Demanded interdisciplinary subjects for integration in medical education program from the point of view of graduated medical physicians and senior medical students: a nationwide mixed qualitative-quantitative study from Iran.

INTRODUCTION: This study aimed to detect interdisciplinary subjects for integration into the medical education program of Iran. METHODS: A qualitative-quantitative method was used. Firstly, interdisciplinary subjects demanded by medical graduates and senior medical students were defined by qualitative study. In the second stage, questionnaire was developed which based on the findings of qualitative stage, experts' opinion and reviewing of the national general guide of professional ethics for medical practitioners. Questionnaire consisted of demographic, occupational and thirteen interdisciplinary items. These items consisted of social determinants of health, social and economic consequences of disease, social prescribing, physicians' social responsibility, role of gender, racial, ethnic, social and economic issues in approach to patients, role of logic and mathematics in clinical decision-making, philosophy of medicine, maintaining work-life balance, self-anger management, national laws of medicine, religious law in medical practice, health system structure, and teamwork principles. Level and importance of knowledge and self-assessed educational needs were asked about each item. In the third stage, a national online survey was conducted. SPSS 25 was used for statistics. RESULTS: By content analysis of data in qualitative stage, 36 sub-themes and 7 themes were extracted. In the quantitative part, 3580 subjects from 41 medical universities across Iran participated in this study. 2896 (80.9%) were medical graduates and 684 (19.1%) were senior medical students. Overall, knowledge about interdisciplinary items was low to intermediate, while high to very high knowledge ranged from maximally 38.7% about socioeconomic consequences of disease to minimally 17.2% about social prescribing. Participants gave the most importance to the having knowledge about self-anger management (88.3%), maintaining work-life balance (87.2%) and social determinants of health (85.8%), respectively. However, national laws of medicine (77.6%), maintaining work-life balance (75.4%) and self-anger management (74%) were the first top three educational demands by participants. CONCLUSION: This study revealed a low to moderate level of knowledge about interdisciplinary topics among both graduated medical physicians and senior medical students. These groups showed a strong demand and tendency to know and to be educated about these topics. These findings underscore the urgency for educational reforms to meet the interdisciplinary needs of medical professionals in Iran.

Happiness in marginalized populations: a community-based study in South Central Iran.

BACKGROUND: Happiness has multiple levels and determinants in different communities, cultures, and social groups. The current study aimed to investigate happiness and its main determinants in slums in south central Iran. METHODS: This community-based, cross-sectional study was conducted with the participation of adults at least 18 years of age living in the biggest slum area in Shiraz, south central Iran. To determine levels of happiness, participants were asked to complete the Persian version of the GHQ28 questionnaire and a checklist based on the 2017 World Happiness Report. Data was analyzed using SPSS software version 19. A p-value less than 0.05 was considered significant. RESULTS: The mean age of the participants was 42.06 ± 16.34 years. Overall, 542 participants (45 %) were females, 257 (21.3 %) were illiterate, 678 (56.3 %) were married, and 495 (41.1 %) were unemployed and lived with their household. The happiness score, according to the Cantril ladder score, was 6.41 ± 2 (out of a total score of 10). Happiness was not correlated with gender (p = 0.37) or immigration (p = 0.06). Lower levels of happiness were seen in older adults (r=- 0.12, p < 0.001), illiterates (p = 0.03), the unemployed (p < 0.001), and people separated from their spouses (p < 0.001). Job satisfaction (p < 0.001, r = 0.47), total general health (p < 0.001, r=-0.36) and hope (p < 0.001, r = 0.41) were significantly correlated with happiness. Social support (< 0.001) and sufficient income and satisfaction (p < 0.001) were related with a higher score of happiness. CONCLUSIONS: Marital status, smoking, employment and job satisfaction, social support and trust, feelings of insecurity in the neighborhood, hope for the future, facing violence, and income satisfaction were the main determinants of happiness in the Sang Siah slum area.

Social, economic, and legislative factors and global road traffic fatalities.

BACKGROUND: Road traffic fatalities (RTF) is the 8th cause of mortality around the world. At the end of the Decade of Action, it would be of utmost importance to revisit our knowledge on the determinants of RTF. The aim of this study is to assess factors related to RTF at global level. METHODS: We used road safety development index which accounts for the interactions between system, human and products to assess the RTF in 115 and 113 countries in 2013 and 2016, respectively. To analyze data, three statistical procedures (linear regression, classification and regression trees, and multivariate adaptive regression splines) were employed. RESULTS: Classification and regression trees has the best performance amongst all others followed by multivariate adaptive regression splines for 2013 and 2016 data set with an R2 around 0.83. Results show that any increase in human development index was associated with RTF reduction. Comparing RTF data of 2013 and 2016, 8 countries experienced a change of more than 30%, which demonstrated a significant relationship with GINI index (named after Corrado Gini). Considering the three components of human development index, it is revealed that education explained most of RTF variation in classification and regression trees model followed by income and life expectancy. CONCLUSION: Policymakers should consider road collisions as a socio-economic issue. In this regard, they can make provisions to reduce RTF in the long run by focusing on enhancing the three components of human development index, mainly education. However, there is a need to investigate the causation pathway among these three components with RTF with different time-trend procedures.