Does watching a movie improve empathy? A cluster randomized controlled trial

Background: We studied if watching a movie about the patient physician encounter alone or in combination with a communication skills training workshop could improve empathy score of medical students. Methods: One hundred and thirty three medical students participated in one of the following four groups of the study. Group A: a three hour workshop (42 students); group B: watching the movie “The Doctor” (23 students); group C: watching the movie “The Doctor”, then, participating in a three hour workshop the next day (22 students); group D: control group with no intervention (46 students). Participants completed Jefferson Scale of Empathy (JSE), Student Version to assess empathy score before and after the intervention, and one month later. A linear mixed effect model analyzed the effect of intervention across groups considering the effects of other significant variables. Results: All of the three interventions had an immediate improving effect on empathy scores compared to control group. However, the improvement effect remained significant only in groups A (p=.015) and C (p=.001) one month later. Conclusions: Watching selected movies has a significant but transient effect on empathy of students. Combining two methods of watching the movie and communication skills workshop, seems to add the beneficial effects

Chronic Kidney Disease in Southwestern Iranian Children

Objective: The aim of the study was to determine the etiology of Chronic Kidney Disease (CKD) among children attending the pediatric nephrology service at Abuzar children's hospital in Ahvaz city, the referral center in Southwest of Iran. Methods: We reviewed the records of 139 children, diagnosed to have CKD over a 10-year period. CKD was defined a glomerular filtration rate (GFR) below 60 ml/1.73 m2/min persisting for more than 3 months. Findings: Among 139 children 81 (58%) were males. The mean age at diagnosis of CKD in the patients was 4.2 (±3.6) years. Mean level of serum creatinine at presentation was 1.9 (±1.4) mg/dl. The mean GFR at presentation was 33.5 (±15.4) ml/1.73m2/min while 22% of the patients were already at end stage renal failure indicating that these children were referred too late. Congenital urologic malformation was the commonest cause of CKD present in 70 (50.4%) children [reflux nephropathy (23.1%), hypo/dysplastic kidney (15.8%), obstructive uropathy (10.8%), and prune belly syndrome (0.7%)]. Other causes included hereditary nephropathies (17.2%), chronic glomerulo-nephritis (6.5%), multisystemic diseases (4.3%), miscellaneous and unknown (each one 10.8%). The mean duration of follow-up was 26 (±24.67) months. Peritoneal or hemodialysis was performed in 10 patients. Six patients underwent (4 live-related and 2 non-related) renal transplantation. The rest have died or received standard conservative management for CKD. Conclusion: The commonest causes of CKD were reflux nephropathy, hypo/dysplastic kidney, hereditary nephropathy and obstructive uropathy. Patients presented late, had severe CKD and were malnourished and stunted

The quality of care index for low back pain: a systematic analysis of the global burden of disease study 1990–2017

Abstract Background . Low back pain is one of the major causes of morbidity worldwide. Studies on low back pain quality of care are limited. This study aimed to evaluate the quality of care of low back pain worldwide and compare gender, age, and socioeconomic groups. Methods . This study used GBD data from 1990 to 2017 from the Institute for Health Metrics and Evaluation (IHME) website. Extracted data included low back pain incidence, prevalence, disability-adjusted life years (DALYs), and years lived with disability (YLDs). DALYs to prevalence ratio and prevalence to incidence ratio were calculated and used in the principal component analysis (PCA) to make a proxy of the quality-of-care index (QCI). Age groups, genders, and countries with different socioeconomic statuses regarding low back pain care quality from 1990 to 2017 were compared. Results The proxy of QCI showed a slight decrease from 36.44 in 1990 to 35.20 in 2017. High- and upper-middle-income countries showed a decrease in the quality of care from 43.17 to 41.57 and from 36.37 to 36.00, respectively, from 1990 to 2017. On the other hand, low and low-middle-income countries improved, from a proxy of QCI of 20.99 to 27.89 and 27.74 to 29.36, respectively. Conclusion . Despite improvements in the quality of care for low back pain in low and lower-middle-income countries between 1990 and 2017, there is still a large gap between these countries and higher-income countries. Continued steps must be taken to reduce healthcare barriers in these countries