Slides with English text that are explained in Persian

The common pattern of presentation in the Iranian medical community is lengthy English text in slides that are presented orally in Farsi, both in conferences and classrooms. In this paper, we aim to further explore this phenomenon based on a theory in the domain of cognitive science named the cognitive load theory (CLT). According to Atkinson and Shiffrin's model introduced in 1968, human memory consists of three parts: sensory memory, working memory, and long-term memory. Information first enters the sensory memory, and if received adequate attention and reaches the level of consciousness, it enters the working memory, which, unlike the other two memories, i.e, sensory and long-term memory, has a limited capacity (1). Interestingly, working memory has two separate and independent channels for processing visual and auditory information with a limited and predetermined capacity (dual-channel theory). As a result, the speed of learning in humans restricts (2). In 1988, Sweller proposed a theory of learning called the CLT, in which the three key components of the cognitive structure, i.e. memory systems, learning processes, and types of the cognitive load imposed on the working memory, were merged. According to this theory, because of the limited capacity of the working memory, any factor that imposes an excessive load on this memory will disrupt the learning process (2). Here three types of loads are introduced: 1. Intrinsic load is related to the task. The more complex the information that must be processed by the working memory, the greater the load imposes. – Cont

On the Nature of Medicine: Necessities, Approaches, and Challenges

After the middle of the twentieth century, symptoms gradually appeared which were collectively called the “crisis of medicine”. This crisis gave philosophy, which had been abstracted from medicine since the mid-nineteenth century, an opportunity to reflect. Medical philosophers attributed the crisis to the inflation of the scientific and technical aspects and, consequently, to the weakening of the human aspects of medicine. Therefore, reflection on the nature of medicine became one of the central issues of philosophy in medicine.In this article, I will first highlight the need to study the nature of medicine, explain the various concpetions of the nature of modern medicine - based on the dichotomy- science vs. art , and show their inadequacy and inappropriatness. Finally, I will provide a model to the nature of medicine beyond the realm of science / art. In this model, medicine is a scientific practice, based on judgment, dialogue, communication and social order. This model faces teleological, epistemological, scientific, political, and professional challenges that require serious and continuous reflection on the nature of medicine

Assessment of demand for and utilization of dental services by insurance coverage in a developing oral health care system

Objectives This study aimed to evaluate the relationship between demand for and utilization of dental services by insurance coverage among adults in Iran.Methods A cross-sectional survey based on telephone interviews was done. A total of 6,029 adults participated in this study conducted in Iran. The interviews were carried out using a structured questionnaire and covered dental visits, demographics and socio-economic background.Results Of 6,029 participants, 86% reported having health insurance, 58% had public, and 28% had both public and commercial insurance. Those with both public and commercial insurance coverage had higher odds for dental visits within the past 12 months [odds ratio (OR) = 1.5], and for dental check-ups (OR = 1.5). Receipt of restorative and expensive services (OR = 1.4) was more likely by those with both public and commercial insurance. Tooth extraction was more likely in subjects with no insurance coverage (OR = 1.6).Conclusion This study revealed a positive relationship between insurance coverage and demand for and utilization of dental services in a country with a developing health care system

Varying manpower alters dental health in a developing healthcare system

Objectives: This study assessed relationships between oral health care workforce and dental health in 12-year-olds in a developing health care system in Iran from 1992 to 2014 and compared these findings with the most recent corresponding findings in selected countries. Methods: Data regarding oral health care workers from 1962 to 2014 were extracted from the comprehensive human resource data bank of the Shahid Beheshti Research Institute of Dental Sciences. Data regarding decayed, missing, and filled permanent teeth (DMFT) of 12-year-olds, extracted from official statistics, described dental health. Comparisons with other countries utilised the database of the World Health Organization. Changes in the DMFT index with fluctuations in the number of oral health care workers were investigated using exploratory data analysis methods. Associations of DMFT with the density of the oral health care workforce were evaluated using a multiple linear regression model. Results: The trend in supply of dental workforce in Iran began to expand in the 1970s and, after a reduction in 2003 to 2007, reached a peak by 2014. Means of DMFT indices of 12-year-olds in Iran fluctuated between 1.50 and 2.40 from 1992 to 2014. The relationship between the dentist to population ratio and the DMFT index of 12-year-olds showed a downwards trend (r = -0.994; P < .001) until 1998 and afterwards an upwards trend (r = 0.887; P < .001). Globally, the DMFT index decreased in countries with a preventively-oriented oral health care workforce. Conclusions: Increased numbers of dentists have no significant impact on improving dental health in 12-year-olds. To promote dental health, the system providing health services should implement a preventively-oriented approach when planning for the oral health workforce. (C) 2021 The Authors. Published by Elsevier Inc. on behalf of FDI World Dental Federation.Peer reviewe

LArginine supplementation influenced nitrite but not nitrate and total nitrite in rabbit model of hypercholesterolemia

ABSTRACT Background: The assessment of altered nitric oxide (NO) availability is of potentially important diagnostic and prognostic significance. The present study is aimed to investigate the effect of L-arginine (as a natural NO donor) supplementation on NO metabolite in a rabbit model of hypercholesterolemia to find a reliable marker for endothelial NO production. Methods: White male rabbits (n = 30) randomly assigned to 2 groups. Rabbits were fed 1% high-cholesterol diet (HC group, n = 15), or HC diet with oral L-arginine (3% in drinking water) (HC + L-arginine group, n = 15) for 4 weeks. The serum levels of lipids, L-arginine, total NO metabolites (NOx), nitrite and nitrate were measured before and after the study. Results: In this study, Larginine supplementation led to a significant increased plasma level of L-arginine. The serum level of nitrite was significantly higher in L-arginine treated group while serum level of nitrate and NOx was significantly lower than HC group. Conclusion: As the result of our study showed, nitrite is a useful marker of endogenous endothelial NO production and although frequently used, neither nitrate nor NOx are reliable markers of acute changes in endothelial NO synthase activity

How to develop clinical reasoning in medical students and interns based on illness script theory : An experimental study

Acknowledgments Authors would like to acknowledge Iran University of Medical Sciences for providing financial support. Extend thanks to medical students and interns for their participation in the study. Funding The present study was financially supported by Iran University of Medical Sciences, for partial fulfillment of Ph.D. dissertation, (Grant No: 6784). The funding organization did not play any roles in the study design, collection, analysis, and interpretation of data, or in writing the manuscript.Peer reviewedPublisher PD

An innovative method to assess clinical reasoning skills: Clinical reasoning tests in the second national medical science Olympiad in Iran

BACKGROUND: Clinical reasoning plays a major role in the ability of doctors to make a diagnosis and reach treatment decisions. This paper describes the use of four clinical reasoning tests in the second National Medical Science Olympiad in Iran: key features (KF), script concordance (SCT), clinical reasoning problems (CRP) and comprehensive integrative puzzles (CIP). The purpose of the study was to design a multi instrument for multiple roles approach in clinical reasoning field based on the theoretical framework, KF was used to measure data gathering, CRP was used to measure hypothesis formation, SCT and CIP were used to measure hypothesis evaluation and investigating the combined use of these tests in the Olympiad. A bank of clinical reasoning test items was developed for emergency medicine by a scientific expert committee representing all the medical schools in the country. These items were pretested by a reference group and the results were analyzed to select items that could be omitted. Then 135 top-ranked medical students from 45 medical universities in Iran participated in the clinical domain of the Olympiad. The reliability of each test was calculated by Cronbach's alpha. Item difficulty and the correlation between each item and the total score were measured. The correlation between the students' final grade and each of the clinical reasoning tests was calculated, as was the correlation between final grades and another measure of knowledge, i.e., the students' grade point average. RESULTS: The combined reliability for all four clinical reasoning tests was 0.91. Of the four clinical reasoning tests we compared, reliability was highest for CIP (0.91). The reliability was 0.83 for KF, 0.78 for SCT and 0.71 for CRP. Most of the tests had an acceptable item difficulty level between 0.2 and 0.8. The correlation between the score for each item and the total test score for each of the four tests was positive. The correlations between scores for each test and total score were highest for KF and CIP. The correlation between scores for each test and grade point average was low to intermediate for all four of the tests. CONCLUSION: The combination of these four clinical reasoning tests is a reliable evaluation tool that can be implemented to assess clinical reasoning skills in talented undergraduate medical students, however these data may not generalizable to whole medical students population. The CIP and KF tests showed the greatest potential to measure clinical reasoning skills. Grade point averages did not necessarily predict performance in the clinical domain of the national competitive examination for medical school students

Philosophy of Science Meets the Scientific Research: Metatheorizing expertise theories in Cognitive Psychology

An obvious feature of the development of the philosophy of science during the past decades is an increasing specialization and fragmentation that have led to reduced impact of philosophy of science outside the sphere of its own discipline. It seems that philosophy of science and scientific research are moving away from each other. The major question of this article is how can reconnect these two?To answer this question I will try to highlight some events especially in the fields of social sciences that researchers are involved in discussions, generally related to philosophy of science, not in an abstract and isolated way, but in a way that is completely intertwined in their research practices.  Unfortunately, this phenomenon has not been properly considered by philosophers of science and has remained more as a subject in the field of social sciences, specifically research methodology. It seems that if philosophy of science enters into dialogue with social sciences, we can expect the revival of the philosophy of general science. In this article, I try to show the signs of this phenomenon in cognitive psychology. I will first turn to one of the most influential theories in the cognitive sciences, expertise theory. After reviewing the important theories of expertise and their differences, in the next step I will discuss the seemingly opposing theories in this field and their efforts to find common ground. Then I will review the current movement in cognitive psychology, which I call the “integration model” stream. After a critical review and categorization of these models, I will show that in a broader view in social science, we can realize the meta-theoretical issues that are a good room for a dialogue between philosophy of science and scientific research. In the end, I will point out the horizons that this view opens to the revival of philosophy of general science

Medical Humanities

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