Investigating the role of clinical exposure on motivational self-regulation skills in medical students based on cognitive apprenticeship model

BACKGROUND

The importance of motivation regulation in medical students is highly significant due to their unique educational circumstances, such as clinical exposure. However, the role of clinical exposure in learning motivational self-regulation skills in students has not been explored thus far. This current study aims to investigate the role of clinical exposure on motivational self-regulation skills in medical students based on cognitive apprenticeship model.

METHOD

This study was descriptive-analytical research conducted in 2022 on medical students. Data collection involved two questionnaires including Meta motivational Strategies in Medical Students Questionnaire and Maastricht Clinical Teaching Questionnaire. The research comprised two stages including measuring motivational self-regulation strategies in students before entering the clinical exposure phase, and simultaneous measurement of clinical exposure based on the student's viewpoint and their motivational self-regulation strategies at the end of the first term of clinical exposure.

RESULTS

The results revealed a significant relationship between six dimensions of the cognitive apprenticeship model, including modeling, coaching, scaffolding, reflection, exploration, and learning environment, with motivational self-regulation strategies. However, there was no significant relationship between the articulation dimension of the cognitive apprenticeship model and motivational self-regulation strategies.

CONCLUSION

Clinical exposure indirectly enhances students' metacognitive skills. Observing the behavior of clinical faculty in the clinical exposure setting leads to the improvement of motivational self-regulation strategies in medical students.

A blueprint for success: lessons learned from developing the official guide to Iranian undergraduate medical education accreditation

We are excited to contribute our thoughts and insights to the discussion initiated by Gandomkar et al. in their article on the accreditation system in Iran (Gandomkar et al., BMC Med Educ 23:379, 2023). As individuals who have been directly involved in the process of meta-accreditation and possess a comprehensive understanding of the various stages of Undergraduate Medical Education (UME) accreditation in Iran, we would like to highlight additional points that were identified through a rigorous hermeneutic phenomenology process proposed by Gadamer (Gadamer, Truth and Method, 2013) and offer a complementary point of view to the previous work. By sharing our insights, we hope to contribute to the ongoing discourse surrounding UME accreditation.

Cerebral protection in acute type A aortic dissection surgery: a systematic review and meta-analysis

Background

Acute type A aortic dissection (ATAAD) still challenges physicians and warrants emergent surgical management. Two main methods to reduce cerebrovascular events in ATAAD surgeries are antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). We conducted a systematic review and meta-analysis to compare the outcomes of ACP and RCP methods during the ATAAD surgery.

Methods

In this study, we searched the databases until March 29th, 2023. Studies that reported the data for comparison of different types of brain perfusion protection during aortic surgery in patients with ATAAD were included.

Results

Twenty-six studies met the eligibility criteria. All studies had a low risk of bias as they were evaluated by the Joanna Briggs Institute (JBI) critical appraisal tool. Eventually, we included 26 studies in the current meta-analysis, and a total of 13,039 patients were evaluated. The calculated risk ratio (RR) for permanent neurologic dysfunction (PND) in ACP and RCP comparison was RR =1.23, 95% confidence interval (CI): (0.84, 1.80) (P value =0.2662), and in unilateral ACP (uACP) and bilateral ACP (bACP) was RR =1.2786, 95% CI: (0.7931, 2.0615) (P value =0.3132). When comparing the ACP-RCP and uACP-bACP groups, significant differences were found between ACP-RCP the groups in terms of circulatory arrest time (P value =0.0017 and P value =0.1995, respectively), cardiopulmonary bypass time (P value =0.5312 and P value =0.7460, respectively), intensive care unit (ICU)-stay time (P value =0.2654 and P value =0.0099), crossclamp time (P value =0.6228 and P value =0.2625), and operative mortality (P value =0.9368 and P value =0.2398, respectively), and when comparing the u-ACP and b-ACP groups for transient neurologic deficit (TND), an RR of 1.32, 95% CI: (1.05, 1.67) (P value =0.0199). The results showed high heterogeneity and no publication bias.

Conclusions

This study demonstrated that the ACP and RCP are both safe and acceptable techniques to use in emergent settings. The uACP technique is equivalent to bACP in terms of PND and mortality, however, uACP is preferred over bACP in terms of TND.

Metamotivation in medical education: The 4F conceptual framework

INTRODUCTION

Several models and frameworks have been developed in the past two decades to explain motivation regulation in different fields. However, a comprehensive framework that explains the dimensions of metamotivation in medical education is lacking. This study aims to address this gap by presenting a conceptual framework to understand metamotivation in medical education.

METHOD

This study was conducted at Tehran University of Medical Sciences in 2022-2023. We applied Crawford's guidance on developing a conceptual framework via collecting data from three sources: experience, literature, and theory. We developed the initial draft of the conceptual framework by identifying gaps in existing models. A panel of experts reviewed the draft and provided feedback on the framework's generation, explanation, and argumentation. The final model was designed in the form of a graphical presentation.

FINDINGS

The study's conceptual framework clearly distinguishes between motivational challenges and motivational problems, and outlines four phases that explain each phase's importance, components, and implementation process. The first phase focuses on promoting metamotivational knowledge among learners. In the second phase, learners face motivational challenges and aim to manage them optimally to prevent motivational problems. The third phase occurs when a motivational problem arises, and learners use motivational regulation strategies to resolve it. In the fourth and final phase, learners use psychological skills to stabilize and strengthen the metamotivational process.

CONCLUSION

This study's conceptual framework focuses specifically on the context of medical education to provide guidance for future research and interventions on metamotivation. By presenting this framework, we aim to capture the attention of researchers toward the topic of metamotivation and encourage further exploration of its dimensions.

Psychometric evaluation of Maastricht clinical teaching questionnaire based on the cognitive apprenticeship model

BACKGROUND

The Maastricht Clinical Teaching Questionnaire is a valid and reliable instrument for measuring the quality of clinical teaching. This study was aimed at translation and psychometric evaluation of the Persian version of this questionnaire to evaluate clinical teaching based on the cognitive apprenticeship model.

MATERIALS AND METHODS

The translation of the questionnaire was performed according to Guillemins framework. Reliability was examined by calculating Cronbach's alpha coefficient. Confirmatory factor analysis was studied among 120 medical students. Content validity was assessed by calculating the content validity index and content validity ratio. Face validity was evaluated by conducting interviews with students using concurrent verbal probing and thinking aloud.

RESULTS

Cronbach's alpha coefficient for the whole scale was 0.95. The content validity index was 0.92, and the content validity ratio was 0.82. Confirmatory factor analysis resulted in a seven-factor model and demonstrated an adequate fit with the data.

CONCLUSION

The Persian version of the Maastricht Clinical Teaching Questionnaire with seven factors including modeling, coaching, scaffolding, articulation, reflection, exploration, and learning environment appears to be a valid and reliable instrument for the evaluation of clinical teaching in Iranian universities of medical sciences.

Could admission level of uric acid predict total diuretic dose in acute heart failure?

BACKGROUND

Recent studies have shown that increases in serum UA levels are associated with adverse clinical outcomes in patients with chronic heart failure (CHF); the aim of this study was to determine the relationship between serum uric acid and total diuretic dose received during hospitalization in hospitalized patients with acute exacerbation of heart failure. The main purpose of this study is to determine the role of uric acid as a biomarker that can be a substitute for pro-BNP in clinical evaluation and the need for diuretics in hospitalized patients with acute heart failure.

METHODS

After approving the plan in the Research Council of the Heart Department and obtaining an ethical code from the Regional Committee on Research Ethics (Human Subjects Studies), the researcher referred to the archives of our center, the case of 100 patients diagnosed with acute heart failure. Cardiac patients were selected, and the information required for the study was collected using a pre-prepared data collection form, and the information was entered into SPSS software after categorization and appropriate analysis and statistical tests were performed on it. Were performed and in all statistical tests the statistical significance level was considered 0.05: RESULTS: 100 patients with acute heart failure were included in this study with a mean age of 63.43 ± 14.78 years. 66% of them were men. The mean dose of furosemide in these patients was 680.92 ± 377.47 mg and the mean serum uric acid level in these patients was 8.55 ± 2.50 mg / dL. In the study of the relationship between the variables, there was a significant relationship between the dose of furosemide received with the serum level of serum uric acid (P = 0.017, r = 0.248 and P = 0.009, r = -0.267, respectively). There is also a significant relationship between serum uric acid level and patient mortality (P = 0.013, r = 0.247). However this relationship lost its significance after multivariate analysis.

CONCLUSION

There is a significant relationship between serum uric acid level and diuretic use. However, in-hospital mortality is not related to uric acid levels at admission.

Promising applications of nanotechnology in inhibiting chemo-resistance in solid tumors by targeting epithelial-mesenchymal transition (EMT)

The resistance of cancer cells to chemotherapy, also known as chemo-resistance, poses a significant obstacle to cancer treatment and can ultimately result in patient mortality. Epithelial-mesenchymal transition (EMT) is one of the many factors and processes responsible for chemo-resistance. Studies have shown that targeting EMT can help overcome chemo-resistance, and nanotechnology and nanomedicine have emerged as promising approaches to achieve this goal. This article discusses the potential of nanotechnology in inhibiting EMT and proposes a viable strategy to combat chemo-resistance in various solid tumors, including breast cancer, lung cancer, pancreatic cancer, glioblastoma, ovarian cancer, gastric cancer, and hepatocellular carcinoma. While nanotechnology has shown promising results in targeting EMT, further research is necessary to explore its full potential in overcoming chemo-resistance and discovering more effective methods in the future.

Keeping motivation on track by metamotivational knowledge: AMEE Guide No. 160

This AMEE guide seeks to improve the metamotivational knowledge of health professions educators as well as students. We present key models and frameworks of Metamotivation, identify several motivation regulation strategies and their measurement tools, and propose applications for health professions education (HPE). Since our work is grounded on evidence from the field, we include new findings about motivation regulation to encourage further exploration. Although much of the research on Metamotivation has been done outside the field of medical education, we share our six years of research experience and findings within the field to inspire others to replicate and expand.

SIMOA-based analysis of plasma NFL levels in MCI and AD patients: a systematic review and meta-analysis

BACKGROUND

The single-molecule array assay (SIMOA)-based detection of neurofilament light (NFL) chain could be useful in diagnosing mild cognitive impairment (MCI) and Alzheimer's disease (AD). This meta-analysis aimed to evaluate the circulating concentration of NFL in AD and MCI patients compared with healthy controls using the SIMOA technique.

METHODS

To this end, Google Scholar, PubMed, Scopus, Web of Science, and the reference lists of relevant articles were systematically searched for studies reporting serum NFL chain levels in healthy controls, MCI, and AD patients. Appropriate statistical methods were employed to achieve the study purpose.

RESULTS

Fifteen eligible studies including 3086 patients were pooled out of a total of 347 publications. Fixed effect model analysis showed that NFL chain level was significantly higher in the serum of patients with MCI (0.361 SMD, 95% CI, 0.286-0.435, p = 0.000, I2 = 49.179) and AD (0.808 SMD, 95% CI, 0.727-0.888, p = 0.000, I2 = 39.433) compared with healthy individuals. The analysis also showed that the NFL chain levels in plasma were significantly different between patients with MCI and AD (0.436 SMD, 95% CI, 0.359-0.513, p = 0.000, I2 = 37.44). The overall heterogeneity of the studies was modest.

CONCLUSIONS

This study highlights the potential of serum NFL chain detected using SIMOA in differentiating MCI, AD, and healthy controls.

The potential role of COVID-19 in progression, chemo-resistance, and tumor recurrence of oral squamous cell carcinoma (OSCC)

Numerous studies have revealed that cancer patients are more likely to develop severe Coronavirus disease-2019 (COVID-19), which can cause mortality, as well as cancer progression and treatment failure. Among these patients who may be particularly vulnerable to severe COVID-19 and COVID-19-associated cancer progression are those with oral squamous cell carcinoma (OSCC). In this regard, therapeutic approaches must be developed to lower the risk of cancer development, chemo-resistance, tumor recurrence, and death in OSCC patients with COVID-19. It may be helpful to comprehend the cellular and molecular mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributes to these problems. In this line, in this review, we described the potential cellular and molecular mechanisms that SARS-CoV-2 can exert its role and based on them pharmacological targeted therapies were suggested. However, in this study, we encourage more investigations in the future to uncover other cellular and molecular mechanisms of action of SARS-CoV-2 to develop beneficial therapeutic strategies for such patients.

The role of motivational components in metamotivational monitoring in medical students: a mixed method study

BACKGROUND

In metamotivational monitoring, students try to identify the declined motivational component in order to regulate their motivation. There is scarcity of evidence on which motivational components are targeted by the medical students when they use each motivational regulation strategies. This study aims were identifying motivational components in motivational regulation process, developing a measurement tool and, testing the predictive relationship between the motivational components and motivational regulation strategies.

METHODS

This exploratory sequential design mixed method study is part of a project has been started from 2018 with medical students at Tehran University of Medical Science. First, in a qualitative study conducting a semi-structured in-depth interview, the motivational components were explored. The interviews continued until saturation of data. Then, in a psychometric study the validity and reliability evidence of questionnaire obtained. In the quantitative study, applying the convenience sampling method, 508 students completed the questionnaires. Predictive relation between the motivational regulation strategies and motivational components was assessed utilising Structural Equation Modelling. Path coefficients, T-Value, and R² index were reported by SmartPLS software.

RESULTS

In the Exploratory Factor Analysis of Motivational Components Questionnaire (MCQ), 6 factors were discovered that explained 74% of the total variance. All paths in seven models of SEM showed a T-Value above 1.96 that means there is a significant correlation between all strategies and components. In examining the predictive relationships, each of the four components of self-efficacy, intrinsic value, self-relevant value and promotion value were specifically predicted by two motivational regulation strategies.

CONCLUSIONS

Evidence of validity and reliability of the MCQ indicates that this questionnaire can be used in medical education contexts. Health Profession Educators can improve the academic motivation of students by identifying one or more declined motivational component and teaching specific motivational regulation strategies. It is recommended to hold training courses on motivational regulation strategies for medical school faculty, study-skills advisors, and students.

Metamotivation in medical students: Explaining motivation regulation strategies in medical students

BACKGROUND

Metamotivation is a process that students use to monitor their motivational states to reach their academic goals. To date, few studies have addressed the ways that medical students manage their motivational states. This study aim to identify the motivational strategies of medical students as they use the metamotivational process to monitor and control their motivational states.

MATERIALS AND METHODS

This qualitative study uses directed content analysis of the narrative responses of 18 medical students to draft an in-depth and semistructured interview protocol which were conducted through WhatsApp due to social distance restrictions of COVID-19. Data were collected, encoded, and analyzed using deductive content analysis approach descripted by Elo and Kyngäs.

RESULTS

Seven main themes were extracted as the motivational strategies of medical students including "regulation of value," "regulation of situational interest," "self-consequating," "environmental structuring," "efficacy management," "regulation of relatedness," and "regulation of situational awareness." In this study by identifying new strategies, we provide a broader framework of metamotivational strategies in the field of the progression of learners in medical education.

CONCLUSION

Medical students use a variety of strategies to regulate their academic motivation. To sustain and improve the motivation of medical students, identifying and strengthening metamotivational strategies is the first step.

The development and validation of metamotivational strategies in medical students questionnaire

INTRODUCTION

Understanding medical students' motivational regulation strategies is particularly salient to monitor their quality and quantity of motivation. This study aims to develop and validate a questionnaire to measure metamotivational strategies in medical students.

METHODS

A Metamotivational Strategies in Medical Students Questionnaire (MSMQ) was developed by using the seven steps presented in 'developing questionnaires for educational research: AMEE Guide No. 87'. First, in a systematic search, related articles extracted and nine instruments were identified. Then, in a qualitative study, the metamotivational strategies of medical students were explained. In the next step, the identified strategies were conceptually compared with previous studies, and the MSMQ items were developed. Finally, expert validation, cognitive interviews, exploratory factor analysis, and reliability analysis were conducted.

RESULTS

The MSMQ consisted of 7 factors and 28 items. CVI >0.79 in terms of relevance, clarity, and simplicity. In exploratory factor analysis, seven subscales explained 67.5% of the variance. Cronbach's alpha = 0.89. ICC = 0.76 - 0.87.

CONCLUSION

The MSMQ has reasonable psychometric properties, with adequate internal reliability and strong evidence of structural validity. However, further validation in other settings applying various psychometric methods is recommended.

Psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form

Background: Despite studies about anxiety in the older adult, the prevalence of anxiety in this age group is not exactly clear, which may be due to the use of tools and criteria that were not born for this age group. One of the instruments designed to assess anxiety in the elderly is the Geriatric Anxiety Inventory (GAI). The aim of this research was to analyze the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form (GAI-PV-SF) in a sample of older adults in Iran. Methods: In this cross-sectional study, a sample of 150 community-dwelling and a psychogeriatric sample of 48 adults older than 60 years completed the GAI-PV and GAI-PV-SF, the anxiety sub-scale of the General Health Questionnaire (GHQ-28), the Geriatric Depression Scale (GDS-15), and the Structured Clinical Interview for DSM-IV (SCID-I). Different types of validity and reliability were evaluated for GAI-PV and GAI-PV-SF using SPSS and the LISREL software. Results: Both the GAI-PV and GAI-PV-SF exhibited excellent internal consistency (over 80 %) and desirable concurrent validity against GHQ-28 and GDS-15. The optimal cutpoint score to detect current generalized anxiety disorder (GAD) was 10/11 and 13/14 for GAI-PV in the community-dwelling and psychogeriatric samples, respectively, and 3/4 for GAI-PV-SF in both study samples. Good test-retest reliability (correlation coefficient: 0.96 and 0.88 for GAI-PV and GAI-PV-SF, respectively) and a single-factor structure were also demonstrated. Conclusion: Sound psychometric properties of the GAI-PV in both subsamples suggest that the instrument could be used successfully as an accurate screening instrument in the elderly Iranian population.

Psychometric evaluation of a questionnaire to evaluate organizational capacity development for faculty development programs

BACKGROUND

Organizational capacity development is an important outcome of faculty development programs, but there is a lack of an appropriate instrument for its evaluation.

AIMS AND OBJECTIVES

The aim of this study was to develop a questionnaire to evaluate the organizational capacity development for faculty development programs and to test its psychometrics.

MATERIALS AND METHODS

The initial capacity development for faculty development questionnaire (CDQ-FD) of 26 items was developed based on a literature review and opinion of experts. Content validity ratio (CVR), content validity index (CVI), content validity index for items (I-CVI), and the content validity index for scales (S-CVI) were computed for content validity. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were performed for construct validation.

RESULTS

The score for CVR, CVI, I-CVI, and S-CVI was 0.71, 0.83, 0.87, and 0.90, respectively. EFA resulted in a three-factor model with total variance extraction of 64%. Cronbach's alpha and Spearman Brown coefficient were investigated for reliability assessment. The Cronbach's alpha of overall scale was 0.8 and the test-retest reliability of the overall scale was 0.78. The final CDQ-FD contained 21 items and three categories.

CONCLUSIONS

The CDQ-FD questionnaire appears to be a valid and reliable instrument for the evaluation of organizational capacity development for faculty development in the medical education.

Modeling and simulating of feed flow in a gas centrifuge using the Monte Carlo method to calculate the maximum separation power

Most of the gas enters into a small portion of the rotating cylinder by increasing the rotational speed in a rotating cylinder. Navier-Stokes equations were used to evaluate gas behavior in this area. In this paper, the mass source calculated by the DSMC method at the boundary of the two regions has been used in the Onsager-Pancake equation and finite difference method was used to solve this equation. One of the assumed flow functions taking into account the effects of the scoop and thermal driving is the Olander's flow function. By combining the flow function that resulted from the Onsager-Pancake equation and the Olander's flow function, a new flow function is suggested, that in addition to applying the effect of thermal and mechanical driving, the feed driving added to it with the DSMC method. The results obtained using this new flow function in the modified diffusion equation by Onsager-Cohen, showing the resulted optimal separation power from that in comparison to the Olander's function occurs in a state where thermal driving is insignificant and scoop driving has increased. The effects of scoop drive have increased by increasing the feed value with the new flow function. Furthermore, the diffusion equations have been solved for ²³⁵UF₆ and ²³⁸UF₆ using the new flow function and it has been calculated the separation parameters.

Assessing the Quality of Existing Clinical Practice Guidelines for Chemotherapy Drug Extravasation by Appraisal of Guidelines for Research and Evaluation II

Background:

Extravasation is a potentially hazardous event that may occur during chemotherapy. The aim of this study is to assess the quality of existing Clinical Practice Guidelines (CPGs) for chemotherapy drug extravasation by Appraisal of Guidelines for Research and Evaluation II (AGREE II).

Materials and Methods:

Valid electronic databases and CPGs from 2007 to August 2018 were searched by keywords of CPGs, extravasation, chemotherapy, and cancer. CPGs were evaluated independently by five experts through AGREE II tool, and the consensus among evaluators was calculated by ICC (Intra-class Correlation Coefficient).

Results:

Five of the 111 CPGs matched the inclusion criteria. The methodological quality of CPGs in domains of “scope and purpose,“ “stakeholder involvement,“ “clarity of presentation,“ and “applicability“ were good, in the domain of “rigor of development,“ was acceptable, and in “editorial independence“ domain, it needed more attention of developers of CPGs. The range of assessors' consensus was within a range of moderate to very good (0.55--0.93).

Conclusions:

The methodological quality of existing CPGs of chemotherapy drugs extravasation assessed by AGREE II tool is appropriate. Four CPGs had high level while one had moderate level of quality. Therefore, their use is recommended in the clinic to reduce the risk of chemotherapy extravasation to the entire treatment team and the nurses working in the oncology departments.

Immune responses to hepatitis B immunization 10-18 years after primary vaccination: a population-based cohort study

We evaluated the immune response to neonatal HBV immunization in children of infected parents 10-18 years after primary vaccination. Healthy individuals immunized with an infantile course of three doses of HBV vaccine were tested for persistence of anti-HB surface antibody (HBsAb). Those with an HBsAb level of <10 IU/mL received a booster dose of the vaccine with subsequent doses to those without protective titres. HBsAb concentrations were determined 4 weeks after each dose of the booster vaccine. The data were analysed separately for three age groups: 10-11, 12-14 and 15-18 years old. A total of 541 healthy individuals were studied. The highest seroprotection rate of 48% was observed in the youngest vaccinees (10-11 years old). This declined to 26.5% in the oldest (15-18 years old) group (P = 0.008). The youngest vaccinees showed the highest rate of anamnestic immune responses (96%). However, 25% of oldest individuals failed to mount an anamnestic immune response in challenge with a booster dose of the vaccine (P = 0.005), suggesting waning immunity with increasing age. Age (OR: 0.80; P = 0.01) and prebooster HBsAb levels (OR: 0.37; P = 0.01) identified responders to first booster doses of the vaccine by logistic regression analysis. The majority of high-risk vaccinees showed anamnestic immune response 10-11 years after primary immunization. However, we found a significant proportion (25%) of older individuals with no anamnetic response, which suggests a waning of immune memory. Detailed long-term follow-up studies are necessary to determine the risk of natural infection among these individuals before a booster schedule can be recommended.

Examining social-cognitive predictors of parenting skills among mothers with preschool and early elementary school-aged children

CONTEXT

Identification of parenting skills determinants among mothers is an ongoing field of research.

AIMS

The aim of this study was to identify the social cognitive predictors of parenting skills among mothers.

SETTINGS AND DESIGN

Previous studies have demonstrated the health action process approach (HAPA) as a credible frame for predicting behavior, but the number of studies considering the predictive value of parenting skills determinants among mothers is rare.

SUBJECTS AND METHODS

An 8 months prospective design was applied. Participants were mothers with preschool and early elementary school-aged children. At the 1(st) time, 120 participants completed self-report questionnaires regarding their risk perception, outcome expectancies, task self-efficacy, and intentions toward parenting skills. At the 2(nd) time, they returned a follow-up questionnaire, which measured planning, coping self-efficacy, and recovery self-efficacy and finally, 8 months later as the 3(rd) time, parenting skills were measured. Path analysis was used for analysis.

RESULTS

Path analysis indicated that, in the motivational phase, there was no relationship between parenting skills intention and risk perception, outcome expectancies, and task self-efficacy. Furthermore, no relationship was found between parenting skills intention and planning. In the volitional phase, coping self-efficacy, recovery self-efficacy, and planning were statistically significant predictors of parenting skills.

CONCLUSION

The results of this study confirm that volitional phase of the HAPA model is useful in determining parenting skills. However, the role motivational variables seem to be unimportant in performing these behaviors. It was concluded that everybody intended to apply parenting skills, in nature, and intervention strategies should be focused on turning intentions into behavior.

Implementation of OSCE Test to Develop Appropriate Tool to Measure Mothers’ Parenting Skills

Introduction:

Parents play a vital role throughout a child’s life. This role is very significant in the beginning years of a child’s life. In this period, the child encounters new experiences and these experiences make him or her to learn and grow. These days, in order to help the parents build a bright future for their children, different parenting programs have been designed. These programs provide a great opportunity for parents to enhance positive parenting skills. The aim of this study was to design a reliable and valid instrument for assessing the mothers’ parenting skills.

Methodology:

44 mothers who had children aged 3–8 were invited to participate in this study. They took part in parenting-skills training sessions for more than two months. Then they were asked to attend the test center after six months to be tested on trained skills. In this study, mothers’ parenting skills were measured by the OSCE test. The reliability of the test was determined with three methods including split half, Cronbach alpha, and correlation between assessors’ scores in two similar stations. The construct validity of the test was determined with Explanatory Factor Analysis.

Results:

The total Cronbach alpha coefficient obtained was 0.83 which indicated that the test had a high internal reliability. The Spearman correlation coefficient obtained for two halves of the test was 0.76. The results of Explanatory Factor Analysis showed that nine stations of OSCE were focused on two factors. The first factor was named positive positions and the second factor was named negative positions.

Conclusion:

The designed OSCE test has the suitable psychometric features to be used by researchers to assess mothers’ parenting skills.

Pilot study of cytological testing for oesophageal squamous cell dysplasia in a high-risk area in Northern Iran

Background:

Oesophageal squamous cell carcinoma (ESCC) is a fatal disease with 5-year survival rates of <5% in Northern Iran. Oesophageal squamous dysplasia (ESD) is the precursor histologic lesion of ESCC. This pilot study was conducted to assess the feasibility, safety, and acceptability of non-endoscopic cytological examination of the oesophagus and to provide initial data on the accuracy of cytological atypia for identifying patients with ESD in this very-high-risk area.

Methods:

Randomly selected asymptomatic participants of the Golestan Cohort Study were recruited. A cytological specimen was taken using a capsule sponge device and evaluated for atypical cells. Sections of the cytological specimen were also stained for p53 protein. Patient acceptability was assessed using a visual analogue scale. The cytological diagnosis was compared with a chromoendoscopic examination using Lugol's solution.

Results:

Three hundred and forty-four subjects (43% male, mean (s.d.) age 55.6 (7.9) years) were referred to the study clinic. Three hundred and twelve met eligibility criteria and consented, of which 301 subjects (96.5%) completed both cytological and endoscopic examinations. There were no complications. Most of the participants (279; 92.7%) were satisfied with the examination. The sensitivity and specificity of the cytological examination for identifying subjects with high-grade ESD were 100 and 97%, respectively. We found an accuracy of 100% (95% CI=99–100%) for a combination of cytological examination and p53 staining to detect high-grade ESD.

Conclusions:

The capsule sponge methodology seems to be a feasible, safe, and acceptable method for diagnosing precancerous lesions of the oesophagus in this population, with promising initial accuracy data for the detection of high-grade ESD.

Dibromido(di-2-pyridylamine-κN,N')mercury(II)

In the mol­ecule of the title compound, [HgBr₂(C₁₀H₉N₃)], the Hg^II atom is four-coordinated in a distorted tetra­hedral configuration by two N atoms from the chelating di-2-pyridylamine ligand and by two Br atoms. In the crystal structure, inter­molecular N—H⋯Br hydrogen bonds link the mol­ecules into centrosymmetric dimers. There are π–π contacts between the pyridine rings [centroid–centroid distances = 3.9662 (5) and 3.9321 (4) Å]. There also exists a C—H⋯π contact between the pyridine CH group and a pyridine ring.

Dichlorido(6-methyl-2,2'-bipyridine-κN,N')mercury(II)

In the mol­ecule of the title compound, [HgCl₂(C₁₁H₁₀N₂)], the Hg^II atom is four-coordinated in a distorted tetra­hedral configuration by two N atoms from a 6-methyl-2,2′-bipyridine ligand and two Cl atoms. There is a π–π contact between the pyridine rings [centroid–centroid distance = 3.9758 (5) Å].