مجله تعالی بالینی
سال دوازدهم شماره 3 (پیاپی 37، زمستان 1401)

The exclusive human milk diet refers to the feeding with breast milk or donated human milk along with human milk-derived fortifiers. This article is a narrative review about feeding of premature infants, especially very low birth weight babies with this type of diet. By searching the articles published in English in the Scopus, PubMed, Science Direct and Google Scholar databases, finally the 15 articles was reviewed in terms of different neonatal outcomes and the information was collected and reported based on the year of publication, the outcomes investigated and the impact. The results of the present study showed that the effect of this nutrition in the limited studies that have been conducted so far, despite its economic efficiency and clinical benefits, has had  different results on many important neonatal outcomes. Reducing the incidence of necrotizing enterocolitis, retinopathy of prematurity, reducing intraventricular bleeding,improving   nutrition tolerance and growth parameters have been among the benefits of this diet in some studies, while in other studies, some of these morbidities have not changed. Therefore, due to the novelty of the fortifiers derived from human milk, more studies are needed to investigate its short-term and long-term effects by conducting more clinical trials.

Health care systems need reforms in the process of education to performance. Reforms with a targeted educational and medical perspective that will permeate all effective health care systems and evidence-based medicine is considered a practical method in the development of health care and treatment in the world. This approach will be effective during its lifetime in the education of medical sciences, on the quality of education, on the quality of education, from the beginning of the education of health and medical sciences until the lifetime of the educators.
The present study is a systematic review by searching in Iranian databases such as: SID, Iranmedex, Magiran, foreign databases such as: Uptodate, Pubmed, Scopous during the years 2019 to 2022 with keywords; Evidence-based medicine, evidence-based education, evidence-based practice, evidence-based learning, evidence-based care, educational quality, medical science education are searched.
Evidence-based medicine in line with its longevity in medical sciences still needs a fundamental review in healthcare and treatment, many studies have stated the lack of use of evidence-based medicine and obstacles to its implementation in their results. However, the growing trend of using evidence-based medicine is not significant and requires inductive impulses to implement, apply and use and evaluate its effects.
Evidence-based medical education and its effects have been clearly studied, but micro and macro policies in its implementation and application require a fundamental review so that the process of education, learning, performance and care is the most favorable process of growth and development in the body. Go through the educational and research system of medical sciences.

Crohn’s disease is a chronic  and common bowel disease caused gestational tract (GI) inflammation. In recent years, the prevalence of this disease has been increasing slowly  in the world and Iran .This study briefly introduces Crohn's disease with a review of related articles published during 2004-2021.
The most accepted theory of the pathophysiology of Crohn's disease is having a genetic background (CARD25/NOD2 mutations and polymorphisms of TLR), along with the abnormal response of the intestinal normal flora. Diarrhea, abdominal pain, bloating, and weight loss are the most common symptoms of the disease. To diagnose, clinical symptoms, physical examination, laboratory tests, endoscopy and colonoscopy are helpful.The aim of the treatment is to control the symptoms, reduce clinical symptoms, prevent the progression of the disease, reduce the need for surgery, nutritional support, and reduce its side effects.Moreover,anti-tumor necrosis factors  and corticosteroid medications to regulate the immune system are used. New biological agents such as anti-integrin medications have opened a better perspective for patients. To reach a good care and treatment, it is requires a team including the patient, health care workers, internal specialists, endocrinologists, infectious disease specialists, and epidemiologists to work together to meet health and treatment needs, physical and psychological support, creating health and preventive measures, approaches fast diagnosis and timely action. Due to the unknown cause of the disease and the lack of adequate treatment response to the existing medications, investigate and research more widely about Crohn's disease is needed.

Moral intelligence is one of the dimensions of intelligence that can provide a framework for the proper functioning of human beings and is considered as a predictor of behavior. The purpose of this study is to investigate moral intelligence in nurses and the factors affecting it. This study was a narrative review. In the present study, to select studies, Persian language databases such as Magiran, SID, Barakat Knowledge Network System Scholar Google were searched with the keywords intelligence, nurse, ethics, professional. Criteria for the study included: a review of Persian articles in the period 2010-2020, which examined the moral intelligence of nurses. Exclusion criteria included non-Persian language articles, unrelated to the purpose of the research and lack of access to the full version of the article. Review articles were also excluded from the study. The search result was 150 articles using the keywords mentioned above. Finally, 11 articles appropriate to the research question were included in the study.
The findings showed that there is a significant relationship between moral intelligence and patient satisfaction with nursing care, resilience, anger, attitude towards patient education and quality of work life of nurses.
According to the findings of the study, spending time and money in order to increase moral intelligence in nurses is necessary. It is recommended for nurses to hold appropriate training programs on the subject of ethics in the form of in-service courses.

The aim of this study was systematic review of components affecting quality of life in families of children with down syndrome. Research method was systematic review based on meta synthesis. Therefore, the research population was all papers and researches published between 2000 and 2021. After initial study, 15 researches were selected from among 289 scientific articles. results showed that quality of life in families who have children with down syndrome have four main domains: physical, social, psychological and environmental, and nine main indicators: gender, family condition (circumstances), function and activity, comorbidities disorder, culture (value), relationships, socio- economic status, resilience, personality traits and life skills.