Higher Education Administration and Accountability the Necessity of Autonomy and Academic Freedom from Faculties’ Viewpoint

Introduction: Originality and dynamism of university activities calls for a democratic atmosphere and considered as a supporting principles for faculties. Giving autonomy to universities is a fundamental policy to enhance their responsibility, accountability, and dynamism. Hence, this study is an endeavor to investigate the autonomy and academic freedom situation in university from the viewpoints of faculty members. Methods: Study population included 550 faculty members in Shiraz University of Medical Sciences. According to Morgan tables, a sample size of 230 faculties was selected from different schools. Academic freedom, the effect of international policies, and university independence were measured through a researcher-designed questionnaire including 15 close questions in 4 points Likert scale. The score for each item was calculated out of 100. The questionnaire’s validity was verified by experts and the reliability was approved by Cronbach's Alpha (91%). Results: The mean scores for main domains were: university’s autonomy (81.3±21.3), the effect of international policies (76.9±20.5), and academic freedom (73.3±21.6). Among the items, lack of university’s financial independence and its reliance to governmental budget (85.6), the effect of international politics on international academic associations (79.1), the effect of political attitude of university managers on academic atmosphere (76.9), continuous changes of programs after management changes (76.5) were factors which showed the highest mean scores respectively. Conclusion: Regarding the importance of academic freedom and autonomy in accountability and the growth of creativity and innovation in university, this subject should be considered more than ever. Besides, according to strategic management and planning and establishment of monitoring system and systematic accountability could prevent the redundancy resulted from political changes

Effect of Cardiac Rehabilitation on Anxiety and Depression in CABG Patients

Objective: Many patients experience with anxiety and depression after cardiac bypass surgery as a consequence of this type of surgery. The aim of this study was to examine the effect of cardiac rehabilitation on anxiety and depression level of patients undergoing Coronary Artery Bypass Graft Surgery in hospitals affiliated to Shiraz University of Medical Sciences. Materials & Methods: In this interventional study 80 randomly patients, based on convenience sampling, who had the required criteria were selected and divided into two groups marked as experimental and control groups. The data were collected using three questionnaires. Demographic questioner and The Spielberger anxiety scale for measuring the state and trait of anxiety and the Beck depression inventory for measuring the depression. Both groups answered these questionnaires in three stages: on discharge from hospital , immediately and two months after cardiac rehabilitation. After measuring anxiety and depression in both groups on discharge the experimental group participated in 8 session cardiac rehabilitation in four weeks. The control group received only routine program. The data was analyzed using t-test, repeated measurement multi–variate test, chi square, regression analysis and correlation coefficient. Results: The results revealed that after cardiac rehabilitation program there was a significant statistical differences in depression level between groups (P=0.0014) but in anxiety level, there was no statistical significant difference (P=0.079) between groups. Conclusion: Cardiac rehabilitation is effective in reducing depression in patients undergoing Coronary Artery Bypass Graft Surgery. Therefore it is recommended to use cardiac rehabilitation in these patients

Comparison of residents’ approaches to clinical decisions before and after the implementation of Evidence Based Medicine course

Introduction: It has been found that the decision-making process in medicine is affected, to a large extent, by one’s experience, individual mentality, previous models, and common habitual approaches, in addition to scientific principles. Evidence-based medicine is an approach attempting to reinforce scientific, systematic and critical thinking in physicians and provide the ground for optimal decision making. In this connection, the purpose of the present study is to find out to what extent the education of evidence based medicine affects clinical decision making. Methods: The present quasi-experimental study was carried out on 110 clinical residents, who started their education in September, 2012 and finally 62 residents filled out the questionnaires. The instrument used was a researchermade questionnaire containing items on four decision-making approaches. The questionnaire was used both as a pre-test and a post-test to assess the residents’ viewpoints on decision making approaches. The validity of the questionnaire was determined using medical education and clinical professionals’ viewpoints, and the reliability was calculated through Chronbach alpha; it was found to be 0.93. The results were analyzed by paired t-test using SPSS, version 14. Results: The results demonstrated that evidence-based medicine workshop significantly affected the residents’ decision-making approaches (p<0.001). The pre-test showed that principles-based, reference-based and routine model-based approaches were more preferred before the program (p<0.001). However, after the implementation of the program, the dominant approaches used by the residents in their decision making were evidence-based ones. Conclusion: To develop the evidence-based approach, it is necessary for educational programs to continue steadily and goal-orientedly. In addition, the equipment infrastructure such as the Internet, access to data bases, scientific data, and clinical guides should develop more in the medical departments

The impact of generic form of Clopidogrel on cardiovascular events in patients with coronary artery stent: results of the OPCES study

Background: To compare the early and late cardiovascular events as well as side effects of Osvix, a generic form of Clopidogrel versus Plavix regimens in patients with chronic stable angina, undergoing bare metal stent (BMS) or drug eluting stent (DES) placement, this study was carried out. Methods: A total of 442 patients with chronic stable angina who were scheduled for elective percutaneous coronary intervention (PCI) were included in a randomized, double blind, multi-centric clinical trial being performed in 6 distinct university hospitals in 5 cities of Iran from March 2007 to November 2009. Baseline, demographic and history of risk factors were recorded using the patients′ medical charts. Stenting procedure was performed via transfemoral approach using low osmolar contrast agents. Patients underwent BMS or DES placements based on the physician selection and were randomly assigned to Osvix or Plavix groups. Patients were followed by telephone in 0 and 6 months intervals regarding the major adverse cardiovascular events (MACE) including death, myocardial infarction, in-stent thrombosis, stroke, target lesion revascularization, and target vascular revascularization. Angina episodes, bleeding, liver enzymes, neutrophils and platelets count were also assessed in these intervals. Results: There was not any significant difference between these two groups regarding the baseline characteristics. In the DES group, the 6-month mortality rate and the incidence of MACE in Osvix and Plavix groups were 0.9% and 1.9% (p = 0.61) and 1.8% and 4.9% (p = 0.26), respectively. During the follow up period after DES or BMS placement, there wasn′t any significant difference regarding neutrophil and platelet counts or liver enzymes between study groups. Conclusions: Using Osvix and Plavix are followed by similar major cardiovascular events and side-effect profile in patients undergoing PCI