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Excerpts from Persian Medical Literature |
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The Effect of Communication Skills Training by Video Feedback Method on Communication Skills of Interns
Effective communication is essential to the practice of high quality medicine. There are methodological challenges in communication skills training. There is compelling evidence that experiential methods of communication skills instruction are superior to the more traditional didactic approach. This study has been performed to assess the educational benefits of communication skills training by the video feedback method versus a more traditional format such as a lecture on communication skills.
This was an interventional, double blind, prospective study which was performed in 2005 – 2006 at Isfahan University of Medical Sciences. There were 40 medical students who participated in this study. We had 20 medical students in each group. Both groups initially participated in communication skills classes and subsequently their communication skills were evaluated with an Objective Structured Clinical Examination (OSCE 1). Group one then participated in a video feedback workshop and their communication skills were evaluated by OSCE 2 two months after the course. The communication skills of group two were re-evaluated by OSCE 2 after two months. The scores of OSCE 1 and OSCE 2 of both groups were compared. Results were analyzed using SPSS.
The mean OSCE 1 communication skills scores of both groups were compared and the results showed no significant difference between the groups (P=0.53). Group one had significantly higher communication skills scores in OSCE2 after the video feedback workshop when compared to the communication skill scores of group two which had no further intervention (P<00).
The study showed our training intervention was effective in producing a significant change in medical students’ communication skills. Video feedback was more effective than traditional didactic methods such as lectures. Repetition of feedback using videotaped performance may be useful to improve communication skills for medical interviews. Evidence suggests that practice with feedback is an essential ingredient of communication skills courses and is more effective than other methods such as simply discussing issues in communication.
Authors: Managheb SE, Zamani A, Shams B, Farajzadegan Z.
Source:
Medical Sciences Ministry of Health and Medical Education (Teb va Tazkiyeh). 2008; 70 – 71:
8 – 15.
Comparing the Effectiveness of Cognitive Behavioral Therapy and
Trans-Theoretical Model on Improving
Abstinence Self-Efficacy in Substance Dependent Adolescents
Understanding the relative effectiveness of various therapeutic methods on abstinence is very important, considering that important variables such as self-efficacy beliefs in addicted adolescents predicts the variance in marijuana and alcohol use up to 69 and 50 percent, respectively. This study aimed to compare the effectiveness of two different therapeutic models on improving self-efficacy in abstinence from drug use in substance dependent adolescents.
This was an experimental study. The sample population was selected from adolescents who voluntarily referred to substance dependence treatment centers affiliated with the Tehran Welfare Organization. There were 45 adolescents selected after obtaining informed consent forms and initial administration of the University of Rhode Island Change Assessment scale to assess the participants' stage of change (motivation). The Drug Abstinence Self-efficacy Questionnaire was subsequently administered and they were randomly allocated to two experimental groups, namely the cognitive behavioral therapy (CBT) and the trans-theoretical model (TTM) groups. A third group was used as a waiting list control group. The experimental groups were assigned to a 12 session (twice weekly) treatment program in either CBT or TTM and were evaluated immediately afterward and after a two month follow up period. Data was analyzed using Multiple Analysis of Covariance through SPSS-16 software.
Results clearly showed the effectiveness of both methods on the self-efficacy in drug use abstinence in adolescents. Furthermore, results showed that TTM was significantly more effective than CBT on general self-efficacy, both immediately after the treatment and at the follow up evaluation.
Results of the present study reiterate the significance of the process of change in the treatment of substance dependent adolescents. Selection and initiation of any therapeutic module should be in accordance with the patient's stage of change process.
Authors: Jafari M, Shahidi S, Abedin A.
Source: Journal of Behavioral Sciences. 2009; 7 (1): 1 – 12.
Prodromal Symptoms in Acute Myocardial Infarction
Today, acute myocardial infarction (AMI) is the most prevalent cause of mortality worldwide. Sometimes prior to an acute phase of AMI there are certain prodromal symptoms. Since there are some social and cultural differences in the Iranian population, this study has been designed to investigate prodromal symptoms in patients with AMI in Birjand, Khorasan Province.
In this analytic-descriptive research, 165 patients with a first AMI who were hospitalized in the CCU and cardiac wards of the Valiassr Hospital in Birjand during 2006 – 2007 were studied. A valid questionnaire, designed by an expert cardiologists was used. The t-test and ANOVA were used for data analysis, and P<0.05 was considered as significant.
Among 165 subjects, there were 118 (71.5%) males. Anterior MI was seen in 102 patients (61.8%). Cardiac prodromal symptoms were reported in 61 patients (37%) and 43 patients (26.1%) reported systemic prodromal symptoms. The most common cardiac prodromal symptom was the occurrence of chest pain in the right and left hemithorax (24.2%) two days before AMI, and the most common systemic prodromal symptom was loss of appetite (12.7%). Women reported more cardiac (P=0.04) and systemic (P=0.00) prodromal symptoms than men. This difference was statistically significant (P<0.05).
Careful attention to medical history and prodromal symptoms in patients with cardiac risk factors may cause an earlier diagnosis, more efficient treatment plan and a better prognosis of AMI in patients.
Authors: Mashreghimoghadam HR, Kazemi T, Besharatimoghadam F.
Source: Iranian Journal of Epidemiology. 2008; 10 (3): 175 – 182.
The Role of Hippocampal Nitric Oxide in Passive Avoidance Learning
Nitric oxide (NO) is a retrograde messenger in hippocampal synaptic plasticity which is involved in learning and memory processes. Previous studies have revealed that hippocampal pyramidal cells contain NO synthase (NOS) enzyme which produces NO and could be a promising target to evaluate the role of NO in cognitive functions. In this study, we conducted an experiment to assess the role of NO in passive avoidance learning by using an NOS inhibitor (L-NAME).
Adult male Wistar rats (200 – 250 g) were bilaterally cannulated in the CAI region of the hippocampus. Animals were subjected to behavioral tests one week after surgery. Rats received different doses of L-NAME (5, 10, and 15 µg/0.5 µL/side) into the CAI of the hippocampus 25 minutes before training. Retrieval tests were performed in three different stages after training: working or immediate (immediately after training), short-term (90 minutes after training) and long-term (24 hours after training) memories.
Our findings showed that pre-training injection of L-NAME 15 µg/0.5 µL/side significantly increased the number of step-through into a dark chamber for immediate memory, while decreased step-through latency for short-term memory.
These results suggest that hippocampal NOS inhibition impairs both immediate and short-term memory, but has no significant effect on long-term memory. Thereby hippocampal NO may affect early learning and memory in passive avoidance tasks.
Authors: Eshagh HH, Naghid N, Haeri RA, Sepehri H.
Source: Physiology and Pharmacology. 2009; 13 (1): 1 – 9.
The Efficacy of Treatment of Acute Corrosive Gastroesophagitis
Corrosive gastroesophagitis is a major problem in surgery and a multidiciplinary approach is used in these patients, but their prognosis is poor. In this retrospective study, we selected patients with corrosive gastroesophagitis who were referred to Loghman Hospital in Tehran, during the last decade. The treatment results were analyzed.
Factors included age, sex, grade, substance use, surgery option and endoscopy results. In this study, 88 patients were evaluated. Most patients were men (64%) of ages 31 – 40 years and the most common substance involved was acid (42%), cleaning (25%) and alkaline (15%) solutions. Mortality on the basis of grading was: grade I=0%, grade II=8.5% and grade III=64%. Endoscopy results in the surgical group were as follows: 48% ulcer and 26% stricture, while in the non-surgical group 7% had ulcers and 46% had strictures. Mortality was 59% in the group that underwent surgery and 80% in the non-surgical group. All grade III patients, however, had dysphagia.
In patients with grade II corrosive esophagitis, gastric surgery is the best option for decreasing morbidity; but in grade III patients, surgery has a very poor prognosis.
Authors: Haji NE, Jafari J, Peivandi H, Haji Esmaeili MR.
Source: The Iranian Journal of Shaheed Sadoughi University of Medical Sciences and Health Services. 2009; 17 (2): 15 – 19.
The Effect of Educational and Psychological Family-Based Early Intervention on the Motor Development of Children with Downs Syndrome
The purpose of this study was to examine the effect of psychological and educational family-based early intervention on the motor development of Isfahanian children with Downs Syndrome under the age of 5.
In this experimental and interventional study, 36 parents who had children with Downs Syndrome were randomly selected and assigned to two groups by a balanced randomized method. Hornby’s counseling model and educational plan was implemented on the experimental group. To collect data, the Winders motor developmental checklist and Gesell psycho-motor scale were used. The Covariance statistical method was used for data analysis.
Findings showed significant differences in the performance of children with Downs Syndrome between the experimental and control groups, in both gross motor and psycho-motor skills (P<0.001).
The results revealed that psychological and educational family-based early intervention significantly increased motor development in both gross motor and psycho-motor skills of children with Downs Syndrome.
Authors: Faramarzi S, Malekpour M.
Source: Quarterly Journal of Rehabilitation. 2009; 10 (1): 24 – 31.