Comparison of problems related to 12 and 24-shift shift work in emergency medical technicians of Ardabil province

Introduction: Shift work is one of the factors affecting the performance of employees in the field of health care, which can have important effects on their health. The present study was conducted to compare the problems related to 12 and 24-hour shift work among emergency medical technicians in Ardabil province. Materials and Methods: The present study was descriptive-analytical research that was conducted on 157 technicians from 115 urban emergency centers in Ardabil province who were selected by census method in 2018. The data collection tool was standard shift work (SSW) questionnaire. The data were analyzed through SPSS version 20 software and using descriptive statistics and a chi-square test. Results: The results showed that the physical and mental workload of emergency medical technicians working 12-hour shifts is higher than that of 24-hour shift workers. Also, the willingness of 12-hour shift workers to continue working according to the productivity improvement law was significantly more than urban 24-hour shift workers (P<0.001). 24-hour shift technicians had more time for personal life compared to 12-hour shift workers (P=0.008). Feeling tired during the day, stomachache and heartburn, and back pain were relatively common problems among all emergency medical workers. Conclusion: Considering that the physical and mental workload of 12-hour shift workers is more than 24-hour shifts, it is recommended that managers should prioritize the work schedule of emergency medical technicians, including reducing their working hours.

Improving nurses' performance in the safe handling of antineoplastic agents: a quasi-experimental study

Background

The safe and standard handling of antineoplastic drugs can reduce the effects of occupational exposure and promote safe behaviors in nurses. Thus, the present study aimed to determine the effects ofstandard guidelines education on the safe handling of antineoplastic drugs among oncologynurses in Ardabil, Iran.

Methods

Thequasi-experimental study with a one-group pretest-posttest design was performed among 32 nursesworking in the oncology wards of two educational hospitals in Ardabil city, during 2020. Allthe nurses in the wards who met the inclusion criteria participated in the study. The data were collectedby usinga demographic information form and nurses’knowledge assessment questionnaire regardingthe standard guidelines for working with antineoplastic drugs, and a standard checklist for examiningtheir performance in this regard. Subsequently, they were analyzed by descriptive (mean and standard deviation) and inferential statistics (t-test)and Pearson’s correlation coefficient) in SPSS 22.

Results

The mean and standard deviation of the knowledge and performance scores of the oncology nurses was59.56±6.41and 18.96±2.54 respectively, which changed to 66±4.82 and 32.03±2.45 respectively three months after training. The results of the t-test represented a statistically significant difference between the level of knowledge and performance before and after the intervention (P=0.001).

Conclusions

Based on the results, the standard guidelines education improved the nurses’ knowledge and performance on the safe handling of antineoplastic drugs in the chemotherapy wards. Therefore, it is advised to increase the awareness of the oncology nurses in this regard in the planning and policy-making ofhealthcare centers.

Nurses' trust in managers and its relationship with nurses' performance behaviors: a descriptive- correlational study

Background

Organizational trust is one of the most important issues in human relations that its importance in organizations is well known. Effective communication and cooperation between individuals require trust. On the other hand, the quality of a nurse’s trust in his/ her manager affects the behavior and performance of the nurse. The purpose of this study was to determine nurses’trust in managers (head-nurses and supervisors) and its relationship with nurses’ performance behavior.

Methods

This descriptive-correlational study was performed with the participation of 431 nurses working in educational centers of Ardabil, Iran. The sampling method was stratified randomly. Questionnaires of the McAllister Trust and Paterson Job Performance were used. Data analysiswas performed using descriptive statistics (mean, standard deviation, frequency) and Chi-square testin SPSS v.22.

Results

The results showed that the majority of nurses trusted head-nurses (80.3%) and supervisors (61.9%). In addition, most nurses’ functional behavior (92.1%) was reported as excellent. There was no significant relationship between nurse trust in head-nurse and nurses’functional behavior (P = 0.58), while it was significant between nurse-supervisor trust and nurses’ functional behavior (P = 0.03).

Conclusion

The results of this study showed a relationship between nurse-supervisor trust and nurses’ functional behavior. Therefore, it is recommended ways to improve the trust between the treatment team, especially among nurses and supervisors are considered as one of the factors influencing the nurses’ behavioral performance.

Diabetes distress and its clinical determinants in patients with type II diabetes

AIM

The present study aimed to determine the status of diabetes distress and its clinical determinants in type II diabetes patients.

METHODS

This descriptive-analytical study was performed on 220 patients with t diabetes referred to Diabetes Clinic of Imam Khomeini Hospital in Ardabil, Iran. The samples were selected using convenience sampling method. Data collection tools included demographic and disease form and Diabetes Mellitus Scale (DDS). Data analysis was performed using SPSS software version 22 via descriptive (frequency, mean, standard deviation) and inferential statistics (compare means, Pearson correlation coefficient and stepwise multiple regression).

RESULTS

The average duration of diabetes was 7.64 (SD = 4.68) years. 63.7% of the patients had moderate to severe diabetes-related distress. Emotional burden dimension had the highest score among the subscales of diabetes distress. In addition, there was a correlation between positive family history (p = 0.017), duration of diabetes (p = 0.028) and type of treatment (p = 0.47) and diabetes distress. HemoglobinA1C levels, body mass index and triglyceride were the major predictors of diabetes distress.

CONCLUSIONS

Considering the high prevalence of diabetes distress in patients with type II diabetes, it seems that paying attention to clinical predictors of distress and screening of patients with diabetes is a reasonable and accessible method for health care providers and patients to improve their disease management.

Cyclin D1 amplification and p16(MTS1/CDK4I) deletion correlate with poor prognosis in head and neck tumors

OBJECTIVES/HYPOTHESIS

Cyclin D1, a cell cycle regulator localized to chromosome 11q13, is amplified in several human tumors including head and neck squamous cell carcinoma (HNSCC). Amplification and/or overexpression of cyclin D1 have been correlated to a poor prognosis. Deletion of the p16 gene, localized to 9p21, has also been observed in a significant proportion of HNSCC. The p16 gene regulates cyclin D1-CDK4 activity and prevents retinoblastoma tumor suppressor gene phosphorylation, thereby downregulating cellular proliferation. Detection of cyclin D1 amplification and p16 deletion using a simple and sensitive method will be valuable for the development of effective treatment modalities for head and neck cancer.

STUDY DESIGN

We have used fluorescence in situ hybridization (FISH) to study cyclin D1 amplification and p16 gene deletion in head and neck tumors. Both single- and dual-color FISH were performed.

METHODS

Paraffin-embedded tissues from 103 patients with HNSCC were analyzed using genomic DNA probes for cyclin D1 and p16. Dual-color FISH was performed with chromosome 11 or 9 centromeric probes as a control. Twenty-eight of these samples were analyzed for p16 expression by immunohistochemistry.

RESULTS

Cyclin D1 amplification was observed in 30% (31/103) of patients, and p16 deletion in 52% (54/103). Lack of p16 expression was observed in 64% (18/28) of patients. There was a good correlation between the deletion of p16 sequences and the loss of p16 expression (P = .008). Amplification of cyclin D1 had a statistically significant association with recurrence, distant metastasis, and survival at 36 months. There was a significant association between p16 deletion and the development of distant metastases. Cyclin D1 amplification and p16 deletion together correlated with recurrence, distant metastasis, and survival.

CONCLUSIONS

We demonstrate that FISH is a simple and sensitive method for detecting cyclin D1 amplification and p16 deletion in head and neck cancer. Our results suggest that these two genetic aberrations together portend a poorer outcome than either of the abnormalities alone in head and neck cancer.

Open bedside tracheotomy in the intensive care unit

OBJECTIVE

To demonstrate that open bedside tracheotomy is an efficient, safe, and cost-effective procedure.

STUDY DESIGN

Retrospective review of more than 200 open bedside tracheotomies performed at UCLA Medical Center, Harbor-UCLA Medical Center, and West Los Angeles VA Medical Center from 1995 to 1998.

METHODS

The only personnel required for the procedure were an attending or senior resident and a junior resident or intern, as well as the respiratory therapist to withdraw the endotracheal tube. No anesthetist or scrub nurse was present for any of the procedures. The procedure took an average of 15 to 25 minutes. Patients were followed for 30 days after surgery to determine the incidence of complications.

RESULTS

The incidence of major complications related to the procedure, including hemorrhage and myocardial infarction, was less than 1%. The incidence of minor complications, including moderate bleeding at the tracheotomy site, was 4%. Overall mortality within 30 days was 8%, but was not related to the tracheotomy for any patients in this series. The charge for the procedure was $233 for the tracheotomy tube supplies and instruments. This cost compares favorably with an average charge of more than $3000 for the procedure in the operating room and about $1000 for a percutaneous tracheotomy kit.

CONCLUSION

Review of our experience demonstrates that open bedside tracheotomies can be performed more efficiently and economically than operating room tracheotomies. The safety of this procedure is comparable to percutaneous tracheotomy but at a decreased cost.