Teaching as the center of every curriculum is a set of actions undertaken to create and facilitate student learning. In recent years, the number of qualitative studies of effective teaching in clinical education of undergraduate medical education has increased. As the number of research studies grows, it is necessary to aggregate them. Therefore, the purpose of this study was to synthesize effective teaching-learning factors through the meta-synthesis in clinical education. In this study, the meta-synthesis approach was used to synthesize qualitative evidence in relation to effective teaching-learning factors in clinical education. From 1990 to 2021, electronic databases and journals were searched to identify studies and publications on effective teaching-learning factors in clinical education. Based on the combination and search strategies in the databases (OVID, PubMed, Web of Science, SCOPUS, Eric, Magiran, and SID), 33,799 and 56 studies were identified from other sources. Following reviewing the full text of the articles, 53 studies were selected. Forty-five studies were selected and included in the meta-synthesis process after critical appraisal using the Critical Appraisal Skills Program. The synthesis of qualitative evidence was developed as an effective teaching-learning framework in clinical education. Based on this comprehensive framework, effective teaching-learning in clinical education can be seen through behavioral or content (learner, teacher, and patient and their behaviors), social (collaborative learning community), pedagogical (instructional design and teaching-learning opportunities), contextual (positive and supportive clinical environment), and educational leadership (classroom management and structure) lenses. The current research is the first qualitative meta-synthesis to provide a thorough and comprehensive review of effective teaching-learning factors in clinical education. The results of this meta-synthesis provide a holistic view of clinical education and can help with clinical teaching-learning design.

Background Clinical teaching-learning is a context-bound phenomenon. One of the problems related to field of medical education research is the lack of sufficient attention to context-appropriate methodologies. The purpose of this qualitative inquiry is to explain and represent teaching-learning in the clinical education of general medicine in Iran using the three types of maps situational, social worlds/arenas, positional, in combination with discourse analysis. Methods In this study, the authors used the situational analysis approach as a postmodern version of grounded theory. The data collection was undertaken in three stages. In the first stage, a mini literature review was conducted to highlight a possible gap in applying situational analysis in medical education research and the development of this methodology. In the second stage, the latest and most up-to-date documents of the Ministry of Health and Medical Education (MOHME) of Iran, the general medicine curriculum, and related documents were analyzed. Finally, the remote semi-structured interviews (web-based and telephone) were undertaken in the third stage. Participants in this stage included expert clinical teachers, medical education specialists, and students. In this study, the notes and transcripts were analyzed for the emergence and categorization of sub-themes and themes, represented in three maps. Results Thirty-one participants were involved in the web-based interviews, while seven participants took part in the telephone interview. Based on this research, the teaching-learning situation in clinical education on general medicine in Iran was represented in three maps; situational, social worlds/arenas, and positional. In addition, the results showed, clinical education of general medicine in Iran in six positions (curriculum; culture, behavior and attitude; management and leadership; environment, space and time; financial; and technology) has serious problems and challenges. Finally, based on the horizontal axis of the positional map, recommendations were provided to develop and support effective clinical teaching. Conclusions The clinical learning environment is a complex and multi-layered social environment in which should be considered these numerous social layers, arenas, social worlds, and discourses while developing curricula and teaching.

ABSTRACT. The degradation of one of the commercially important hydrogel based on acrylic acid and acryl amide, (acrylic acid-co-acryl amide) hydrogels, by means of ultrasound irradiation and its combination with heterogeneous (TiO2) was investigated. 24 kHz of ultrasound irradiation was provided by a sonicator, while an ultraviolet source of 16 W was used for UV irradiation. The extent of sonolytic degradation increased with increasing ultrasound power (in the range 30-80 W). TiO2 sonophotocatalysis led to complete (acrylic acid-co-acryl amide) hydrogels degradation with increasing catalyst loading, while, the presence of TiO2 in the dark generally had little effect on degradation. Therefore, emphasis was totally on the sonolytic and sonophotocatalytic degradation of hydrogels and a synergy effect was calculated for combined degradation procedures (Ultrasound and Ultraviolet) in the presence of TiO2 nanoparticles. TiO2 sonophotocatalysis was always faster than the respective individual processes due to the enhanced formation of reactive radicals as well as the possible ultrasound-induced increase of the active surface area of the catalyst. A kinetics model based on viscosity data was used for estimation of degradation rate constants at different conditions and a negative order for the dependence of the reaction rate on total molar concentration of (acrylic acid-co-acryl amide) hydrogels solution within the degradation process was suggested.

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Introduction: Tuberculosis (TB) is one of the most important infectious diseases in the recent century caused by Mycobacterium (MB) tuberculosis. Despite new medical technologies and effective drugs, it still causes human deaths. This study aimed to investigate the trend and factors affecting TB prevalence in Yazd city from 2005 to 2014. Methods: In this study, the medical files of TB patients referring to Yazd health and treatment centers from 2005 to 2014 were investigated. frequency, mean, standard deviation, and 95% confidence interval were calculated and reported for quantitative data, and the number and percentage are reported for qualitative data. The patients' demographics and disease features were recorded in a checklist and analyzed using SPSS version16 software. Results: In this study, 882 TB patients were studied, out of which 51.9% were male 57.7% were Iranian, 42.3% were from other nationalities, and 33.8% were 80 and older. The average age of TB patients studied was 49.32±17. The percentage of patients with pulmonary TB and patients with extrapulmonary tuberculosis was 71% and 29%, respectively. Conclusion: This study shows that health officials must pay more attention to TB disease in Yazd city. Enhancing life standards, active case-finding among prisoners, increasing physicians' and people's awareness about the health and treatment system services, and taking samples from suspected patients can play a crucial role in decreasing this disease.