[Show abstract][Hide abstract] ABSTRACT: Although many planners of professional continuing education programs believe that this type of education positively affects the nurses' performance, the results obtained by conducted research do not confirm such a perspective. In fact, inadequate application of these trainings in clinical practice is among the most challenging areas in nursing practices. Hence, this study was conducted to describe the challenges nurses encounter in order to apply what they have learned during continuing education programs in clinical settings of TUMS hospitals.
This cross-sectional study was conducted on 400 medical-surgical nurses who worked in the hospitals of Tehran University of Medical sciences. For sampling, after listing all the general hospitals, their wards were selected in proportion to hospital. Nurses filled out a questionnaire about factors affecting the application of continuing education. The questionnaire contained 43 items and the dimensions were supportive-organizational, individual, professional, and educational program design factors. The analysis was carried out using parametric and non-parametric method using SPSS 16 package.
The results showed while 48.5% and 53.8% of nurses mentioned organizational and professional factors, respectively as the most inhibiting factors; only 2.25% of the nurses believed that organizational factors are facilitating.
The results obtained in this study are important regarding the fact that organizational and professional factors have a key role in applying or lack of application of learned materials. Thus, hospital authorities as well as nursing managers can provide the necessary condition in application of continuing education through promotion of facilitating factors and eliminating the hindering ones.
[Show abstract][Hide abstract] ABSTRACT: Severe Congenital Neutropenia is one of primary immunodeficiency disorders that characterized by severe neutropenia and is associated with severe systemic bacterial infections from early infancy. Granulocyte Colony Stimulating Factor (GCSF) is clinically used as a treatment for congenital and acquired neutropenia. The aim of this study was evaluation of GCSF (PD- Grastim) in treatment of these patients. Patients with severe congenital neutropenia referred to Immunology, Asthma and Allergy Research Institute between Jan 2007 and Dec 2010 enrolled the study. Other causes of neutropenia were excluded by serial CBC and bone marrow studies, medical and drug histories and immunological tests. Patients were visited and examined monthly to evaluate their CBC and ANC (Absolute Neutrophil Count), GCSF side effects and dosage adjustment. Cytogenetic studies were being done for all the patients for early detection of progression to AML/MDS. From twenty two patients who enrolled this study, 16 patients regularly evaluated. They were ten males and six females, range in age from 2 to 18 years old. Two patients failed to continue our follow up unfortunately and four patients died due to disease complications. Patients were followed for 24 to 48 months. In a period of 12-24 months before treatment, the mean of hospitalization frequency was 3.1 times and duration was 10 days; while during receiving treatment, they decreased to 0.2 times and 3 days, respectively (p<0.01). Also significant increase in mean ANC was observed during follow up (315/µl before treatment versus 1749/µl after 12 month regular treatment). Bone pain was the most common side effect. There have been no evidences of developing AML/MDS up to present time. Treatment with GCSF significantly reduced the duration and the frequency of hospitalization. Because of plausible progression to AML/MDS, regular follow-up of patients should be continued.
Full-text · Article · Mar 2012 · Iranian journal of allergy, asthma, and immunology
[Show abstract][Hide abstract] ABSTRACT: Nurses are amongst the employees whose lives are fully affected by the quality of work life (QWL) as a consequence of dynamic changes in work environment. Excessive workload and poor work conditions are focal issues in nursing. The QWL assessment is an important and basic effort to deal with this issue. Moreover, staff productivity is a worthy goal of organizations tending to grow. If the relationship between the QWL and productivity becomes apparent, managers can provide conditions for promoting the QWL for personnel to be productive. To our knowledge, these variables and their relationships have not been studied yet among Iranian nurses. This descriptive study was carried out to investigate the relationship between the QWL and productivity among 360 clinical nurses working in the hospitals of Tehran University of Medical Sciences. Findings showed that the QWL is at a moderate level among 61.4% of the participants. Only 3.6% of the nurses reported that they were satisfied with their works. None of those who reported the productivity as low reported their work life quality to be desirable. Spearman-rho test showed a significant relationship between productivity and one's QWL (p < 0.001). Considering the results, managers should adopt appropriate policies to promote the QWL and productivity.
No preview · Article · Aug 2011 · Contemporary nurse: a journal for the Australian nursing profession
[Show abstract][Hide abstract] ABSTRACT: Severe congenital neutropenia (SCN) is a rare primary immunodeficiency. Typically, affected children are recognized in early infancy with recurrent bacterial infections, low absolute neutrophil counts (mostly less than 500/µL) and also, maturation arrest at the promyelocyte-myelocyte stage in their bone marrow. Different genes are found to be associated to SCN, including ELA2, HAX1, WAS, GFI1, G-CSFR and G6PC3. Aim. The aim of this study is to determine the new mutations of ELA2 and HAX1 in Iranian patients with severe congenital neutropenia referred to Immunology, Asthma and Allergy Research Institute from 2008 to 2010. Methods. Patients with persistent severe neutropenia, recurrent infection and maturation arrest at promyelocyte-myelocyte stage in their bone marrow entered in this study. Genomic DNA of the patients and their parents was extracted from peripheral blood sample (3 ml whole blood), and all 5 exons of ELA2 and 7 exons of HAX1 genes and their respected flanking regions were amplified by polymerase chain reaction and subjected to direct sequencing. Results. Sequence analyses of ELA2 and HAX1 genes in 15 patients had revealed 6 cases of homozygous HAX1 mutation in exon 2, including 5 W44X mutations and one W59X mutation. One patient was heterozygous for ELA2 mutation in exon5 (P257L), and one showed sporadic ELA2 mutation in exon3 (V98L, V101L). The other 7 patients had no mutation in ELA2 and HAX1. Conclusions. It can be concluded that ELA2 and HAX1 genes are more common in our patients. Despite previous reports, we found HAX1 mutation more than ELA2 mutation in the patients. Based on our results, so far, no new mutations in ELA2 and HAX1 observed in Iranian neutropenic patients included in this study. Further studies to find other responsible genes for neutropenia, are under investigation in our lab.
[Show abstract][Hide abstract] ABSTRACT: : Food allergy plays a significant pathogenic role among children with atopic dermatitis (AD).
: The aims of this study were to evaluate allergy to egg in these children and determine the egg specific immunoglobulin E (IgE) cutoff point.
: It was a cross-sectional study that took place at Immunology, Asthma and Allergy Research Institute from 2005 to 2007.
: Children younger than 14 years old with AD entered the study. Careful medical histories were taken and skin prick and Immuno-CAP tests with the most commonly offending foods (cow's milk, egg, wheat, peanut, and soy) were performed. Children with a clear, positive history of food allergy and a positive IgE-mediated test or those with positive responses to both IgE-mediated tests were determined to have food allergies. The egg-specific IgE level cutoff point was determined.
: A hundred patients entered the study (from 2 months to 12 years old). They were divided into 3 age groups: first <2 years, second from 2 to <6 years, and third from 6 to 14 years. The most common food allergens were egg (39.22%) in the first, cow's milk (35.13%) and egg (32.43%) in the second, and peanut (25%) and egg (16.67%) in the third group. The egg-specific IgE cutoff point value was 0.62 kUA/L (kilounits of allergen-specific IgE per liter). The positive predictive value was 95%.
: Prevalence of egg allergy is highly significant in patients with AD.To use egg-specific IgE level cutoff point, the patient population under study must be considered.