Publications by authors named "Neda Mehrdad"

67 Publications

Policy options for strengthening evidence-informed health policy-making in Iran: overall SASHA project findings.

Health Res Policy Syst 2022 Jan 15;20(1):10. Epub 2022 Jan 15.

Department of Treatment and Social Support, IRAN Drug Control Headquarter, Tehran, Iran.

Background: The institutionalization of evidence-informed health policy-making (EIHP) is complex and complicated. It is complex because it has many players and is complicated because its institutionalization will require many changes that will be challenging to make. Like many other issues, strengthening EIHP needs a road map, which should consider challenges and address them through effective, harmonized and contextualized strategies. This study aims to develop a road map for enhancing EIHP in Iran based on steps of planning.

Methods: This study consisted of three phases: (1) identifying barriers to EIHP, (2) recognizing interventions and (3) measuring the use of evidence in Iran's health policy-making. A set of activities was established for conducting these, including foresight, systematic review and policy dialogue, to identify the current and potential barriers for the first phase. For the second phase, an evidence synthesis was performed through a scoping review, by searching the websites of benchmark institutions which had good examples of EIHP practices in order to extract and identify interventions, and through eight policy dialogues and two broad opinion polls to contextualize the list of interventions. Simultaneously, two qualitative-quantitative studies were conducted to design and use a tool for assessing EIHP in the third phase.

Results: We identified 97 barriers to EIHP and categorized them into three groups, including 35 barriers on the "generation of evidence" (push side), 41 on the "use of evidence" (pull side) and 21 on the "interaction between these two" (exchange side). The list of 41 interventions identified through evidence synthesis and eight policy dialogues was reduced to 32 interventions after two expert opinion polling rounds. These interventions were classified into four main strategies for strengthening (1) the education and training system (6 interventions), (2) the incentives programmes (7 interventions), (3) the structure of policy support organizations (4 interventions) and (4) the enabling processes to support EIHP (15 interventions).

Conclusion: The policy options developed in the study provide a comprehensive framework to chart a path for strengthening the country's EIHP considering both global practices and the context of Iran. It is recommended that operational plans be prepared for road map interventions, and the necessary resources provided for their implementation. The implementation of the road map will require attention to the principles of good governance, with a focus on transparency and accountability. Video abstract.
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http://dx.doi.org/10.1186/s12961-021-00803-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760808PMC
January 2022

The ethical challenges in pharmacy practice in community Pharmacies: A qualitative study.

Saudi Pharm J 2021 Dec 11;29(12):1441-1448. Epub 2021 Nov 11.

Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Pharmacists as a group of health care professionals, face different types of ethical challenges in their everyday routine that may impede pharmaceutical care.

Objectives: In this study, we aimed at evaluation and recognition of the ethical challenges of pharmacy practice in community pharmacies.

Methods: This exploratory study was conducted as a qualitative study consisting of open-ended in-depth interviews and focus group discussions followed by content analysis. The study participants were chosen from pharmacists with PharmD degree who had at least 4 years work experience and were the founders or technical managers of community pharmacies, either as governmental or private. Interviews continued until data saturation and transcribed verbatim. The content analysis was done by Graneheim and Lundman method. The codes were generated, and categorized. After assessment and final modifications, the results of the study were discussed and confirmed in a focus group discussion conducted by 7 experts who teach medical ethics and/or pharmacy ethics.

Results: Overall, 40 pharmacists were interviewed (mean age 46 ± 11.3 years). The extracted ethical challenges of pharmacy practice were categorized into 3 main themes, 11 subthemes and 102 codes. The themes were achieved as challenges related to professionalism and professional practice, challenges related to professional communications and challenges related to regulations and policies.

Conclusion: Taken together, it seems that most of the challenges of pharmacy practice are related to professionalism and professional commitment; however, the regulations and policies provide serious obstacles for pharmacy practice and pharmaceutical care. More efforts towards teaching professionalism and modification of regulations and policies are recommended.
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http://dx.doi.org/10.1016/j.jsps.2021.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720823PMC
December 2021

Diabetic Foot scientific activities in Endocrinology and Metabolism Research Institute.

J Diabetes Metab Disord 2021 Dec 15;20(2):1767-1772. Epub 2021 Jun 15.

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Diabetic Foot (DF) as a common complication of Diabetes should be intensive intervention for prevention, management and rehabilitation. In this regard, Diabetes Research Center of Endocrinology and Metabolism Research Institute (EMRI) of Tehran University of Medical Sciences (TUMS) considered DF as a priority research area to investigate multidimensional aspects of DF care. We are intended to summarize DF research studies affiliated to the EMRI for over the last two decades.

Methods: Three Electronic databases including Web of Science, PubMed, and Scopus were searched until January 2020 to find articles about DF published affiliated to EMRI. The main concepts of search strategies were "diabetes", "Foot". 115 documents retrieved from these databases which screened for inclusion and exclusion criteria. The visualization of the network of co-authorship of authors and co-occurrence of keywords was illustrated and documents were analyzed for content according to the Main areas of DF Research studies.

Result: 64 related documents including original articles, reviews, letters, notes, and book chapter have included to this study. According to the objectives of the retrieved studies, DF documents and research studies categorized in the two main groups including DF prevention, classification and risk stratification in addition management of DF.

Conclusion: Despite conducted research and educational activities in DF prevention and management, the following topics would be considered as well: effective offloading treatment, correcting the nutritional status for improving wound healing and novel educational strategies for diabetic foot multi-disciplinary team.
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http://dx.doi.org/10.1007/s40200-021-00823-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630246PMC
December 2021

Studying the relationship between cognitive impairment and frailty phenotype: a cross-sectional analysis of the Bushehr Elderly Health (BEH) program.

J Diabetes Metab Disord 2021 Dec 6;20(2):1229-1237. Epub 2021 Jul 6.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, NO. 10, Jalale-Al- Ahmad Ave, Chamran Highway, Tehran, Iran.

Background: Some pathophysiological effects of physical frailty and cognitive impairment might be similar; therefore, finding the associations in epidemiologic studies could guide clinicians and researchers to recognize effective strategies for each type of frailty such as frailty phenotype and frailty index, which in turn will result in a preventive approach. The study aimed to reveal which components of frailty phenotype are more associated with cognitive impairment. The findings of this study may help other researchers clarify the related pathways.

Methods: This is a cross-sectional analysis of the results of the second phase of Bushehr Elderly Health Program; a community-based elderly prospective cohort study conducted in 2015-2016. The participants were selected through a multistage stratified cluster random sampling method. Frailty was assessed based on the Fried frailty phenotype criteria. Cognitive impairment was assessed by the Mini-Mental State Examination (MMSE), the Mini-Cog, and the Category Fluency Test (CFT). Multiple logistic regression models were applied to determine the association between frailty and cognitive impairment. Depression trait was assessed using the Patient Health Questionnaire-9 (PHQ-9). Activities of daily living were assessed using the Barthel Index and Instrumental Activities of Daily Living (IADLs) using Lawton's IADL.

Results: The studyp conducted among people ≥ 60 years old (N = 2336) with women consisting 51.44% of the sample group. The mean age of the participants was 69.26 years old. The prevalence of pre-frailty and frailty were 42.59% and 7.66%, respectively. In the fully adjusted model, the odds ratio of the association between pre-frailty and frailty with cognitive impairment was 1.239, 95% CI: 1.011 - 1.519 and 1.765, 95% CI: 1.071 - 2.908, respectively (adjusted for age, sex, education, body mass index, smoking, diabetes mellitus, PHQ- 9, Barthel Index, and IADLs). In the fully adjusted multiple logistic regression models, all of the components of Fried frailty phenotype were significantly related to cognitive impairment except weight loss.

Conclusion: Cognitive impairment may be associated with frailty phenotype. Moreover, low strength and function of muscles had a stronger association with cognitive impairment. It seems that a consideration of cognitive impairment assessment in older people along with frailty and vice versa in clinical settings is reasonable.
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http://dx.doi.org/10.1007/s40200-021-00847-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630203PMC
December 2021

Challenges and Expectations of Diabetic Foot Care from the Patients' Point of Views.

J Diabetes Metab Disord 2021 Dec 3;20(2):1111-1118. Epub 2021 Aug 3.

Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences (IUMS), Hemmat Highway, 1449614535 Tehran, Iran.

Introduction: Diabetic foot ulcer (DFU) as a common complication of diabetes needs a multi-disciplinary care approach in which the patient suffering from DFU is considered as a member of the care team. According to the effective role of patients in DFU prevention and management, this study was an attempt to explore patients' views and expectations regarding provision of DFU preventive and therapeutic care to facilitate the process of care and management.

Methods: A qualitative research approach, using two focus group discussions, was conducted with patients suffering from diabetes and DFU. The questions designed to encourage the discussion were focused on the patients' experience of foot and DFU care. We continued the discussions until we reached data saturation. The participants' responses were recorded via a recorder and by taking notes. Afterwards, the discussions were transcribed and common themes were identified and categorized.

Results: Initially, fifty-seven codes were extracted which were then summarized and classified. Afterward, three themes and six sub-themes were determined as follows: defective education and ineffective communication("a defect in the patient education system", "impaired communication"), multi-faceted challenges of wound healing ("out of pocket expenses, treatment compliance", "non-physical injury"), and full support ("empathy" and "patient-centeredness").

Conclusion: According to patients' views, patients' concerns, and their socioeconomic conditions should be taken into consideration in designing an effective DFU care plan. In this regard, a strong communication with the patients to prepare a holistic care intended for patients' full support would be essential.
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http://dx.doi.org/10.1007/s40200-021-00825-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630281PMC
December 2021

Potential for Stem Cell-Based Therapy in the Road of Treatment for Neurological Disorders Secondary to COVID-19.

Regen Eng Transl Med 2021 Oct 29:1-15. Epub 2021 Oct 29.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Abstract: The severe acute respiratory syndrome coronavirus 2 has led to the worldwide pandemic named coronavirus disease 2019 (COVID-19). It has caused a significant increase in the number of cases and mortalities since its first diagnosis in December 2019. Although COVID-19 primarily affects the respiratory system, neurological involvement of the central and peripheral nervous system has been also reported. Herein, the higher risk of neurodegenerative diseases in COVID-19 patients in future is also imaginable. Neurological complications of COVID-19 infection are more commonly seen in severely ill individuals; but, earlier diagnosis and treatment can lead to better long-lasting results. In this respect, stem cell biotechnologies with considerable self-renewal and differentiation capacities have experienced great progress in the field of neurological disorders whether in finding out their underlying processes or proving them promising therapeutic approaches. Herein, many neurological disorders have been found to benefit from stem cell medicine strategies. Accordingly, in the present review, the authors are trying to discuss stem cell-based biotechnologies as promising therapeutic options for neurological disorders secondary to COVID-19 infection through reviewing neurological manifestations of COVID-19 and current stem cell-based biotechnologies for neurological disorders.

Lay Summary: Due to the substantial burden of neurological disorders in the health, economic, and social system of society, the emergence of neurological manifestations following COVID-19 (as a life-threatening pandemic) creates the need to use efficient and modern methods of treatment. Since stem cell-based methods have been efficient for a large number of neurological diseases, it seems that the use of mentioned methods is also effective in the process of improving neurological disorders caused by COVID-19. Hereupon, the current review aims to address stem cell-based approaches as treatments showing promise to neurological disorders related to COVID-19.
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http://dx.doi.org/10.1007/s40883-021-00234-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8555723PMC
October 2021

Metabolomics Signatures of SARS-CoV-2 Infection.

Adv Exp Med Biol 2021 Nov 5. Epub 2021 Nov 5.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran.

For a very long time, viral infections have been considered as one of the most important causes of death and disability around the world. Through the viral infection, viruses as small pathogens enter the host cells and use hosts' biosynthesis machinery to replicate and collect infectious lineages. Moreover, they can modify hosts' metabolic pathways in order to their own purposes. Nowadays (in 2019-2020), the most famous type of viral infection which was caused by a novel type of coronavirus is called COVID-19 disease. It has claimed the lives of many people around the world and is a very serious threat to health. Since investigations of the effects of viruses on host metabolism using metabolomics tools may have given focuses on novel appropriate treatments, in the current review the authors highlighted the virus-host metabolic interactions and metabolomics perspective in COVID-19.
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http://dx.doi.org/10.1007/5584_2021_674DOI Listing
November 2021

Diabetic foot self-care practice in women with diabetes in Iran.

Diabetes Metab Syndr 2021 Sep-Oct;15(5):102225. Epub 2021 Jul 26.

Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Background And Aims: The present study was conducted to determine the situation of foot self-care practice among Iranian women with diabetes.

Methods: In this cross-sectional study, 475 women completed the Diabetic Foot Self-Care Questionnaire (DFSQ) along with other questions. The overall and three components scores including personal care, podiatric care, and foot wearing, were calculated and their relationship with other factors was analyzed.

Results: The average total DFSQ score was 60.38 ± 9.9, and 16.98 ± 7, 5.95 ± 2.11, and 12.26 ± 3.95 for personal care, podiatric care, and footwear respectively. Education level, self-reported health status, and life satisfaction had a significant relationship with footwear score, and smoking and life satisfaction were related to personal care and podiatric care respectively. In Pearson regression, DM self-care was correlated with all three components and total DFSQ score. Also, depression and SCS (Social Capital Status) correlated with DFSQ scores except with personal self-care and footwear respectively. Body Mass Index (BMI) and Quality of Life (QoL) were significantly correlated with footwear and podiatric care scores.

Conclusion: In this study, the DFSQ result was almost acceptable, however, it highlights the importance of suitable interventions to establish better self-care practice among Iranian diabetic women.
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http://dx.doi.org/10.1016/j.dsx.2021.102225DOI Listing
July 2021

Social-capital determinants of the women with diabetes: a population-based study.

J Diabetes Metab Disord 2021 Jun 9;20(1):511-521. Epub 2021 May 9.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Social-capital level contributes to clinical factors and health outcomes of patients suffering from diabetes. Considering the social determinants of type 2 diabetes patients could benefit to prevention of diabetes complications especially in women population. This study aims to determine social capital determinants in women with diabetes.

Methods: Four hundred and thirty-five women with diabetes take-part in this cross-sectional, multi-centric study. The data was completed by a demographic questionnaire and the Social Capital instrument (SC-IQ). This study is investigating demographic (age, gender, BMI, marital, educational and social-economic status), and lifestyle factors (physical activity, nutrition), Diabetes status (HbA1c Level, medications, complications, duration of diabetes), general health status (life satisfaction, self-rated health, physical activity, and depression) and Social capital items (Value of life, Tolerance of Diversity, Neighborhood network, Family and Friends Connections, Work connections, Community participation, Feeling of trust and Safety and Proactivity). The descriptive statistics and linear regression models were used to assess the associations between social capital and determinants.

Results: The mean age of participants was 50 (SD: 7.7), range 28-71 year. The mean social capital score was 77.8 (SD: 15.8). In linear regression analysis, results showed that women who had the greater score in total social-capital (ß: 3.7, SE: 1.5) and Feeling of trust and Safety (ß: 0.87, SE: 0.42) had vigorous physical activity and also women who had greater score in Neighborhood Connections had moderate physical activity in comparison with patients who had low physical activity. (ß: 0.67, SE: 0.26 and ß: 0.61, SE: 0.26).Also, the findings showed that women who had had a lower score in total social-capital (ß: 6, SE: 1.47), Community participation (ß: 1.44, SE: 0.37), Value of life (ß: 1.71, SE: 0.24), Family and Friends Connections (ß: 0.88, SE: 0.25) and proactivity (ß: 0.71, SE: 0.25) had depression in comparison with patients who had no depression. The findings revealed that instead of each year increase in the duration of diabetes, the total social-capital score had decreased about the half score (ß: 0.48, SE: 0.21).

Conclusions: Important social factors that make diabetes control are alterable to health interventions. The results of the current study suggest that social capital status may determine how effectively the women with diabetes have been managed. This initial finding permits subsequent experimental investigations to identify social strategies that can be valuable to improve diabetes control.
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http://dx.doi.org/10.1007/s40200-021-00772-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212190PMC
June 2021

Association between cardiometabolic risk factors and COVID-19 susceptibility, severity and mortality: a review.

J Diabetes Metab Disord 2021 Jun 26:1-23. Epub 2021 Jun 26.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

The novel coronavirus, which began spreading from China Wuhan and gradually spreaded to most countries, led to the announcement by the World Health Organization on March 11, 2020, as a new pandemic. The most important point presented by the World Health Organization about this disease is to better understand the risk factors that exacerbate the course of the disease and worsen its prognosis. Due to the high majority of cardio metabolic risk factors like obesity, hypertension, diabetes, and dyslipidemia among the population over 60 years old and higher, these cardio metabolic risk factors along with the age of these people could worsen the prognosis of the coronavirus disease of 2019 (COVID-19) and its mortality. In this study, we aimed to review the articles from the beginning of the pandemic on the impression of cardio metabolic risk factors on COVID-19 and the effectiveness of COVID-19 on how to manage these diseases. All the factors studied in this article, including hypertension, diabetes mellitus, dyslipidemia, and obesity exacerbate the course of Covid-19 disease by different mechanisms, and the inflammatory process caused by coronavirus can also create a vicious cycle in controlling these diseases for patients.
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http://dx.doi.org/10.1007/s40200-021-00822-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233632PMC
June 2021

Diabetic foot care course: a quasi-experimental study on E-learning versus interactive workshop.

J Diabetes Metab Disord 2021 Jun 23;20(1):15-20. Epub 2021 Jan 23.

Center for Educational Research in Medical Sciences (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Nurses, as multidisciplinary Diabetic Foot Care (DFC) team members, need to be trained in DF prevention and management. Regarding the increasing use of e-learning educational courses as the new learning strategy with potential benefits among health care providers, this study attempted to evaluate the educational effects of an e-learning course on DFC compared to that of an interactive workshop in the related knowledge attainment.

Methods: This was a quasi-experimental study compared two non-randomized groups consisting of nurses who attended an e-learning course (intervention group) and a face-to-face interactive workshop (control group) on DFC using a pre- and post-test design. The eligible nurses enrolled by convenience sampling. All five e-modules on DF prevention and care were the same for both groups. A value of <0.05 was considered as significant.

Results: The study findings indicated that both e-learning course and interactive workshop increased DFC knowledge among nurses. There is a significant difference between the learning level (after training) in the intervention and control groups ( < 0.01).

Conclusions: The findings suggest that the e-learning course of DF could be as effective as conventional educational methods. However, considering the time, cost savings and providing an opportunity to learn anytime and anywhere, of the e-learning course, it is recommend for the future and required that more health care providers be trained to use of distance learning.
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http://dx.doi.org/10.1007/s40200-020-00630-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8212321PMC
June 2021

Bone characteristics and metabolic phenotypes of obesity in an Iranian Elderly population: Bushehr Elderly Health Program (BEHP).

Arch Osteoporos 2021 06 8;16(1):92. Epub 2021 Jun 8.

Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Introduction: Obesity and osteoporosis are health problems with high impact on the morbidity and mortality rate. While the association between BMI and bone density is known, the combined effects of obesity and metabolic components on bone health have not yet been revealed. The objectives of this study were to determine the association between bone health and different phenotypes of obesity in an elderly population.

Methods: This cross-sectional study was conducted on the data collected in the Bushehr Elderly Health Program (BEHP). The participants were classified in four groups based on the metabolic phenotypes of obesity (metabolic healthy obese (MHO), metabolic non-healthy non-obese (MNHNO), metabolic non-healthy obese (MNHO), and metabolic healthy non-obese (MHNO)). The association between osteoporosis and TBS and the metabolic phenotypes of obesity were assessed using multiple variable logistic regression models.

Results: Totally, 2378 people (1227 women) were considered for analyses. The prevalence of MHNO, MHO, MNHNO, and MNHO were 902 (39.9%), 138 (6.1%), 758 (33.5%), and 464 (20.5%), respectively. In the multivariate logistic regression models, those with MHO (OR 0.22; 95% CI 0.12-0.36), MNHNO (OR 0.52; 95% CI 0.4-0.66), and MNHO phenotypes (OR 0.22; 95% CI 0.16-0.3) had a significantly lower risk of osteoporosis. Likewise, those having MHO (OR 2.38; 95% CI 1.51-3.76), MNHNO (OR 1.49; 95% CI 1.11-2), and MNHO (OR 2.50; 95% CI 1.82-3.42) phenotypes were found to had higher risk of low bone quality as confirmed by TBS.

Conclusions: The obese subjects have lower bone quality, regardless of their obesity phenotype.
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http://dx.doi.org/10.1007/s11657-021-00953-2DOI Listing
June 2021

The Process of Managing the Children with Type 1 Diabetes in the Family: A Grounded Theory Study.

Iran J Nurs Midwifery Res 2021 Jan-Feb;26(1):25-33. Epub 2021 Jan 18.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Diabetes is a disease that affects all family members. Parents of children with type 1 diabetes are always concerned about all aspects of children's life. The aim of this study was to elucidate the process of managing children with diabetes in the family.

Materials And Methods: This is a qualitative grounded theory of a doctoral dissertation, which was done on 2016. The 18 participants were selected through purposive and theoretical sampling until data saturation. The main participants in this study included parents, siblings, and children with type 1 diabetes. The data was gathered by semi-structured interviews as well as field notes and memos. Data analysis was done concurrently with data collection in four levels, including data analysis for concept and contex, bringing the process into the analysis, and integration of categories according to Corbin and Struss (2008). Core category appeared at the end of integrated categories.

Results: "The family with diabetes in the child's diabetes orbit" as a core category contains the process of managing children with diabetes within the family, which included three main subcategories, including "entering into the diabetes orbit", "movement into the diabetes orbit", and "living into the diabetes orbit".

Conclusions: The family through the concept of "The family with diabetes in the child's diabetes orbit "as a main concern of families with diabetes suffering diabetes attempt to select and practicing appropriate strategies and manage diabetes and children with diabetes.
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http://dx.doi.org/10.4103/ijnmr.IJNMR_5_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074732PMC
January 2021

Prevalence of osteoporosis among the elderly population of Iran.

Arch Osteoporos 2021 01 21;16(1):16. Epub 2021 Jan 21.

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

In a large population-based study of Iran, the age-standardized prevalence of osteoporosis was 24.6% in men and 62.7% in women aged ≥ 60 years. Osteoporosis was negatively associated with body mass index in both sexes, and with diabetes in men and hypertriglyceridemia in women.

Purpose: Population aging has made osteoporosis and osteoporotic fractures an important health problem, especially in developing countries. This study aimed to explore the prevalence of osteoporosis and associated factors among the elderly population of the south-west of Iran.

Methods: Baseline data of the second stage of the Bushehr Elderly Health program was used. Spinal, total hip, or femoral neck osteoporosis was described as a BMD that lies 2.5 standard deviations or more, below the average values of a young healthy adult in the lumbar spine, total hip, or femoral neck, respectively. Osteoporosis at either site was defined as total osteoporosis. Age-standardized prevalence of osteoporosis was estimated. We used the modified Poisson regression with a robust variance estimator to identify the factors related to osteoporosis, adjusting for potential confounders.

Results: Overall, 2425 individuals (1166 men) aged over 60 years were included. In all, total osteoporosis was detected in 1006 (41.5%) of the participants. Using the reference value derived from Caucasian women aged 20-29 years, the age-standardized prevalence of total osteoporosis was 24.6 (95% CI: 21.9-27.3) in men, and 62.7 (95% CI: 60.0-65.4) in women. In men, osteoporosis was positively associated with age, smoking, history of fracture, and history of renal/liver diseases and negatively associated with body mass index (BMI) and diabetes. BMI, hypertriglyceridemia, and education were negatively correlated with osteoporosis in women, while years after menopause and history of fracture increased the likelihood of osteoporosis, significantly.

Conclusion: Results support the high prevalence of osteoporosis and osteopenia in the elderly population. Considering the importance of severe complications, especially fractures, comprehensive interventions should be expanded.
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http://dx.doi.org/10.1007/s11657-020-00872-8DOI Listing
January 2021

Endocrinology and Metabolism Research Institute from inception to maturity: an overview of 25-year activity.

J Diabetes Metab Disord 2020 Oct 3:1-7. Epub 2020 Oct 3.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Beneath Dr. Shariati Hospital, Gomnam Highway, Tehran, Iran.

Endocrinology and Metabolism Research Institute (EMRI) was founded in 1993. EMRI progressed step by step from inception and reached to its maturation during the past 25 years. EMRI has expanded and progressed in different aspects including human resources and infrastructures (laboratories and new technologies) and has obtained the first rank in the country in endocrinology research. It has also collaborated with regional and international organizations such as World Health Organization (WHO), International Osteoporosis Foundation (IOF), and American Association of Clinical Endocrinologists (AACE). This article provides an overview of EMRI activities during a quarter of a century.
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http://dx.doi.org/10.1007/s40200-020-00645-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532120PMC
October 2020

Osteoporosis and cognitive impairment interwoven warning signs: community-based study on older adults-Bushehr Elderly Health (BEH) Program.

Arch Osteoporos 2020 09 10;15(1):140. Epub 2020 Sep 10.

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Cognitive impairment and osteoporosis are frequently seen to coincide in clinical practice. Osteoporosis was higher in elderly populations with cognitive impairment, especially in postmenopausal women. Thus, prophylaxis for osteoporosis, falls, and fractures should be considered as part of the treatment of patients with cognitive impairment.

Introduction: Cognitive impairment and osteoporosis are two important health concerns among older adults that their possible relationship, concurrent occurrence, and linking mechanism have recently been highlighted. The purpose of this study was to assess the sex-independent association of these two conditions.

Materials And Methods: From among 2331 individuals aged ≥ 60 years selected in Bushehr Elderly Health (BEH) Program, Iran; data of 1508 participants were analyzed. Cognitive status was assessed using Category Fluency Test and Mini-cog assessment instrument. Association between osteopenia-osteoporosis and cognitive impairment were assessed using uni- and multivariable logistic regression models.

Results: Osteoporosis was diagnosed in 598 (39.6%) of the participants (58.3% female and 21.9% male, P < 0.001). From among them, 677 (44.9%) had evidence of cognitive impairment (64.5% female and 31.0% male, P < 0.001). Multivariate logistic regressions showed spinal and total hip osteoporosis was associated with 1.83 (CI 95% 1.13-2.96) and 2.24-fold (CI 95% 1.28-3.89) increase in the risk of cognitive impairment among female subjects, respectively. Ordinal logistic regression, on the other hand, revealed cognitive impairment to be associated with 1.42-fold (CI 95% 1.04-1.92) increase in the risk of spinal osteopenia-osteoporosis, 1.5-fold increase in total hip osteoporosis (CI 95% 1.09-2.05), and 1.48-fold increase in general osteoporosis (CI 95% 1.06-2.0).

Conclusion: Different degrees of bone loss and cognitive impairment may be a risk factor for each other among women but not in men. It is suggested that the screening, adopting preventive measures for the other condition and regular follow-ups, if needed, could be of utmost importance.
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http://dx.doi.org/10.1007/s11657-020-00817-1DOI Listing
September 2020

Prospect of Stem Cell Therapy and Regenerative Medicine in Osteoporosis.

Front Endocrinol (Lausanne) 2020 3;11:430. Epub 2020 Jul 3.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

The field of cell therapy and regenerative medicine can hold the promise of restoring normal tissues structure and function. Additionally, the main targets of stem cell-based therapies are chronic diseases and lifelong disabilities without definite cures such as osteoporosis. Osteoporosis as one of the important causes of morbidity in older men and post-menopausal women is characterized by reduced bone quantity or skeletal tissue atrophy that leads to an increased risk of osteoporotic fractures. The common therapeutic methods for osteoporosis only can prevent the loss of bone mass and recover the bone partially. Nevertheless, stem cell-based therapy is considered as a new approach to regenerate the bone tissue. Herein, mesenchymal stem cells as pivotal candidates for regenerative medicine purposes especially bone regeneration are the most common type of cells with anti-inflammatory, immune-privileged potential, and less ethical concerns than other types of stem cells which are investigated in osteoporosis. Based on several findings, the mesenchymal stem cells effectiveness near to a great extent depends on their secretory function. Indeed, they can be involved in the establishment of normal bone remodeling via initiation of specific molecular signaling pathways. Accordingly, the aim herein was to review the effects of stem cell-based therapies in osteoporosis.
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http://dx.doi.org/10.3389/fendo.2020.00430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347755PMC
May 2021

GMP-Compliant Human Schwann Cell Manufacturing for Clinical Application.

Methods Mol Biol 2021 ;2286:227-235

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Schwann cells as glial cells in the peripheral nervous system can participate in neurons protection and forming myelin. Additionally, they are important for nerve pulse conduction supporting along axons. On the other hand, it was demonstrated that they are promising cells for the treatment of demyelinating disorders and also central nervous system damages. Herein, for therapeutic application, Schwann cells should be manufactured based on good manufacturing practice standards to achieve safe and effective clinical products. In this respect, the current chapter tries to introduce a standard protocol for manufacturing of human GMP-compliant Schwann cells for clinical application.
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http://dx.doi.org/10.1007/7651_2020_283DOI Listing
June 2021

Conceptual map of diabetes education: necessity of establishing iran diabetes academy.

J Diabetes Metab Disord 2019 Dec 8;18(2):729-731. Epub 2019 Oct 8.

7Endocrinology Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Diabetes Mellitus as a one of common non communicable diseases needs to be managed using multidisciplinary and coordinated approach. Incidentally, Clinical practice guidelines along with Continuing Medical Education (CME) would be essential section in this approach. In this regard Iran Diabetes Academy (IDA) affiliated Endocrinology and Metabolism Research Institute (EMRI) of Tehran University of Medical Sciences (TUMS) was established in 2017. IDA intended to provide and deliver appropriate source of updated information for all health care providers in field of diabetes prevention, management and rehabilitation.
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http://dx.doi.org/10.1007/s40200-019-00441-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915169PMC
December 2019

A multidisciplinary team approach in Iranian diabetic foot research group.

J Diabetes Metab Disord 2019 Dec 9;18(2):721-723. Epub 2019 Nov 9.

1Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Jalale Ale Ahmad Av, Tehran, 1414713138 Iran.

Diabetic Foot (DF) as a common complication of Diabetes needs to intensive intervention for prevention, management and rehabilitation. In this regard the Iranian Diabetic Foot Research Group (IDFRG) of Diabetes Research Center of Endocrinology and Metabolism Research Institute (EMRI) of Tehran University of Medical Sciences (TUMS) with multi-disciplinary approach have begun its activity since 2014. The aim of this paper is introducing the IDFRG in four main categories including Education, Research, Knowledge Translation and Clinical Care. According to the strategic plan, Future activities would be considered as five following areas: National Diabetic Foot Research Network (NDFRN) Establishment, Podiatrist Curriculum Development, Iranian Diabetic Foot Registry System (IDFRS) Launch, DF guideline Implementation and last but not least DF Ward Establishment.
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http://dx.doi.org/10.1007/s40200-019-00450-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915241PMC
December 2019

Older adults' self-advocacy in patient safety: a cross-sectional study.

Br J Nurs 2019 Sep;28(16):1076-1084

Associate Professor, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamedan, Iran.

Background: patient advocacy is a major nursing role, which is linked to supporting, encouraging and reinforcing self-advocacy in patients. Patient safety is an important nursing outcome, especially in older adults.

Aims: older adults' self-advocacy regarding patient safety behaviour and its relationship with some demographic characteristics were assessed.

Methods: a valid older adult patients' self-advocacy questionnaire, which included subscales of behaviour, self-efficacy, attitude and outcome efficacy (range of scores=0-63), was used. In this cross-sectional study, 230 patients aged over 60 years were selected using a stratified sampling method.

Findings: an association was found between total self-advocacy score (mean=40.16; SD=9.6) and rural living (β=-0.168; P=0.016) using multiple linear regression analysis. Similar findings were found between questionnaire subscales and sex, rural living, occupation and age.

Conclusion: older adults, especially women, those of advanced age and those in rural areas, may benefit from nursing interventions to improve their self-advocacy in patient safety.
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http://dx.doi.org/10.12968/bjon.2019.28.16.1076DOI Listing
September 2019

Effect of diabetes on BMD and TBS values as determinants of bone health in the elderly: Bushehr Elderly Health program.

J Diabetes Metab Disord 2019 Jun 9;18(1):99-106. Epub 2019 Mar 9.

1Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

Background: Considering the aging population associated with higher osteoporotic fracture risk, high prevalence of diabetes and its effect on bone health along with lack of information on bone quality using common methods (BMD) the aim of present study was to determine the association between trabecular bone score (TBS) and diabetes in an elderly population participating in Bushehr Elderly Health (BEH) program.

Materials And Methods: This cross-sectional study was performed on data collected during the BEH Program, stage II. Anthropometric indices were measured based on NHANES III protocol. Diabetes and pre-diabetes were defined according to ADA Guideline 2018. Bone density was measured using DXA method (DXA, Discovery WI, Hologic Inc., USA). A software installed on the same device (TBS iNsight® software) was applied to assess TBS values. Variables related to bone health were compared based on their glycemic status (participants with diabetes, participants with prediabetes, and normoglycemic) using analysis of variance. Univariate and multivariate linear and logistic regression models were used to determine the association between TBS values and bone density in different glycemic states.

Results: The data of 2263 participant aged 60 years and over were analyzed. Mean TBS values were significantly different between participants with diabetes, participants with prediabetes, and normoglycemic groups ( = 0.004;, however, P trend was not significant (0.400)). Mean BMD values at femoral neck and lumbar spine were significantly higher in diabetics compared with those diagnosed with pre-diabetes; the latter also had higher bone density compared with normoglycemic individuals (both P ANOVA test and P trends for means were < 0.01]. In univariate linear regression model, TBS values were negatively associated with pre-diabetes (β = -0.070;  < 0.001) but not with diabetes (β = -0.002,  = 0.915). This significant relationship disappeared when the results were adjusted for BMI. In fully adjusted multivariate logistic regression models, odds ratio linking pre-diabetes and diabetes with spinal osteoporosis was 0.861 (CI 95% 0.670-1.105) and 0.525 (CI 95% 0.392-0.701), respectively. As for femoral osteoporosis, odds ratio was 0.615 (CI 95% 0.407-0.928) and 0.968 (CI 95% 0.629-1.489), correspondingly. Moreover, for cumulative osteoporosis, the odds were 0.843 (CI 95% 0.676-1.106) and 0.551 (CI 95% 0.415-0.732), respectively.

Conclusion: Our findings suggest that subjects with pre-diabetes and diabetes have higher bone mineral density than normoglycemic subjects; the quality of bone, however, was not different between them. The discordance between BMD and TBS values in participants with diabetes suggest that although these patients have higher BMD values, their quality of bone microarchitecture may not be better than normoglycemic subjects.
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http://dx.doi.org/10.1007/s40200-019-00395-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582089PMC
June 2019

Associations between the lipid profile and the lumbar spine bone mineral density and trabecular bone score in elderly Iranian individuals participating in the Bushehr Elderly Health Program: a population-based study.

Arch Osteoporos 2019 05 11;14(1):52. Epub 2019 May 11.

Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

We hypothesized that the lipid profile or dyslipidemia may have an influence on the bone mineral density and bone microstructure in an elderly Iranian population. The results of this study showed some significant associations between the serum lipid levels and the lumbar spine and femoral areal bone mineral densities and the trabecular bone score (TBS).

Purpose: Serum lipid abnormalities are possible risk factors for cardiovascular diseases and osteoporosis. Our aim was to evaluate the associations between the lipid profile and the areal bone mineral density (aBMD) and trabecular bone score in an elderly Iranian population.

Methods: The study subjects included 2426 elderly women and men participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study. The aBMDs of the lumbar spine and femoral neck and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. The associations between the lipid profiles and the aBMDs and TBSs were examined using multivariable linear regression analyses stratified by sex and adjusted for potential confounders.

Results: In men, we found negative correlations between the lumbar spine aBMD and TBS and the total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels (TC: p < 0.001 and p < 0.006, HDL-C: p = 0.002 and p = 0.004, and LDL-C: p < 0.001 and p < 0.009, respectively). However, only the HDL-C level was negatively associated with the aBMD in women (p = 0.016). A positive and statistically significant correlation was found between the serum triglyceride (TG) level and the aBMD in the women (p < 0.001). The TG level and the TBS were not statistically significantly correlated in either sex, and the TBS was not correlated with any of the lipid values in women.

Conclusion: The results of this study showed some significant but generally weak associations between the lipid profile and the aBMD. The associations that were significant for both the men and the women included positive associations between the TG level and the femoral neck aBMD, as well as the HDL-C level and the femoral neck and lumbar spine aBMDs.
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http://dx.doi.org/10.1007/s11657-019-0602-5DOI Listing
May 2019

Exploring the concept of scholarship of teaching and learning (SoTL): Concept analysis.

Med J Islam Repub Iran 2018 3;32:96. Epub 2018 Oct 3.

Nursing Research Center, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences (GOUMS), Gorgan, Iran.

Researchers have contributed to the definition of SoTL; however, the literature is not conclusive on its definitions and attributes. Therefore, this study was an attempt to precisely define SoTL by its attributes, antecedents and consequences. The Walker and Avant (2011) concept analysis method was used. The 9 emerged attributes are: Committed engagement in action, Critique-based, Disciplinary, Context-oriented, Critical enquiry process, Continuous deep reflection, Dynamic process, Shared publicly, and Learning focused. This study helps promote understanding and application of SoTL.
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http://dx.doi.org/10.14196/mjiri.32.96DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6477884PMC
October 2018

Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents.

Med J Islam Repub Iran 2018 30;32:105. Epub 2018 Oct 30.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents. Nursing home participant's aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity. The Cronbach's alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under-nutrition (cutoff=11) respectively. The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.
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http://dx.doi.org/10.14196/mjiri.32.105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387812PMC
October 2018

Do-Not-Resuscitate in Iranian Muslim Families: A Conventional Content Analysis.

Holist Nurs Pract 2018 Sep/Oct;32(5):240-246

Faculty of Nursing and Midwifery (Drs Bahramnezhad and Cheraghi), and Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute (Dr Mehrdad), Tehran University of Medical Sciences, Iran.

Families of patients who are dying have a key role in decisions regarding do-not-resuscitate orders. The objective of this study was to explore the aspects and characteristics of this decision by the families of Muslim patients with cancer. This study is a conventional content analysis. Eighteen families who met the inclusion criteria participated in this study and were selected by purposive sampling. Data collection was done by a semistructured interview (each interview was 60-110 minutes). The data analysis was performed using content analysis. The data analysis introduced 4 main categories and 8 subcategories: (a) feeling duality ("sacrifice against selfishness," and "logic against emotion"), (b) religious beliefs ("guilt" and "miracle"), (c) stigmatized ("purgatory talk" and "family rejection") and (d) decision-making mediators ("religious clergymen" and "the application of the deceased"). Maybe, since the effect of religion in Iran is more significant than other elements such as ethnicity and law, it is possible to receive help from clergymen. It seems necessary for Iran's Ministry of Health and Medical Education to plan clinical guidelines in this context.
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http://dx.doi.org/10.1097/HNP.0000000000000284DOI Listing
December 2018

Priority-setting in health research in Iran: a qualitative study on barriers and facilitators.

Health Res Policy Syst 2018 Jul 2;16(1):57. Epub 2018 Jul 2.

Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran.

Background: Priority-setting is a complicated and time-consuming process; however, if appropriately conducted, it could efficiently divert resources to the most important studies. A considerable body of evidence indicates that priority-setting measures in health research taken so far in Iran have not satisfied decision-makers, policy-makers, funders, communities, or even researchers. This study was designed to explore the flaws of these measures and their deciding factors.

Methods: We conducted semi-structured interviews with 23 key participants and used a thematic data-analysis approach to analyse verbatim transcripts and documents. Our interviewees, who were skilful at conducting health research and worked as managers at different levels of the health system, were selected using a purposeful sampling. We asked about their experiences of priority-setting in health and relevant challenges and asked for recommendations. These semi-structured interviews were taped, transcribed and analysed in terms of content and themes using the MAXQDA10 qualitative data-analysis software.

Results: With regard to priority-setting facilitators and barriers, four themes were extracted, namely managerial factors, structural factors, motivational factors, and process factors. Managers' commitment, consideration of intellectual property, compliance with superordinate rules, and provision of a definition of reliable criteria were among the facilitators. The rapid turnover of managers, inefficiency of criteria for faculty promotion, and disregard of appeal mechanisms were examples of the barriers.

Conclusion: It is important to consider appropriate regulations and motivations to provide research priorities and divert scarce resources to them. In addition, it is necessary to improve the knowledge and skills of researchers and research administration offices on priority-setting methods, thereby enhancing priority-oriented research projects.
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http://dx.doi.org/10.1186/s12961-018-0313-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027571PMC
July 2018

Influence of MTHFR gene variations on perceived stress modification: Preliminary results of NURSE study.

Med J Islam Repub Iran 2017 25;31:128. Epub 2017 Dec 25.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

High level of perceived stress in nurses is due to a genetic predisposition and environmental stressors. The aim of NURSE (Nursing Unacquainted Related Stress Etiologies) study was to investigate the association of C677T MTHFR gene polymorphism and stress perception among nurses. In this comprehensive study, 216 female nurses were recruited. Perceived stress was assessed using the Cohen Perceived Stress Scale (PSS). Genomic DNA was extracted from peripheral blood, and MTHFR genotype was detected by the polymerase chain reaction. MTHFR C677T genotype analysis revealed that half of the participants had normal C/C genotype, and the remaining half presented higher frequencies of C/T genotype (39.8%) compared to T/T genotype (10.2%). The mean±SD stress score in morning shift, night shift, and rotation was 15.39±4.75, 15.92±4.94, and 15.83±5.61, respectively (p= 0.7). Perceived stress score was more in highly educated group but it was not significant (p= 0.2). Distribution of different MTHFR genotypes in diverse groups revealed that in groups with more stress score, the frequency of heterozygote (C/T) and homozygote (T/T) genotypes increased. Data revealed that in low stress category, 87% of the participants had a normal genotype. However, in high stress category, 71.3% of the participants had a normal genotype. MTHFR genotype, independent of folate availability and probable confounding parameters, might be a potential risk factor of perceived stress among nurses.
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http://dx.doi.org/10.14196/mjiri.31.128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014759PMC
December 2017

A professional commitment scale for clinical nurses: A study protoco.

Med J Islam Repub Iran 2017 23;31:123. Epub 2017 Dec 23.

Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.

As the largest and most fundamental group targeted by programs developed to improve quality of care, nurses should be the focus of attention in the management of human resources in the field of health care. A review of literature on this subject revealed the lack of scales designed for measuring professional commitment in nurses. The present study was designed to develop a scale to measure professional commitment in clinical nurses and examine its psychometric properties. This study will develop a professional commitment scale for clinical nurses within one qualitative and one quantitative step. The first step of the study will entail a review of the literature on the subject and interviews with clinical nurses so as to develop the categories and the items. The second step, the quantitative step, will analyze the items extracted in the qualitative step, determining the features of the topics and factor structure of the scale. The initial scale will be completed by 300 clinical nurses. The correlation among the topics, the construct validity, and reliability of the scale will also be examined in this step. This study will develop an instrument that can measure professional commitment in clinical nurses. Given the lack of instruments for measuring professional commitment in clinical nurses, the findings of this study may be of help to nursing managers, authorities, and the health system in general.
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http://dx.doi.org/10.14196/mjiri.31.123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014805PMC
December 2017

Professional Socialization of Iranian BSN Students: A Grounded Theory Study.

J Caring Sci 2017 Dec 1;6(4):359-369. Epub 2017 Dec 1.

Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Professional socialization is a critical aspect of nursing students' development, which begins with entry into the nursing program and continues when their professional practice begins. The aim of this study was to explore the socialization of Iranian BSN students in the nursing profession. An exploratory qualitative approach utilizing Straussian version of the grounded theory (1998) method was used. Individual in-depth semi-structured interviews were undertaken with 14 participants chosen from two large nursing schools in an urban area through purposive and theoretical sampling. The data were analyzed, using the constant comparative method. Five main categories and eleven subcategories emerged and integrated around one core category. Professional metamorphosis as the core variable was a complex and interrelated process (consisting of three stages: dependence, disintegration, and integration) with dynamic, ongoing, and personal features influenced by professional and extra-professional context. The students assumed a passive role in the initial of their studies. However, during the last year of the educational program, they gradually involved actively in dealing with own personal and professional issues. This study introduced "professional metamorphosis of BSN students" as a substantive grounded theory in the socio-cultural context of the health care system in Iran. During this process, students move from outsider personal position to insider professional position. The nurse educators and administrators may develop effective educational interventions to promote professional socialization of students with an understanding of the promoting and driving forces influencing socialization.
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http://dx.doi.org/10.15171/jcs.2017.034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5747594PMC
December 2017
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