فهرست مطالب

Archives of Iranian Medicine - Volume:20 Issue: 11, Nov 2017

Archives of Iranian Medicine
Volume:20 Issue: 11, Nov 2017

  • تاریخ انتشار: 1396/10/10
  • تعداد عناوین: 11
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  • Shirin Djalalinia, Mohammad Bagher Talei, Farzaneh Barhemmat, Fatemeh Mohammadali Khalaj, Hamideh Heydari, Hossein Zokaei, Shahin Akhondzadeh, Asghar Ebadifar* Pages 659-664
    Background
    In 1990, one of the most important strategies of supporting and managing reproductive research focused on development of research structures. This targeted vision, at the first step, mainly followed through creating research units. The present paper aims to explore the policies and strategies of medical research centers (MRCs)development, and its achievements and challenges over the last 25 years.
    Methods
    Based on expected outcomes of better directions of research activities aligned with the priorities and policies of research, the Deputy of Research and Technology of Ministry of Health and Medical Education (MOHME), initiated the set up and development of research units.
    Results
    During the last 24 years, the number of MRCs has increased from 1 in 1992 to 736 in 2016. The progressive trends of expansion of the research centers are affected by a complex set of influencing factors. At first steps of program, the process of establishment and development of research structures followed slow trends in few unstructured primary centers. From 2008 to 2012, a rapid investment in development of research structures in biomedicine fields led to numerous complex challenges in supervision and management of MRCs (MRCs).
    Conclusion
    Participatory approach in research centers management, benefiting from all available capacities of research stakeholders, could be considered as a practical strategy for better management of limitations and achieving targeted goals.
    Keywords: Health research, Iran, Research center
  • Shahin Akhondzadeh, Asghar Ebadifar, Monir Baradaran Eftekhari*, Katayoun Falahat Pages 665-672
    Background
    During the last 3 decades, Iran has experienced a rapid population growth and at the same time the health of Iranian people has improved greatly. This achievement was mainly due to training and availability of health manpower, well organized public health network and medical science and research improvement. In this article, we aimed to report the relevant data about the medical science and research situation in Iran and compare them with other countries.
    Methods
    In this study, after reviewing science development and research indicators in medical sciences with participation of key stakeholders, we selected 3 main hybrid indexes consisting of "Research and Development (R&D) expenditures," "Personnel in Science and Technology sector" and "knowledge generation" for evaluation of medical science and research situation. Data was extracted from reliable databases.
    Results
    Over the past decade, Iran has achieved significant success in medical sciences and for the first time in 2015 based on Scopus index, Iran ranked first in the number of published scientific papers and number of citations in the region and among all Islamic countries. Also, 2% of the world’s publications belong to Iran. Regarding innovation, the number of Iranian patents submitted to the United States Patent and Trademark Office (USPTO) was 3 and 43 in 2008 and 2013, respectively. In these years, the number of personnel in science and technology sectors including post graduate students, researchers and academic members in universities of medical sciences (UMSs) have increased. The female students in medical sciences field account for about twothirds of all students. Also, women comprise about one-third of faculty members. Since 5 years ago, Iran has had growth in science and technology parks. These achievements were attained in spite of the fact that research spending in Iran was still very low (0.5% of gross domestic product [GDP]) due to economic hardships and sanctions.
    Conclusion
    Medical science and research development has been at least partially due to health technological development, training and availability of health manpower and improvement of overall health status in Iran compared to other Islamic countries.
    Keywords: Iran, Medicine, Publications, Research, Science, Technology
  • Monir Baradaran Eftekhari, Zahra Sobhani, Masoumeh Eltemasi, Elham Ghalenoee, Katayoun Falahat, Elham Habibi, Shirin Djalalinia, Niloofar Paykari, Asghar Ebadifar* Pages 673-679
    Background
    In recent years, international ranking systems have been used by diverse users for various purposes. In most of these rankings, different aspects of performance of universities and research institutes, especially scientific performance, have been evaluated and ranked. In this article, we aimed to report the results of research ranking of Iranian universities of medical sciences (UMSs) based on some international indicators in 2015.
    Methods
    In this study, after reviewing the research indicators of the majority of international ranking systems, with the participation of key stakeholders, we selected eight research indicators, namely research output, high-quality publications, leadership, total citations, citations per paper in 2015, papers per faculty member and h-index. The main sources for data gathering were Scopus, PubMed, and ISI, Web of Science. Data were extracted and normalized for Iranian governmental UMSs for 2015.
    Results
    A total of 18023 articles were indexed in 2015 in Scopus with affiliations of UMSs affiliation. Almost 17% of all articles were published in top journals and 15% were published with international collaborations. The maximum h-index (h-index = 110) belonged to Tehran University of Medical Sciences. The average paper per faculty member was 1.14 (Max = 2.5, Min = 0.13). The mean citation per published articles in Scopus was 0.33.
    Conclusion
    Research ranking of Iranian UMSs can create favorable competition among them towards knowledge production.
    Keywords: International ranking, Iran, Medical science, Research, University
  • Asghar Ebadifar, Monir Baradaran Eftekhari*, Parviz Owli, Elham Habibi, Elham Ghalenoee, Mohammad Reza Bagheri, Katayoun Falahat, Masoumeh Eltemasi, Zahra Sobhani, Shahin Akhondzadeh Pages 680-685
    Background
    Research evaluation is a systematic and objective process to measure relevance, efficiency and effectiveness of research activities, and peer review is one of the most important tools for assessing quality of research. The aim of this study was introducing research evaluation indicators based on peer reviewing.
    Methods
    This study was implemented in 4 stages. A list of objective-oriented evaluation indicators were designed in 4 axes, including; governance and leadership, structure, knowledge production and research impact.
    Results
    The top 10% medical sciences research centers (RCs) were evaluated based on peer review. Adequate equipment and laboratory instruments, high quality research publication and national or international cooperation were the main strengths in medical sciences RCs and the most important weaknesses included failure to adhere to strategic plans, parallel actions in similar fields, problems in manpower recruitment, knowledge translation & exchange (KTE) in service providers and policy makers’ levels.
    Conclusion
    Peer review evaluation can improve the quality of research.
    Keywords: Evaluation, Iran, Peer review, Qualitative, Research
  • Monir Baradaran Eftekhari, Katayoun Falahat*, Asghar Ebadifar, Masoumeh Eltemasi, Zahra Sobhani, Elham Ghalenoee, Elham Habibi, Shahin Akhondzadeh Pages 686-690
    Background
    Research centers, defined as organized research units having research as their primary mission, are positioned as an organizational solution to tighten the knowledge to do gap in health research system (HRS). Therefore, this study aims to explore the roles of medical research centers (MRCs) in promoting HRS.
    Methods
    In this cross-sectional study, we reviewed the evaluation results of research performance of MRCs from 2001 to 2014. Data of evaluation indicators (in knowledge production and capacity building domains) were gathered and finally compared for these years.
    Results
    In the mentioned period, the number of medical research centers has grown by more than 11 folds. In the domain of knowledge production, the total number of published articles and published articles in ISI, Web of Science per researcher rose from 0.5 and 0.05 to about 3.5 and 1.2, respectively. The number of indexed articles in scientific international databases has increased more than 66 times and the total number of citations of MRCs’ articles has increased to more than 80000. In the domain of capacity building, the trend of workshops and held congresses is ascending.
    Conclusion
    MRCs are well empowered in knowledge production in national HRS.
    Keywords: Evaluation, health research system, medical research center
  • Motamed-Gorji, Seyed Ali Montazeri, Sahar Masoudi, Masoumeh Amin-Esmaeili, Navid Danaie, Seyed Reza Mirhafez, Hasan Hashemi, Hossein Poustchi*, Reza Malekzadeh* Pages 691-695
    In the past, communicable diseases caused the highest mortality in Iran. Improvements in socioeconomic status and living standards including access to safe drinking water, along with the inception of Health Houses in the 1980s, have changed disease patterns, decreasing the spread of and deaths from infectious and communicable diseases. The incidence and prevalence of non-communicable diseases (NCD), however, have now increased in Iran, accounting for nearly 80% of deaths and disabilities. Without interventions, NCD are predicted to impose a substantial human and economic burden in the next 2 decades. However, Iran’s health system is not equipped with the necessary policies to combat this growth and must refocus and reform. Therefore, in the year 2013, the Ministry of Health and Medical Education funded a well-designed nationwide cohort study—Prospective Epidemiological Research Studies in IrAN (PERSIAN)—in order to assess the burden of NCD and investigate the risk factors associated with them in the different ethnicities and geographical areas of Iran. The PERSIAN Cohort, which aims to include 200000 participants, has 4 components: Adult (main), Birth, Youth and Elderly, which are being carried out in 22 different regions of Iran. Having an enormous dataset along with a biobank of blood, urine, hair and nail samples, the PERSIAN Cohort will serve as an important infrastructure for future implementation research and will provide the evidence needed for new healthcare policies in order to better control, manage and prevent NCD.
    Keywords: PERSIAN, Cohort, NCD, Iran
  • Shahnaz Mojarrab, Ali Rafei, Shahin Akhondzadeh, Alireza Jeddian, Maryam Jafarpour, Kazem Zendehdel* Pages 696-703
    Registration systems for diseases and other health outcomes provide important resource for biomedical research, as well as tools for public health surveillance and improvement of quality of care. The Ministry of Health and Medical Education (MOHME) of Iran launched a national program to establish registration systems for different diseases and health outcomes. Based on the national program, we organized several workshops and training programs and disseminated the concepts and knowledge of the registration systems. Following a call for proposals, we received 100 applications and after thorough evaluation and corrections by the principal investigators, we approved and granted about 80 registries for three years. Having strong steering committee, committed executive and scientific group, establishing national and international collaboration, stating clear objectives, applying feasible software, and considering stable financing were key components for a successful registry and were considered in the evaluation processes. We paid particulate attention to non-communicable diseases, which constitute an emerging public health problem. We prioritized establishment of regional population-based cancer registries (PBCRs) in 10 provinces in collaboration with the International Agency for Research on Cancer. This initiative was successful and registry programs became popular among researchers and research centers and created several national and international collaborations in different areas to answer important public health and clinical questions. In this paper, we report the details of the program and list of registries that were granted in the first round.
    Keywords: Biomedical research, Diseases, health outcome registry, Registration system, Public health
  • Nazli Namazi, Bagher Larijani*, Leila Azadbakht* Pages 704-713
    Background
    Previous trials have reported beneficial effects of isolated and complex fiber supplements in obesity treatment. However, recommending fiber supplements in obese subjects remains controversial. To the best of our knowledge, no systematic review has updated the data on the effects of fiber supplements on obesity since 2010 and the need exists for a systematic review on this topic. Accordingly, a systematic review was undertaken to summarize the efficacy of different types of fiber supplements as a complementary treatment for weight management.
    Methods
    We searched PubMed, Scopus, Cochrane Library and Google Scholar between January 2010 to August 2016 with no language restriction. Considering the inclusion/exclusion criteria and quality assessment score, finally 17 clinical trials met the eligibility criteria and were included.
    Results
    The present study indicated that the efficacy of various fiber supplements on losing weight is variable. Several mechanisms related to physicochemical properties of fibers such as solubility, fermentability and viscosity rates can be involved in their anti-obesity effects. Dextrin, Mannan (gum Arabic) and pectin-rich fiber (lupin kernel) with no dietary interventions indicated a reduction in body weight and energy intake, while from clinical point of view, their effects were not considerable.
    Conclusion
    Overall, findings indicated that the efficacy of fiber supplements on obesity management is dependent on their contents and physicochemical properties. It seems that fiber supplements with no weight-loss interventions did not have considerable antiobesity effects. However, due to limited studies on each type of fiber, findings should be declared by caution. Additional research is needed on comparison of different fiber supplements in similar conditions to clarify the best type and dosage of fiber supplement as a complementary therapy in obesity management.
    Keywords: Appetite, Fiber supplement, Physicochemical property, Weight management
  • Obstructive Tracheal Pseudomembrane
    Shanay Niusha, Farshid Salehi, Mohammad Behgam Shadmehr* Pages 714-715
    Obstructive tracheal pseudomembrane is a rare complication of endotracheal intubation, which could cause fatal airway obstruction following extubation. Hereby, we reported a patient who had only undergone a short course of intubation for a laparoscopic cholecystectomy and developed progressive respiratory distress after extubation.
    Keywords: Airway obstruction, Stenosis, Tracheal pseudomembrane
  • Jessica Ares Blanco*, Lorena Su, Aacute, Rez GutiÉrrez, Mar, Iacute, A. Galiana Rodr, Iacute, Guez Caballero Pages 716-717
  • Touraj Nayernouri* Pages 718-722