Evaluation of anti-microbial activity of Lactobacillus acidophillus and Lactobacillus ruteri against entero-pathoges by in vitro and in vivo methods

Background and Objective: Probiotics are beneficial organisms therapeutic within microbial flora. Shigella, Escherichia coli and Salmonella are the most common cause of intestinal infectious diseases that lead to morbidity and mortality in infant and children worldwide. The aim of this study was to evaluate anti-microbial activity of Lactobacillus acidophillus and Lactobacillus ruteri against entero-pathoges by in vitro and in vivo methods

Methods: In this experimental study, the therapeutic effect of the lactobacillus acidophilus ATCC 4356 and ruteri ATCC 23272 against Shigella sonnei ATCC 9290, Escherichia coli ATCC 25922 and Salmonella enterica BAA-708 were evaluated by in vitro [spot agar] and in vivo [BALB/c mice] methods. Weight improvment and survival rate in mice were recorded

Results: Lactobacillus acidophillus and ruteri had protective and therapeutic effect against diarrhea caused by pathogenic bacteria. Probiotics reduced the weight, colonization of pathogens and increased the survival rate of animals [P<0.05]

Conclusion: Lactobacillus acidophillus and ruteri has anti-microbial activity and their consumption can be effective in the prevention and also the treatment of intestinal disease

[Microshear bond strength of transbond XT and assure universal bonding resin to stainless steel brackets, amalgam and porcelain]

Assure universal bonding resin is marketed with fluoride releasing potential. The manufacturer claims that it provides adequate bond strength between the bracket and amalgam and porcelain. This study compared the shear bond strength of Transbond XT and Assure universal bonding resin to stainless steel brackets, amalgam and porcelain in vitro. In this vitro study, 20 standard brackets of the maxillary central incisors, 20 feldspathic porcelain specimens and 20 self-cure acrylic cavities filled with amalgam were divided into 2 groups bonded with Transbond XT, and Assure. After surface preparation in each group, Transbond XT composite was applied to the surfaces using silicon tubes and light-cured for 20 seconds. Then, the microshear bond strength was determined using Zwick Roell machine. The data were subjected to two-way ANOVA, Tukey's post hoc test, Student's t-test and the Kruskal Wallis test. Different microshear bond strengths were obtained for the bond to stainless steel brackets, amalgam and porcelain by Transbond XT and Assure resin [p<0.000]. Using Assure for bonding to amalgam [7.2 +/- 1.46 vs. 10.12 +/- 4.97] and brackets [16.14 +/- 3.2 vs. 20.16 +/- 5.12; p<0.05] decreased microshear bond strength. However, Assure significantly increased the bond strength to porcelain compared to Transbond XT [28.84 +/- 6.42 vs. 22.48 +/- 3.6; p<0.01]. Non-parametric Kruskal-Wallis test showed significant differences in adhesive remnant index [ARI] between the two bonding agents only in the amalgam group [p=0.029]. Although the bond strength values of Assure were less than those of Transbond XT, Assure was able to create sufficient bond strength especially to porcelain

[Effect of saliva contamination on shear bond strength of transbond XT and assure universal bonding resin to enamel]

Assure universal bonding resin is a modified cement with fluoride releasing property. It is claimed to provide adequate bond strength between the bracket and enamel in wet conditions; although more studies are required in this regard. This study compared the shear bond strength of Transbond XT and Assure universal bonding resin to dry and saliva-contaminated enamel in vitro. In this in vitro study, 60 extracted human premolars were selected and stainless steel brackets were bonded to enamel surfaces. Bonding of brackets to enamel surfaces was done using Assure universal bonding resin [dry condition], Transbond XT [dry condition] and Assure [saliva-contaminated condition]. The shear bond strength of brackets to the enamel was determined by Zwick/Roell machine in three groups. Data were analyzed using one-way analysis of variance [ANOVA], and the Kruskal Wallis test. The mean shear bond strength of brackets to enamel surfaces bonded with Assure [dry condition], Transbond XT and Assure [saliva-contaminated condition] was 14.18 +/- 4.78 MPa, 16.13 +/- 5.49 MPa and 13.32 +/- 4.74 MPa, respectively [with no significant differences]. Non-parametric Kruskal-Wallis test found no significant differences regarding the adhesive remnant index [ARI]. [P=0.053]. Bonding of stainless steel brackets to enamel surfaces with Assure universal bonding resin provided adequate bond strength in dry and saliva-contaminated conditions. Thus, it may be used for bonding of orthodontic brackets to the enamel surfaces in the clinical setting

[Effect of magnesium supplementation on calorie intake and weight loss of overweight or obese insomniac elderly subjects: a double-blind randomized clinical trial]

There is evidence suggesting an association between insomnia and obesity and probable beneficial effects of magnesium supplementation on insomnia. The objective of this study was to determine the effects of dietary magnesium supplementation on the energy intake and weight reduction of insomniac overweight or obese elderly subjects. A double-blind randomized clinical trial was conducted on 46 overweight or obese subjects randomly allocated into the magnesium or the placebo group, receiving, daily for 8 weeks, either 500 mg magnesium or a placebo, respectively. Using appropriate questionnaires, data were collected on insomnia [insomnia severity index = ISI], physical activity, and sleep-log at baseline and at the end of the intervention period. In addition, information was obtained on anthropometric confounding factors and daily intakes of magnesium, calcium, potassium, caffeine, energy form carbohydrates, fat and protein, and total daily energy intake using the 24-hr dietary recall questionnaire for 3 days. The N4 and SPSS software version 16 were used for data analysis, the level of significance being a p-value < 0.05. No significant differences were observed in the assessed variables between the two groups at baseline. As compared to the placebo group, in the experimental group diatery magnesium supplementation brought about statistically significant increases in sleep duration and sleep efficiency, as well as significant decreases in the total energy intake and energy from carbohydrate and fat. The total length of time in bed, morning awakening time, energy from protein, serum magnesium concentration, or body weight were not different between the experimental and the placebo groups. In this study diatery magnesium supplementation resulted in improvements in sleep indices and a decrease in energy intake in elderly subjects. However, it had no beneficial effect on their body weight

Bone density and bone metabolism in patients with inflammatory bowel disease

Patients with inflammatory bowel disease [IBD] are at high risk for low bone mineral density [BMD]. This study aimed to evaluate BMD in IBD patients and its relationship with bone metabolism in a group of Iranian patients. A cross-sectional study was conducted on patients with IBD to assess BMD status and serum biochemical factors. After getting the demographic data from 200 patients, they were screened using dual-energy X-ray absorptiometry of the lumbar spine [L2-L4] and femoral neck for BMD status. Serum levels of calcium, phosphate, alkaline phosphatase [ALP], and 25-hydroxyvitamin D [25-OH vitamin D] were measured to assess the bone metabolism status. Two hundred patients with IBD were enrolled in the study. One hundred and eighty three [91.5%] patients were identified as having ulcerative colitis [UC] and 17 [8.5%] as having Crohn's disease [CD]. Based on the lumbar and femoral neck bone mass densitometry, 148 [74.4%] patients had low BMD at either lumbar spine or femoral neck. Of these, 100 patients [50.3%] were osteopenic and 48 patients [24.1%] were osteoporotic. A 58.6% and 61% of patients with UC had low BMD in the lumbar and femoral neck, respectively. These results for those with CD were 76.5% and 70.6%, respectively. The mean of femoral neck and lumbar T-scores in patients with UC were -1.14 and -1.38, and in patients with CD were -1.24 and -1.47, respectively [P > 0.05]. The mean [ +/- SD] levels for calcium [Ca] in UC and CD were in the normal range. The mean [ +/- SD] levels of ALP and 25-OH vitamin D in both the groups were in the normal range, and in comparison between groups [UC and CD], no significant differences were observed [P = 0.20 for ALP and P = 0.44 for 25-OH vitamin D]. In the assessment of correlation between biochemical markers and BMD, an inverse correlation between lumbar T-score and ALP or 25-OH vitamin D only in patients with UC was observed. The high prevalence of low BMD in the Iranian population with IBD needs attention. The subclinical vitamin D deficiency may contribute to bone loss in IBD patients, which is more pronounced in patients with UC in this study because of the small population of patients with CD

[ effect of self care program education by group discussion method on self concept in diabetic adolescent girls reffered to Iranian diabetes society]

Diabetes is a chronic illness which needs the self care behaviors up to the end of life. If this illness attends with adolescence because of the nature and properties of the adolescence creates problems of adapting to the illness and doing self care behaviors for adolescent and his/her family. On the other hand studies have shown that in chronic illnesses such as diabetes, self care interacts with self concept. How ever diabetes adolescents affiliating has problem for self concept and since adolescence the effect of self care on self concept has important value. So this study has been done to assess the effect of self care program with group discussion on self concept of diabetic young girls. This research is a semi experimental study has been done in 2008- 2009 with 80 diabetic adolescent girls between 15-19 [40 as test group and 40 as evidence group] in Iranian Diabetes Society. After data collection result in pre intervention stage with knowledge, practice and self concept questionnaire and need measuring in each group, self care program was designed and then self care program was discussed in 6 sessions for test group. Then immediately and after one month of intervention again the same questionnaire completed for test and evidence group of diabetic adolescent girls. Results after data analysis showed that test and evidence group were same for independent sample t test and chi-square test for demographic information [age, height, weight, fathers job...]. In test group in comparison among before, immediately after and after one month of intervention there was significant difference in increasing score of knowledge, practice and self concept [P<0.0001]. But this difference was not significant in evidence group [P>0.05] and independent t-test [P>0.05] showed no significant difference in knowledge, practice and self concept between test group, and evidence group before intervention. Immediately and after one month of intervention between two groups with independent t-test, was seen significant difference in mean score of knowledge, practice and self concept [P<0.05]. Generally results of the research showed that performing the self care program by group discussion was effective in increasing self concept of diabetic adolescent girls and it is suggested that teaching self care behavior by group discussion is used as a effective method to improve self concept in other adolescents with chronic disease

[Assessment of users' intention to use hospital information systems based on diffusion of innovation theory in Razi hospital of Ahvaz]

Users' role in the successful application of Hospital Information Systems [HIS] is of crucial importance. Diffusion of Innovation Theory [DIT] is a theoretical model for understanding the relationship between users and technological systems including HIS by assessing users' intentions to use these systems. This study aimed at determining the factors associated with users' intentions to use HIS on the basis of DIT. The participants of this descriptive and analytical study were randomly selected from 50 HIS users of Razi Hospital in Ahvaz. The instrument was a questionnaire the reliability of which was measured by test-retest [r = 0.84] and its internal consistency by Cronbach's alpha [alpha=0/90]. Content validity, and face validity of the questionnaire were also determined. The data were analyzed by SPSS [version 17] using descriptive and inferential statistics. There were negative correlations between age and relative advantage [r = -0.56, p<0.05], kinds of job and relative advantage [r = -0.32, p< 0. 05], age and compatibility [r = -0.28, p< 0.05], kinds of job and compatibility [r = - 0.29, p< 0.05] and kinds of job and observed ability [r = - 0.30, p< 0.05]. However, there were positive correlations between educational level and complexity [r = 0.29, p< 0.05], computer training and trial ability [r= 0. 28, p< 0.05], financial organizational support and relative advantage [r =0.31, p< 0.05], emotional organizational support and relative advantage [r = 0.36, p< 0.05], and emotional organizational support and compatibility [r = 0. 27, p< 0.05]. The results revealed the effects of DIT on users' intentions to use HIS. Further studies are required to support the findings of the present study in order to enhance adaptation and compatibility of HIS

[ targeted implementation of teaching in small group discussion for second- year students in physiotherapy: a comparative assessment of teaching effect on satisfaction and learning level]

One of the main problems in learning is ignoring the teaching in small group discussion. So, today, teaching in student-based methods such as work in small group is emphasized. Nevertheless, this method is not used for teaching physiotherapy students. This study was performed to determine the effect of teaching in small group on satisfaction and learning level of second- year students in physiotherapy in comparison with lecture teaching. An experimental study was performed on 29 physiotherapy students. The students were randomly classified into two groups; lecture [14 people] and work in small group [15 people]. Students were educated for 4 sessions. Two separate questionnaires were used to assess learning and satisfaction levels. Overall satisfaction in small group was significantly greater than lecture group [P<0.0001]. However, there was no significant difference between learning levels of the methods [p>0.05]. 86.7% of students in small groups preferred to be educated in the future semesters using this teaching method. This study showed the role of small group teaching on increasing students' satisfaction level. Due to increased satisfaction in small group, despite the lack of significant difference between the two methods of learning, learning process can be facilitated .Thus this method is recommended for education of the undergraduate students

[Comparison of effects of three diets containing "Fish Oil", "Iranian fat consumption pattern", and "standard" diet on serum glucose and insulin sensitivity in Wistar rat]

The aim of this study was to investigate the effects of fish oil containing diet versus Iranian fat consumption pattern and standard diets on serum glucose and insulin sensitivity in Wistar rat. Thirty female Wistar rats were randomly allocated to three dietary groups: a standard diet [containing soy bean-oil], diet containing fish oil and diet containing mixed oil which was designed based on Iranian population fatty acid intake. Dams in each group were fed one of the diets during pregnancy and lactation and the pups were also weaned onto the same diet. Fasting serum glucose [Photometry] and insulin [ELISA] in pups were assessed and insulin sensitivity calculated on puberty. Fasting serum insulin in fish oil-fed group was significantly less than two other groups [P=0.018] and insulin sensitivity in fish oil-fed rats was significantly more than two other groups [P=0.002]. It seems a diet containing fish oil [rich in long chain omega-3 fatty acids] causes more insulin sensitivity comparing to diet containing soy bean oil [rich in omega-6 fatty acids] and diet with Iranian population fatty acid intake pattern [rich in saturated fatty acids]

[Prevalence of substance use among students of Guilan University of Medical Sciences [2005-2006]]

Regarding the high prevalence of substance use among youth, its destructive effects and consequent problems, this research was performed. to determine the prevalence of substance use among students of Guilan University of Medical Sciences [GUMS] This was a cross-sectional study carried out on a representative sample of 845 students of GUMS in 2006. The data such as demographic information and history of substance use were collected using a questionnaire which completed by every single student. Later, the data were analyzed by EPI 2002 software and chi-square and Fisher-Exact tests. Due to incomplete responses, 18 questionnaires were excluded. Out of a total of 827 students, 30.1% had a history of substance use at least once during their lives. The prevalence rate of each substance in use was: cigarette [26.36%], alcohol [17.04%], opium [3.86%], cannabis [2.78%], ecstasy [2.05%], heroin [1.08], crystal [0.84%], cocaine [0.84%], morphine [0.6%] and others [0.6%]. Substance use was significantly associated with male gender, higher age groups, living with friends or alone, and marital status. There were significant relationships between substance use during past 30 days and studying medicine and dentistry. In addition, a relationship between substance use; once or more during life and residency period, was observed. Our study demonstrated that the substance use among students of GUMS is considerably high and specific interventions seem to be necessary in preventing or reducing the rate of substance use in students

[Comparison of the effects of a fish-oil containing diet, a diet with a fat composition based on the Iranian fat consumption pattern, and a standard diet on pathologic changes in the wistar rat liver]

Information of the effects of different types of fat on liver pathology is limited. The present study was designed to compare the effects of a fish-oil containing diet, a diet with a fat composition based on the Iranian fat consumption pattern, and a standard diet on pathologic changes in the Wistar rat liver. Thirty female Wistar rats were randomly allocated to one of three diets: a standard diet [containing soy bean-oil], a diet containing fish oil, and one containing mixed oil based on the Iranian population fatty acid intake. Dams in each group were fed one of the diets during pregnancy and lactation, and the pups were weaned onto the same diet. Hepato-cellular pathology in pups was assessed on days 21 and 70 postnatal. Data were analyzed using the SPSS software and Kruskal-Wallis test. Fish oil-fed and Iranian mixed oil-fed pups showed more ductular cell hyperplasia on day 70 postnatal, as compared to the soy bean oil-fed pups [p=0.005]. The pathologic changes increased from day 21 to day 70 in all the 3 groups [p=0.002]. The magnitude of the increase was significant in the fish oil-fed rats [p=0.007]. A diet containing fish oil as the only fat source and a diet with the Iranian population fatty acid intake pattern may lead to pathologic changes in the rat liver. It seems this adverse effect increases by age of the animal

Determining the topics and content of CME programs in five selected subjects: comparing the view points of experts and target group; a Tehran University of Medical Sciences experience

One of the most appropriate methods for needs assessment is to assess learners' needs and arrange the educational programs based on their viewpoints. The aim of this study was to determine the topics and content of Continuing Medical Education [CME] programs in five selected subjects by medical education experts and target group, based on the real needs of General Practitioners [GPs] in order to revise CME national programs. In this cross-sectional applied study, 700 GPs covered by Medical Sciences Universities in Tehran province were studied. A questionnaire consisting of two parts of demographic features and 80 scientific questions regarding their knowledge in five domains of clinical pharmacology, skin diseases, toxicology, emergencies, and forensic medicine was used. The questionnaires were delivered to physicians' offices by trained personnel using a list or by direct referral to offices and then gathered. Three topics in each subject and 15 standard educational contents in total were developed for the target group. There was almost a complete relationship between the opinion of experts and target group in forensic medicine. Some of the first five priorities of the two groups overlapped in skin diseases, forensic medicine, and emergencies. No common viewpoints were observed between experts and target group in pharmacology. In toxicology, there was no common viewpoint in the first three selections of the two groups. Real educational needs of GPs in receiving new information in order to promote their competencies and knowledge were different from those considered by experts. It is recommended to design the educational content for the target groups in the health care field based on their real deficiencies in knowledge and practice and by assessing their views and knowledge

Diagnostic value of prostate specific antigen and its density in Iranian men with prostate cancer

The specific threshold for prostate-specific antigen and density [PSA, PSAD] to delineate which patients are at the highest risk has been controversial. The purpose of this study was to evaluate the diagnostic value of PSA and PSAD in Iranian patients with prostate cancer. Three hundred men with the serum PSA greater than 4.0 ng/ml, abnormal digital rectal examination and/or suspicious transrectal ultrasound underwent transrectal ultrasound-guided prostate biopsies. PSAD was calculated by dividing the serum PSA in ng/ml by the volume of the entire prostate in cm3. Correlation with Gleason grade of the tumor was also made. The patients were divided into three groups according to their PSA values. The receiver operator characteristic [ROC] curve was produced from the raw data on all patients. One hundred and two patients showed a cancer rate of 34%. The mean PSA and PSAD of the cancer group were significantly higher than those of the non-cancer group with better performance of PSAD as confirmed by ROC curve. In patients with PSA levels between 4 and 10 ng/ml, mean PSAD values in positive and negative biopsy groups showed a significant difference while mean PSA values between these biopsy groups revealed no significant difference. The PSAD cutoff of more than 0.1 had higher sensitivity than 0.15 at the expense of increasing the number of unnecessary biopsies. Among those the patients with PSA levels above 10ng/ml, both mean PSA and PSAD values of positive and negative biopsy groups had significant differences. The sensitivity of PSAD cutoff of 0.1 was not significantly higher than 0.15 while PSAD of 0.15 showed a higher specificity. PSAD >0.15 missed cancer in 18 out of 102 patients, nearly half of those with clinically significant mid and high grade cancers. Overall, PSAD is a better diagnostic tool for the detection of prostate cancer than PSA, especially in patients with PSA between 4 and 10ng/ml. PSAD cutoff of 0.15 is not inclusive enough in patients with PSA levels between 4 and 10ng/ml and we propose PSAD of 0.1 as a better threshold for prostate biopsy in men with PSA at this range to detect clinically important cancers. Also, we recommend transrectal ultrasound guided biopsy in any patient with PSAD greater than 0.15 and PSA more than 4 ng/ml

Detection of salmonella typhi based on the ViaB sequence by polymerase chain reaction

Background and Purpose: Typhoid fever, a disease caused by Salmonella typhi, is still one of the most important infectious diseases across the world. Different methods such as biochemical and Elisa methods are used for detection of this bacterium, which produce false responses in addition to being time-consuming and expensive. Therefore, the present research was conducted to detect Salmonella typhi by PCR method which is rapid, inexpensive and specific

Materials and methods: In this descriptive study which was conducted via diagnostic method, polymerase chain reaction [PCR] assay was developed for detection of Salmonella typhi. This strain had formerly been confirmed by biochemical methods. For detection by PCR, one primer pair was designed, being specific to ViaB gene. The PCR product was digested by restricted enzyme. For specificity of assay, 6 different strains were used as control negative and for sensitivity of PCR reaction, serial dilution of bacteria was used

Results: The PCR product of Salmonella typhi was 530 bp which were then confirmed by digestion enzymes. In testing the specificity of the assay, Salmonella typhimorium, Shigella flexneri, E. coli, Clostridium botulinum, Staphylococcus aureus and Bacillus subtilis were used as negative control, and did not yield a PCR product. The sensitivity of this method was estimated to be about 50 CFU/ml

Conclusion: The results of this study suggest that detection of ViaB gene with PCR method can be used for diagnossis of Salmonella typhi in clinical samples as a rapid, inexpensive, specific and highly sensitive method

impact of postraumatic stress disorder on partner of Iranian veterans

Veterans with Post Traumatic Stress Disorder [PTSD] suffer from distressing and disabling symptoms. Many studies have shown that PTSD symptoms can negatively influence quality of life of their partners. This study was designed to assess general health, marital satisfaction and self-esteem levels of partners of Iranian veterans with PTSD. We performed a case-control study. Cases were comprised of 40 partners of veterans with PTSD. Controls were comprised of 40 married women referred to general health center in Rasht city. Three self report psychometric inventories including General Health Questionnaire [GHQ28], Evaluating and Nurturing Relationship Issues, Communication and Happiness questionnaire [ENRICH] and Cooper-Smith inventory-adult form were applied assessing general health, marital satisfaction and self-esteem levels in our subjects. Mean score of GHQ28 questionnaire was 39.77 +/- 20.96 in case group and 17.12 +/- 9.08 in control group [P = 0.0001, t = 6.269]. Average scores of ENRICH questionnaire in case and control groups were 133.7 +/- 28.05 and 165.90 +/- 31.10 respectively [P = 0.0001, t = 4.861]. Mean score of Cooper-Smith test was 29.62 +/- 7.89 in cases while it was 39.92 +/- 6.36 between controls [P = 0.0001, t = 4.551]. We concluded that partners of veterans with PTSD significantly showed lower levels of general health, marital satisfaction and selfesteem than other women. In general, our results demonstrated that partners of veterans with PTSD had lower levels of quality of life comparing other women

Evaluation of knowledge and practice of newly graduated midwives in normal vaginal delivery in hospitals affiliated to Tehran University of medical sciences

Evaluating the knowledge and practice of newly graduated midwifery students can reflect to some extent the results of midwifery educational planning. This study was done to assess knowledge and practice of newly graduated midwives in Normal Vaginal Delivery [NVD] in hospitals affiliated to Medical Sciences Universities in Tehran. In a survey study, all newly graduated midwives [n=30] employed in hospitals affiliated to Med-ical Universities in Tehran and graduated in the past two years were selected through census sampling method. A self-administered questionnaire containing 40 multiple-choice questions for measuring knowledge was completed by midwives. Then the practice of midwives while performing normal vaginal delivery and episiotomy was observed using a 109 item checklist. The data was analyzed by SPSS software using freque-ncy distribution, mean and standard deviation. Pearson Correlation Coefficient was used to measure the correlation between knowledge and practice scores, and age and experience of midwives. Most of the subjects had an average knowledge [90%] and desirable practice in all stages of NVD including first stage [60%], second stage [73.3%] third stage [73.3%] and forth stage [60%]. In immediate care of the new born 86.7% and in episiotomy 80% had a desirable practice. This study showed that graduated midwives were competent enough to perform a safe normal vaginal delivery

Assessing the gap between current and desirable needs in TUMS* CME Unit: participants' viewpoints

Background: given the limited resources for medical education it seems reasonable to specify the exact educational needs and make sure that these needs are met. In this respect determining priorities and appropriate educational strategies and teaching methods allows for optimum use of limited available resources

Purpose: to determine the perceived educational priorities and effective educational methods for five groups of medical care providers with respect to their views

Method: a cross-sectional study was conducted to determine the perceived knowledge, and preferences of the participants. Five valid and reliable questionnaires were developed, verified by 4 CME experts, filled out during the planned programs and on receiving their temporary of final certificates by each participant in the relevant subgroup. SPSS 9.0 was used for the analysis of collected data

Results: of the 3300 medical care providers who received the questionnaires, 2687 filled them out. The overall response rate was 81%. Educational needs based on the priorities in the questionnaires included required educational methods and techniques for the five subgroups and specific priorities for each subgroup. Among the most requested methods were: lectures accompanied by video [54.1%], lectures followed by questions and answers [49.3%], case presentations [37.5%], educational workshops [37.4%], education through the internet [26.4%], conventional lectures [23.9%], morning reports [16.4%], and education in the field [15.1%]

Conclusion: demographic characteristics were relevant to determine educational priorities and learning methods. For the most-preferred learning needs, the five subgroups suggested different topics. The observation suggests that the participants assess their learning needs closely related to their perceived job requirements. However, these perceived needs may not be well related to the participants, actual level of knowledge or skill