Jorjani Biomedicine Journal
Volume:6 Issue: 2, Summer 2018

Educational technology is widely used in all parts of medical education. The use and application of common educational technologies and adoption of educational design patterns in medical sciences education can greatly help in medical simulations, training, and improving of clinical skills of nurses and medical students. The aim of this research was to study computer-assisted instruction, virtual patients, and human patient simulation in medical science education based on Gagne’s educational design pattern. The research methodology in this paper was a review-article of applied type, which helps the education designer in the field of medical education to choose the most suitable educational technologies in medical science education to achieve their desired goals by considering the advantages and disadvantages of computer-assisted instruction, virtual patients, and human patient simulation. In this article, we first reviewed the educational technology and common technologies in medical education and its advantages and disadvantages as well as the most appropriate educational technology to achieve the needed goals. We then described two multimedia (Computer-Assisted Instruction and Virtual Patients) and educational models for virtual patients as well as two simulators (virtual patient and human patient simulation). Subsequently, we explored the educational design and its patterns (including Ganja, Watson, Merrill, Reigeluth, Asher, Camp, and Siemens) and selected the best pattern (Gagne’s pattern) according to the learning theories and research background. Finally, the three approaches mentioned in this article (computer-assisted instruction, virtual patients, human patient simulation) were designed based on the Gagne’s model. Based on the results, one can conclude that the computer-assisted instruction, virtual patients, and human patient simulation based on the Gagne’s educational design model can help medical education instructors in training communication skills, clinical skills, and skills of obtaining medical history from the patient as well as problem-solving skills, knowledge acquisition, and critical thinking. They can also help the educational designer in the field of medical education to select the most suitable educational technologies in medical science education due to the best educational model of virtual patients and the Meyer educational media principles and simulation-based learning-educational theories tailored to the goals and content of medical education courses. Therapies for autoimmune disorders such as SLE.

Prostate cancer is the second leading cause of mortality among men worldwide, and the eighth cancer-related cause of death in Iran. Male sex hormones (androgens) are the main cause of prostate cancer cells. Triptorelin is considered a synthetic decapeptide analogue of gonadotropin-releasing hormone (GnRH) in the treatment of prostate cancer. This study aimed to evaluate the methods to deal with the constraints in use of lipid nanoarchaeosomes. Due to their adjuvant feature and presence of ether links, archaeosomes are more stable in blood, compared to other lipid-based formulations. In the present study, the effects of nanoarchaeosomes containing triptorelin acetate on the cellular toxicity of the PC3 prostate cancer cell line were evaluated. Halobacterium salinarum bacteria were cultured in HS medium, and their polar lipids of the membrane were removed applying the Blight&Dye technique in order to obtain nanoarchaeosome containing membrane polar lipids. In the next stage, nanoarchaeosomes were prepared by the hydration of polar lipids. In addition, cell viability was evaluated using the MTT assay on the PC3 cell line. In this research, mean diameter of the drug-containing nanoarchaeosomes was estimated at 263 nm using the ZetaSizer device. Moreover, drug loading efficiency of nanoarchaeosomes was estimated at 98%. Furthermore, the toxicity of the free and nanoarchaeosome drugs was assessed via the MTT assay, results of which were indicative of a mean of IC 50 0.22 µg/ml in this regard. According to the results of the study, archaeosomes extracted from polar lipids were produced with high concentration and purity on the nanoscale. Considering the high stability, ease of production, level of drug loading, and toxic effect on cancer cells, nanoarchaeosomes can be used as a suitable technique for targeted drug delivery in future studies.

Coronary artery disease (CAD) is associated with negative emotions of anger and stress, which are one of the nonclinical risk factors of the disease. Therefore, evaluation of the effective therapeutic models alleviating the patients’ negative emotions is of paramount importance. This study aimed to examine the effect of mindfulness-based stress reduction (MBSR) on anger and stress in patients with coronary heart disease after coronary artery bypass graft (CABG). This research had an A-B single-subject design. The research population encompassed all patients with coronary heart disease referring to Shahid Madani Hospital of Tabriz, Iran during the second half of 2016 for rehabilitation measures. Four patients were selected using convenience sampling. Before the interventions, the participants completed state-trait anger expression inventory (STAXI-2, Spielberger) and depression anxiety stress scale (DASS) throughout two consecutive weeks, which led to establishing two baselines. Afterwards, they received mindfulness-based stress reduction training during seven consecutive weeks and completed the questionnaires after each intervention. Percentage of recovery, percentage of non-overlapping data (PND), standard mean difference (SMD), and effect size were used to analyze the data, and eye diagram analysis was adopted to interpret the data. The findings indicated that the mean recovery rate for all participants was 0.84 and its effect size index was 2.7. Moreover, the mean percentage of recovery and the effect size index of mindfulness intervention on the patients’ anger were 0.18 and 1.38, respectively. According to the results of the study, it could be concluded that mindfulness-based stress reduction is an effective intervention to regulate stress in patients suffering from coronary heart disease.

Birth spacing is an important variable for identification of fertility acceleration, total fertility rate, and maternal and fetal health. Therefore, special attention has been paid to this issue by researchers in the fields of medical sciences, health, and population. In addition, proper analysis of this concept is of foremost importance. Application of classical analytical techniques with no attention to their assumptions (e.g., independence of events) is associated with inefficient results. As such, this study aimed to present frailty models as effective models for this analysis. Frailty models consider the dependence between unobserved intervals and dispersions by exerting a random impact on the model. Different types of these models include shared, conditional, correlated and time-dependent frailty, each of which along with their applications were presented in the current research using two examples. In practice, the shared frailty model is highly applied due to its simplicity. Nevertheless, since most of the unknown factors affecting the birth spacing are not common between different births, the shared frailty models must be used with caution. Use of classical statistical methods, such as the Cox proportional hazards model, the important assumption of which is the dependence of events occurred, is not appropriate for the accurate analysis of birth spacing. On the other hand, frailty models consider the correlation between the intervals and are an effective method for analysis of birth spacing, use of which is recommended to researchers in fields of medicine and population.

The development and distribution of hospital beds, regardless of effective factors, may downgrade equity in access to health services through imposing costs of inefficiency. This study aimed to develop a hospital bed distribution model in Iran in order to facilitate the optimal and cost-effective development and distribution of hospital beds. This descriptive-analytical study with mixed-methods analysis was carried out during 2015-2016. The research population encompassed 345 managers and experts in the field of health, who were selected using multistage quota sampling method from five regions of Iran (north, south, center, west and east). A total pool of 23 experts were selected from each university, and a researcher-made questionnaire was used to collect data. Content Validity Ratio (CVR) was used to evaluate the questionnaire content and face validity. Cronbach's alpha coefficient and exploratory factor analysis with Varimax rotation were run as well to determine the questionnaire reliability and item consistency, respectively. For this purpose, AMOS version 20 and SPSS version 20 software were employed. To determine the fit of the model, the fit indices were also considered. Out of 51 effective factors included in the questionnaire in accordance with content validity, 23 items were confirmed by the experts. Exploratory factor analysis detected five organizational (seven components), economic (four components), social (six components), political (three components) and geographic (three components) factors as the main dimensions of hospital bed distribution, which could explain 70.745% of variance for all variables. The organizational and geographical dimensions had the highest (1.00) and lowest (0.16) influence on the hospital bed distribution. After running confirmatory factor analysis, two components of social and economic attributes with factor load of 0.46 in social dimension and efficiency and effectiveness of existing centers with factor load of 0.31 in the economic dimension were excluded from the model. This study confirmed the hospital bed distribution model with five organizational, social, economic, political, and geographical dimensions, in which the organizational dimension with high explanatory power had the greatest impact on the hospital bed distribution. Therefore, this model seems efficient to be used as a comprehensive and appropriate method in making policies and decisions about the development and distribution of hospital beds.

Knowledge-based economy is one of the major parts of the resistance economy and is recognized as the essentials of the information technology age. As one of the most important educational units and the custodian of community health, universities of medical sciences play a pivotal role in the success of resistance economy based on the knowledge-based economy. Among the employees of a university, the managers and faculty members play an important role in this regard. This study aimed to explain the dimensions of the resistance economy based on the knowledge-based economy in universities of medical sciences. This qualitative research had a purposeful sampling method. Data were collected via library and field research. In the library method, the relevant specialized scientific texts and resources were exploited, whereas in the fieldwork, the researcher interviewed 24 faculty members. The interviews continued until saturation, and after being recorded, they were transcribed in Word software, coded, classified, and encoded by Microsoft OneNote. After that, the interviews were analyzed. It is notable that ethical considerations were observed during the research process. In the field method, the texts and books were evaluated and information searched in scientific and specialized websites. In addition, relevant articles recently published in valid international journals were translated, and primary data with the topic of translation were collected. In the field research and after coordination with faculty members and main elites with a history of article or innovation production or a management background, the opinions of the interviewees were asked about some questions in a semi-structured manner. In addition, three-stage coding, open coding, axial coding, and selective coding were applied in the research. To perform open coding, the main sentences were recorded as codes, followed by classifying the similar codes. In axial coding, the classes were related to their subclasses by comparing the primary classes of open coding and revolving the ones that resembled around the common axis. In selective coding, the integration and refining process of the categories was performed to form and present the model, and the dimensions were extracted and explained. From the perspective of the faculty members and key experts, resistance economy based on knowledge-based economy in universities of medical sciences could be explained in dimensions of information and communications technology, innovation and entrepreneurship in medical sciences, human resources and knowledge-based team, administrative and structural system, resources of equipment and abilities, policy and socio-environmental impacts. Each of these dimensions also included sub-groups and special themes. According to the results of the study, it could be stated that moving towards the knowledge-based economy is one of the requirements of the country on the path to economic development, which involves dimensions such as information and communications technology, innovation and entrepreneurship, specialized knowledge-generating team, strategic planning and policy-making, formulating and ensuring the legal framework and legal system, supplying and developing electronic infrastructures, and paying attention to capabilities and resources of facilities.

As the most important assets of each organization, employees face numerous challenges, which can have adverse effects on the quality of their work life and productivity, physical and mental health, well-being, and different dimensions of their health-related quality of life. This study aimed to evaluate the relationship between health literacy and health-related quality of life and work life quality of the employees in Golestan University of Medical Sciences, Gorgan, Iran. This cross-sectional research was conducted on 285 individuals working in the departments of Golestan University of Medical Sciences. Subjects were selected through proportionate stratified random sampling. Data were collected using Walton Standard Health Literacy Questionnaire, as well as Quality of Life and Work Life Quality questionnaires. In addition, data analysis was performed in SPSS version 16 using descriptive indicators (frequency, mean and standard deviation) and inferential statistics (ANOVA, Tukey’s test, and Pearson’s correlation). In this study, the mean age of the participants was 36.1263 years. According to one-way ANOVA, a significant difference was observed between the age groups and their health literacy level (P=0.04). Moreover, a significant association was found between health literacy and all aspects of health-related quality of life and work life quality of the participants (P=0.001). In the present study, the lowest score of quality of work life was related to fair payment, which showed the importance of more attention to this area by authorities and managers of universities.

Cataract disease is among the conditions that impose a substantial economic cost on countries every year due to their high prevalence rate. The prevalence of this disease has caused significant direct and indirect costs. This study aimed to estimate the economic burden caused by the costs of the cataract disease. This descriptive, analytical, and cross-sectional study was conducted on patients with cataract disease in Farabi Hospital of Tehran, Iran in 2014. Data were collected using the cost-determination checklist, a questionnaire, interviews with experts, and previous studies in this field. In addition, the Prevalence-based and social capital approaches were exploited to estimate the economic burden and costs of the cataract disease, respectively. Costs were divided into three types of medical expenses, patient and family expenses, and productivity lost costs. Data analysis was performed in Excel software. The economic burden of the cataract disease was estimated at 6202529401500 rials. Results demonstrated that the hospitalization costs were significantly higher, compared to the other costs related to the cataract disease. According to the results of the study, the economic burden associated with the cataract disease was equal to 0.13% of the gross domestic product and included 2.43% health expenditure of Iran in 2010.