Regarding the high rate of scoliosis in our population and approval of this screening test in different studies, routine use of this screening method is highly recommended in schoolchildren. It is cost beneficial and can be effective in prevention and early treatment of scoliosis.
Background. Burnout is a psychological syndrome identified by different degrees of emotional exhaustion depersonalization and a low sense of personal accomplishment, which is an increasing problem among medical students. Emotional intelligence is a set of noncognitive skills that propagates an individual’s capability to encounter environmental complications, particularly burnout, successfully. This research was conducted to investigate the relationship between emotional intelligence and academic burnout among medical students. Methods. This cross-sectional study was carried out on 136 medical students at Tehran University of Medical Sciences in 2018. Data were collected by a demographic checklist, Siberia Schering’s Emotional Intelligence questionnaire, and Bresso Academic Burnout questionnaire and analyzed by SPSS22 software using descriptive methods and linear regression tests. The significance level was set at a P value <0.05. Results. The study enrolled 136 medical students, including 70 (51.5%) men and 66 (48.5%) women, with an average age of 24.94 (SD = 1.03). Besides, 112 students were single (82.4%), and 24 were married (17.6%). Most students’ emotional intelligence and academic burnout were moderate (89% and 69.1%, respectively). According to the results, none of the burnout dimensions significantly correlated with age and gender. Among emotional intelligence dimensions, students possessing higher self-motivation experienced more significant academic fatigue. Students with higher self-awareness and self-regulation experienced lower academic fatigue, academic apathy, academic inefficiency, and academic burnout. In general, medical students with higher scores on emotional intelligence experienced significantly lower academic fatigue, academic apathy, academic inefficiency, and academic burnout. There was a significant negative association between emotional intelligence and burnout (β = −0.496, P < 0.001). Conclusion. Emotional intelligence appeared as a significant factor in protecting medical students against academic burnout, so enhancing emotional intelligence through training may be an essential intervention for reducing burnout.
BackgroundAdherence to ethical principles is a requirement for palliative care delivery to children and a main concern of healthcare providers. Physicians usually face ethical challenges during their daily practice in hospitals and need adequate skills and the ability to identify and manage them. This study sought to explore the ethical challenges of palliative care from the perspectives of pediatricians.MethodsThis qualitative study was conducted between April and July 2019 using the content analysis approach. Participants were fifteen pediatric medical residents, specialists, and subspecialists purposively recruited from pediatric hospitals in Tehran, Iran. Data were collected using in-depth semi-structured interviews and were analyzed using Graneheim and Lundman's approach to conventional content analysis. Trustworthiness was ensured through the four criteria proposed by Guba and Lincoln.ResultsParticipants' experiences of the ethical challenges of palliative care for children were grouped into two main categories, namely “bewilderment in dealing with children and their families” (with two subcategories) and “conflicts in decision making” (with three subcategories). The final five subcategories were: (a) inability to effectively communicate with children and their families, (b) inability to tell the truth about the disease, (c) physician-parent conflicts, (d) parent-child conflicts, and (e) physician-physician conflicts.ConclusionThe main ethical challenges of palliative care from the perspectives of Iranian pediatricians are the inability to effectively communicate with children and their families, the inability to tell them the truth, and the inability to manage physician-parent, parent-child, and physician-physician conflicts. Identification and management of these challenges may help improve the quality of pediatric palliative care in Iran. Further studies are needed to confirm these findings in other settings.
Background: Ataxia is a symptom of a wide range of disorders, which manifests as a lack of coordinated movements. It is commonly associated with cerebellar disorders. Objectives: To evaluate the neuroimaging findings of children with acute ataxia (AA) and to identify the association between these findings and clinical results. Patients and Methods: This cross-sectional study was conducted using the electronic medical records of patients, presenting to a major pediatric referral center over 10 years from March 2009 to February 2020. Patients were included in the study if they were younger than 18 years, were diagnosed with AA (< 30 days), and underwent magnetic resonance imaging (MRI), computed tomography (CT) scan, or both. The exclusion criteria were as follows: A history of neurological or medical disorders, explaining ataxia; pseudo-ataxia; a traumatic brain injury; severe loss of consciousness; and missing key information in the medical records (e.g., no brain imaging findings). Patient data, including the demographic data, clinical history, laboratory findings, imaging results, and in-hospital outcomes, were collected. A P-value less than 0.05 was considered statistically significant, and the confidence interval was set at 95%. Results: A total of 119 patients were included in this study (51% female; mean age, 4.9 years). Clinically urgent neurological pathology (CUNP) was detected in 37 (31.09%) patients. The most common pathologies on images were tumors, acute disseminated encephalomyelitis (ADEM), and stroke. However, the most common diagnosis was acute post-infectious cerebellar ataxia (APCA; 24.4%), followed by brain tumors (16.8%) and Guillain-Barre syndrome (GBS; 15.1%), respectively. Overall, 11 variables were significantly different between patients with and without CUNP. Most notably, the duration of symptoms (P < 0.01), ophthalmoplegia (OR = 13.93; 95% CI: 3.5 - 54.7), focal neurologic deficit (OR = 7.26; 95% CI: 2.6 - 20.5), and fever (OR = 3.33; 95% CI: 1.1 - 9.8) were associated with a higher risk of CUNP. On the other hand, some features, such as a recent history of febrile illness (presence of fever or body temperature above 38°C in the last month) (OR = 0.36; 95% CI: 0.16 - 0.8) and hyporeflexia (P < 0.01), were associated with a lower risk of CUNP. Conclusion: Acute post-infectious cerebellar ataxia (APCA) was the most common diagnosis of AA in children, undergoing neuroimaging studies in our center. Nevertheless, tumor was the most common pathology detected on the images of patients with CUNP. Some pathologies might not be detected by some imaging modalities. Considering the associations identified in this study, patients with risk factors, such as a longer duration of symptoms, ophthalmoplegia, focal neurologic deficit, and fever, need to undergo another imaging modality with higher sensitivity if there are no positive findings in the initial imaging study. On the other hand, patients with protective factors, such as hyporeflexia and a recent history of febrile illness, could benefit more from other diagnostic modalities.
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