaerobic degradation at laboratory batch scale at 35 [degree sign] C. Fresh leachate had extremely high COD of 66,710 - 89,501 mg/L along with low pH of 4.1-5.9 in contrast to older and therefore partially stabilized leachate with a COD of about 19,000 mg/L and higher pH of 8.4. Filtration of fresh leachate samples showed to have considerable effect on continuation of degradation as for the unfiltered samples, degradation nearly stopped after a slight reduction in COD. As a first attempt, it was shown that a considerably better fit was achieved for COD variations of filtered fresh leachate samples using first order multistage kinetic model based on which hydrolysis was found to have the smallest rate, therefore being the rate limiting stage in anaerobic degradation process

effects and maintenance of constraint-induced therapy on spasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old

Cerebral palsy is a non progressive disorder and the most common movement problem in children. Many children with cerebral palsy are of hemiplegic type. One of the important problems of this children is unilateral upper limb dysfunction, that not using the affected side causes forgetfulness and more problems on this side. In this study, effectiveness of Constraint-Induced Therapy [CIT] and the maintainance of this technique on spasticity and performance of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old have been investigated. In this pretest - posttest quasi experimental study, 20 cerebral palsy hemiplegic children 6 to 12 years old [15 boys and 5 girls] with 8.7 years mean age were selected. Interventions were performed about 8 weeks and patients were followed for 4 weeks. Spasticity on the affected side in wrist and elbow were tested by Modified Ashworth Scale and upper extremity function by the Box and Block test. The data were analyzed with the Wilcoxon and paired t- tests. Constraint-Induced Therapy in the affected limb decreases significantly the spasticity of wrist [p = 0.00] and elbow [p = 0.005] and significantly increases performance score [p = 0.00], and the recovery significantly maintained one month after the interventions. Constraint-Induced Therapy of affected upper extremity could possibly decrease limb spasticity and increase function with two mechanisms: Fierstly, The reduction of not using the plegic side and secondly, neuroplasticity in CNS. This improvement may remain viable in the affected limb

[ concept of scholarship: educational scholarship and its application in Iran]

One of the notions entered in university fields in the last two decades is the concept of scholarship and especially educational scholarship. Due to the inclusion of this concept in the first article of faculty members' academic promotion bylaw and considering it as a mandatory component for academic promotion, great attention has been paid to this topic. Remarking the background and principles prevailing this almost new perspective, this short communication endeavors for developing a ground for familiarizing the readers with the concept of scholarship, especially educational scholarship, and its manner of evaluation. Moreover, a little note has been made about substructures needed for broadening scholarship activities in the field of education as well as the challenges before that

[Diagnostic value of power doppler sonography in acute pyelonephritis in children]

Urinary tract infection is common in pediatric age group and can result in serious complications such as chronic renal failure and hypertension if renal parenchyma is involved. Thus, definitive diagnosis of pyelonephritis in equivocal cases is of great importance. Comparing the diagnostic value of power color Doppler sonography and DMSA scan in acute pyelonephritis in children. This was a descriptive study carried out on 80 pediatric patients [160 renal units] suspected of having pyelonephritis. Two diagnostic methods [DMSA scan and power color Doppler sonography] were performed for all patients. Assuming DMSA scan as the gold standard method in diagnosis of acute pyelonephritis, the sensitivity, specificity, positive and negative predictive values and also the accuracy of power color Doppler sonography were calculated and analyzed, statistically. Power color Doppler sonography showed a sensitivity of 66.3%, specificity of 77.5%, positive predictive value of 78.7%, and negative predictive value of 64.7% with an accuracy of 71.3% in diagnosis of acute pyelonephritis in children. The agreement between the two diagnostic tests was shown to be around 43%. Based on our data, the power color Doppler sonography of kidneys has lower sensitivity and specificity compared to those obtained by DMSA scan in diagnosing acute pyelonephritis in children and is not considered as an ideal diagnostic technique for this particular clinical condition

Evaluating the recovery potential of solid wastes

The purpose of this research was to evaluate the recovery potential of solid waste in Mashhad. The solid waste generated in the regions 4, 5 and 6 has been quantified and characterized using direct weighing, physical testing and truckload sampling methods. To determine the quantity and quality of waste generated and it seasonal variations, chemical and physical analysis were carried out for one year. The current situation concerning resource recovery and disposal of solid waste in Mashhad is also described. Results show that the average solid waste generation rate is around 0.58% kg/capita per day in these regions. Statistical studies reveal that the quantity of waste generated differ significantly in various seasons. The composition [on a weight basis] of the solid wastes sampled was as follows: food wastes 46%, yard waste 8%, plastics 12%, paper and cardboard 6%, textiles 15%, metals 2%, glass 6% and rubber 4% indicating a high amount of organic matter. Vegetable and food wastes from the kitchen and yard wastes accounted for more than 50% of the waste stream. The moisture content was around 45% and the heating value of the mixed wastes around 4228 KJ/Kg [as-discarded basis]. The nature of the wastes indicate that amongst the recovery options, composting at household level would be most appropriate as it would divert more than 50% of the wastes from the traditional waste stream and provide households with compost which could be used to enrich solids in the gardens

Comparison of neural network and principal component-regression analysis to predict the solid waste generation in Tehran

Municipal solid waste [MSW] is the natural result of human activities. MSW generation modeling is of prime importance in designing and programming municipal solid waste management system. This study tests the short-term prediction of waste generation by artificial neural network [ANN] and principal component-regression analysis. Two forecasting techniques are presented in this paper for prediction of waste generation [WG]. One of them, multivariate linear regression [MLR], is based on principal component analysis [PCA]. The other technique is ANN model. For ANN, a feed-forward multi-layer perceptron was considered the best choice for this study. However, in this research after removing the problem of multicolinearity of independent variables by PCA, an appropriate model [PCA-MLR] was developed for predicting WG. Correlation coefficient [R] and average absolute relative error [AARE] in ANN model obtained as equal to 0.837 and 4.4% respectively. In comparison whit PCA-MLR model [R= 0.445, MARE= 6.6%], ANN model has a better results. However, threshold statistic error is done for the both models in the testing stage that the maximum absolute relative error [ARE] for 50% of prediction is 3.7% in ANN model but it is 6.2% for PCA-MLR model. Also we can say that the maximum ARE for 90% of prediction in testing step of ANN model is about 8.6% but it is 10.5% for PCA-MLR model. The ANN model has better results in comparison with the PCA-MLR model therefore this model is selected for prediction of WG in Tehran