Search

Background: The rapidly increasing use of mobile phones has led to public concerns about possible health effects of these popular communication devices. This study is an attempt to investigate the effects of radiofrequency (RF) radiation produced by GSM mobile phones on the insulin release in rats. Methods: Forty two female adult Sprague Dawley rats were randomly divided into 4 groups. Group1 were exposed to RF radiation 6 hours per day for 7 days. Group 2 received sham exposure (6 hours per day for 7 days). Groups 3 and 4 received RF radiation 3 hours per day for 7 days and sham exposure (3 hours per day), respectively. The specific absorption rate (SAR) of RF was 2.0W/kg. Results: Our results showed that RF radiations emitted from mobile phone could not alter insulin release in rats. However, mild to severe inflammatory changes in the portal spaces of the liver of rats as well as damage in the cells of islet of Langerhans were observed. These changes were linked with the duration of the exposures. Conclusion: RF exposure can induce inflammatory changes in the liver as well causing damage in the cells of islet of Langerhans.

Background: Airport workers are continuously exposed to different levels of radiofrequency microwave (RF/MW) radiation emitted by radar equipments. Radars are extensively used in military and aviation industries. Over the past several years, our lab has focused on the health effects of exposure to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. The main goal of this study was to investigate if occupational exposure of Shahid Dastghieb international airport workers to radiofrequency radiation affects their short term memory and reaction time. Methods: Thirty two airport workers involved in duties at control and approach tower (21 males and 11 females), with the age range of 27-67 years old (mean age of 37.38), participated voluntary in this study. On the other hand, 29 workers (13 males, and 16 females) whose offices were in the city with no exposure history to radar systems were also participated in this study as the control group. The employees’ reaction time and short term memory were analyzed using a standard visual reaction time (VRT) test software and the modified Wechsler memory scale test, respectively. Results: The mean± SD values for the reaction times of the airport employees (N=32) and the control group (N=29) were 0.45±0.12 sec and 0.46±0.17 sec, respectively. Moreover, in the four subset tests; i.e. paired words, forward digit span, backward digit span and word recognition, the following points were obtained for the airport employees and the control group, respectively: (i) pair words test: 28.00±13.13 and 32.07±11.65, (ii) forward digit span: 8.38±1.40 and 9.03±1.32, (iii) backward digit span: 5.54±1.87 and 6.31±1.46, and (iv) word recognition: 5.73±2.36 and 6.50±1.93. These differences were not statistically significant. Conclusion: The occupational exposure of the employees to the RF radiation in Shahid Dastghieb international airport does not have any significant detrimental effect on their reaction time as well as short term memory.

Alzheimer’s disease, the most common type of dementia and a progressive neurodegenerative disease, occurs when the nerve cells in the brain die. Although there are medications that can help delay the development of Alzheimer’s disease, there is currently no cure for this disease. Exposure to ionizing and non-ionizing radiation may cause adverse health effects such as cancer. Looking at the other side of the coin, there are reports indicating stimulatory or benefcial effects after exposure to cell phone radiofrequency radiation. Mortazavi et al. have previously reported some benefcial cognitive effects such as decreased reaction time after human short-term exposure to cell phone radiation or occupational exposure to radar microwave radiation. On the other hand, some recent reports have indicated that RF radiation may have a role in protecting against cognitive impairment in Alzheimer’s disease. Although the majority of these data come from animal studies that cannot be easily extrapolated to humans, it can be concluded that this memory enhancing approach may open new horizons in treatment of cognitive impairment in Alzheimer disease.

Background: Over the past several years, the rapidly increasing use of mobile phones has raised global concerns about the biological effects of exposure to radiofrequency (RF) radiation. Numerous studies have shown that exposure to electromagnetic fields (EMFs) can be associated with effects on the nervous, endocrine, immune, cardiovascular, hematopoietic and ocular systems. In spite of genetic diversity, the onset and progression of cancer can be controlled by epigenetic mechanisms such as gene promoter methylation. There are extensive studies on the epigenetic changes of the tumor suppressor genes as well as the identification of methylation biomarkers in colorectal cancer. Some studies have revealed that genetic changes can be induced by exposure to RF radiation. However, whether or not RF radiation is capable of inducing epigenetic alteration has not been clarified yet. To date, no study has been conducted on the effect of radiation on epigenetic alterations in colorectal cancer (CRC). Several studies have also shown that methylation of estrogen receptor α (ERα), MYOD, MGMT, SFRP2 and P16 play an important role in CRC. It can be hypothesized that RF exposure can be a reason for the high incidence of CRC in Iran. This study aimed to investigate whether epigenetic pattern of ERα is susceptible to RF radiation and if RF radiation can induce radioadaptive response as epigenetic changes after receiving the challenge dose (γ-ray). Material and Method: 40 male Sprague-Dawley rats were divided into 4 equal groups (Group I: exposure to RF radiation of a GSM cell phone for 4 hours and sacrificed after 24 hours; Group II: RF exposure for 4 hours, exposure to Co-60 gamma radiation (3 Gy) after 24 hours and sacrificed after 72 hrs; Group III: only 3Gy gamma radiation; Group 4: control group). DNA from colon tissues was extracted to evaluate the methylation status by methylation specific PCR. Results: Our finding showed that exposure to GSM cell phone RF radiation was capable of altering the pattern of ERα gene methylation compared to that of non-exposed controls. Furthermore, no adaptive response phenomenon was induced in the pattern of ERα gene methylation after exposure to the challenging dose of Co-60 γ-rays. Conclusion: It can be concluded that exposure to RF radiation emitted by GSM mobile phones can lead to epigenetic detrimental changes in ERα promoter methylation pattern.

This study aimed to determine the relationship between creativity on one hand and lexical reception and production knowledge of Iranian EFL students on the other hand. The data were collected using three tests: a creativity test (Torrance, 1990), the Vocabulary Levels Test (Schmitt, Schmitt, & Clapham, 2001), and the Productive Version of the Vocabulary Levels Test (Laufer & Nation, 1995) which were administered to a group of 141 Iranian undergraduate students majoring in English Translation and Literature at Arak and Qom universities. The results demonstrated that there was not a high correlation between creativity on one hand and lexical reception and production on the other hand. The learners' passive and active vocabulary knowledge in the tests as a whole and at different word-frequency level were highly correlated. Passive vocabulary was always larger than active vocabulary at all levels; however, the gap between the two increased at lower word-frequency levels.

Byline: M. Movvahedi, A. Tavakkoli-Golpayegani, S. A. R.. Mortazavi, M. Haghani, Z. Razi, M. Shojaie-fard, M. Zare, E. Mina, L. Mansourabadi, Nazari-Jahromi, A. Safari, N. Shokrpour, S. M. J.. Mortazavi [...]

Background: The rapidly increasing use of mobile phones has led to public concerns about possible health effects of these popular communication devices. This study is an attempt to investigate the effects of radiofrequency (RF) radiation produced by GSM mobile phones on the insulin release in rats. Methods: Forty two female adult Sprague Dawley rats were randomly divided into 4 groups. Group1 were exposed to RF radiation 6 hours per day for 7 days. Group 2 received sham exposure (6 hours per day for 7 days). Groups 3 and 4 received RF radiation 3 hours per day for 7 days and sham exposure (3 hours per day), respectively. The specific absorption rate (SAR) of RF was 2.0 W/kg. Results: Our results showed that RF radiations emitted from mobile phone could not alter insulin release in rats. However, mild to severe inflammatory changes in the portal spaces of the liver of rats as well as damage in the cells of islet of Langerhans were observed. These changes were linked with the duration of the exposures. Conclusion: RF exposure can induce inflammatory changes in the liver as well causing damage in the cells of islet of Langerhans. [ABSTRACT FROM AUTHOR]

Background: In diagnostic radiology lead apron, are usually used to protect patients and radiology staff against ionizing radiation. Lead apron is a desirable shield due to high absorption and effective attenuation of x-ray photons in the diagnostic radiology range. Objective: Although lead aprons have good radiation protection properties, in recent years, researchers have been looking for alternative materials to be used instead of lead apron because of some problems derived from lead-content of aprons. Because of its lead-content, these radiation protection garments are so heavy and uncomfortable for the staff to wear, particularly in long-time uses. In addition, lead is a toxic element and its disposal is associated with environmental and human-health hazards. Method: In this study, several new combinations of lead free materials ((W-Si), (W-Sn-Ba-EPVC ), (W-Sn-Cd-EPVC)) have been investigated in the energy range of diagnostic radiology in two geometries: narrow and broad beam. Geometries of the radiation attenuation characteristics of these materials was assessed in 40, 60, 90 and 120 kVp and the results compared with those of some lead-containing materials ((Pb-Si), (Pb-EPVC)). Results: Lead shields still provide better protection in low energies (below 40 kVp). Combination of W-Sn-Cd-EPVC has shown the best radiation attenuation features in 60 and 90 kVp and the composition of (W-Sn-Ba-EPVC) represents the best attenuation in 120 kVp, even better than previously mentioned lead- containing composites. Conclusion: Lead free shields are completely effective for protection against X-ray energies in the range of 60 to 120 kVp. [ABSTRACT FROM AUTHOR]

Substantial evidence indicates that adaptive response induced by low doses of ionizing radiation can result in resistance to the damage caused by a subsequently high-dose radiation or cause cross-resistance to other non-radiation stressors. Adaptive response contradicts the linear-non-threshold (LNT) dose-response model for ionizing radiation. We have previously reported that exposure of laboratory animals to radiofrequency radiation can induce a survival adaptive response. Furthermore, we have indicated that pre-exposure of mice to radiofrequency radiation emitted by a GSM mobile phone increased their resistance to a subsequent Escherichia coli infection. In this study, the survival rates in animals receiving both adapting (radiofrequency) and challenge dose (bacteria) and the animals receiving only the challenge dose (bacteria) were 56% and 20%, respectively. In this light, our findings contribute to the assumption that radiofrequency-induced adaptive response can be used as an efficient method for decreasing the risk of infection in immunosuppressed irradiated individuals. The implication of this phenomenon in human's long term stay in the space is also discussed. [ABSTRACT FROM AUTHOR]

Introduction: Motivation is a driving force behind man's behavior which has led to many psychological studies throughout the world. Moreover, it is the fuel for successful learning. While intrinsic motives provide the internal rewards, extrinsic motivation supplies the required external rewards to keep the engine of learning running. Knowing the factors which impact intrinsic/extrinsic motivation helps educators target their efforts at a higher level and make more informed decisions., Method: This study intends to examine how intrinsic vs. extrinsic motivation may be influenced by demographics including learners' background factors of major, age, and occupation and to determine the relationships that may exist between intrinsic and extrinsic motivation. To this end, an explanatory sequential mixed-methods research was conducted at one of the public universities in Shiraz on the majors of Elementary Education, Educational Affairs, Social Studies and Theology, and the Arabic language which were selected through cluster sampling. These students were having their English courses at the university. Based on Krejcie and Morgan's formula for sample size, a questionnaire was administered to 100 participants to collect quantitative data. Moreover, semi-structured interview sessions were conducted with one fourth of the participants., Results: Using Multiple Analysis of Variance (MANOVA) and Pearson correlation, we found that learners' background factors of age, field of study and professional status did not affect intrinsic nor extrinsic motivation. However, significant and positive relationships were found between intrinsic motivation and total motivation index, and between extrinsic motivation and total motivation index. Qualitative data obtained from the interviews were analyzed using a thematic analysis. The results of the interviews showed some new illuminating trends as revealed from the participants' responses and it was found that most interviewees followed intrinsic motives and considered motivation as a factor of great significance., Conclusion: In the English as a Foreign Language (EFL) context in which our study was conducted, instructors can follow more similar classroom motivational techniques and strategies since neither type of motivation was influenced by the variables of different major, age and occupation. Though many studies have shown that EFL learners are more extrinsically motivated in comparison with ESL ones, our study revealed that participants were more intrinsically motivated. Thus, this study may be replicated in other educational contexts such as an ESL context. The study can also be repeated in some universities in which other educational systems such as coed education is used to see the possible similarities and differences. Motivation is the important stimulant to impel the learners to achieve their learning goals; thus, it should receive sufficient attention in various educational settings., (© 2024. The Author(s).)

Background: Emergency medical services preparedness in mass casualty incidents is one of the most important concerns in emergency systems. A mass casualty incident is a sudden event with several injured individuals that overwhelms the local health care system. This study aimed to identify and validate the components of emergency medical services readiness in mass casualty incidents which ultimately led to designing a conceptual model., Methods: This research was an explanatory mixed-method study conducted in five consecutive stages in Iran between November 2021 and September 2023. First, a systematic review was carried out to extract the components of emergency medical services preparedness in mass casualty incidents based on the PRISMA guideline. Second, a qualitative study was designed to explore the preparedness components through in-depth semi-structured interviews and analyzed using the content analysis approach. Third, the integration of the components extracted from the two stages of the systematic review and qualitative study was done by an expert panel. Fourth, the obtained components were validated using the Delphi technique. Two rounds were done in the Delphi phase. Finally, the conceptual model of emergency medical services preparedness in mass casualty incidents was designed by a panel of experts., Results: 10 articles were included in the systematic review stage and sixteen main components were extracted and classified into four categories. In the second stage, thirteen components were extracted from the qualitative study and classified into five categories. Then, the components of the previous two phases were integrated into the panel of experts and 23 components were identified. After validation with the Delphi technique, 22 components were extracted. Lastly, the final components were examined by the panel of experts, and the conceptual schematic of the model was drawn., Conclusions: It is necessary to have an integrated framework and model of emergency medical service readiness in the planning and management of mass casualty incidents. The components and the final model of this research were obtained after the systematic scientific steps, which can be used as a scheme to improve emergency medical service preparedness in response to mass casualty incidents., (© 2024. The Author(s).)

Competing Interests: Nasrin Shokrpour, as the English Editor, was not involved in the peer-review and decision making processes for this manuscript. A team of independent experts were formed by the Editorial Board to review the article without her knowledge.

Research conducted over the years has established that artificial light at night (ALAN), particularly short wavelengths in the blue region (~400-500 nm), can disrupt the circadian rhythm, cause sleep disturbances, and lead to metabolic dysregulation. With the increasing number of people spending considerable amounts of time at home or work staring at digital screens such as smartphones, tablets, and laptops, the negative impacts of blue light are becoming more apparent. While blue wavelengths during the day can enhance attention and reaction times, they are disruptive at night and are associated with a wide range of health problems such as poor sleep quality, mental health problems, and increased risk of some cancers. The growing global concern over the detrimental effects of ALAN on human health is supported by epidemiological and experimental studies, which suggest that exposure to ALAN is associated with disorders like type 2 diabetes, obesity, and increased risk of breast and prostate cancer. Moreover, several studies have reported a connection between ALAN, night-shift work, reduced cognitive performance, and a higher likelihood of human errors. The purpose of this paper is to review the biological impacts of blue light exposure on human cognitive functions and vision quality. Additionally, studies indicating a potential link between exposure to blue light from digital screens and increased risk of breast cancer are also reviewed. However, more research is needed to fully comprehend the relationship between blue light exposure and adverse health effects, such as the risk of breast cancer., Competing Interests: SMJ. Mortazavi, as the Editorial Board Member, was not involved in the peer-review and decision-making processes for this manuscript., (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: Teamwork has played a critical role in ensuring patients' safety and preventing human errors in surgery. With advancements in educational technologies, including virtual reality, it is necessary to develop new teaching methods for interpersonal teamwork based on local needs assessments in countries with indigenous cultures. This study aimed to design and develop a new method of teaching teamwork in cesarean section surgery using virtual reality; we further evaluated the effects of this method on healthcare professionals' knowledge and attitudes about teamwork., Methods: This study was designed using the ADDIE instructional design model. The TeamSTEPPS Learning Benchmarks questionnaire was used to assess the educational needs of 85 participants who were members of the cesarean section surgery team. A specialized panel analyzed the extracted needs, and the scenario was compiled during the design stage. Finally, four virtual reality contents were created using 360-video H.265 format, which were prepared from specified scenarios in the development of the educational program. The TeamSTEPPS Learning Benchmarks questionnaire was used to measure knowledge, and the T-TAQ was used to measure the participants' attitudes., Results: Six micro- skills were identified as training needs, including briefing, debriefing, cross-monitoring, I'M SAFE checklist, call-out and check-back, and two-challenge rule. Intervention results showed that the virtual reality content improved teamwork competencies in an interprofessional team performing cesarean section surgery. A significant increase was observed in the mean score of knowledge and attitude after the intervention., Conclusion: Through addressing the need for teamwork training, utilizing the TeamSTEPPS strategy, and incorporating new educational technologies like virtual reality, the collaboration among surgical team members can be enhanced., (© 2023. The Author(s).)

Introduction: Medical education is beyond gaining a certain level of knowledge and mastering a specific set of skill. Medical students should try to improve the self and system, which necessitates personal growth and professional identity development. In this study, we aimed to investigate the factors which contribute to the formation of professional identity of medical students in basic sciences stage and finding out the significance of each factor., Methods: In this cross-sectional practical survey, semi-structured interviews were done with 10 medical students. The interview results yielded several items, which were used to make a 14-item questionnaire, the validity and reliability of which were verified. The contribution of the items to the factors was verified through factor analysis, the prerequisites of which were KMO and Bartlett test, which were done and approved. The significance of the factors obtained was evaluated and ranked through one sample t-test and Friedman test, respectively., Results: The result showed that professional identity development in the stage of basic sciences was influenced by several factors, including educational, socioeconomic, personal, and familial ones. Also, the personal factor ranked first, followed by socioeconomic, educational, and familial factors, respectively., Conclusion: In this study, it was concluded that the participants were more influenced by their own personal attitudes as compared to their familial, socioeconomic, or educational factors. Moreover, the factors which contributed to the professional identity of medical students were not at the same level of significance. To train physicians with high professional identity, medical education authorities are recommended to consider the above-mentioned factors., Competing Interests: Nasrin Shokrpour, as the English Editor, was not involved in the peer-review and decision making processes for this manuscript. A team of independent experts were formed by the Editorial Board to review the article without her knowledge., (Copyright: © Journal of Advances in Medical Education & Professionalism.)

Background and Aims: The reasons for the unfavorable performance of hospitals in providing care to Coronavirus Disease 2019 (COVID-19) patients include the lack of preparation, knowledge, and relevant skills, making it necessary to evaluate the preparedness of nurses to respond to COVID-19. Therefore, the present study aimed to investigate the preparedness of hospitals affiliated with Shahrekord University of Medical Sciences during the COVID-19 pandemic in 2022., Methods: In this analytical study, data were collected from 350 randomly selected nurses who worked in three hospitals affiliated with Shahrekord University of Medical Sciences; demographic information tools and the preparation of nurses for COVID-19 patients were used to collect the data. We analyzed the data using SPSS software version 26., Results: The mean and standard deviation of the total preparation score was 118.85 ± 0.98. The lowest (6.80 ± 0.18) and highest (23.35 ± 0.19) average values belonged to risk assessment and management and COVID-19, respectively. The score of nurses' preparedness to deal with COVID-19 was not statistically correlated with age, work experience, and so on. The average preparation score was significantly different in different treatment departments (operating room and COVID-19)., Conclusion: The preparation of nurses was low in dealing with COVID-19. Thus, managers of nursing services should design and implement educational programs to strengthen the nurses' weaknesses and ultimately increase their awareness and skills in dealing with disasters., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background and Aims: The effective response of emergency medical services in mass casualty incidents (MCIs) calls for sufficient preparation. The components of preparation must be determined first to achieve this goal. This study aimed to describe the elements of preparedness of emergency medical services for MCIs., Methods: A qualitative study was carried out on emergency medical service systems in Iran (from April 2022 to mid-March 2023), using in-depth semistructured interviews with participants who were managers and members of the incident command team, experts, technicians, paramedics, and telecommunicators of emergency medical services. Interviews were carried out face-to-face and via telephone. The data were collected using voice recorder and transcript and analyzed by content analysis method. This study was conducted using the consolidated criteria for reporting qualitative research., Results: Thirty-six participants were included in the study. A total of 834 codes were analyzed. Thirteen components were extracted from the study and classified as five categories including "Strengthening management and organization," "individual and group empowerment," "capacity expansion," "technology and infrastructure development," and "operational response measures.", Conclusion: Emergency medical service preparedness in response to MCIs is a critical issue. For improving preparedness, the main components must be identified. The study results described the elements of emergency medical service preparedness, which could be used as a framework for developing the national model of emergency medical service preparedness in MCIs., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Competing Interests: Nasrin Shokrpour, as the English Editor, was not involved in the peer-review and decision making processes for this manuscript. A team of independent experts were formed by the Editorial Board to review the article without her knowledge.

Background: Evidence suggests that menopause can be associated with a variety of negative psychological changes such as depression and anxiety, and improving the mental health status of women during menopause is one of the important priorities and challenges of the health system. The aim of this study was to determine the effect of saffron (Crocus sativus L., Iridaceae) herbal tea on happiness in postmenopausal women., Methods: In this randomized clinical trial which was conducted in 2021, 72 postmenopausal women were enrolled and divided into intervention and control groups. The randomization blocks method was used for random allocation, and the Oxford Happiness Questionnaire was utilized to measure the scores. The intervention included the use of 30 mg of dried stigmas of the saffron plant, which was boiled once (in the morning, in 300 ml of boiling water for 10-15 min) and consumed with white rock candy as one cup of saffron tea daily. To compare the trend of changes and after removing the effect of other variables, generalized estimating equation (GEE) was used., Results: There was no significant difference between the intervention and control groups in any of the quantitative and qualitative characteristics (p > 0.05). The results of paired samples t-test showed that the happiness mean score in the intervention group increased significantly (p < 0.001) from 42.93 ± 8.54 to 61.58 ± 8.24, while in the control group, there was no significant difference between the happiness mean score at the beginning and end of the study (p = 0.861). Also, after applying the treatment program in the intervention group, there was a significant difference between the two groups in terms of the happiness mean scores (p < 0.001)., Conclusion: Saffron herbal tea had a positive effect on reducing depression and increasing the happiness score; thus, it is recommended that it should be used as a complementary treatment in consultation with the treating physician., Trial Registration: The present study was registered with the code of IRCT20210403050818N1 (Registration date: 09/04/2021) in the Iranian Registry of Clinical Trials. It was also approved by the Ethics Committee of Larestan University of Medical Sciences (Approval ID: IR.LARUMS.REC.1399.017)., (© 2023. The Author(s).)

Background: This study aimed to identify and explain the strategies of faculty development based on their role at Iranian Universities of Medical Sciences., Methods: We conducted a qualitative content analysis study in 2021 using purposive, snowball sampling, with a maximum variation in the faculty members' age and experience level. Twenty four participants were enrolled in this study (eighteen faculty members and six medical sciences students); data collection consisted of two phases of semi-structured interviews and a brainstorming group technique. Data were categorized into two themes and six related subthemes, based on their similarities and differences after frequent summarization., Results: The data analysis yielded two themes and eight categories. The first theme was to explain competencies based on role and task with two sub-themes: Tasks and capabilities and development and excellence of personal qualities. The second theme was the best strategies for empowering the teachers with four sub-themes, including problem-based learning, integration of methods, evaluation-based education, and scholarship in education (PIES), which explains the strategies that can support the development of teachers in medical sciences universities, and all the concepts were interrelated to each other., Conclusion: From the experiences of faculty members, the importance of some strategies in education and empowering the teachers' professional competence dimensions should be emphasized. PIES could explain the practical strategies that can support the development of teachers in medical sciences universities., (© 2023. The Author(s).)

Competing Interests: Nasrin Shokrpour, as the English Editor, was not involved in the peer-review and decision-making processes for this manuscript. A team of independent experts were formed by the Editorial Board to review the article without her knowledge.

Background: Application of a Clinical Information System (CIS) like Electronic Patient Record (EPR), PACS system and CPOE has turned into one of the most important criteria of priorities of health care systems. The aims of the clinical information system include improving the physicians' efficiency level, integrating the caring process, and expanding the fuzzy quality of the services offered to patients. Achievement of these benefits in reality is not an easy task, and there are lots of plans in this field which are doomed to failure. About 50% of the implementation plans of clinical information systems in health care organizations have failed, and this trend is significantly affecting industrial countries. Proper implementation of hospital information systems lies in identifying and assessing the relationships among the most important risk factors of fuzzy. The present study aimed to provide an applicable model for identifying, ranking and evaluating the risk factors associated with projects of clinical information technology in hospitals of Shiraz University of Medical Sciences., Method: This is an applied study which evaluates the risk factors associated with implementation of clinical information technology projects in hospitals of Shiraz Medical Sciences University. The participants consisted of professionals and senior experts of clinical information technology. Fuzzy logic was used in this study. We also applied ANP-DEMATEL combined model with fuzzy procedure to provide the analytic model of the study., Results: According to the study findings, lack of top-executive supports, and unstable organizational environment were the two most important risk factors, while the main organizational factors and technology were also highly important. In addition, the factors associated with technology had the highest influence on the other studied risk factors., Conclusion: Hospital authorities can benefit from this proposed model to reduce the risk of implementing the projects of clinical information technology and improve the success coefficient of the risk of such projects., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sharifian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Continuing medical education is essential for nurses to provide quality patient care and upgrade their professional skills and competence. The need for continuing medical education (CME) has become more apparent in the face of advances in medical science, the ever-changing healthcare system, and nurses' vital role in improving health care. It is, therefore, imperative to explore the nurses' experience of CME courses and the extent to which such programs are effective., Objective: The present qualitative study aimed to explore and describe nurses' experiences of the effect of CE programs in promoting their competencies toward non-communicable diseases., Methods: This qualitative content analysis study was conducted from December 2019 to April 2020 at various hospitals affiliated to Shiraz University of Medical Sciences (Shiraz, Iran) and based on the principles of conventional content analysis. The target population was nurses who actively worked in the chronic wards of these hospitals. The participants were selected using maximum variation sampling, including nine nursing managers, education and clinical supervisors, and staff nurses. Data were collected through individual, face-to-face, semi-structured interviews guided by an interview guide, and data collection continued until data saturation was achieved. Each interview took about 30-45 min. Follow up questions were used for clarification when needed. Data trustworthiness was assessed according to the criteria proposed by Guba and Lincoln., Results: Analysis of the interview data resulted in 230 primary codes, based on 8 categories, and three themes were identified. The extracted themes were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency. The associated categories were gaps in the planning of the CME program, problematic context, and training to improve professional skills and competency., Conclusion: Professional competence and performance of nurses can be improved through intrinsic motivation stimulation, planning, and implementation of training programs based on professional needs and effective assessment of the teaching/learning process., (© 2022. The Author(s).)

Introduction: Reflectivity is one of the fundamental methods of education. This study aimed to investigate the relationship between reflectivity and self-regulated learning in MA medical education students of Shiraz University of Medical Sciences in 2018 and 2019., Methods: In this descriptive study, 34 full time and virtual MA students of medical education participated, using census method. Data were collected through the Pintrich and DeGroot self-regulated learning and the Kember et al.'s reflectivity questionnaires. Descriptive and inferential statistics were used for data analysis, through SPSS., Results: The results showed that self-regulatory learning strategies in subjects with good reflectivity were significantly higher than those with poor reflectivity; also, the scores of cognitive strategies and motivational beliefs were significantly higher in the participants with good reflectivity. There was no significant relationship between reflectivity and subscales of self-regulated learning strategies and also between reflectivity and self-regulated learning strategies in the full time and virtual courses., Conclusion: It was found that there was a positive and meaningful relationship between reflectivity and self-regulated learning. Therefore, it is recommended that the managers and professors in medical universities should provide training programs in this field in order for the students to benefit from the advantages of reflectivity and self-regulated learning., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

In the new era, many people seek their health-related information through the Internet due to the increasing access to this technology. Searching online health information can affect the health behavior. This study aimed to investigate the correlation between online health information-seeking behavior and a healthy lifestyle during pregnancy in a sample of Iranian pregnant women. This cross-sectional study was conducted among pregnant women admitted to health centers of Eghlid city, Fars province, Iran in 2019. A total of 193 women participated in the study. The required data were gathered using two validated questionnaires to measure the online health information-seeking behavior and the healthy lifestyle practices of the participants. The collected data were analyzed through descriptive statistics and Pearson correlation coefficient using SPSS version 22. Online health information experience and its subscales showed no statistical correlation with a healthy lifestyle. Age and education did not correlate with online health information-seeking behavior. Age had a statistical correlation with a healthy lifestyle, but education had the same correlation only with some subscales of a healthy lifestyle. The findings were surprising, suggesting that online health information-seeking behavior does not affect the lifestyle of pregnant women. These finding and probable explanations are discussed, but due to the limited literature on the subject, further studies are recommended to be conducted., Competing Interests: The authors have declared that no competing interests exist.

Background: Given the relationship between positivity interventions and psychological problems, this study aimed to investigate the effect of positive thinking training on stress, anxiety, depression, and quality of life of hemodialysis patients., Materials and Methods: This is a quasi-experimental and interventional study conducted on 70 hemodialysis patients referred to Fasa hemodialysis centers, Iran, between April 2019 and October 2019. Patients were selected using a simple sampling method and randomly divided into control ( n = 35) and intervention ( n = 35) groups. The intervention group was trained on positive thinking skills in eight sessions of a workshop. Before and after the intervention, stress, anxiety, depression, and quality of life in both the groups were measured using the Depression, Anxiety, and Stress Scale-21 and Short Form-36 Questionnaire. Data were analyzed using paired t -test, independent t -test, Kolmogorov-Smirnov, and Chi-square tests., Results: There was no significant difference in the mean scores of stress, anxiety, depression, and quality of life in the two groups before the intervention.( P > 0.05), and in the control group, there was no statistically significant difference before and after the intervention ( P = 0.092, P = 0.228, 0.280, respectively). In the intervention group, the mean score of stress and anxiety decreased from 23.65 ± 4.12 to 16.68 ± 4.41 ( P < 0.001) and from 17.77 ± 5.15 to 14.57 ± 4.18 ( P = 0.002), respectively, and that of the patients' quality of life also increased from 35.19 ± 10.07 to 55.98 ± 11.71 ( P < 0.001). However, the mean score of depression did not change significantly after the intervention ( P = 0.689)., Conclusion: According to the results of this study, the use of positive thinking intervention programs with other methods for hemodialysis patients' care and treatment is recommended as a nonpharmacological, cost-effective, and uncomplicated method., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Introduction: Health-care workers in community service professions are the formerly candidate for occupation burnout. This study aimed to investigate the relationship between empowerment and job burnout among auxiliary health workers (behvarzan) at Fasa University of Medical Sciences., Materials and Methods: In this descriptive-analytical study, 120 auxiliary health workers were enrolled using the census. Spritzer's psychological empowerment and Maslach burnout inventory questionnaires were used to collect the data. Then, they were analyzed through the SPSS software, using descriptive analytical tests., Results: The findings of this study revealed that the auxiliary health workers' empowerment was in the range of 22-75 with a mean ± standard deviation [SD] of 48.5 ± 9.71, which is in a fairly high level considering the highest score (75) in this scale. Moreover, with respect to burnout (mean ± SD of 58.03 ± 18.64), 36 participants (30%) had low level of burnout, 69 subjects (57.5%) were at the intermediate level, and 15 (12.5%) suffered high levels of job burnout. According to the results of this study, there were a high correlation and negative relationship ( r = 0.406, P > 0.001) between psychological empowerment and job burnout among the auxiliary health workers. On the other hand, all empowerment components (competence, autonomy or independence, effectiveness, and trust) had a reverse and significant association with burnout., Conclusion: Based on the results of this study, the auxiliary health workers (behvarzan) were in a good range of empowerment; also, the dimensions of empowerment were correlated with job burnout in Fasa university-affiliated hospitals' health workers. On the other hand, demographic features had no association with these two factors. It is suggested that health authorities should take measures to empower the workers and identify and remove the effects of the various dimensions of job burnout among the health workers in these hospitals., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Background: Communication apprehension (CA) is the fear or anxiety about communicating. This study was designed to investigate the CA and its related factors in the medical students at Rafsanjan University of Medical Sciences (RUMS)., Materials and Methods: In this cross-sectional study, personal report of CA (PRCA-24) was administered to 340 medical and paramedical students to measure anxiety in four domains of large groups, small groups, public speaking, and dyadic interaction. Pearson's correlation and linear regression analysis were used to investigate the relationship between CA and the variables of birth order, number of siblings, and university entrance score. Data were analyzed using descriptive and inferential statistics (Chi-square and Kruskal-Wallis Test)., Results: CA in the dimension of public speaking was higher than the other dimensions. Evaluation of the economic stability and its relationship to CA indicated a significant difference among all the domains of the PRCA-24. There was a significant relationship between the scores of CA and the number of siblings ( P = 0.001). Linear regression and Pearson's correlation tests indicated a significant correlation between the variables of birth order, number of siblings, and university entrance score. The correlation between the CA with dimensions of group discussion, interpersonal, speaking, and meeting was weak but significant ( P < 0.01)., Conclusion: Without communication, the materialization and development of the human community are not possible. This aspect is more evident and crucial in the healthcare industry. Based on the results of this study, the medical and paramedical students at RUMS have a medium-to-high level of CA. Therefore, it is of utmost importance to detect students with high CA to prevent further communication problems after graduation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Background: The function of healthcare workers, particularly nursing staff, in taking care of coronavirus disease 2019 (COVID-19) patients, cannot be overemphasized. As the pandemic lasts, burnout among the nursing staff needs to be considered as an important challenge. This was aimed to assess the nurses' burnout and factors affecting this variable., Materials and Methods: In this cross-sectional study, Maslach Burnout Inventory was completed by 261 nurses in Shiraz hospitals (Iran) in April 2020. This questionnaire addresses different aspects, including emotional exhaustion, personal achievement, and depersonalization, to determine the intensity of perceived burnout among nurses during the outbreak., Results: Our data demonstrated that the nurses' burnout in Shiraz hospitals during the COVID-19 pandemic was high (64.6%). Emotional exhaustion and depersonalization were observed in 63.6 and 53.3 percent of the participants, respectively. Moreover, the rate of successful personal achievement among these nurses was >97%. Work experience <10 years (P=0.016), hospital ward (P=0.044), the number of deaths observed by nurses during the COVID-19 pandemic (P<0.001), and the total number of shifts during the COVID-19 pandemic (P=0.006) had a positive correlation with emotional exhaustion., Conclusion: Workload and stress resulting from the COVID-19 outbreak seem to be one of the major causes of emotional exhaustion in nurses. The emotional exhaustion among nurses must be considered in epidemics, such as COVID-19., (Copyright© 2020, Galen Medical Journal.)

Background: The prevalence of hookah smoking in the Islamic Republic of Iran is increasing among females, especially in the southern cities., Aims: The aim of this study was to investigate the factors influencing hookah tobacco smoking among females in the Islamic Republic of Iran., Methods: In this qualitative study, 52 females who use hookah were selected (25-71 years old) from the cities of Evaz and Gerash and were interviewed. The participants were selected using purposive sampling and the data were gathered using semi-structured interviews. Data analysis was performed using the conventional approach of qualitative content analysis., Results: Most participants were aged between 25 and 35 years old and 55.8% were married. Three main themes were identified from the qualitative data including: personal factors, family factors and social factors., Conclusions: The findings of this study indicate that the reasons for hookah smoking were based on complex interactions between individual, family, and social factors. In order to successfully reduce hookah smoking in females it is necessary to consider an approach that uses these social factors., (Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Background: The current corona virus pandemic is acting as a stressor or trauma, which not only threats physical health status, but also threats mental health status and well-being of people. Currently, COVID-19 pandemic is a life-threatening unpredictable condition accompanied with a large number of uncertainties. The present study has mainly aimed to assess mental health and the relevant social factors during this pandemic in Fars province., Methods: This cross-sectional study was performed on 922 participants in Fars province, Iran, using internet-based data collection technique. All the included participants filled out the General Health Questionnaire (GHQ-28). Moreover, demographic variables and some social factors were evaluated by asking some questions. All the participants were ensured of the confidentiality of the collected data, and willingly completed the questionnaire., Results: Among the participants, there were 629 women (68.2%) and 293 men (31.2%). The mean age of the participants was 36.98 ± 11.08 years old. Four hundred twenty-five subjects (46.1%) obtained GHQ-28 scores above the cut-off point, and accordingly, they were suspected of having poor mental health statuses. Women, in comparison to men (OR = 2.034, 95%:1.62-3.28), and individuals aged < 50 years old, in comparison to those aged > 50 years old (OR: 4.01 95%:2.15-7.50), have poorer mental health statuses. Trusting on media, health authorities, and cooperation with policy makers, as well as having uncertainty on information about Coronavirus pandemic were also shown to be associated with poor mental health condition (P < 0.05)., Conclusion: The present study revealed that the number of those people with suspected poor mental health in Fars province significantly increased compared to a previous study using the same questionnaire. Furthermore, the participants who had less trust in media and policymakers were more prone to mental health problems. Therefore, it can be concluded that supporting people in these life-threatening pandemic crises is of great importance, so the policy makers and media must present reliable and valid information to people as soon as possible.

Introduction: Academic burnout is one of the issues involving the educational systems at all levels, which wastes the human resources and expenditures. Academic burnout refers to the sense of exhaustion due to educational requirements, the sense of cynicism and indifference, and the sense of lack of competence. Considering the fact that burnout has already been studied in different professions and in cultures different from that of ours, there is a need to identify these factors among the Iranian medical students and accordingly propose some strategies to reduce burnout symptoms among these students. With this end, this study aimed to identify and quantify the importance of possible factors causing burnout among medical students in the 2 nd and 4 th years of their studies in Mashahd University of Medical Sciences and provide some suggestions., Methods: The present research is a cross-sectional study conducted in 2017. The participants included medical students who had entered Mashhad University of Medical Sciences in Iran in 2013 and 2015 and were in their 4 th and 2 nd year of their studies in the university. A questionnaire prepared and validated by Maslach et al . was used to collect the data and distributed among 195 participants who were selected randomly as the sample., Results: The results showed that the mean scores given by 195 selected respondents regarding emotional exhaustion, indifference, and inefficiency were respectively 3.89, 3.87 and 4.12 out of 7., Conclusion: Based on the results, students had the highest level of academic burnout in personal inefficiency or incompetence component and the lowest level was observed in indifference. Therefore, burnout and its components were explicitly seen among medical students; the authorities are recommended to take measures to reduce academic burnout among the students., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Background: Malaria is one of the major human health problems that have become increasingly important in recent decades., Objective: The present study aimed to identify the epidemiological status of malaria in the years 2006-2018 in the southern region of Fars province in southern Iran., Methods: This is a cross-sectional descriptive-analytical study. The study population consisted of all persons with malaria referred to the Center for Disease Control in the four cities of Larestan, Gerash, Evaz and Khonj in the south of Fars province, Southern Iran, between 2006 and 2018. Frequency (%) was used to report descriptive statistics and mean and standard deviation for quantitative variables. The trend of malaria incidence during these years was analyzed using the Cochran Armitage Test. The significance level was considered 5%., Findings: A total of 190 cases of malaria in the period of 2006 to 2018 occurred in the southern region of Fars province; 77.9% were men, more than 95% were Afghans, and most of them were workers. The incidence of malaria in one hundred thousand people per month showed that most of the new malaria cases were in the months of July to October. The peak incidence was in August, with 19.88 cases per 100,000 people. Cochran-Armitage test results showed that this trend was not statistically significant (P = 0.399), despite an almost upward trend in malaria incidence in the south of Fars province., Conclusion: The results of this study showed that the trend of malaria in the south of Fars province was ascending; therefore, increasing surveillance activities to prevent and control malaria in such area is of utmost importance., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Introduction: The aim of this study was to evaluate the cognitive, psychomotor, and attitudinal readiness of faculty members and students of Shiraz University of Medical Sciences for using e-learning in 2019 in order to move toward the desired future of e-learning in medical education, promote the benefits of e-learning in the country, and provide training to each of the research groups if needed., Methods: This is a cross-sectional study conducted in Shiraz University of Medical Sciences, Iran, in 2019. The study population consisted of 379 students and 281 professors selected through the systematic random sampling in Shiraz University of Medical Sciences. The e-learning readiness questionnaire developed by Zarif Sanaei et al . was used to evaluate the students' and teachers' viewpoints., Results: The results showed that the average level of skill, knowledge, and attitude among students and teachers was positive and higher than the mean ( P < 0.05). It had only a significant relationship in the level of education of the teachers and the marital status of the participants. There was also a significant interaction between skill, knowledge, and attitude., Conclusion: There is a need for successful implementation of e-learning by creating appropriate infrastructure, applying the required standards, as well as taking measures to reduce the existing resistance in this regard, which can be achieved through training workshops. The experience of successful universities in the country and abroad can also be used to implement e-learning., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Education and Health Promotion.)

Recognition of the factors affecting the medical students' academic success is one of the most important challenges and concerns in medical schools. Hence, this study aimed to investigate the mediating effects of metacognitive learning strategies and learning-related emotions in the relationship between academic self-efficacy with academic performance in medical students., Methods: The present study was carried out on 279 students of medicine studying at Shiraz University of Medical Sciences. The students filled out three questionnaires: academic emotions (AEQ), metacognitive learning strategies, and academic self-efficacy questionnaires. The data were analyzed using SPSS and Smart PLS3., Results: The results of structural equation modeling revealed that the students' self-efficacy has an impact on their learning-related emotions and metacognitive learning strategies, and these, in turn, affect the students' academic performance. Moreover, learning-related emotions influence the metacognitive learning strategies, which in turn mediate the effect of emotions on academic performance., Discussion: The results of this study revealed that metacognitive strategies and learning-related emotions could play a mediating role in the relationship between students' self-efficacy and academic performance.

Introduction: Emotional intelligence is a social skill that controls stress and affects one's ability to cope with the demands and environmental pressures; it so can improve professional competence in health care providers such as nursing students. Training on emotional intelligence increases the mental health and influences the mutual relationships, stress, depression and aggression. This study aimed to determine the effect of emotional intelligence skills training program on the stress and academic success of nursing students in a higher education health complex., Methods: This study is a quasi-experimental study with an educational intervention. The participants included 100 students of nursing selected by stratified random sampling from both genders. They were randomly categorized into two intervention and control groups including 50 subjects, respectively. We used Meyer and Salvia model in Emotional Intelligence training in the intervention group. During the training sessions in the intervention group, the control group did not receive any intervention. Academic stress and professional competence in both groups were measured before and two weeks after the experiment. SPSS version 21 was used to analyze the data, using Paired t-test, independent t-test, Wilcoxon, Mann-Whitney and Chi-Square tests., Results: The mean age of the participants was 20 ± 2.14 years old. According to the results, the mean difference of the changes in the professional competence (P<0.001), total academic stress (P<0.001), and the four areas of academic stress such as emotional response (P<0.001), physical response (P<0.001) and physiological response (p<0.001) were significant. The intervention group, as compared with the control group, showed no significant effect on the other factors of academic stress such as frustration, conflict, academic pressure, changes and self-imposed stress., Conclusion: The education of emotional intelligence components can improve the efficiency of nursing care services and professional competence due to deceased stress.

Background: Among manuscripts submitted to biomedical journals, randomized controlled trials (RCTs) form the backbone of evidence-based medicine. Hence, their protocol should be designed rigorously and their results should be reported clearly. To improve the quality of RCT reporting, researchers developed the CONSORT Statement in 1996 and updated it in 2010. This study was designed to assess the quality of RCT reporting vis-à-vis adherence to CONSORT among articles published in Iranian medical journals (English, Persian, CONSORT-endorsing, and non-CONSORT-endorsing)., Methods: In this cross-sectional study, all RCTs published in all Iranian medical journals from September 2012 to September 2013 were retrieved to evaluate their adherence to CONSORT. The journals' instructions for authors were also reviewed to find out whether or not they endorsed CONSORT. The CONSORT 2010 Checklist was used. Microsoft Excel 2007 was applied to analyze the data, and MedCalc was employed to compare the groups., Results: Totally, 492 pharmacological RCTs that met our inclusion criteria were identified. Twenty-five items were reported in fewer than 50% of the articles. The differences between the articles published in Persian and English language journals were statistically significant in 17 items. The differences between the articles published in the CONSORT-endorsing and non-CONSORT-endorsing journals were significant in 8 items., Conclusion: Our findings showed very weak adherence to CONSORT. Authors, reviewers, and editors should be trained to use standards expressed by the CONSORT Group in reporting RCTs.

Introduction: Non-verbal communication skills, also called sign language or silent language, include all behaviors performed in the presence of others or perceived either consciously or unconsciously. The main aim of this review article was to determine the effect of the teachers' non-verbal communication on success in teaching using the findings of the studies conducted on the relationship between quality of teaching and the teachers' use of non-verbal communication and also its impact on success in teaching., Methods: Considering the research method, i.e. a review article, we searched for all articles in this field using key words such as success in teaching, verbal communication and non-verbal communication. In this study, we did not encode the articles., Results: The results of this revealed that there was a strong relationship among the quality, amount and the method of using non-verbal communication by teachers while teaching. Based on the findings of the studies reviewed, it was found that the more the teachers used verbal and non-verbal communication, the more efficacious their education and the students' academic progress were. Under non-verbal communication, some other patterns were used. For example, emotive, team work, supportive, imaginative, purposive, and balanced communication using speech, body, and pictures all have been effective in students' learning and academic success. The teachers' attention to the students' non-verbal reactions and arranging the syllabus considering the students' mood and readiness have been emphasized in the studies reviewed., Conclusion: It was concluded that if this skill is practiced by teachers, it will have a positive and profound effect on the students' mood. Non-verbal communication is highly reliable in the communication process, so if the recipient of a message is between two contradictory verbal and nonverbal messages, logic dictates that we push him toward the non-verbal message and ask him to pay more attention to non-verbal than verbal messages because non-verbal cues frequently reveal the intention of the sender of the information and reflect his/her emotional reactions. Based on the obtained results of this study, it is recommended that attention to non-verbal communication skills can make a positive change in the future of a student's life. It seems necessary for the teachers to practice and learn effective communication skills, especially for those who always interact with a large group of students. One of the factors contributing to the success or failure of students is the quality of the relationship and how the teacher builds this relationship with students. Especially, it is more effective for students who are more responsive to human relations and communication skills. Finally, it is recommended that the teachers should improve their communication skills to have better communication with their audience. The authorities are recommended to help improve the teachers' level of communication skills through holding training courses., Competing Interests: Conflict of interests: None declared.

Introduction: In e-learning, people get involved in a process and create the content (product) and make it available for virtual learners. The present study was carried out in order to evaluate the first virtual master program in medical education at Shiraz University of Medical Sciences according to P3 Model., Methods: This is an evaluation research study with post single group design used to determine how effective this program was. All students 60 who participated more than one year in this virtual program and 21 experts including teachers and directors participated in this evaluation project. Based on the P3 e-learning model, an evaluation tool with 5-point Likert rating scale was designed and applied to collect the descriptive data., Results: Students reported storyboard and course design as the most desirable element of learning environment (2.30±0.76), but they declared technical support as the less desirable part (1.17±1.23)., Conclusion: Presence of such framework in this regard and using it within the format of appropriate tools for evaluation of e-learning in universities and higher education institutes, which present e-learning curricula in the country, may contribute to implementation of the present and future e-learning curricula efficiently and guarantee its implementation in an appropriate way., Competing Interests: Conflict of interests:None declared.

Team-based learning is designed to provide students with both conceptual and procedural knowledge, aiming to enhance active learning and critical thinking. In the present study, team-based learning and lecture methods in teaching the "hospital organization and management" course among hospital management students were compared. This quasi-experimental study was conducted on 25 undergraduate students of management. Teaching sessions were divided into two parts. The first part was taught with interactive lectures and the second part with team-based learning method. The students' knowledge was measured before, immediately and two months (late post-test) after teaching. Finally, the mean scores of the final exam and students' satisfaction towards the methods of teaching were measured. There was an improvement in test scores of the students after the TBL sessions when compared to the test scores after lecture sessions (P<0.001). Also, TBL group had significantly a higher amount of knowledge retention compared to the lecture group (P<0.001), but no significant relationship was found between the mean scores of the final exam in the TBL and lecture groups (P=0.116). Finally, the majority of the respondents were more satisfied with TBL sessions compared to the ones held through lecture (P=0.037). The results indicated that TBL provides a better outcome for students. We found that the TBL approach allowed us to create an active learning environment that contributed to the improvement of the students' performances.

Introduction: Assuming any social role has obligations and fulfilling the related responsibilities has ethical aspects that must be addressed carefully. Each role requires extensive training, which usually takes place in university institutions. Ethics is applied in at least three academic areas, including: a) in education of students' personal growth, b) in patient care, and c) in university communion in population-based health care. Given the importance of this issue in the moral domain, this study examines the correlation among the students, nurses and teacher's opinions regarding principles of medical ethics at Shiraz University of Medical Sciences., Methods: This is a descriptive-analytic and cross-sectional study conducted in 2010. The participants of this research consisted of all medical students, nurses in public hospitals, and faculty members in Shiraz University of Medical Sciences. For validity evaluation, the expert panel method and for reliability evaluation, test-retest method was used., Results: Based on the medical ethics' scores in these three groups, there was a significant relationship between the mean scores of student-nurses and employed nurses, but there was no significant relationship between those of student-faculties. Also the mean score of the students was the highest in medical ethics., Conclusion: In this study, we presented a list of virtues and moral characteristics of medical staff and found out the method of practicing medical ethics in everyday life of students to improve the moral reasoning of teachers, nurses and students. Moreover, medical ethics, with the presentation of specific criteria for ethical behavior in various domains of human life, especially in dealing with patients, can help practice ethical values in the medical community.