Job burnout and some of its risk factors on the health workers (Behvarz) in Koohrang County, I.R.Iran, in 2010

زمینه و هدف : فرسودگی شغلی، شامل خستگی عاطفی ، مسخ شخصیت و کاهش موفقیت فردی است و زمانی که توانایی های فرد برای تقاضاهای محیط کار کافی نباشد علائم آن آشکار می شود. کارکنان نظام سلامت به دلیل مواجهه با استرس های فیزیکی و روانی در معرض فرسودگی می باشند. این مطالعه با هدف تعیین میزان فرسودگی شغلی بهورزان و بررسی ارتباط خصوصیات جمعیت شناختی با آن انجام گرفت . روش بررسی: این پژوهش توصیفی-تحلیلی، بر روی همه بهورزان شهرستان کوهرنگ ( 81 نفر) در آبانماه سال 1389 انجام شد . ابزار گردآوری داده ها پرسشنامه­ای شامل اطلاعات جمعیت شناختی و پرسشنامه فرسودگی شغلی مازلاک ( MBI ) بود. پرسشنامه توسط بهورزان تکمیل و داده­ها با استفاده از آزمون های آماری ANOVA ، ضریب همبستگی اسپیرمن و آزمون تی مستقل تحلیل گردید. یافته ها: از نظر فراوانی، کاهش موفقیت فردی زیاد ( 5/24 ) ، خستگی عاطفی زیاد ( 6/4 ) و مسخ شخصیت زیاد ( 7/2 ) ، به ترتیب از بیشترین فراوانی و از نظر شدت، خستگی عاطفی شدید ( 7/6 ) و مسخ شخصیت شدید ( 3/1 ) ، به ترتیب از بیشترین شدت برخوردار بودند. هیچ یک از بهورزان کاهش شدید موفقیت فردی را گزارش ننمود. میزان خستگی عاطفی با مسخ شخصیت و میزان کاهش موفقیت فردی با خستگی عاطفی رابطه معنی داری داشت (001/0 > P ) . بین جنس، سن، وضعیت تأهل، سابقه کار، نوع استخدام و میزان تحصیلات بهورزان و فرسودگی رابطه معنی داری دیده نشد. نتیجه گیری: این مطالعه نشان داد که فراوانی و شدت فرسودگی شغلی در بهورزان شهرستان کوهرنگ پایین است که از دلایل آن می توان به موقعیت اجتماعی مناسب، نزدیکی محل کار و زندگی، درآمد متناسب با حجم کار و تحصیلات، امنیت شغلی، سطح توقع پایین و شرایط آب و هوایی و فرهنگی منطقه اشاره کر

Rehabilitation Educators′ Perceptions of Clinical Education Challenges in Iran: Is COVID-19 Having Redundant Effects?

Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many shortcomings that should be addressed.Methods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators with particular focus on the new challenges created bythe COVID-19 outbreak. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were conducted with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences, Iran. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.Results: Through data analysis, 240 initial codes were extracted in three main categories and nine sub-categories, indicating redundant challenges imposed by COVID-19 comprising restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), an inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), and personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).Conclusion: The results of this study provide deeper insight into the perceptions and experiences of rehabilitation educators regarding clinical education challenges. At present, an accidental and unexpected problematic event (COVID-19 pandemic) has inflicted detrimental effects on various aspects of clinical rehabilitation sciences. It is necessary to implement changes in future plans which include adaptations for COVID-19

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background Disorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021. Methods We estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined. Findings Globally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer. Interpretation As the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed. Funding Bill & Melinda Gates Foundation

Modified montmorillonite nanolayers for nano-encapsulation of biomolecules

Vitamin B6 was nano-encapsulated in between modified montmorillonite nanolayers. Results indicated that electrostatic interaction forces dominate the adsorption onto different sites of the nanolayers. The successful nano-encapsulation was achieved when the interlayers spaces of the nanolayer were saturated with cations of Na+ or Ca2+ resulted in adsorption of vitamin B6 in between nanosheets. At these conditions, controlled pH-responsive desorption properties were detected and vitamin B6 was released mostly from the interlayer spaces. The presented modified montmorillonite could be used for nanoencapsulation of drugs and biomolecules with high protection of carrying materials during storage and even through the digestion process