Repository of Research and Investigative Information Isfahan University of Medical Sciences
Not a member yet
23244 research outputs found
Sort by
The experience of 10 years of institutional and program accreditation in Iran with an emphasis on the strengths and implementation challenges: a qualitative study
No full textBackgroundThe global emphasis on medical education quality has established accreditation as a crucial evaluation method. Iran has implemented systematic institutional and program accreditation in medical universities over the past decade. This study analyzes the strengths and implementation challenges of educational accreditation from the perspective of field experts.MethodsWe conducted a qualitative content analysis study, engaging accreditation experts selected through purposive sampling. Semi-structured interviews were employed to gather expert opinions on the strengths and challenges of implementing educational accreditation in Iran. The resulting data underwent inductive content analysis to distill key themes and insights.ResultsAnalysis of the interviews yielded 140 primary codes, which were organized into two main themes and six categories. The first theme, "the Pillars of the Accreditation System," encompassed four main categories: accreditation standards, accreditation structure, accreditation evaluators, and accreditation outcomes. The second theme, "Improvement in Conducting Accreditation," comprised two main categories: improving the structure and improving the implementation process. While accreditation efforts have improved institutional adherence to basic quality standards, challenges such as excessive governmental control and the approval of underperforming institutions raise concerns about the credibility of the process.ConclusionThe efforts of the Ministry of Health and Medical Education in implementing accreditation have guided programs and institutions towards achieving minimum quality assurance standards. Structural issues within Iran's accreditation framework, such as governmental control over the accreditation process and the consideration of multiple factors in accreditation decisions, have led to some concerns. One of these concerns is approving underperforming institutions and programs which has raised some questions about quality and necessity of the accreditation process itself. It is hoped that in the near future, the Ministry of Health and Medical Education will devise and implement strategies to enhance the current system, paving the way for a more robust and effective accreditation process in the future
A comparative study of infection prevention and control curricula in nursing master's degree programs worldwide, with practical suggestions for Iran
No full textBACKGROUND:Emerging and re-emerging infectious diseases, particularly lessons learned from the last coronavirus disease 2019 (COVID-19) pandemic, have highlighted the importance of infection prevention and control (IPC) plans to battle against these life-threatening diseases. As frontline care providers, nurses must receive specialized training and possess the necessary skills to provide high-quality care to patients in infectious units. For this reason, master's (MSc) degree programs in nursing should incorporate an IPC curriculum to train nurses in this area. This study aimed to compare the IPC curriculums offered by MSc degree programs across the globe and provide recommendations for developing an IPC curriculum in Iran.MATERIALS AND METHODS:A descriptive, cross-sectional, and comparative study was conducted to collect data on IPC-related curricula, in 2023. The data were obtained through a comprehensive literature search on scientific databases and websites of universities worldwide. All curricula that offered for IPC nursing MSc were included. Data were analyzed according to the Bereday model in four steps, including description, interpretation, juxtaposition, and comparison. The data collection instrument was a researcher-made checklist, which was used to extract data from the included curricula. This checklist consisted of items, which included course title; definition; objectives; implementation strategies; students' evaluation, conditions and admission process, curriculum structure, course length, and type/number of units; expected capabilities, roles, and professional's responsibility of graduates; and basic/optional units.RESULTS:According to the Bereday model, in the descriptive step, 19 curricula were identified. After interpreting, juxtaposition, and the comparison of their data, three curricula were related to IPC nursing. In other curriculums, the nurses could participate in nursing care with other experts but the content of the programs was not specialized. Expected capabilities of the graduates dealing with five categories of educational abilities, leadership and management, research and data interpretation, knowledge, and executive of basic sciences. The content of the units was three sections, including basic and professional courses and theses. Educational strategies were different in person or virtual and courses were theoretical and practical.CONCLUSIONS:Educational curricula for training IPC nurse specialists are rare in the world. Therefore, given the emergence of infectious diseases and their global burden, designing the IPC curriculum is vital. The curriculum designers of the IPC field in Iran should pay attention to Iran's social, economic, cultural, national, regional, geographical, and international situation
Effects of stevia consumption on appetite in adults: A systematic review and dose-response meta-analysis of randomized controlled trials
No full textStevia is an intense, calorie-free sweetener that is frequently used to reduce energy intake; however, studies examining its effects on appetite and energy intake have produced mixed results, indicating that a definitive consensus has not yet been reached. This systematic review and meta-analysis aimed to determine the impact of stevia on appetite and energy intake in adults. The PROSPERO registration number for this research is CRD42023414411. The databases PubMed (MEDLINE), Scopus, Web of Science, and Google Scholar were systematically searched. In addition, the reference lists of extracted articles and pertinent reviews were examined. Two evaluators performed screening, quality assessment, and data extraction independently. Furthermore, the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was employed to systematically assess the certainty level of the evidence presented in our study. Eleven clinical trials with a total of 428 participants were included. We found no significant changes in any appetite scores following stevia consumption (very low to moderate certainty of the evidence). Moreover, subgroup analyses demonstrated the scores of desires to eat increased significantly in the oral intake of stevia and not enteral intake subgroup (WMD: 0.45; 95 CI: 0.009, 0.89; P = 0.046). In addition, the number of studies reporting energy intake was limited, preventing a meta-analysis of this variable. In conclusion, stevia consumption has no significant effect on appetite scores in adults but it seems that more long-term clinical trials are needed to obtain more accurate results
Splitting and Merging for Active Contours: Plug-and-Play
No full textThis study tackles the challenge of splitting and merging in parametric active contours or snakes. The proposed method comprises three stages: (1) fully 4-connected interpolation, (2) snake splitting, and (3) snakes merging. For this purpose, first, the coordinates of snake points are separated into two corrupted 1D signals, with missing X/Y samples in the signals representing missing snakes' coordinates. These missing X/Y samples are estimated using a constrained Tikhonov regularisation model, ensuring fully 4-connected snakes. Next, crossing points are identified by plotting snake points onto a raster matrix, detecting overlaps where multiple snake points occupy the same raster cell. Finally, snakes are split or merged by extracting snake points between crossing snake points that form a loop using a heuristic approach. Experimental results on the boundary detection of enamel in Micro-CT images and coronary arteries' lumen in CT images demonstrate the proposed method's ability to handle contour splitting and merging effectively
Using metabolomics to investigate the relationship between the metabolomic profile of the intestinal microbiota derivatives and mental disorders in inflammatory bowel diseases: a narrative review
No full textIndividuals with inflammatory bowel disease (IBD) are at a higher risk of developing mental disorders, such as anxiety and depression. The imbalance between the intestinal microbiota and its host, known as dysbiosis, is one of the factors, disrupting the balance of metabolite production and their signaling pathways, leading to disease progression. A metabolomics approach can help identify the role of gut microbiota in mental disorders associated with IBD by evaluating metabolites and their signaling comprehensively. This narrative review focuses on metabolomics studies that have comprehensively elucidated the altered gut microbial metabolites and their signaling pathways underlying mental disorders in IBD patients. The information was compiled by searching PubMed, Web of Science, Scopus, and Google Scholar from 2005 to 2023. The findings indicated that intestinal microbial dysbiosis in IBD patients leads to mental disorders such as anxiety and depression through disturbances in the metabolism of carbohydrates, sphingolipids, bile acids, neurotransmitters, neuroprotective, inflammatory factors, and amino acids. Furthermore, the reduction in the production of neuroprotective factors and the increase in inflammation observed in these patients can also contribute to the worsening of psychological symptoms. Analyzing the metabolite profile of the patients and comparing it with that of healthy individuals using advanced technologies like metabolomics, aids in the early diagnosis and prevention of mental disorders. This approach allows for the more precise identification of the microbes responsible for metabolite production, enabling the development of tailored dietary and pharmaceutical interventions or targeted manipulation of microbiota
Community Involvement in COVID-19 Management: A Central Component of Comprehensive Public Health Responses to COVID-19 and Future Health Crises
No full textThe COVID-19 pandemic is highly contagious, with symptoms such as myalgia, cough, fever, and weakness, posing a greater risk to older adults and individuals with chronic conditions. Effective management requires meaningful community involvement to reduce health inequalities and ensure people-centered health care. Engaging local voices, including leaders, health care professionals, and vulnerable populations, enhances decision-making, transparent communication, and resource mobilization. A whole-community approach, involving collaboration across various sectors, strengthens prevention, testing, and recovery efforts. By prioritizing vulnerable groups and adapting interventions to local contexts, community engagement plays a vital role in addressing the pandemic's challenges and building a resilient health care system. This strategy not only aids in managing the current crisis but also prepares public health systems for future emergencies, emphasizing equity and comprehensive public health responses
Estimating population attributable risk fraction of determinants of pediatric obesity
No full textObjectivesChildhood obesity imposes a remarkable socio-economic and health-related burden, with an increasing worldwide trend. We aimed to assess the relationship between modifiable factors and obesity in Iranian children and adolescents along with to determine the population attributable risk fraction (PARF) for the risk factors of obesity in Iranian children and adolescents.MethodsThis is a nationwide cross-sectional study involving 14,400 school-aged students. In addition to physical examination, a self-administered questionnaire was completed to obtain the study variables including dietary behavior, physical activity, screen time, sleep duration, socioe-conomic status (SES), and passive smoking. Logistic regression models were applied to assess the relationship between modifiable risk factors and obesity. Population attributable risk fractions (PARFs) were used to estimate the prevalence of obesity if demonstrated modifiable risk factors would be removed.ResultsOf 14,400 recruited students, data on 12,153 subjects were analyzed in the current study. The mean (SD) age of participants was 12.3 (3.16) years, and 49.1 were female. Overall prevalence of obesity was 10.4. In total, 33.2 of obesity in Iranian children and adolescents might be attributed to unhealthy dietary habits, moderate or high familial SES, body shape dissatisfaction, and prolonged screen time.ConclusionsConsidering the inherent limitations of the cross-sectional studies, our findings suggest that a notable proportion of obesity in children and adolescents might be attributable to unhealthy dietary habits, prolonged screen time as well as higher family SES. These findings may provide insights for planning and optimizing future obesity intervention endeavors
Role of phage therapy in acute gastroenteritis
No full textThe gut ecosystem, comprising the gut microbiota and its interactions, plays a crucial role in human health and disease. This complex ecosystem involves a diverse array of microorganisms such as viruses, fungi, and bacteria, collectively known as the gut microbiota. These microorganisms contribute to various functions, including nutrient metabolism and immune modulation, thereby impacting human health. Dysbiosis, or an imbalance in the gut microbiota, has been associated with the pathogenesis of several diseases, ranging from intestinal disorders such as inflammatory bowel disease to extra-intestinal conditions such as metabolic and neurological disorders. The implications of dysbiosis in the gut ecosystem are far-reaching, affecting not only gastrointestinal health but also contributing to the development and progression of conditions such as autoimmune gastritis and gastric cancer. Furthermore, the burden of antimicrobial use and subsequent side effects, including antibiotic resistance, poses additional challenges in managing gastrointestinal diseases. In light of these complexities, investigating the role of bacteriophages as regulators of the gut ecosystem and their potential clinical applications presents a promising opportunity to tackle antibiotic resistance and fight infectious diseases
Womb to wisdom: Early-life exposure to midwifery laws and later-life disability
No full textPrevious research documented that midwifery service quality improvements lead to improving maternal and infants' health outcomes. However, little is known about its influence for later-life outcomes including disability. This paper explores the potential effects of early-life exposure to the establishment of midwifery laws across US states on later-life disability outcomes. Midwifery laws were enacted during the late 19th and early 20th century and required midwives to gain formal education and training to obtain a license in order to legally practice. We use decennial census data over the years 1970-2000 and implement a difference-in-difference method and show that being born in a reform state is associated with significant reductions in various measures of disability, including work disability, cognitive difficulty, ambulatory difficulty, self-care difficulty, and a proxy for severe mental health. We also find significant increases in education, socioeconomic scores, housing wealth, and income. We further discuss the policy implications of the results
The concentration of malachite green in fish: a systematic review, meta-analysis, and probabilistic risk assessment
No full textMalachite Green (MG) is an antibiotic with antifungal activity, which is illegal to use in agriculture due to its mutagenic and teratogenic properties. Several scientific papers have been published on MG in fish. Therefore, an attempt was made to determine the meta-analysis concentration of MG in fish based on countries and types of fish subgroups, as well as the health risks of consumers, using the Monte Carlo simulation (MCS) model. The three countries with the highest concentration of MG were Iran (14.697 mu g/kg), Brazil (2.840 mu g/kg), and China (2.277 mu g/kg). The overall pooled concentration of MG in fish was 3.036 mu g/kg, 95CI (2.860-3.212 mu g/kg), and the highest concentration of MG was observed in Pacu fish (6.603 mu g/kg). The health risk assessment shows adults in Malaysia, China, and Iran and children in Italy, Spain, Brazil, Malaysia, China, and Iran are at considerable risk (MOE <10,000); hence, carrying out control plans in these countries is recommended