Comparing the effectiveness of airway management devices in pre-hospital emergency care: a randomized clinical trial

To assess the effectiveness of laryngeal mask airway, endotracheal tube and oropharyngeal airway for airway management in prehospital emergency care. The study sample of this randomized clinical trial was 54 patients needing pre-hospital airway management. All cases of intubation [ETI] ; after two failed attempts [37 patients], were randomly assigned to the oropharyngeal airway [OPA], and the laryngeal mask airway [LMA] groups. Patients' hemodynamic, SaO2 and airway management parameters, were compared in three groups. The study data were analyzed by the Chi-square and one-way ANOVA, Bonferroni post-hoc, using SPSS, v. 18.0. The results demonstrated that before and after the study, there was no significant difference among the study groups in terms of hemodynamic variables [P > 0.05] expect SaO2 [P < 0.001]. The results also revealed that in the ETI group [n=17], the number of attempts and the time spent on inserting the airway device was significantly more than other two groups [P < 0.05]. Laryngeal mask airway is as effective as oropharyngial airway for pre-hospital airway management by paramedics

Leadership and management curriculum planning for Iranian general practitioners

Introduction: Leadership and management are two expected features and competencies for general practitioners [GPs]. The purpose of this study was leadership and management curriculum planning for GPs which was performed based on Kern's curriculum planning cycle

Methods: This study was conducted in 2011-2012 in Iran using an explanatory mixed-methods approach. It was conducted through an initial qualitative phase using two focus group discussions and 28 semi-structured interviews with key informants to capture their experiences and viewpoints about the necessity of management courses for undergraduate medical students, goals, objectives, and educational strategies according to Kern's curriculum planning cycle. The data was used to develop a questionnaire to be used in a quantitative written survey. Results of these two phases and that of the review of medical curriculum in other countries and management curriculum of other medical disciplines in Iran were used in management and leadership curriculum planning. In the qualitative phase, purposeful sampling and content analysis with constant comparison based on Strauss and Corbin's method were used; descriptive and analytic tests were used for quantitative data by SPSS version 14

Results: In the qualitatively stage of this research, 6 main categories including the necessity of management course, features and objectives of management curriculum, proper educational setting, educational methods and strategies, evolutionary method and feedback result were determined. In the quantitatively stage of the research, from the viewpoints of 51.6% of 126 units of research who filled out the questionnaire, ranked high necessary of management courses. The coordination of care and clinical leadership was determined as the most important role for GPs with a mean of 6.2 from sample viewpoint. Also, team working and group dynamics had the first priority related to the principles and basics of management with a mean of 3.59. Other results were shown in the paper

Conclusion: Results of this study indicated the need to provide educational programs for GPs; it led to a systematic curriculum theory and clinical management using Kern cycle for general practitioner's discipline. Implementation and evaluation of this program is recommended

Effects of continuous care model based non- pharmacological intervention on sleep quality in patients with type 2 diabetes mellitus: a randomized controlled clinical trial

Sleep is an important aspect of healthy lifestyle. One of the prevalent Diabetes mellitus-related non-vascular complications is sleep problems. The aim of this study was to investigate the effects of a non-pharmacological care plan designed based on the Continuous Care Model [CCM] on sleep quality in patients with type II diabetes with two month follow up. This randomized controlled clinical trial was conducted from May to November 2012 among 68 the patients with type II DM referring to the Diabetes Clinic of Gonabad University of Medical Sciences. The study instrument consisted of a self-report demographic questionnaire and the Pittsburgh Sleep Quality Index. The gathered data were analyzed via SPSS [V. 20] using t-test and Chi-square statistics. After the intervention, the study groups did not differ significantly in terms of sleep quality [0.628]. However, the study findings revealed that the interventional group's sleep quality improved significantly after the intervention [P<0.001]. Non-pharmacologic intervention according to CCM improved the sleep quality in the experimental group. Sleep care is a matter of great importance in diabetes mellitus, which deserves particular attention. The present study adds to the growing literature of the use of non-pharmaceutics intervention to improve sleep disorders of diabetic patients

effect of a multi-strategy program on developing social behaviors based on Pender's health promotion model to prevent loneliness of old women referred to Gonabad urban health centers

Loneliness is one of the most significant problems during aging. This research has been done to determine the effect of a multi-strategy program based on Pender's Health Promotion model to prevent loneliness of elderly women by improving social relationships. In this quasi-experimental study done in 2013 from January to November, 150 old women suffering medium loneliness referred to Gonabad urban Health Centers were enrolled. Data were gathered using Russell's UCLA loneliness questionnaire and the questionnaires based on Pender's Health Promotion Model about loneliness. The results were analyzed by descriptive statistics and Chi-square, T-pair, and independent-T tests through SPSS, version 20. Loneliness decreased significantly in the interventional group compared to the control group [P<0.00]. In addition, mean scores related to variables of Health Promotion Model [received benefits and barriers, self-efficacy, interpersonal effectives of loneliness] in both groups were significantly different before and after the study [P<0.05]. Constructs of Pender's Health Promotion Model can be used as a framework for planning interventions in order to anticipate, improve and modify related behaviors related to loneliness in old women

Adolescents' self-esteem in single and two-parent families

Self-esteem is one of the basic needs for all individuals especially in adolescence. The aim of this study was to determine associations between adolescents' self-esteem and perceived maternal parenting styles as well as its dimensions in terms of family type. In this analytic cross-sectional study, 356 high school students [250 two-parent nuclear family and 106 single-parent family] participated and filled out the Coppersmith self-esteem and the Robinson and colleagues [2001] perceived parenting styles questionnaires. Data were analyzed by SPSS software, version 18. To assess the relationship between participants' self-esteem and parenting styles and dimensions, Mantel-Haenszel Chi-square test was used to adjust the effect of potential confounder variables. P