Iranian clinical practice guideline for amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3–5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations

1. Assistant professor of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Background & Objective: Cancer is a global concern, and the management of cancer patients dealing with various psychological symptoms is a growing concern. Acceptance and commitment therapy (ACT) is effective psychological management in cancer patients improving psychological symptoms. However, the effect of ACT on cancer patients' resilience and general health has not been widely studied. The present study aimed to evaluate the effect of ACT on the general health and resilience of cancer patients undergoing chemotherapy. Materials and Methods: Sixty patients with breast, lung, or colorectal cancer enrolled in the present study and allocated into intervention and control groups. The Connor-Davidson Resilience Scale (CD-RISC) and General health questionnaire (GHQ) were filled as pretest and post-test after ACT as eight sessions (each session 9') during four weeks for the intervention group and after 4-weeks for the control group. Results: The mean age of the participants was 35±76.3 years, and the mean age, gender, cancer duration, duration of receiving chemotherapy, and marital status were not significantly different among the study groups. After adjusting for baseline scores, there was a significant difference in study groups in resilience and general health scores. The effects indicate that treatment accounted for 70.9% and 62.6% of the post-test covariance of resilience and general health scores, respectively. Conclusion: ACT could be an effective psychological intervention in increasing general health and resilience among cancer patient

بررسی رابطه بین کیفیت محیط یادگیری و پیشرفت دانشجویان دانشگاه علوم پزشکی رفسنجان بر اساس مدل DREEM

مقدمه: محیط یادگیری در ارائه آموزش موفق به دانش آموزان مهم است. مطالعه حاضر با هدف تعیین رابطه بین کیفیت محیط یادگیری و رضایت دانشجویان پزشکی و دندانپزشکی دانشگاه علوم پزشکی رفسنجان در سال 1400 انجام شد.روش کار: این مطالعه توصیفی مقطعی بر روی 386 دانشجوی پزشکی و دندانپزشکی شهر رفسنجان، کرمان، انجام شد. پرسشنامه معتبر دانشگاه داندی (DREEM) توسط دانشجویان دانشکده های پزشکی و دندانپزشکی دانشگاه علوم پزشکی رفسنجان تکمیل شد. داده ها با استفاده از آمار توصیفی، ضریب همبستگی پیرسون، مجذور خی، آزمون تی ، تحلیل واریانس و توکی و نرم افزار SPSS  نسخه 17 تحلیل شدند.یافته ها: میانگین نمره پنج حوزه محیط یادگیری دانشجویان پزشکی 8/113 و دندانپزشکی 110 و میانگین نمره کل محیط یادگیری کل جامعه 5/113 بود. دانش‌آموزان دختر در محیط آموزشی میانگین نمرات بالاتری نسبت به پسران داشتند (05/0>P).  همچنین بیشترین امتیاز مربوط به حوزه درک توانایی تحصیلی (64.11 درصد) و درک از یادگیری (57.2 درصد) و کمترین میانگین نمره مربوط به حوزه درک موقعیت اجتماعی (56.38 درصد) بوده است. برخلاف دانشکده دندانپزشکی، دانشجویان دانشکده پزشکی از محیط یادگیری مثبت و قابل قبولی برخوردار بودند.نتیجه‌گیری: مطالعه حاضر نشان داد که دانشجویان از تمامی جنبه‌های محیط آموزشی دانشگاه خود رضایت دارند، اما توجه اساتید و مدیران باید بیشتر به دانشجویان دندان‌پزشکی معطوف شود تا فضای آموزشی مناسب ایجاد شود

Iranian clinical practice guideline for amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegeneration involving motor neurons. The 3-5 years that patients have to live is marked by day-to-day loss of motor and sometimes cognitive abilities. Enormous amounts of healthcare services and resources are necessary to support patients and their caregivers during this relatively short but burdensome journey. Organization and management of these resources need to best meet patients' expectations and health system efficiency mandates. This can only occur in the setting of multidisciplinary ALS clinics which are known as the gold standard of ALS care worldwide. To introduce this standard to the care of Iranian ALS patients, which is an inevitable quality milestone, a national ALS clinical practice guideline is the necessary first step. The National ALS guideline will serve as the knowledge base for the development of local clinical pathways to guide patient journeys in multidisciplinary ALS clinics. To this end, we gathered a team of national neuromuscular experts as well as experts in related specialties necessary for delivering multidisciplinary care to ALS patients to develop the Iranian ALS clinical practice guideline. Clinical questions were prepared in the Patient, Intervention, Comparison, and Outcome (PICO) format to serve as a guide for the literature search. Considering the lack of adequate national/local studies at this time, a consensus-based approach was taken to evaluate the quality of the retrieved evidence and summarize recommendations