The Relationship between Information Literacy Skills and Evidence-based Medicine Competencies in Clinical Residents

Introduction: The emergence of new information and communication technologies has emphasized the importance of obtaining reliable and up-to-date information. There is a need to encourage clinical residents to use up-to-date medical evidence in clinical decision-making, which could empower their information literacy skills. This study aimed to investigate the relationship between possessing information literacy skills and competencies of evidence-based medicine by clinical residents at Kerman University of Medical Sciences (KUMS), Iran. Methods: The present study was survey-based. The study population consisted of all clinical residents at KUMS. One hundred fifty participants were selected at random to participate in completing the questionnaire. The data were presented using descriptive statistics (mean; SD) and analyzed using statistical tests: Pearson correlation coefficient; linear regression; independent t-test. Results: Pearson Correlation Coefficient between information literacy and evidence-based medicine was obtained 0.529 (p-value=0.001(. Also, there was a significant relationship between information literacy skills and evidence-based medicine competencies by the clinical residency. With a mean score equal to 3.22, the clinical residency’s ability as to the components "information need" and "information organization" was more than that with other information literacy skills. The clinical residents' ability to use pieces of evidence (3.09) in the evidence-based approach was also higher than that of other components in this approach. Conclusion: Improving clinical residents' ability to apply information literacy skills to gain medical evidence improves their clinical decision-making performance and may lead to the improvement of health in society

Study of alexithymia among people with low distress tolerance compared to non-clinical sample

Background: Alexithymia is a personality construct described as an asymptomatic clinical disability to identify and describe individual feelings. Individuals with alexithymia have difficulties regarding distress tolerance. The present research aimed at studying alexithymia among people with low distress tolerance in comparison to non-clinical sample.Methods: The study population consisted of all male employees working for General Education Office of Kermanshah Province, Iran. A total of 300 individuals from among these employees were selected based on Morgan table using multistep clustering method. Demographic data questionnaire, Toronto alexithymia scale, and distress tolerance questionnaire were used for data collection.Results: Mean (SD) score for tolerance, attracting, Assessment and Regulation were 7.3 (2.74), 8.4 (3.20), 16.8 (4.99), and 6.7 (2.63), respectively, in the normal group and 22.54 (6.07), 17 (4.28), 30.67 (6.65), and 30.50 (74.6) in the group with low distress tolerance. independent t-test showed that low distress tolerance group had significantly higher score regarding tolerance, absorption, evaluation, and regulation in comparison with the normal group (P<0.001).Conclusion: Findings of the present study can help psychologists and counsellors to pay more attention in alexithymia among people with Low Distress Tolerance to help them for better adaptability and confrontation ability against life difficulties such as distress, and ultimately for better health

Ki-67/MIB-1 as a prognostic marker in cervical cancer - a systematic review with meta-analysis

Background: In cervical cancer patients it has been reported that there in a significant Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value is still not well understood. Materials and Methods: In the present meta-analysis the prognostic value of Ki-67/MIB-1 with regard to overall survival (OS) and disease-free survival (DFS) in cervical cancer was investigated. The databases of PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, Science Direct and Wiley Online Library were used to identify appropriate literature. Results: In order to explore the relationship between Ki-67/MIB-1 and cervical cancer, we have included 13 studies covering 894 patients in the current meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63 (95confidence interval (CI) 1.09-2.45; P0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95CI 2.65-5.09) in Asians. Conclusions: According to this meta-analysis, Ki-67/MIB-1 has prognostic value for OS in patients suffering from cervical cancer. For better evaluation of the prognostic role of Ki-67/MIB-1 on DFS, studies with larger numbers of patients are needed to validate present findings in the future

Status of decayed, missing, filled teeth index among Iranian children and adults: A systematic review and meta-analysis

Introduction: Oral health status is one of the health-related priorities in Iran. The present study was conducted with the aim to systematically review the status of oral health in Iran using the decayed, missing, filled teeth (DMFT) index. Methods: In this meta-analysis, all data available on DMFT were reviewed and 35 published studies were included in the study based on search strategy. To estimate overall DMFT and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software was used. Results: Of all 876 articles, 35 were included in the study. A total of 21849 individuals were included in the meta-analysis. The overall DMFT index was 3.65 [95% confidence interval (CI), 3.01-4.34]. In addition, this rate was 2.30, 8.60, and 3.85 among children, adults, and children with mental/physical disabilities with (CI 95%, 1.76-2.95), (CI 95%, 6.10-9.60), and (CI 95, 2.98-4.80), respectively. Conclusion: Mean DMFT in the assessed published data was higher than that set forth by the World Health Organization (WHO). Further planning and taking effective preventive measures to improve the oral health status seems necessary

Epidemiological Study of Fatal and Nonfatal Road Traffic Accidents and Their Outcomes on Children and Adolescents in Shahroud, Iran

Background: Traffic accidents are among the important health issues that threaten human life. Children are among the main victims of these accidents. This research aimed to study the epidemiology of fatal and nonfatal road traffic accidents and their outcomes in children and adolescents in Shahroud, Iran. Materials and Methods: This descriptive and analytical study was conducted from July to December 2011. Data were collected through a researcher-made questionnaire. After verifying its content validity and reliability, the questionnaire was completed by emergency medical technicians. The data were analyzed using descriptive and inferential statistics (the Chi-square test). Results: Of 363 studied cases, the majority of accidents happened in July with 108 (29.8%) cases and on Thursdays (18.7%). About 89.3% of drivers were male and aged 39 to 40 years (44.6%). Most accidents happened during 8 to 12 AM (23.7%). Moreover, 21.28% (1161 persons) of all injured people and 18.75% (48 persons) of all deceased victims were children under 14 years old. None of the victims under 14 years of age used protective tools. Head and spine trauma, respectively, were reported as the most common injury in this age group. There was no significant differences between victims aged less and more than 14 years old in terms of spinal cord injury (P=0.03). Conclusion: Based on the results of this study, it is recommended to take some basic actions such as improving roads, identification of black spots, installation of warning signs at those points, and extending controls and supervisions by police. It is also very important to use standard protective tools for children and adolescents, force rules for using appropriate safety equipment for this age group, and provide public trainings for the people to raise their level of awareness

Assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran

Introduction: Patients satisfaction includes the assessment of healthcare which she/he received. This study aims at assessment of mothers’ satisfaction with the care of maternal care in Specialized Educational-Medical Centers in obstetrics and gynecological disease in Northwest, Iran. Methods: In an analytic-descriptive cross-sectional study, 1000 female patients who admitted in educational-medical centers of Northwest were studied during a 2 years period (2010-2012). They asked to fill a 34-item closed-answer questionnaire (ranking from very unsatisfied to very satisfied responses) following their discharge. Validity of the questionnaire was improved by gynecologist’s experts comments, and reliability of the questionnaire were assessed by test-retest methods (α = 0.946). Results: The satisfaction score (satisfied or very satisfied responses) were 61.2, 55.8, 61.8 and 59.5 percent for admitting process, primary care services, treatments and therapeutic interventions and overall, respectively. The satisfaction score for access to doctors was highest in the morning and lowest at the night shifts. The satisfaction score about the personnel’s behavior was lowest during the night shifts. The satisfaction score about the residents’ behavior was highest for the morning shifts. There was no significant difference between the three working shifts regarding psychological feelings, humanitarian respect, and issues like nutrition and private and public hygiene. There was a significant direct correlation between the mean score of satisfaction and patients’ age (Spearman’s rho = 0.117, P < 0.001). Conclusion: The satisfaction level of patients hospitalized in Northwest of Iran's Hospitals was intermediate. Planning new strategies in this regard with emphasis on the main limitations may improve the satisfaction rate in the future

Effectiveness of the non-pharmaceutical public health interventions against COVID-19; a protocol of a systematic review and realist review

BACKGROUND: Without any pharmaceutical intervention and vaccination, the only way to combat Coronavirus Disease 2019 (COVID-19) is to slow down the spread of the disease by adopting non-pharmaceutical public health interventions (PHIs). Patient isolation, lockdown, quarantine, social distancing, changes in health care provision, and mass screening are the most common non-pharmaceutical PHIs to cope with the epidemic. However, there is neither systematic evidence on the effectiveness of non-pharmaceutical PHIs in controlling the COVID-19 nor on how these interventions work in different contexts. Therefore, in this study we will address two main objectives: 1) to assess the effectiveness of the non-pharmaceutical PHIs in controlling the spread of COVID-19 using a systematic review and meta-analyses; 2) to explore why, how, and for whom these interventions work using a realist review. MATERIALS AND METHODS: This review study has two main phases. In the first phase of this study, we will extract data from two main types of studies including quasi-experimental studies (such as quasi-randomized trials, controlled before-after studies (CBAs) and interrupted time series studies (ITSs)) and observational studies (such as cohort, case-control, and cross-sectional studies), written in the English language. We will explore effectiveness of the non-pharmaceutical PHIs targeted either suppression or mitigation strategies (or a combination of both) in controlling the COVID-19 epidemics in the community level. Effectiveness will be considered as the changes in mortality rate, incidence rate, basic reproduction number rate, morbidity rate, rates of hospitalization, rates of intensive care unit (ICU) hospitalization, and other health outcomes where possible. We will perform random-effects meta-analyses, if possible, using CMA software. In the second phase, we will conduct a realist review to find out how, why, for whom, and in what circumstances the non-pharmaceutical PHIs work. At the realist review, we will identify and explore Context-Mechanism-Outcome configurations to provide a robust explanation on the effectiveness of the interventions in different contexts using Pawson's 5-step realist review template including: "clarify scope; search for evidence; appraise primary studies and extract data; synthesize evidence and draw conclusions; and disseminate, implement and evaluate". Although the steps are presented in a linear manner, in practice, we will follow them in iterative stages to fill any potential overlap. DISCUSSION: The findings of this research will provide a crucial insight into how and in which context the non-pharmaceutical PHIs work in controlling the spread of COVID-19. Conducting a systematic review and meta-analysis in line with a realist review will allow us to draw a robust conclusion on the effects and the way in which the interventions work. Understanding the role of contextual factors in the effectiveness of non-pharmaceutical PHIs and the mechanism of this process could enable policymakers to implement appropriate policies and manage the COVID-19 epidemics more efficiently

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