Understanding Non-Adherence to Treatment in Hypertension: A Qualitative Study

Background: Hypertension is a major public health issue. With regard to the current trend, it has been estimated that one out of three people will be suffering from hypertension by 2025. This study was designed to provide a better insight into the adherence to treatment and its underlying reasons. Methods: A directed qualitative content analysis approach was conducted in collaboration with 35 hypertensive patients and 3 cardiologists in the form of in-depth interviews and focused group discussions from October 2015 to February 2016. Sampling was carried out from patients with hypertension using purposeful and heterogeneous method. Some of the PRECEDE model structures were applied as the conceptual framework. Results: The reasons affecting adherence to hypertension treatment were analyzed in three general categories of predisposing, enabling and reinforcing factors based on the model structures. Factors such as “knowledge”, “belief and attitude”, “mental-personality traits”, “culture and lifestyle” were classified as the predisposing factors category. “Access to health service” and “access to facilities in the workplace, home and society” were fit in the enabling factor category. The reinforcing factors category addresses “individuals’ internal incentives” and “family and health service providers’ support”. Conclusion: Several reasons account for non-adherence to treatment in hypertensive patients. Diversity of these reasons is an indication that design and implementation of different kinds of interventions are required in order to increase the patients’ awareness, empower them and encourage self-efficacy

A Six-Year Follow-up of People Who Use Cannabis in Iran – A Case Series

Background: Frequent cannabis use is associated with adverse health-related outcomes. This study followed up individuals who used cannabis to assess their use and adverse event status. Methods: The eligible individuals, recruited in the Iranian Mental Health Survey (IranMHS), were contacted via telephone calls six years after the index interview. The frequency of cannabis use and the occurrence of selected adverse events were recorded. The baseline status was extracted from the index survey. If any individual was inaccessible, his/her vital status was assessed.  Findings: Of the 50 eligible individuals (all male), two had died. Moreover, from among 25 reached participants, 19 reported abstinence from cannabis in the past year, and 18 reported at least one adverse event in the past six years. Violence and imprisonment were the most common events reported.  Conclusion: Six years after the index interview, most of the participants abstained from cannabis. Besides, adverse events were common, emphasizing the need for further investigations on larger samples of cannabis users

Knowledge transfer in Tehran University of Medical Sciences: an academic example of a developing country

<p>Abstract</p> <p>Background</p> <p>In the past two decades, scientific publications in Iran have considerably increased their medical science content, and the number of articles published in ISI journals has doubled between 1997 and 2001. The aim of the present study was to determine how frequently knowledge transfer strategies were applied in Tehran University of Medical Sciences (TUMS). We were also interested in studying the determining factors leading to the type of strategy selected.</p> <p>Methodology</p> <p>All TUMS research projects that had received grants from inside and outside the university in 2004, and were completed by the end of 2006, were included in the study. In total, 301 projects were examined, and data on each of the projects were collected by the research team using a standardized questionnaire. The projects' principle investigators filled out a second questionnaire. In all, 208 questionnaires were collected.</p> <p>Results</p> <p>Researchers stated being more engaged in the passive strategies of knowledge transfer, especially those publishing in peer-reviewed journals. The mean score for the researchers' performance in passive and active strategies were 22% and 9% of the total score, respectively. Linear regression analysis showed that the passive strategy score decreased with the increase in the number of years working as a professional (p = 0.01) and personal interest as the only reason for choosing the research topic (p = 0.01). Regarding the active strategies of knowledge transfer, health system research studies significantly raised the score (p = 0.02) and 'executive responsibility' significantly lowered it (p = 0.03).</p> <p>Conclusion</p> <p>As a study carried out in a Middle Eastern developing country, we see that, like many other universities in the world, many academicians still do not give priority to active strategies of knowledge transfer. Therefore, if 'linking knowledge to action' is necessary, it may also be necessary to introduce considerable changes in academic procedures and encouragement policies (<it>e.g.</it>, employment and promotion criteria of academic members).</p

Knowledge transfer in Tehran University of Medical Sciences: an academic example of a developing country

<p>Abstract</p> <p>Background</p> <p>In the past two decades, scientific publications in Iran have considerably increased their medical science content, and the number of articles published in ISI journals has doubled between 1997 and 2001. The aim of the present study was to determine how frequently knowledge transfer strategies were applied in Tehran University of Medical Sciences (TUMS). We were also interested in studying the determining factors leading to the type of strategy selected.</p> <p>Methodology</p> <p>All TUMS research projects that had received grants from inside and outside the university in 2004, and were completed by the end of 2006, were included in the study. In total, 301 projects were examined, and data on each of the projects were collected by the research team using a standardized questionnaire. The projects' principle investigators filled out a second questionnaire. In all, 208 questionnaires were collected.</p> <p>Results</p> <p>Researchers stated being more engaged in the passive strategies of knowledge transfer, especially those publishing in peer-reviewed journals. The mean score for the researchers' performance in passive and active strategies were 22% and 9% of the total score, respectively. Linear regression analysis showed that the passive strategy score decreased with the increase in the number of years working as a professional (p = 0.01) and personal interest as the only reason for choosing the research topic (p = 0.01). Regarding the active strategies of knowledge transfer, health system research studies significantly raised the score (p = 0.02) and 'executive responsibility' significantly lowered it (p = 0.03).</p> <p>Conclusion</p> <p>As a study carried out in a Middle Eastern developing country, we see that, like many other universities in the world, many academicians still do not give priority to active strategies of knowledge transfer. Therefore, if 'linking knowledge to action' is necessary, it may also be necessary to introduce considerable changes in academic procedures and encouragement policies (<it>e.g.</it>, employment and promotion criteria of academic members).</p

Research collaboration in Tehran University of Medical Sciences: two decades after integration

Background: In 1985 medical schools were integrated into the Ministry of Health, and the Ministry of Health and Medical Education was created in Iran. Under this infrastructure education, research and service provision are unified, and it is expected that collaboration between researchers and decision makers become easier in such an integrated context. The question here is how the researchers behavior in the biggest medical university of the country towards collaboration is, i.e. how much do decision makers participate in different stages of research? Which factors affect it? Methodology: The samples under study were all Tehran University of Medical Sciences (TUMS) completed research projects that had gotten grants in 2004 and were over by the time this study was done. Two questionnaires were designed for this study: i) the research checklist which was filled for 301 projects, ii) the researcher's questionnaire, which was sent to principle investigators, 208 of which were collected. Multiple linear regression analysis was used for evaluating the potential factors affecting individuals 'collaboration score'. Results: Only 2.2 percent of TUMS' projects initiated in 2004 have had collaboration as a joint PI or co-investigator from non-academic organizations. The principle investigators mean collaboration score was 2.09, where 6 was the total score. So the collaboration score obtained was 35%. The 'type of research' had significant association with the collaboration score which is shown in the linear regression; collaboration was seen more in clinical (p = 0.007) and health system researches (p = 0.001) as compared to basic research. Conclusion: The present study shows that not many individuals collaborated as co-investigators from outside the university. This finding shows that research policy makers need to introduce interventions in this field. And assessment of barriers to collaboration and its facilitating factors should be considered in order to make it actually happen. © 2009 Majdzadeh et al; licensee BioMed Central Ltd

How should we assess knowledge translation in research organizations; designing a knowledge translation self-assessment tool for research institutes (SATORI)

<p>Abstract</p> <p>Background</p> <p>The knowledge translation self-assessment tool for research institutes (SATORI) was designed to assess the status of knowledge translation in research institutes. The objective was, to identify the weaknesses and strengths of knowledge translation in research centres and faculties associated with Tehran University of Medical Sciences (TUMS).</p> <p>Methods</p> <p>The tool, consisting of 50 statements in four main domains, was used in 20 TUMS-affiliated research centres and departments after its reliability was established. It was completed in a group discussion by the members of the research council, researchers and research users' representatives from each centre and/or department.</p> <p>Results</p> <p>The mean score obtained in the four domains of 'The question of research', 'Knowledge production', 'Knowledge transfer' and 'Promoting the use of evidence' were 2.26, 2.92, 2 and 1.89 (out of 5) respectively.</p> <p>Nine out of 12 interventional priorities with the lowest quartile score were related to knowledge transfer resources and strategies, whereas eight of them were in the highest quartile and related to 'The question of research' and 'Knowledge production'.</p> <p>Conclusions</p> <p>The self-assessment tool identifies the gaps in capacity and infrastructure of knowledge translation support within research organizations. Assessment of research institutes using SATORI pointed out that strengthening knowledge translation through provision of financial support for knowledge translation activities, creating supportive and facilitating infrastructures, and facilitating interactions between researchers and target audiences to exchange questions and research findings are among the priorities of research centres and/or departments.</p

Faculty Members’ Inclination to Leave University and its Related Factors, Tehran University of Medical Sciences

Background & Objective : A significant part of resources in each country is used for training human resources, and loss of experts means irreparable drawbacks for the system. Leaving university by faculty members who are doubtless one of the main assets of universities is of utmost importance. This study was conducted to determine the frequency of inclination to leave the university in faculty members and also to evaluate the relationship between the variables affecting on this decision. Finding out about related variables can help specify possible interventions in the university. Methods : In this cross-sectional study, 149 academic members of Tehran University of Medical Sciences were chosen systematically and completed the questionnaire during summer, 2006. The participants determined their inclination to leave the university within the next two years answering one question. Demographic factors, the attitude towards cooperation, and satisfaction from the current cooperation level, the effective factors on leaving the university, were analyzed using logistic regression. Results : Mean age of the participants was 48.2 years while 71.8% were male. Among 131 persons who answered the question related to the inclination to leave the university within two years, 25(19%) had positive answers Using logistic regression, the attitude of these 25 members towards participation in management of the university’s affairs was not significantly different from the others (P=0.49) but satisfaction from the current cooperation level was significantly lower in the group who inclined to leave the university in the next two years (P =0.007). Conclusion : Considering “current status of faculty members’ satisfaction from cooperation” in the department, school, and university spectrum can decrease the inclination to leave. Perhaps preserving human resources and national assets will be possible if their satisfaction is guaranteed. Keywords: Inclination to leave, Satisfaction, Tehran University of Medical Sciences

Promoting the quality of health research-based news: Introduction of a tool

Introduction: While disseminating health research findings to the public, it is very important to present appropriate and accurate information to give the target audience a correct understanding of the subject matter. The objective of this study was to design and psychometrically evaluate a checklist for health journalists to help them prepare news of appropriate accuracy and authenticity. Methods: The study consisted of two phases, checklist design and psychometrics. Literature review and expert opinion were used to extract the items of the checklist in the first phase. In the second phase, to assess content and face validity, the judgment of 38 persons (epidemiologists with a tool production history, editors-in-chief, and health journalists) was used to check the items' understandability, nonambiguity, relevancy, and clarity. Reliability was assessed by the test–retest method using intra-cluster correlation (ICC) indices in the two phases. Cronbach's alpha was used to assess internal validity of the checklist. Results: Based on the participants' opinions, the items were reduced from 20 to 14 in number. The items were categorized into the following three domains: (a) items assessing the source of news and its validity, (b) items addressing the presentation of complete and accurate information on research findings, and (c) items which if adhered to lead to the target audiences' better understanding. The checklist was approved for content and face validity. The reliability of the checklist was assessed in the last stage; the ICC was 1 for 12 items and above 0.8 for the other two. Internal consistency (Cronbach's alpha) was 0.98. Discussion and Conclusions: The resultant indices of the study indicate that the checklist has appropriate validity and reliability. Hence, it can be used by health journalists to develop health research-based news