Prevalence of Anemia in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#Anemia is a common public health concern in patients with type 2 diabetes worldwide. This study aimed to identify the prevalence of anemia among patients with diabetes.@*METHODS@#Electronic databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, were searched systematically for studies published between 2010 and 2021. After removing duplicates and inappropriate reports, the remaining manuscripts were reviewed and appraised using theNewcastle-Ottawa Scale (NOS) tool. A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17. Heterogeneity of the studies was assessed using the Q statistic.@*RESULTS@#A total of 51 articles containing information on 26,485 patients with diabetes were included in this study. The articles were mainly from Asia (58.82%) and Africa (35.29%). The overall prevalence of anemia was 35.45% (95% CI: 30.30-40.76), with no evidence of heterogeneity by sex. Among the two continents with the highest number of studies, the prevalence of anemia in patients with diabetes was significantly higher in Asia [40.02; 95% CI: 32.72-47.54] compared to Africa [28.46; 95% CI: 21.90-35.50] ( P for heterogeneity = 0.029). Moreover, there has been an increasing trend in the prevalence of anemia in patients with diabetes over time, from [15.28; 95% CI: 9.83-22.21] in 2012 to [40.70; 95% CI: 10.21-75.93] in 2022.@*CONCLUSION@#Globally, approximately 4 in 10 patients with diabetes suffer from anemia. Therefore, routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

Core components of clinical education: a qualitative study with attending physicians and their residents

Introduction: In medical education, particularly in residency courses, most of the training occurs in real clinical environments. Workplace-based learning profoundly affects students' knowledge, attitudes, and practice; therefore, it should be properly planned. Due to the extensiveness of the clinical environment and its importance in training residents, investigating how residents learn in these environments and detecting factors that influence effectiveness will help curriculum designers to promote residents' learning by improving their learning environment. Therefore, our qualitative content analysis study, aimed to examine the experiences and perspectives of internal and surgical residents and their attending physicians about learning in clinical settings

Methods: This qualitative content analysis study was conducted through purposeful sampling. Semi-structured interviews were conducted with 15 internal and surgical residents and 15 of their attending physicians at educational hospitals of Tehran University of Medical Sciences

Results: The main categories explored in this study were hidden curriculum, learning resources, and learning conditions. In the context of clinical environment and under its individual culture, residents learn professionalism and learn to improve their communication skills with patients and colleagues. Because of clinical obligations such as priority of treating the patients for education or workload of the attending physicians, residents acquire most of their practical knowledge from colleagues, fellows, or follow-up patients in different learning conditions [such as: educational rounds, morning reports and outpatient clinics] They see some of their attending physicians as role models

Conclusion: Changing cultural and contextual factors is of prime importance to promote a learning-oriented environment in a clinical setting. The present findings will help curriculum planners and attending physicians to improve residents' learning by means of appropriate workplace planning and by considering the components involved in clinical learning

[Validity and Reliability of Direct Observation of Procedural Skills in Evaluating Clinical Skills of midwifery Students of Kashan Nursing and Midwifery School]

Background: Direct observation is a method for objective assessment of practical skills and giving feedback to the students. This study investigated the reliability and validity testing direct observation of practical skills in the assessment of midwifery students' clinical skills.

Material and Method: In this cross-sectional study, participants included 44 midwifery students Internship of Kashan University Medical Sciences selected through census sampling method. Based on faculty members of Guilan, Kashan and Zahedan universities' opinions foure midwifery skills choosed among the basice clinical skills and prepared related check list. Students were obzerved over the procedure in a real work environment by the experimenter and recorded the results according to the check list and objective feedback was given to the students. Content validity - criterion validity [correlation between mean score of clinical and theoretical courses of midwifery and dops - Each item relationship with dops each skill] - validity [internal structure], reliability [internal consistency determination - rater reliability] was analyzed using the SPSS software.

Result: Dops test content validity index and content validity ratio were reported over 0.75% and 0.50%, respectively.Dops scores correlated with theoretical, 0.071 [p =0.647] and clinical 0.093 [p =0.548].The dops significantly correlated with the total score of each skill expressing the desired internal validity [p<0/001]. Reliability test was measured using Cronbach's alpha coefficient[0.814]. the Minimum and maximum values of the correlation coefficient of interrater reliability were 0.97 and 0.99, respectivelywhich were significant in all cases [p<0.001].Students' satisfaction was rated from satisfay to very satisfy with 78.2 percent.

Conclusion: According to the results of tha study, dops has suitable validity and reliability to use for objective evaluation of onstetrical skills.