Post-test Changes Research Articles

Functionality and jump performance in patellar tendinopathy with the application of three different treatments

ObjectivesThe aim is to assess performance characteristics in jumps and functionality in participants with patellar tendinopathy and compare changes with various tendinopathy treatments in the short and medium term. As a secondary objective, the study aims to verify the relationship between changes in knee functionality assessed by the VISA-P and jump capacity in the different treatment groups. DesignA double-blinded randomized controlled trial. MethodsRecruitment was conducted at sport clubs, with 48 participants with patellar tendinopathy included in the study. Participants were randomized into groups: dry needling (DN), percutaneous electrolysis (PNE), and sham needling as the control group (CG), all combined with eccentric exercise (EE). Functionality and performance during jumps, including squat jump (SJ) and counter movement jump (CMJ), were assessed. ResultsSignificant differences were found in functionality between the pre-test and post-test evaluations, as well as between the pre-test and follow-up evaluations, in all three groups (p < 0.001). The DN group experienced an improvement in eccentric power (p = 0.021). A moderate correlation was found between the pre-test and post-test changes in functionality and SJ maximum concentric force (r = 0.63, p < 0.01, CI: 0.1; 0.8), CMJ maximum concentric force (r = 0.52, p = 0.05, CI: −0.01; 0.8), and CMJ eccentric power in the DN group (r = 0.63, p = 0.01, CI: 0.1; 0.8). ConclusionsEccentric exercise could be effective in improving functionality in patellar tendinopathy and DN could improve eccentric power in jumps performance. Moreover, the DN group experienced an increase in functionality that correlated with the improvements found in jump performance in eccentric power and concentric strength.

학교 적응이 어려운 초등학교 6학년 남아의 인지 행동 놀이치료 사례연구 : 가상 현실(virtual Reality), 문제해결력(PSI), ‘양떼를 지켜라’ 문제 해결 스토리텔링을 중심으로

This study was to determine changes following a cognitive-behavioral play therapy intervention with two sixth grade boys with school maladjustment. Virtual Reality, Problem Solving Skills, and "Protect the Flock" were used to determine pre- and post-test changes, and the results showed, first, increases in the domains of attention, working memory, executive functioning, behavioral control, socialization, and impulse control as measured by VR, and second, increases in all domains of PSI except for Client A's problem-solving confidence. Third, the "Protect the Flock" revealed new strategies and responses in the sixth-grade boy and a change in his willingness to use them to actively solve problems. The study attempted to measure new outcomes of pre- and post-change, including a traditional screening tool, the Problem Solving Skills Scale, and a new screening tool, Virtual Reality and "Protect the Flock" and found positive changes following the intervention of a cognitive behavioral play therapy program.

Mastering Sedation and Associated Respiratory Events through Simulation-Based Training: A Randomised Controlled Trial Involving Non-Anaesthesiology Residents.

Non-anaesthetists commonly administer procedural sedation worldwide, posing the risk of respiratory events that can lead to severe complications. This study aimed to evaluate whether simulation-based learning could lead to enhancements in the clinical proficiency of non-anaesthesiology residents in managing sedation and related respiratory complications. Following the evaluation of baseline clinical performance through a pre-test simulation, 34 residents were randomly allocated to either participate in an innovative simulation-based learning module (intervention group) or view a brief self-learning video (control group). After a one-month period, their clinical performance was assessed again in a post-test simulation involving respiratory arrest during procedural sedation. Two independent assessors rated each resident's performance using video recordings and a scoring tool with scores ranging from 0 to 19/19. The two assessments were averaged for each performance, and the pre- to post-test change was calculated for each resident. While baseline clinical performance was similar, mean (SD) increase in clinical performance was significantly greater in the intervention group than in the control group (+2.4 (1.6) points versus +0.8 (1.3) points, respectively; p = 0.002). Our simulation-based learning sedation module resulted in the enhanced management of sedation-related complications compared to baseline and minimal self-learning. Simulation-based medical education may offer an effective approach for equipping non-anaesthesiology residents with essential skills to mitigate risks associated with sedation. (ClinicalTrials.gov identifier: NCT02722226).

Co-design and evaluation of a digital serious game to promote public awareness about pancreatic cancer

BackgroundPancreatic cancer, ranking seventh in global cancer-related deaths, poses a significant public health challenge with increasing incidence and mortality. Most cases are diagnosed at an advanced stage, resulting in low survival rates. Early diagnosis significantly impacts prognosis, making symptom awareness crucial. Symptoms are often subtle, leading to delayed help-seeking behaviour. Patients and their carers prioritise increased public awareness, indicating a need for innovative approaches to promote awareness of the disease.MethodsThis study employed a quasi-experimental pre-test/post-test design to assess the relationship between a serious game and pancreatic cancer awareness. Members of the public (N = 727) were recruited internationally, via social media and with signposting by relevant organisations. Participants completed measures of symptom awareness and help-seeking intentions before and after playing the game. The serious game, co-designed with experts by lived experience, patient advocates and healthcare professionals, presented participants with a human anatomy diagram, with each section linked to a question about pancreatic cancer.ResultsThe serious game demonstrated a statistically significant improvement on pancreatic cancer awareness based on matched paired t-tests. Due to missing data, paired comparisons were only possible for 489 cases. Symptom awareness scores exhibited a statistically significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.43). Help-seeking intentions also markedly improved, showing a significant increase from pre-test to post-test, with a large effect size (p < 0.001, d = 1.10). Independent-samples t-tests were also conducted to determine if there were any group differences on pre- to post-test changes based on age, gender, and previous knowledge and/or experience of pancreatic cancer. Participants overwhelmingly endorsed the game’s usability and educational value, suggesting its potential as an effective tool for enhancing public awareness and proactive health-seeking behaviour.DiscussionThis study is the first to explore a serious game’s utility in pancreatic cancer awareness. Results suggest that such interventions can effectively increase public awareness and influence help-seeking intentions. The co-design process ensured content relevance, and participant satisfaction was high. Findings highlight the game’s potential as an accessible and convenient tool for diverse populations.

Preventative intervention home visitation programme for mothers with fussy infants: a mixed methods, pilot assessment of maternal self-efficacy, mental health, infant-bonding, and programme experiences

ABSTRACT This study assessed a preventive intervention home visiting programme (Fussy Baby Network (FBN)) designed to support mothers struggling with infant crying, sleeping, or feeding concerns. Mothers were referred to the programme through local health- and social service providers and were eligible to participate in the study if they were age 18 or older and had a child ≤12 months of age. A mixed methods design quantitatively assessed pre- to post-test changes in maternal mental health, parenting confidence, and parent-infant bonding and qualitatively explored mothers’ experiences of the programme. Statistically significant differences were found with effect sizes (Cohen's D) as follows: improved parenting self-efficacy (0.72) and confidence (0.44); reduced maternal anxiety (0.50), stress (0.44), mother-infant bonding difficulties (0.42), and depression (0.35). Qualitative findings revealed that Empathic Inquiry and Capacity Building, two core processes of the FBN model, emerged as the most salient themes of the programme.

Effect of Betty Neuman's systemic model on the anxiety of patients undergoing endoscopy: A randomized control trial

The present study aims to determine the effect of Betty Neuman's systemic model on the anxiety of patients undergoing endoscopy. This randomized control trial investigation involved 44 participants recruited from the endoscopy center of Golestan Province Hospital in the 2022, specifically those prescribed for endoscopic procedures. The data collection instruments employed in this research encompassed a demographic characteristics questionnaire focusing on age, gender, education, and occupation, as well as Spielberger's state-trait anxiety questionnaire (form Y) (STAI-Y). The pre-intervention anxiety levels were 111.41 (SD=17.61) in the intervention group and 109.27 (SD=6.64) in the control group. The Mann-Whitney U test indicated no statistically significant difference in the anxiety levels between the two groups before the intervention (P=0.29). Following the intervention, the anxiety levels were 116.56 (SD=12.25) in the intervention group and 111.95 (SD=4.70) in the control group. The independent t-test revealed a significant difference between the two groups (P&lt;0.01). Furthermore, the Wilcoxon test demonstrated no significant difference in anxiety levels within the control group before and after the intervention (P=0.36), whereas a significant difference was observed in the intervention group before and after the intervention (P&lt;0.01). Moreover, the ANCOVA revealed a statistically significant difference between the two groups after accounting for the pre-test effects (Eta=0.58, P&lt;0.01). This indicates that 58% of the variance in post-test changes can be attributed to the training provided based on the Betty Neuman's systemic model. In conclusion, the implementation of Betty Neuman's systemic model has proven to be effective in reducing anxiety levels among patients undergoing endoscopy. The demonstrated efficacy of Betty Neuman's model suggests that nursing models can serve as a cost-efficient, impactful, and secure treatment approach in patient care.

Effects of video game play, avatar choice, and avatar power on motivation to prepare for earthquakes

This study investigates the potential for motivating earthquake preparedness through video game play. 112 participants played a custom-built video game for between 5 and 30 min in an experiment involving two avatar selection conditions (choice vs. random assignment) and two avatar power conditions (more vs. fewer resources). We assessed self-reported pre- and post-test changes in levels of self-efficacy, sense of control, outcome expectation, and intent to act relating to 20 earthquake preparedness and response actions. We found that increases in social cognitive variable scores were significantly greater for actions central to game challenges than for actions peripherally or not included in the game. Where avatar characteristics were significant, high power and randomly assigned avatars led to greater increases in social cognitive variable scores. After 7 months, self-reported changes in preparedness increased significantly for 8 out of 10 actions.

Belonging mediates changes to resilience among separated siblings at camp-based reunification intervention

Previous work has established camp-based sibling reunification impacts to youths’ resilience and sense of belonging. The current study tested the mediating effects of belonging on pre-test-post test changes to youth resilience. We examined survey data from 2,260 youth who attended one of 16 camp-based reunification programs in the U.S. and Australia. Youth belonging at camp partially mediated pre-test post-test changes to measures of resilience. In a multi-group model, the indirect effects of belonging on youth resilience differed according to youth individual characteristics. Belonging is a resilience promoting mechanism for youth in out-of-home care.

Transcranial Magnetic Stimulation for Reducing the Relative Reinforcing Value of Food in Adult Patients With Obesity Pursuing Metabolic and Bariatric Surgery: Protocol for a Pilot, Within-Participants, Sham-Controlled Trial.

Metabolic and bariatric surgery (MBS) is the most effective and durable obesity treatment. However, there is heterogeneity in weight outcomes, which is partially attributed to variability in appetite and eating regulation. Patients with a strong desire to eat in response to the reward of palatable foods are more likely to overeat and experience suboptimal outcomes. This subgroup, classified as at risk, may benefit from repetitive transcranial magnetic stimulation (rTMS), a noninvasive brain stimulation technique that shows promise for reducing cravings and consumption of addictive drugs and food; no study has evaluated how rTMS affects the reinforcing value of food and brain reward processing in the context of MBS. The goal of the Transcranial Magnetic Stimulation to Reduce the Relative Reinforcing Value of Food (RESTRAIN) study is to perform an initial rTMS test on the relative reinforcing value (RRV) of food (the reinforcing value of palatable food compared with money) among adult patients who are pursuing MBS and report high food reinforcement. Using a within-participants sham-controlled crossover design, we will compare the active and sham rTMS conditions on pre- to posttest changes in the RRV of food (primary objective) and the neural modulation of reward, measured via electroencephalography (EEG; secondary objective). We hypothesize that participants will show larger decreases in food reinforcement and increases in brain reward processing after active versus sham rTMS. Participants (n=10) will attend 2 study sessions separated by a washout period. They will be randomized to active rTMS on 1 day and sham rTMS on the other day using a counterbalanced schedule. For both sessions, participants will arrive fasted in the morning and consume a standardized breakfast before being assessed on the RRV of food and reward tasks via EEG before and after rTMS of the left dorsolateral prefrontal cortex. Recruitment and data collection began in December 2022. As of October 2023, overall, 52 patients have been screened; 36 (69%) screened eligible, and 17 (47%) were enrolled. Of these 17 patients, 3 (18%) were excluded before rTMS, 5 (29%) withdrew, 4 (24%) are in the process of completing the protocol, and 5 (29%) completed the protocol. The RESTRAIN study is the first to test whether rTMS can target neural reward circuits to reduce behavioral (RRV) and neural (EEG) measures of food reward in patients who are pursuing MBS. If successful, the results would provide a rationale for a fully powered trial to examine whether rTMS-related changes in food reinforcement translate into healthier eating patterns and improved MBS outcomes. If the results do not support our hypotheses, we will continue this line of research to evaluate whether additional rTMS sessions and pulses as well as different stimulation locations produce clinically meaningful changes in food reinforcement. ClinicalTrials.gov NCT05522803; https://clinicaltrials.gov/study/NCT05522803. DERR1-10.2196/50714.

More than procurement: Examination of a farm-to-early-care and education pilot

Although there is a wealth of research on farm-to-school programs (FTS), less has been published about farm to early care and education programs (ECE). This paper examines the results of partici­pating in a farm-to-ECE procurement pilot pro­gram on provider practices across the three core elements of farm to ECE: (1) purchasing, (2) gar­dening, and (3) nutrition and education activities. In order to address the geographic and funding constraints of an existing procurement pilot, Michigan offered an expansion of this model so that ECE sites could take part in a learning collab­orative. They did this by examining the effective­ness of evidence-based practices in obtaining locally grown foods from a variety of sources among ECE sites, for statewide replication. Partici­pation included self-assessment of learning envi­ronments using a nationally available, validated instrument to determine pre- to post-test changes in farm-to-ECE practices and what, if any, changes in practices might have occurred for those partici­pating in the procurement pilot, with the goal of sharing what was learned statewide. Key findings include improvements of statistical significance from pre-test to post-test and changes in best prac­tices among participants using Go NAPSACC, with the top three most improved practices involv­ing garden-based practices. The role of self-assess­ment, funding, and limitations are discussed, along with implications for practice and further research.

Comparing low volume of blood flow restricted to high-intensity resistance training of the finger flexors to maintain climbing-specific strength and endurance: a crossover study.

It is acknowledged that training during recovery periods after injury involves reducing both volume and intensity, often resulting in losses of sport-specific fitness. Therefore, this study aimed to compare the effects of high-intensity training (HIT) and low-intensity training with blood flow restriction (LIT + BFR) of the finger flexors in order to preserve climbing-specific strength and endurance. In a crossover design, thirteen intermediate climbers completed two 5-week periods of isometric finger flexors training on a hangboard. The trainings consisted of ten LIT + BFR (30% of max) or HIT sessions (60% of max without BFR) and were undertaken in a randomized order. The training session consisted of 6 unilateral sets of 1 min intermittent hanging at a 7:3 work relief ratio for both hands. Maximal voluntary contraction (MVC), force impulse from the 4 min all out test (W), critical force (CF) and force impulse above the critical force (W') of the finger flexors were assessed before, after the first, and after the second training period, using a climbing-specific dynamometer. Forearm muscle oxidative capacity was estimated from an occlusion test using near-infrared spectroscopy at the same time points. Both training methods led to maintaining strength and endurance indicators, however, no interaction (P > 0.05) was found between the training methods for any strength or endurance variable. A significant increase (P = 0.002) was found for W, primarily driven by the HIT group (pretest-25078 ± 7584 N.s, post-test-27327 ± 8051 N.s, P = 0.012, Cohen's d = 0.29). There were no significant (P > 0.05) pre- post-test changes for MVC (HIT: Cohen's d = 0.13; LIT + BFR: Cohen's d = -0.10), CF (HIT: Cohen's d = 0.36; LIT + BFR = 0.05), W` (HIT: Cohen's d = -0.03, LIT + BFR = 0.12), and forearm muscle oxidative capacity (HIT: Cohen's d = -0.23; LIT + BFR: Cohen's d = -0.07). Low volume of BFR and HIT led to similar results, maintaining climbing-specific strength and endurance in lower grade and intermediate climbers. It appears that using BFR training may be an alternative approach after finger injury as low mechanical impact occurs during training.

Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy

PurposeBreast cancer (BC) and its treatments significantly impact the psychological wellbeing of women. Interventions offered during cancer survivorship have documented positive consequences for quality of life. However, limited evidence is available regarding the implementation of therapeutic photography. This study investigated the efficacy of the framed portrait experience (FPE) when implemented to BC survivors.MethodsA quasi-experimental study was conducted. Participants were enrolled in a non-randomized pre-post intervention with a comparison group. Forty BC survivors were recruited using a convenience sampling approach; of these, 20 were subsequently allocated to the intervention (FPE group) and 20 to the comparison group. Participants were assessed at pretest and posttest (3 weeks later) using self-reported measures of body image, coping, self-esteem, and self-efficacy. Independent samples t-tests compared group composition at pretest. Mixed between-within 2 × 2 repeated-measures ANOVAs examined pretest–posttest changes in the variables of interest.ResultsNo differences were detected between groups at pretest. A significant interaction effect on body image, problem-focused coping, emotion-focused coping, and in self-efficacy competence subscale (p < 0.05) was identified. Post hoc pairwise comparisons with the Bonferroni correction indicated improvement on these domains in the FPE group vs. comparison group. Additionally, significant main effects of time on self-efficacy total score and magnitude subscale (p < 0.05) were found.ConclusionsPreliminary results support the efficacy of FPE, but further research is needed.Implications for Cancer SurvivorsExistential approaches inclusive of self-portraits and illness narratives can be utilized to support BC survivors in the management of the psychological consequences of the illness.

Closing the gap in substance use disorder treatment through paraprofessional counselor training

ABSTRACT There is currently an insufficient supply of licensed substance use disorder counselors (SUDCs) to meet demand for services and the gap between supply and demand is projected to grow. Paraprofessional SUDCs offer one path to helping close this gap. The current study presents outcomes from a paraprofessional SUDC certificate program for Bachelor of Social Work (BSW) students. Student data (N = 66) were used to examine pre- to post-program changes in generalized SUDC knowledge and pre- to posttest changes in knowledge and self-efficacy from evidence-based workshops. Paired sample t-tests indicated that program participation significantly increased generalized SUDC knowledge. Participation in workshops significantly increased knowledge of motivational interviewing, integrative medicine, harm reduction, and grief and loss and self-efficacy for integrative medicine and harm reduction. BSW students gained generalized and treatment-specific knowledge via participation in a SUDC certificate program. The deployment of paraprofessionals SUDCs may provide one strategy to reduce treatment gaps.

Impact of the Integrative Oncology Scholars Program on Oncology Providers' Key Knowledge of Dietary Supplements and Antioxidants for Providing Evidence-based Oncology Care.

Dietary supplements are commonly used among cancer survivors. Oncology providers rarely receive training about dietary supplements. We evaluated whether e-learning modules could improve oncology providers' dietary supplement knowledge. Oncology providers participated in the National Cancer Institute funded Integrative Oncology Scholars (IOS) program. We used posttest readiness assurance tests (RAT) to measure knowledge acquisition from modules. One cohort completed a pre and posttest RAT to assess change in knowledge. Multivariate linear regression models adjusted for gender, race, profession, and years in practice were used to determine if these characteristics were associated with posttest RAT performance and change in pre to posttest RAT scores. Scholars (N = 101) included 86% (N = 87) females; age 44 ± 10years; 72% (N = 73) Non-Hispanic White; years in practice mean range 11-15 ± 10. There were 37 physicians, 11 physician assistants, 23 nurses, 21 social workers, 2 psychologists, 4 pharmacists, and 2 physical therapists. The posttest dietary supplement and antioxidant RAT scores for all Scholars were 67 ± 18% and 71 ± 14%. In adjusted models there were no significant associations between dietary supplement and antioxidant posttest RAT scores with Scholar characteristics. Change in RAT scores for dietary supplement and antioxidants were 25% ± 23 and 26% ± 27 (P < 0.0001). In adjusted models, there were no significant predictors of change in dietary supplement RATs. For antioxidant RATs, profession was associated with change in scores (P = 0.021). Improvement in Scholar's test scores demonstrate the IOS program can significantly increase oncology providers' knowledge of dietary supplements and antioxidants.

Fidelity of D.A.R.E. Officers’ Delivery of “keepin’ it REAL” in Elementary & Middle School

The goal of the current study is to examine the degree to which measures of quality of implementation and student engagement moderate pretest–posttest changes in mediating variables that are targeted by DARE “keepin’ it REAL.” DARE officers (10 elementary school, five middle school) taught DARE “keepin’ it REAL lessons to 1,017 elementary students (480 boys and 534 girls) and 435 middle school students (217 boys and 215 girls). We examined teachers’ and students’ ratings of elementary and middle schools in response to DARE officers’ delivery of the program. HLM analyses revealed that students’ engagement was a significant and meaningful predictor of changes in targeted mediators. Teachers’ ratings of student responsiveness added little in terms of understanding these outcomes with main effects observed only for students’ ability to respond to bulling and students’ estimates of peer drug use. Teachers’ ratings of the quality of officer implementation, on the other hand, did add to understanding students’ outcomes. Effects were seen for three (peer norms about drug use, decision-making (DM) skills, intentions to avoid drug use) out of six outcome variables and suggest a stronger positive effect for elementary versus middle school students. At least for these three outcomes, understanding quality of implementation added to our ability to interpret results. Specifically, in addition to students’ engagement, quality of implementation (which varied by grade) contributed to achieving positive changes in students’ outcomes.

Closing the gap in substance use disorder treatment through paraprofessional counselor training

ABSTRACT There is currently an insufficient supply of licensed substance use disorder counselors (SUDCs) to meet demand for services and the gap between supply and demand is projected to grow. Paraprofessional SUDCs offer one path to helping close this gap. The current study presents outcomes from a paraprofessional SUDC certificate program for Bachelor of Social Work (BSW) students. Student data (N = 66) were used to examine pre- to post-program changes in generalized SUDC knowledge and pre- to posttest changes in knowledge and self-efficacy from evidence-based workshops. Paired sample t-tests indicated that program participation significantly increased generalized SUDC knowledge. Participation in workshops significantly increased knowledge of motivational interviewing, integrative medicine, harm reduction, and grief and loss and self-efficacy related to integrative medicine and harm reduction. BSW students gain generalized and treatment-specific knowledge via participation in a SUDC certificate program. The deployment of paraprofessional SUDCs may provide one strategy to reduce treatment gaps

Impact of an immersive, interactive medical education initiative on guideline-based retinal disease management knowledge/competence and effectual practice change

BackgroundRetinal diseases, including wet or dry age-related macular degeneration, diabetic macular edema, and diabetic retinopathy (DR), are underdiagnosed and undertreated in the United States. Clinical trials support the effectiveness of anti-vascular endothelial growth factor (anti-VEGF) therapies for several retinal conditions, but real-world data suggest underuse by clinicians, resulting in patients experiencing poorer visual outcomes over time. Continuing education (CE) has demonstrated effectiveness at changing practice behaviors, but more research is needed to understand whether CE can help address diagnostic and treatment gaps.MethodsThis test and control matched pair analysis examined pre-/post-test knowledge of retinal diseases and guideline-based screening and intervention among 10,786 healthcare practitioners (i.e., retina specialists, ophthalmologists, optometrists, primary care providers, diabetes educators, pharmacists/managed care specialists, and other healthcare providers, such as registered nurses, nurse practitioners, and physician assistants) who participated in a modular, interactive CE initiative. An additional medical claims analysis provided data on practice change, evaluating use of VEGF-A inhibitors among retina specialist and ophthalmologist learners (n = 7,827) pre-/post-education, compared to a matched control group of non-learners. Outcomes were pre-/post-test change in knowledge/competence and clinical change in application of anti-VEGF therapy, as identified by the medical claims analysis.ResultsLearners significantly improved knowledge/competence scores on early identification and treatment, identifying patients who could benefit from anti-VEGF agents, using guideline-recommended care, recognizing the importance of screening and referral, and recognizing the importance of early detection and care for DR (all P-values = 0.003 to 0.004). Compared with matched controls, learners’ incremental total injections for anti-VEGF agents for retinal conditions increased more after the CE intervention (P < 0.001); specifically, there were 18,513 more (new) anti-VEGF injections prescribed versus non-learners (P < 0.001).ConclusionsThis modular, interactive, immersive CE initiative resulted in significant knowledge/competence gains among retinal disease care providers and changes in practice-related treatment behaviors (i.e., appropriate consideration and greater incorporation of guideline-recommended anti-VEGF therapies) among participating ophthalmologists and retina specialists compared to matched controls. Future studies will utilize medical claims data to show longitudinal impact of this CE initiative on treatment behavior among specialists and impact on diagnosis and referral rates among optometrists and primary care providers who participate in future programming.

Effectiveness of an online course for medicine residents on glycaemic management of hospitalized patients with diabetes.

Background Hyperglycaemia and hypoglycaemia in hospitalized patients are associated with poor clinical outcomes. We assessed whether administration of an online educational course for medicine residents improves the glycaemic management of hospitalized patients with diabetes. Methods We conducted this quasi-experimental, pre-post study from January 2019 to April 2019. The contents of the course were in compliance with the American Diabetes Association Guidelines 2018. After participating in the online course, the change in the knowledge of residents was assessed by pre- and post-test questionnaire and changes in the inpatient diabetes care were assessed by case record review of the hospitalized patients with diabetes managed by them before and after the participation in the course. Results Fifty-six residents participated and completed the online course. Their average post-test scores increased by 11.6%. One hundred and eighteen patients managed by the residents in the same wards before and after the participation in the course were studied. After attending the course, glycaemic targets were predetermined in 75.4% of patients compared to 32.2% before and adequacy of glucose monitoring improved. The total hypoglycaemic event rate reduced significantly by 45.8% and this was accompanied by a trend towards improved glycaemic control. At the time of discharge, the patient awareness on insulin injection technique, hypoglycaemic symptoms and its home remedies were significantly increased. Conclusion The administration of an online course increases the knowledge level of residents, improves patient safety and may improve glycaemic control in hospitalized patients with diabetes.

Comparing the effectiveness of teaching cognitive and metacognitive strategies on academic buoyancy

Background and Aim: The present research was designed and implemented to compare the effectiveness of teaching cognitive learning strategies and metacognitive learning strategies on the academic buoyancy of Tehran students in the academic year 2020-21. Methods: The current research was conducted as a quasi-experimental study with a pre-test and post-test along with a control and follow-up group. The research population included students who were studying in Tehran in 2021; A random sampling method was used to select the sample. They were replaced in the test 1 and test 2 groups and the control group. First, the pre-test was performed for all three groups, then one training group was taught cognitive learning strategies and the other experimental group was taught metacognitive learning strategies; However, there was no intervention in the control group, and at the end, a post-test was taken from all three groups. The questionnaire used in the research was the Academic Buoyancy Questionnaire by Martin and Marsh (2008). To analyze the data, the method of mixed variance analysis was used. Results: The interaction of stages with the experimental group was effective in three stages of measurement in academic monitoring (F=8.78, P=0.001). Conclusion: The results showed that according to the average scores of the pre-test and post-test and comparing them with the control group, the academic buoyancy of the students has increased; Also, a follow-up test was taken after one month, in which the post-test changes remained stable and stable.

The Effect of Problem-Solving-Based Learning on Critical Thinking Skills of Nursing Students

Background: Nurses need critical thinking (CT) skills when faced with unstable clinical conditions. CT is a style of thinking, which requires new and student-oriented education. Nursing educators should train active students interested in continuous learning with their educational methods. Objectives: Therefore, this study aimed to determine the effect of problem-solving-based education on the CT skills of nursing students of the Islamic Azad University of Golestan province in Iran. Methods: This experimental study used a pre-test and post-test with a control group. The study area was the department of undergraduate nursing students of the Islamic Azad University of Golestan province in the 7th and 8th semesters in the Islamic Azad University of Golestan province in 2022. The population included 50 nursing students, who were selected by convenient sampling. The data collection tool was the demographic profile form and the California Critical Skills Test (CCST). Results: In the control group, the results of the paired t-test in different dimensions, including truth-seeking (P = 0.91), criticism (P = 0.82), organization (P = 0.74), Curiosity (P = 0.52) and the overall size (P = 0.06) did not show significant differences before and after the intervention. However, there was a significant difference in the dimensions of analysis (P = 0.03) and self-confidence (P &lt; 0.01). The ANCOVA test showed a significant difference (P &lt; 0.01, Eta = 0.55) by removing the pre-test. Thus, 55% of post-test changes could be related to problem-solving skills. Conclusions: Based on the effectiveness of problem-solving learning in increasing the CT of nursing students, CT levels can be raised using this method. Therefore, it is recommended to hold the related courses in educational centers, especially universities and higher education centers.