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

The Relation Between Mentor-Mentee Relationship and Mentee\'s Satisfaction: A Survey of Mentoring Program of Tehran University of Medical Science (TUMS).

Abstract Introduction Mentoring programs have been planned and executed in Iran particularly in the field of medicine. This study aims to evaluate mentor-mentee relationship in mentoring program at Faculty of Medicine of Tehran University of Medical Science in the 2017-2018 academic year. Methods: This cross sectional study was conducted on all year one medical student enrolled at TUMS in 2017 who attended in mentoring program as a mentee. Data is collected via self-designed questionnaire. Result: 210 and 180 persons answered the first and second questionnaire respectively. There was no significant relation between gender of mentor-mentee and features of relationship, although male mentees asked their mentors to visit more than female mentees. (P= 0.000, X ²= 17.62). Significant correlation has been seen between mentee's satisfaction of mentor and any different aspect of mentee's improvement, education (r=0.48) and adaptation to academic environment (r= 0.47). There is not a significant difference in mentees satisfaction between mentees who reached their expectations and mentees who did not (p= 0.758, t= 0.449). Conclusion: This study shows that planning for preparing an efficient structure for mentor-mentee relationship is important, and recommends paying more attention to support new students by introducing the mentoring program to them

What do the first year medical students ask their mentors: the report of a 4-year study

Introduction: Entering University can cause stress and tension in the first year medical students due to the changing educational environment, the volume and difficulty of the courses and the distance from their family. This can lead to academic failure, mental health, depression and life style change. The purpose of this study was to investigate the problems of the first year medical students, classify them and to investigate the changes of these problems in a year. Methods: This research was a qualitative study conducted from 1393 to 97. The target sample was a group of 3rd and 4th year medical students who had participated in faculty mentoring program as mentors. Every two weeks, the subjects were contacted by the coordinators about the problems that the mentees (first year students) faced and the answers the mentors provided, and these data were recorded in the forms. Referring to the forms, the codes were extracted at the initial stage and then classified according to the similarity of the items between these codes. Result: During the four years implementation of the program, 3420 forms were collected and reviewed. The questions and problems of the first year students in this study were categorized into four groups of learning problems, psychosocial, role modeling and organizational issues. Conclusion: The results of this study emphasized the importance of support system in the fields of study (providing appropriate scientific resources, learning and study methods, time management and curriculum planning); psychosocial fields (increasing interpersonal relations management skills, stress management, skills for balancing personal and educational life, and improving the accommodation condition), and recalled the importance of introducing the appropriate role models for medical students. Keywords: Medical student, Medical education, Mentorin

Burnout and clinical learning environment among residents in Tehran: A cross-sectional study

Purpose: This study aimed to evaluate the quality of the educational environment in Tehran University of Medical Sciences across different medical specialties and its correlation with residents’ burnout. Materials and methods: This cross-sectional study was conducted at Tehran University of Medical Sciences among residents drawn from three largest teaching hospitals affiliated. The Maslach Burnout Inventory and Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire were used to collect data through web-based, as well as paper-and pencil questionnaires. The data was analyzed using SPSS. Results: A total of 221 residents completed the survey, with a response rate of 82%. Burnout was reported by 67.4% of medical residents. The total PHEEM score had a negative correlation with emotional exhaustion (r = - 0.57, P < 0.001), depersonalization (r = - 0.40, P < 0.001), and a positive one with personal accomplishment (r = 0.42, P < 0.001). Perception of social support significantly predicted burnout subscales (P < 0.05). PHEEM subscales also explained a small proportion of variance in emotional exhaustion (R = 0.55, R2 = 0.308, P < .001). Clinical learning environment independent of personal characteristics was associated with residents' burnout according to multivariate regression analysis [OR = 0.567 (0.170–0.883), P = 0.012]. Conclusion: Clinical learning environment independent of personal characteristics was associated with residents' burnout in Iran. We suggest some initiatives to be introduced ranging from improving the clinical environments, reduce workloads and provide social support to all residents as well as encouraging them to involve in other extracurricular activities like music and physical exercise