Evaluation of Educational Environment of Residents of Internal Medicine Based on D-RECT Questionnaire at Shiraz University of Medical Sciences, Iran, in 2014-2015: A Step towards Group Accreditation

Background & Objective: Evaluation of the clinical training environment should be considered as an integral component of an optimal learning environment. Therefore, the purpose of this study was to evaluate the educational environment of residents at Shiraz University of Medical Sciences, Iran, based on D-RECT (Dutch Residency Educational Climate Test) questionnaire toward educational group accreditation in 2014-2015. Methods: This mixed-method study was conducted in two phases. The statistical population consisted of all residents in the field of internal medicine (n = 50). The first phase of the present study was performed quantitatively and using D-RECT questionnaire. The second phase of the study was performed a qualitatively through semi-structured interviews with the target group. The face validity and reliability of the questionnaire were approved using the views of 5 educational experts and Cronbach’s alpha (α = 0.90), respectively. The collected data were analyzed using Pearson coefficient and independent t-test in SPSS software. Results: The results of this study demonstrated a meaningful correlation between the fields of professors' role, formal education, guiding and evaluation, and decision making for patients' treatment. The highest correlation was related to the two fields of formal education and decision making for patients' treatment (P = 0.001) and the least correlation was related to professors' role and formal education (P = 0.009). In qualitative analysis, the strengthens of the group were regular attendance of classes, morning reports, and planning. The weaknesses included revising the educational environment, high load of clinical work, high number of shifts, little amount of time for theoretical studying, and lack of attention to specialty skills. Conclusion: According to the results, the head of educational groups should move toward improving the quality of education in terms of residents' cooperation and team work. Key Words: Evaluation, Residents, Educational environment, Clinical training, Accreditation, D-REC

A study on association of premarital attitude toward intact hymen in new grooms: A cross-sectional study

BACKGROUND: Young people's attitudes toward marriage have been undergone changes in recent years and it seems to be contradicting in the struggle between conservative and modern liberal attitudes. The purpose of this study was to evaluate the attitude of new grooms toward intact hymen in Kerman. MATERIALS AND METHODS: This cross-sectional study has been conducted on 790 new grooms in Kerman, Iran. In this study, we examined the attitudes in two aspects of sexual norm and personal attitude toward premarital relationships in new grooms. The sampling method was purposive sampling and the data were analyzed using t-test and analysis of variance. RESULTS: The results of this study have showed a more conservative sexual attitude toward the sexual norms of premarital sex. The average score of the participants in the sexual norm and personal attitude was, respectively 15.86 and 48.15, indicating that their conservative views have been overcome. Most of the samples (90%) have believed in required preserving virginity before marriage, and 82% believed in virginity as the most valuable asset of the girls. In this study, the conservative attitudes of men were inversely related with their age and were directly related with perceived sexual norm and the level of affinity to religious affairs. CONCLUSION: According to the results of this study, conservative attitudes toward premarital relationships are predominating in new grooms, but this is not generalized. The conservative attitude of new grooms may have harmful effects on their interpersonal behaviors after marriage, which requires purposeful training

Designing A Model of Educational Guidance for the First Period of Secondary School Students (Tehran City Case Study)

This study aimed to design an educational guidance model for the students in the first period of secondary school students in Tehran. The field of research included experts in the field of academic guidance who were selected by purposeful sampling. The sample size after reaching the theoretical saturation stage was 21 people. A semi structure interview was applied to collecting data. Data analysis was through open, central and selective coding. The results revealed six dimentions and 18 components. In the first dimension (student), three components were identified include: 1- intelligence and talent 2- motivation, interest, desire and spirit of the student 3- abilities and skills. In the second (family) three components were identified include:  1- providing comprehensive information to parents 2- family economy 3- cultural and social background of parents. In the third dimension (the teacher) three components were identified include: 1- access to expert teachers 2- professional commitment of teachers in correct guidance 3- continuous training of teachers. In the fourth dimension (counselor) three components were identified include: 1- Desirable counseling and psychological services 2- Using an expert in the field of educational guidance planning 3- Improving the level of knowledge and qualification of educational guides. In the fifth identified dimension (school) three components were identified include: 1- Implementation of intelligence and talent tests 2- Academic records of students 3- Providing counseling and online tests. Finally in the sixth dimension (society) three components were identified include: 1- Considering the needs of the country 2- Guiding the student without compulsion, 3- Paying attention to the labor market. In general, our findings contribute to the development of an native model of educational guidance for use in the first period of secondary schools in Iran

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Safiri S, Sepanlou SG, Ikuta KS, et al. The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. LANCET GASTROENTEROLOGY & HEPATOLOGY. 2019;4(12):913-933.Background Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. Methods Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. Findings In 2017, there were 1.8 million (95% UI 1.8-1.9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23.2 (22.7-23.7) per 100 000 person-years that increased by 9.5% (4.5-13.5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11.5 (11.3-11.8) per 100 000 person-years, which decreased between 1990 and 2017 (-13.5% [-18.4 to -10.0]). Colorectal cancer was also responsible for 19.0 million (18.5-19.5) DALYs globally in 2017, with an age-standardised rate of 235.7 (229.7-242.0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14.5% [-20.4 to -10.3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (>= 95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20.5% [12.9-28.9]), alcohol use (15.2% [12.1-18.3]), and diet low in milk (14.3% [5.1-24.8]). Interpretation There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd