Association between burnout and empathy in medical residents.

BACKGROUND: Burnout is a work-related syndrome that can affect physicians' performance. Empathy is one of the clinical competencies in whose formation many factors play a role. Empathy and burnout are important topics of research in medical sciences, and both are related to the communication between the patient and the physician. This study investigated the relationship between occupational burnout and empathy among medical residents. METHOD: This cross-sectional study was conducted on 297 medical residents in Ahvaz Jundishapur University of Medical Sciences from January to March 2021. The data collection tools were the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI). The reliability of the instruments was measured by calculating Cronbach's alpha. Data were analyzed by SPSS-18, using the Pearson correlation test and linear regression models. RESULTS: The average age of the study population was 33.06 ±4.7 years, with more than half being females (57.6%) and married (51.9%). The residents' mean scores of empathy and overall burnout were 102.87 out of 140 and 55.90 out of 132, respectively. The burnout scores showed an inverse correlation with the overall empathy scores (r = -0.123, P = 0.035), and the score of standing in the patient's shoes (r = -0.165, P = 0.004). Linear regression test was used to detect which dimension of empathy was a better predictor for the reduction of burnout scores. Results showed that the best predictor was standing in the patient's shoes (P = 0.014). CONCLUSION: The findings showed a negative association between empathy and burnout among medical residents, which suggests the need for adjustment of the existing burnout management at the institutional level. Therefore, residents should be supported by managers to reduce burnout and improve their empathic behavior.

Comparison of the level of critical thinking skills of faculties and medical students of Ahvaz Jundishapur University of Medical Sciences, 2021.

BACKGROUND: One of the main tasks of educational institutions, in addition to developing students' professional competencies, is to develop decision-making and problem-solving skills, which are themselves influenced by critical thinking that should be developed by instructors at the university. The aim of this study was to compare the level of critical thinking skills in students and faculties of Ahwaz Jundishapur University of Medical Sciences. MATERIALS AND METHODS: In this cross-sectional descriptive study, the sample consisted of 81 medical students and 52 faculty members of the medical school who were teaching and studying in 2021. The research method was descriptiveanalytical and the data collection tool was the California Critical Thinking Questionnaire Form B. SPSS-18 software and t-test were used to analyze the data. RESULTS: The mean score of students' critical thinking skills was 12.49 ± 4.43 and that of faculties was 12.44 ± 3.76 and no significant difference was observed between the scores of the two groups (P = 0.94). CONCLUSION: The findings of the study show that the level of critical thinking skills in both faculties and students is below the standard and poor. The results of the study indicate the weakness of critical thinking in students and faculties in all dimensions, which indicates the need to teach critical thinking skills at the university level. Therefore, educational planners and faculty officials should pay more attention to developing critical thinking skills in their educational programs.

The trend of critical thinking disposition in medical students and its relationship with their academic performance.

BACKGROUND: Critical thinking is one of the important skills required for medical students. It is considered as a main component in medical education and training competent physicians. The current study aimed to investigate the trend of critical thinking disposition of medical students and its association with their academic performance. MATERIALS AND METHODS: This descriptive cross sectional study was conducted in 2019 on 315 medical students of Ahvaz Jundishapur University of Medical sciences. A two-section questionnaire was used for data collection. The first section dealt with demographic characteristics and the second section included Ricketts critical thinking disposition inventory using t-test, analysis of variance, and Pearson correlation coefficient. RESULTS: Mean and standard deviation of critical thinking disposition of medical students was 121.85 ± 11.32. No significant difference was observed between the mean score of critical thinking disposition and years of study (P = 0.74, F = 0.590). Pearson correlation test also showed no significant association between critical thinking disposition and the students' grade point average (P = 0.89, r = 0.007). CONCLUSIONS: The results of the current study showed that medical students' level of critical thinking disposition is above average, and there is no significant correlation between critical thinking disposition and years of study and academic performance of the students. It seems that the educational process in medical school has not been effective in improving the level of students' critical thinking disposition.

Sugarcane molasses enhances TGF-ß secretion and FOXP3 gene expression by Bifidobacterium Animalis Subsp. Lactis stimulated PBMCs of Ulcerative Colitis patients.

Ulcerative colitis (UC) is one of the inflammatory diseases of the gut with frequent bloody diarrhea leads to increased rates of anemia. Evidences indicate the immunomodulation disorders in the response to intestinal microbiota in UC. Although sugarcane molasses, rich in necessary minerals and vitamins, could be a good support nutrient but its effect on immune system of UC patients is unknown. To determine how the immune system of UC patients responds to molasses this study was planned. Bifidobacterium lactis were cultivated on MRS broth. PBMCs of 12 UC patients were separated by Ficoll-Hypaque centrifugation and co-cultured with different concentrations of UV killed bacteria and/or molasses in RPMI-1640 plus 10 % FCS. The gene expression of FoxP3 was measured by real-time PCR. TGF-ß and TNF-α were measured in supernatant of PBMCs by ELISA. Sugarcane molasses and B. lactis significantly augmented TGF-ß compared to control (p < 0.01 and p < 0.001 respectively). The secretion levels of TGF-ß by B. lactis plus molasses compared to B. lactis stimulated PBMCs was significantly higher (p < 0.05) but the level of TNF-α by PBMCs after 2/4/12 h incubation with B. lactis plus molasses compared to B. lactis alone was not changed (p > 0.2). The level of FOXP3 expression after treatment with molasses was increased significantly (p < 0.05). These data show that if sugarcane molasses added to B. lactis, not only do not increase the pro-inflammatory cytokine, TNF-α, but also augments the anti-inflammatory cytokine, TGF-ß by PBMCs. Therefore, these results pave the way for further investigation to show sugarcane molasses as a safe support to compensate the lost nutrients in UC patients.

Eleven-year surveillance of acute flaccid paralysis in southwestern Iran.

Momen AA, Shakurnia A, Momen M. Eleven-year surveillance of acute flaccid paralysis in southwestern Iran. Turk J Pediatr 2019; 61: 544-551. The purpose of the study was to report the results of acute flaccid paralysis (AFP) surveillance in the southwestern Iran in the 11 years' period. This is a retrospective descriptive study based on WHO guidelines. The collected data includes all pediatric AFP cases reported between of January 2006 to December 2016 by all health centers of Khuzestan province in Southwest of Iran. During an eleven-year period, 274 cases of AFP were reported in Khuzestan Province. Among them, 56.9% were younger than five years of age, and 55.9% were male. None of these cases was confirmed as poliomyelitis. The annual incidence of non-polio AFP ranged from 1.46/100,000 to 3.11/100,000 (Mean: 2.04 cases/100,000). The incidence rate of AFP in children under five years of age was significantly higher compared to older children (p=0.001), and the most common cause of paralysis (74.5%) was Guillain-Barre syndrome. All performance indicators met the WHO-specified targets. The follow-up of patients with AFP is essential to the eradication of poliomyelitis.

The effect of question generation activity on students' learning and perception.

INTRODUCTION: Student-generated questions can be a very helpful tool in medical education. The use of this activity can allow the students to feel more involved in the subjects covered and may improve their knowledge and learning. The aim of this study was to identify the effect of question-writing activity as a stimulus factor on learning in midwifery students and determine their perception about this activity. METHODS: This quasi-experimental study with two groups of pre- and post-tests was conducted on two groups of midwifery students who had taken the immunology course. Two classes of midwifery students (N=62) participated and were randomly assigned to two different groups. One class was selected as the experimental group (n=32) and the other class was considered as the control group (n=30). The experimental group's students were asked to write questions covering different topics of the syllabus components taught during 15 weeks from February 2016 to May 2016. They were asked to write, answer and explain their multiple-choice questions (MCQs). The students' performance in immunology course was compared between the two groups at the end of the semester. After their final exam, we asked them to fill in a questionnaire on their views about this activity. The data were analyzed by independent t- test using SPSS software, version 18. RESULTS: The differences between pre- and post-test mean scores of the experimental and control groups were 24.53±5.74 and 20.63±5.58, respectively. The results of independent t-test showed that these differences in the two groups were significant (p=0.009). Nevertheless, most of the students stated that question-writing activity as a learning tool is an unfamiliar exercise and unpopular learning strategy. CONCLUSION: Results showed that question writing by students has been found to promote learning when it is implemented as a part of the teaching curriculum in immunology course; therefore, this activity could be effective in improving the students' learning.

The Epidemiology of Guillain-Barré Syndrome in Children under 15 Years Old in Southwest Iran.

BACKGROUND: Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy, which has become the most common cause of acute flaccid paralysis. An accurate estimation of GBS occurrence would be useful for investigating the potential causal relationships between risk factors and GBS. The aim of the study was to analyze the incidence, annual time trend, and some epidemiological aspects of GBS in children in the Southwest of Iran. METHODS: This was a retrospective study conducted by the Department of Pediatrics of Ahvaz Jundishapur University of Medical Sciences from January 2006 to December 2015. We extracted data from the national database of Acute Flaccid Paralysis Surveillance System. RESULTS: A total of 184 subjects with GBS were assessed. The mean age of subjects was 5.43 ± 4.07 years. The average annual incidence rate of GBS was 1.51 per 100,000 children under 15 years old (95% CI: 1.29-1.73). There was no significant statistical difference in GBS incidence rate between girls and boys (p = 0.376). The highest and lowest proportions of the GBS occurrences were in autumn (32.2%) and summer (14.7%), respectively. CONCLUSIONS: The findings indicated that the annual incidence rate of GBS in this study was similar to those in other studies in this area.

An epidemiological analysis of acute flaccid paralysis in Khuzestan Province, southwest Iran, from 2006 to 2010.

OBJECTIVES: Investigations into the epidemiology of acute flaccid paralysis (AFP) are an essential strategic component of the Global Poliomyelitis Eradication Initiative of the World Health Organization (WHO), and are part of the certification process for polio eradication worldwide. This is an epidemiological report of AFP incidence in children less than 15 years old in southwest Iran. METHODS: This was a retrospective cohort study, carried out based on WHO guidelines, in which we reviewed non-polio AFP cases recorded from January 2006 to December 2010 in different regions of Khuzestan Province, southwest Iran. In this study, the records of all children under 15 years old with AFP were evaluated. RESULTS: During a 5-year period, 137 cases of AFP were reported (incidence rate, 2.21 per 100,000 children <15 years old). More than 50% (73 of 137) of the cases were boys, and 52.6% (72 of 137) were under 5 years of age, with a mean age of 5.39±3.98 years. The incidence of AFP was significantly higher in older children (p=0.001). The most common cause of paralysis was Guillain-Barré syndrome (117 of 137). None of the cases were diagnosed with acute poliomyelitis. CONCLUSIONS: In this study, we found that the incidence rate of AFP in the region was almost in agreement with the expected incidence of AFP in children less than 15 years old; therefore, the AFP surveillance program in Khuzestan Province is satisfactory in terms of reliability and effectiveness. Nevertheless, routine vaccination against polio and ensuring that patients with AFP receive follow-up are essential for eradicating polio.