seyed reza moallem

To identify the pattern and causes of death and to deal with them are among the most appropriate strategies to increase human life expectancy. The pattern of death in society must be identified to cope with the causes of premature deaths. The aim of this study was to epidemiologically investigate the causes of death in people aged 5-14 years in northeastern Iran.  Data on the deaths of people aged 5-14 years from Khorasan Razavi province during 2013- 2019, drawn from the Causes of Mortality Classification System of the Ministry of Health and Medical Education, were used to conduct the study.  Data on 2084 deaths were examined, of which 824 (40.04%) occurred in girls. The number of deaths was 976 (53.83%) and 1108 (46.17%) in the age group of 5-9 and 10-14, respectively. Traffic accidents, cancers, external causes (unexpected events), and circulatory system diseases were found as the main causes of death. Among the cancers, lymphoid leukemia, malignant brain tumors, and myeloid leukemia (18%, 12%, and 7%, respectively) were the most common cancers, leading to death. In rural areas, unexpected events (20%) were the leading cause of death, followed by traffic accidents and cancers (19% and 13%, respectively).  Overall, the mortality rate in children aged 5-14 years due to traffic accidents and unexpected events (suffocation, burns, and the like) seems to be substantially higher in Iran compared to some developing countries and some neighboring countries such as Turkey. Given the possibility of taking preventive measures in this regard, it is necessary to develop policies to reduce the mortality rate in the age group.

In recent years, in order to improve the quality of medical care, physicians have integrated their clinical expertise and best available research evidences to form evidence-based medicine. This study aims to assess the impact of training of evidence-based medicine on knowledge and attitude of medical students of Mashhad University of Medical Sciences.

This experimental study had a before-after design and did not use a control group and was carried out among 244 medical externs in a course of an educational year. During the one-month course of family medicine, a three-day workshop consisting of seven two-hour sessions were held by faculty staff of community medicine department about definition, components, and how to clinically use EBM in practice. SPSS version 16 was used for data analysis.

The average attitude (total 5 points) improved from 2.2 before the workshop to 4.1, which was statistically significant (P = 0.001). The attitude regarding the positive effects of evidence-based medicine on patient outcome and its practicality and cost-effectiveness for the patient changed drastically. The knowledge of the participants regarding common concepts of EBM improved from 1.4 points to 2.4 points (total 3 points) after the workshop, which was statistically significant (P = 0.001).

Considering negative attitude and inadequate knowledge of students regarding evidence-based medicine, and favorable impact of the workshops on the knowledge and attitude of the students, even in the short-term, necessitates more extensive programs to be designed by the educational staff of the university.

Nurses are the largest group of medical caregivers in the world. Having highly capable nurses in a healthcare system is directly associated with more favorable outcomes for patients. The rapid development of new medical procedures and equipment necessitates constantly developing new skills and competencies. Thus one of the effective means towards their efficient training is to identify and assess their educational needs. The purpose of this investigation is to study educational needs of nurses by ISO 10015 method.

A descriptive survey research was designed surveying all of the nursing staff of Razi Hospital of Torbat Heydarieh. At the first stage of the study, necessary competencies and skills were identified using two methods of Delphi and job analysis, and then educational needs assessment was done according to ISO 10015 steps. The tools used were researcher designed questionnaires and their reliability and validity were tested by achieving a Cronbach's alpha of 83.9%, and by content validity method, respectively. Data analysis was done using version 16 of SPSS software.

Three hundred and sixty-one skills were identified and were categorized into three categories of general (48 skills), specialized (303 skills), and management (10 skills). Nurses had acceptable competencies in 312 of the identified skills, while there were educational and structural gaps found in 8 general, 36 specialized and 5 management skills, as well as the solutions to overcome the gaps were proposed by a group of experts. At the end, 7 general, 33 specialized and 5 management skills were identified and recorded as knowledge gaps.

In this study we found out that the specialized skills are the most important educational needs (ABG interpretation, ventilator settings, and cardiac arrhythmias for nurses; and staff and patients’ needs assessment for head nurses) followed by general nursing skills (hemovigilance), and management skills (quality management). The identified knowledge gaps were considered in planning for the future trainings of the study population.

Envenomation is common in Asia including Iran that induces morbidity and mortality. This study investigated the epidemiological characteristics of cases with snake, spider and scorpion bites.
In this cross-sectional design, epidemiologic data of admitted cases to the Toxicology Department of Imam Reza Hospital of Mashhad, Iran were analyzed across a 7-yr period, from 2004 to 2011. SPSS was used for data analysis.
This study reports 686 admissions due to animal envenomation with an incidence rate of 2.9 per 100000. Mean (SD, min-max) age of admitted patients was 30 (19, 1-90) yr, and 471 (69%) were male. Snakebite (n, percentage, annual incidence) (299, 44%, 1.3 per 100000) and spider bite (188, 27%, 0.8 per 100000) and scorpion sting (126, 18.4%, 0.5 per 100000) were most frequent cases. Overall, case fatality rate was 0.09 per 100000 which were due to scorpion and unknown bite. No cases of snakebites died in this period. The highest age-specific incidence rate was 4.6 per 100000 and related to 10-20 yr of age.
Animal envenomation is frequent in this area and a matter of health concern. While deaths related to snake bite are no longer reported-presumably due to using effective anti-venom - managing unknown and scorpion bites need to be addressed. Envenomation was not overtly an age-specific event in this province.