A comprehensive "real need" assessment, a step toward improving the quality of faculty development programs: A survey-based study in Hormozgan University of Medical Sciences

Background and Aims

Developing a framework to identify the "real" needs of faculty members, the gap between the current and desired conditions, would lead to an effective faculty development program (FDP) and improve higher education quality and health system promotion. For the first time in Iran, instead of needs assessment based on faculty members preferences or assessing needs only in a few areas, this study aimed to assess the difference between "self-rated level of skill" as the current condition and "perceived importance" as the expected condition, regarding all faculty roles and levels at Hormozgan University of Medical Sciences (HUMS).

Methods

This study used a research-made questionnaire that included 73 items within nine domains. The content validity of the questionnaire was confirmed, and Cronbach's alpha coefficient ranged from 0.86 to 0.96 for domains. The census method was applied. Participants rated their current skill level and perceived importance for professional development of each item on a 10-anchor scale. Statistical software, SPSS 19, analyzed the data using descriptive statistics and analytic tests.

Results

Significant differences existed among participants' ratings of skills and the importance of further training in various areas. Priority professional development domains were e-learning, curriculum development, personal development, program evaluation, leadership and management, student assessment, learning theories and teaching strategies, research and scholarship, and ethics and communication.

Conclusion

Additional formal training is required, especially in e-learning and curriculum development, for most faculty members at HUMS to enhance their academic performance. This study is the first needs assessment in Iran based on gaps between current and desired conditions. Conducting a "real needs" assessment before initiating an FDP is necessary for its feasibility.

Clinical reasoning in emergency medical technicians and its compliance with the illness script theory: A pilot study

BACKGROUND

Emergency medical technicians (EMTs) play a pivotal role in the management and treatment chain of emergency patients and their health outcomes. Knowing the clinical reasoning pattern in prehospital procedures is of particular importance that can help to develop a correct clinical decision-making process in this group. Therefore, this study aimed to clarify the clinical reasoning in EMTs and evaluate its compliance with the "illness script" theory.

MATERIALS AND METHODS

This descriptive-analytical study was conducted in 2021 at Hormozgan University of Medical Sciences (HUMS) by involving EMTs in two groups of experts and novices. To collect and analyze participants' mental script-based information, the "think aloud" method was used. In the content analysis of extracted protocols, two main steps were considered: 1) preparing a suitable map to compare the protocol with the base pattern and 2) quantifying the relationship between the protocol and the base pattern. Statistical Package for the Social Sciences (SPSS)-21 software, the Shapiro-Wilk test, and the independent t-test were used for analyzing quantitative data.

RESULTS

After exploring the concordance of the clinical reasoning of EMTs with the base pattern, results showed that the components of Enabling condition and Management were consistent with the illness script strategy. Pathophysiology and Diagnosis components did not conform to the base pattern. Regarding Signs and Symptoms, these were significantly different from the classic pattern of illness script. A new component called Contextual insight was suggested for this pattern. Generally, on comparing the clinical script content of experts and novices, only two components of Pathophysiology and Diagnosis did not show any significant difference (P > 0.05) between these two groups.

CONCLUSION

Results of evaluating the clinical reasoning of the under-study groups showed that in some components of the pattern, they practiced as in other medical groups, but in relation to some components, this was not the case. It is due to the different nature of the prehospital conditions. Also, there is a need to add new components to the base model, which should be considered in distinguishing between expert and novice EMTs.

Association of TNF-α -857 Polymorphism with Inflammatory Bowel Disease in a Group of Iranian Azeri Individuals

BACKGROUND Inflammatory bowel disease (IBD) is a chronic, relapsing, inflammatory disorder of the gastrointestinal tract that includes two entities, Crohn's disease (CD) and ulcerative colitis (UC). As with other complex diseases, both genetic susceptibility and environmental factors play role in the pathogenesis of these diseases. The tumor necrosis factor α (TNF-α) gene is located in the IBD3 region on chromosome 6p21 which is a good functional candidate for involvement in susceptibility to IBD. In addition, the promoter region of TNF-α contains various polymorphisms that have shown a significant association with IBD. METHODS In this case control study we investigated the TNF-α -857 polymorphism in 109 patients (89 UC and 16 CD) who suffered from IBD and 100 healthy age, sex and ethnicity matched adults selected from the same population, as the control group. The polymorphism was checked by amplification refractory system (ARMS) and polymerase chain reaction (PCR). RESULTS Investigation of the association of TNF-α -857 gene promoter polymorphism with both types of IBD showed no significant difference in genotype and allele frequencies of this polymorphism between UC patients and controls. However, a possible association of TNF-α -857 polymorphism (p=0.03) was identified with CD. CONCLUSION TNF-α -857 polymorphism may have a role in the development of CD in the Iranian Azeri Turkish population.

Anticancer effects of crocetin in both human adenocarcinoma gastric cancer cells and rat model of gastric cancer

This study investigated the therapeutic effect of crocetin, a carotenoid derived from saffron, on gastric adenocarcinoma (AGS) cells and 1-methyl-3-nitro-1-nitrosoguanidine (MNNG)-induced gastric cancer in rats. An MTT assay showed a significant dose- and time-dependent inhibition of AGS cell proliferation as a result of crocetin administration. Flow cytometry and caspases activity assays revealed apoptosis had been induced in these cells; RT-PCR and Western blot analyses revealed the suppression of Bcl-2 and up-regulation of Bax expression in AGS cells treated with crocetin. These changes were not observed in normal human fibroblast (HFSF-PI3) cells. Pathological study of the tumor tissue in MNNG-induced gastric cancer in rats indicated the dose-dependent inhibition of tumor progression. In addition, crocetin reversed some changed biochemical parameters, including serum antioxidant activity and lactate dehydrogenase in rat serum. The present study demonstrates the antioxidant, anti-proliferative, and apoptotic activities of crocetin against gastric cancer that may benefit human stomach cancer treatment.

Saffron Aqueous Extract Inhibits the Chemically-induced Gastric Cancer Progression in the Wistar Albino Rat

OBJECTIVE(S)

Gastric cancer is the first and second leading cause of cancer related death in Iranian men and women, respectively. Gastric cancer management is based on the surgery, radiotherapy and chemotherapy. In the present study, for the first time, the beneficial effect of saffron (Crocus sativus L.) aqueous extract (SAE) on the 1-Methyl -3- nitro -1- nitrosoguanidine (MNNG)-induced gastric cancer in rat was investigated.

MATERIALS AND METHODS

MNNG was used to induce gastric cancer and then, different concentrations of SAE were administered to rats. After sacrificing, the stomach tissue was investigated by both pathologist and flow cytometry, and several biochemical parameters was determined in the plasma (or serum) and stomach of rats.

RESULTS

Pathologic data indicated the induction of cancer at different stages from hyperplasia to adenoma in rats; and the inhibition of cancer progression in the gastric tissue by SAE administration; so that, 20% of cancerous rats treated with higher doses of SAE was completely normal at the end of experiment and there was no rat with adenoma in the SAE treated groups. In addition, the results of the flow cytometry/ propidium iodide staining showed that the apoptosis/proliferation ratio was increased due to the SAE treatment of cancerous rats. Moreover, the significantly increased serum LDH and decreased plasma antioxidant activity due to cancer induction fell backwards after treatment of rats with SAE. But changes in the other parameters (Ca(2+), tyrosine kinase activity and carcino-embryonic antigen) were not significant.

CONCLUSION

SAE inhibits the progression of gastric cancer in rats, in a dose dependent manner.

A noninvasive method for early detection of MNNG-induced gastric cancer of male Wistar rat: ultrasonic study

Gastric cancer is often diagnosed at advanced stages and there is no accurate method for its screening and diagnosis, especially in small animals. Here, we explain the application of B-mode ultrasound imaging (BMUI) for screening of gastric changes in the rat. Thus, male Albino Wistar rats, weighing 100-120 grams were randomly divided into two groups. The control group rats (n=10) were given water as routine; the remaining (n=90), were given N-methyl-N-nitro-N-nitrosoguanidine (MNNG, 100 μg/mL) in drinking water ad libitum for 40 weeks. Fifteen rats were killed at different time intervals and the others were sacrificed after 55 weeks. The BMUI of the stomach of animals after MNNG administration show some changes compared with the normal groups. Pathologic investigations of the stomach indicate cancer induction at different levels. The sensitivity and specificity of BMUI is 96.6% and 78.78%, respectively. Thus, it is a useful method of diagnosis of gastric cancer in rats.