Socialization of health: An undeniable necessity for the formation of responsible medical universities in Iran

The World Health Organization introduced social responsibility for the medical universities centered on education, research and provision of services. This definition states that social responsibility is "obligation of the medical schools to direct their education, research and service activities towards addressing the priority health concerns of the community, region, and/or nation they have a mandate to serve, The priority health concerns are to be identified jointly by governments, health care organizations, health professionals and the public"(1).Using the above definition as a model, Iran's medical universities were expected to think about socialization of health much earlier than what actually recently happened. However, what has occurred in relation to community-oriented medicine in Iran over the last quarter century has mainly been focused on increasing community access to specialized medical services and hasty implementation of the family physician program in rural areas and some cities.Clearly, socialization of health is not possible with merely setting up a social deputy in the body of the Ministry of Health and Medical Education. Socialization of health means communal involvement in maintaining and promoting individual, social, and psychological health of the community, and this will only be achieved through community-based medical education that not only trains skilled and competent human resources, but also focuses on empowerment of the community, or in another sense, promotion of community health. In other words, it is necessary to consider social responsibility as a principle in the excellence of medical education (2).Indeed what percentage of Iranians actually take part in decision-making about health? What percentage of the general public in Iran are addressed by articles published by medical universities' experts? To what extent contents of the medical universities' portals cover requirements of the general community? What is universities' approach to community empowerment? Moreover, the bigger question is whether Iranians know what their own health requirements are.As much as a responsible medical university is concerned about professional competence and professionalism of its graduates, it should look at improving health literacy of the community it covers. Such a university does not confine education to the enclosure of the university, but addresses education of the community at three levels: Generic, Targeted, and Tailored. Graduates from a responsible university know that community health can be ensured only by increasing health literacy of the community, and even their participation in the field of health research known as community-based participatory research. Although increasing access of different strata of the community to health services and providing the highest quality of services are worthwhile per se; these are not sufficient for community to encounter and cope with health-threatening factors.A responsible university responds to the ever-changing community needs, and to this end, takes advantage of a surveillance system that is able to quickly identify new community needs and finding support to resolve these needs (3).A responsible university collaborates with other organizations and institutions, general community, other professional groups, policy-makers and even statesmen, and that is how it can conduce the system of continuous provision of health services (3).In addition, a medical university formed on the bases of social responsibility will undoubtedly put health promotion and diseases prevention on top of its agenda (4). The fact that despite quantitative progress of medical universities in recent decades, some simplest health hazards are still not easily prevented, this means that responsiveness and accountability are neglected by most Iran's medical universities.Although in recent years, indicators of social responsibility of medical universities have been defined (5), and even highlighted in the last transformation of Iran's medical education, there seems to be a long way to achieving the ultimate goal of social accountability.

The perspectives of faculty around factors affecting the development and sustainability of educational scholarship: A qualitative content analysis

Background: New horizons have been opened for educational excellence in medical universities by commencing the role of scholarship for medical teachers in recent years. The low rate of faculty reception towards educational scholarship and their low interest in continuing scholarly activities indicated a need for the current study. Methods: In this qualitative research, a non-probability purposive sample of thirteen participants(n=13) engaged in two focus group discussions (FGDs), consisting of executors, collaborators, consultants, and referees of university or national educational processes in the last ten years. Participants were asked several critical questions concerning factors affecting educational scholarship development and sustainability. Qualitative content analysis with a conventional approach was used to analyze the data obtained from the discussions. Results: Merging the codes extracted from the two FGD sessions and repeated review yielded 101 codes classified into two themes: educational scholarship development and sustainability. In all, 19 categories were identified: personal commitment, educational requirements, financial support, faculty development, team building, information resources, educational leadership and management, institutional motivation, culture building, individual characteristics, outcome evaluation of educational scholarship, material and spiritual support, mentorship, sustained training, supportive learning environments, curriculum development, organizational administration and leadership, application of results, and publication of results. Conclusion: Our findings show that encouraging educational scholarship among faculty members and ensuring the sustainability of innovative educational processes are influenced by factors rooted in both individual and institutional dynamics

Improvement in patient–reported outcomes after group poetry therapy of women with breast cancer

Background: One of the best ways of achieving the patients’ views and expectations about the effects of a therapeutic or palliative intervention on their quality of life is using PatientReported Outcome Measures (PROMs). Poetry therapy as a psychotherapy intervention has been used for palliation of stressful conditions of several chronic diseases and disabilities. In the present study, we aimed to evaluate the effectiveness of group poetry therapy on the quality of life measures in women with breast cancer.Methods: A total of 30 women with breast cancer, undergoing chemotherapy at a referral center in the north of Iran, participated in the current quasi-experimental before-after study conducted in 2016. The study protocol included eight weekly sessions of group poetry therapy using poems from the great Persian poets. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) was completed by the patients before beginning group poetry therapy and, twice more, one week and two months after the last session. Items of the questionnaire were manually scored and then analyzed using appropriate statistical tests in IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.Results: A total of 28 patients participated in all the group poetry therapy sessions and completed the questionnaire. The mean and standard deviation of age were 45±66. The changes in the score of quality of life from 51.8 to 65.5 and 69 were observed to be significant in the one-week and two-month follow ups (both with P=0.002). Also, changes in symptom score from 34.5 to 23.7 (P=0.01) and functional score from 65.6 to 77.2 (P=0.01) in the two-month follow up were found to be statistically significant.Conclusion: Based on the findings of the study, it can be concluded that group poetry therapy, as a psychotherapy approach, can be used to improve quality of life in breast cancer patients

Relationship between Serum Osteocalcin Level and Gestational Diabetes Mellitus: A Case-Control Study

BACKGROUND: Osteocalcin (OC) is the most common noncollagenous protein in bone matrix, which is synthesized only in bone tissue and by osteoblasts. The potential role of osteocalcin on glucose and fat metabolism has been previously reported. The aim of this study was to compare the serum OC level in pregnant women with and without gestational diabetes mellitus (GDM).METHODS: In the present case-control study, all pregnant women who were referred to a obstetrics and gynecology clinic in Sari, Iran, and met the inclusion criteria underwent an overall screening with a 75-g glucose tolerance test (GTT) at week 24 to 28 of gestation. The study was conducted between September 2018 and February 2019. Based on criteria, the pregnant women with confirmed GDM were matched with pregnant women without GDM in terms of baseline characteristics such as chronological age and BMI. The serum OC levels were also measured if vitamin D and calcium levels were normal. All data were analyzed using SPSS 21.RESULTS: The two groups with and without GDM had no significant difference in terms of age, BMI and OC level. There was no significant correlation between age and BMI with OC level in healthy pregnant women, respectively (P=0.49 and P=0.58). The correlation between BMI and age with OC level in GTT-positive pregnant women was 0.05 and -0.172, respectively, which was not significant (P=0.77 and P=0.36).CONCLUSION: According to the results of this study, there is no significant difference of serum OC levels in pregnant women with GDM compared to healthy pregnancy. Given that the levels of serum insulin or insulin resistance have not been assessed, these indices are recommended to be evaluated in future studies.&nbsp

Immunohistochemical Evaluation of Fibronectin and Tenascin Following Direct Pulp Capping with Mineral Trioxide Aggregate, Platelet-Rich Plasma and Propolis in Dogs’ Teeth

Introduction: The aim of the present study was to evaluate the expression of fibronectin (FN) and tenascin (TN) after direct pulp capping (DPC) in dogs’ teeth with either mineral trioxide aggregate (MTA), Propolis or Platelet-rich plasma (PRP), by means of immunohistochemistry. Methods and Materials: A total of 48 sound molars and premolars with mature apices from four dogs, were included. The teeth were randomly divided into 4 groups according to the material used for DPC: PRP, Propolis, MTA, and glass-ionomer (as the negative control group). Each group was divided into two 7-day and 30-day subgroups. The teeth were restored at the same session. The animals were sacrificed at the mentioned time intervals and the expression of FN and TN in each test group and between each time intervals was assessed with Wilcoxon and Mann-Whitney U tests, respectively. The Kruskal-Wallis test was used to compare FN and TN staining among the test groups. The significance level was set at 0.05. Results: The amount of FN in the MTA group in the 30-day interval was significantly higher than the 7-day interval; however, there were no significant differences among the other groups. The amount of TN in the MTA and Propolis groups in the 30-day interval was significantly higher than that in the 7-day interval; no recognizable difference was observed in the other groups. Moreover, the difference in expression of FN and TN in the 7-day interval was not significant in the experimental groups. Nevertheless, the difference was significant in the 30-day interval, with the highest and lowest expressions belonging to the MTA and glass-ionomer groups, respectively. Conclusion: Based on the results of the present animal study, MTA is still a better choice for direct pulp capping.Keywords: Fibronectin; Immunohistochemistry; Propolis; Pulp Capping; Tenasci

The relationship of mood status, quality of life, and dietary intake with migraine symptoms among women with migraine

Background and aims: Migraine is a neurologic disorder with wide global spread. Quality of life (QOL) and dietary factors are important parameters in migraine management. The aim of this study was to evaluate the relationship of mood status, QOL, and dietary intake with migraine symptoms among women with migraine. Methods: This cross-sectional study was conducted on 143 women with migraine aged 20–40 years who were randomly selected from two clinics in Isfahan, Iran. Data were collected using the Food Frequency Questionnaire for Assessing Dietary Patterns, a visual analogue scale for migraine headaches, the Migraine-Specific Quality of Life Questionnaire, and the Depression Anxiety Stress Scale. The serum level of calcitonin gene-related peptide (CGRP) was also measured. Results: Participants’ age and number of sleeping hours per 24 hours had significant relationship with migraine severity, depression and anxiety had significant relationship with migraine severity and the duration of migraine attacks, and QOL had significant relationship with migraine severity and the duration and frequency of migraine attacks. Daily intake of riboflavin also had significant relationship with frequency of migraine attacks, while daily intake of water had significant relationship with migraine severity (P 0.05). The relationships of vitamin D and magnesium intake with depression were also significant (P < 0.05). Conclusion: Serum level of CGRP has no significant relationship with migraine attacks, while depression, anxiety, QOL, and magnesium and vitamin D intake have significant relationship with migraine attacks. Keywords: Migraine, Depression, Mood status, Quality of life, Dietary intak

Investigation of social capital and its relationship with emotional adjustment in infertile couples: A cross-sectional study

Background: Infertility is an abnormal event in the life of families and can have various consequences on a personal and social level. Therefore, infertile couples need to manage their emotional responses. Social capital, as one of the social determinants of health, can affect mental health. Objective: This study was conducted to determine the relationship between social capital and emotional adjustment in infertile couples. Materials and Methods: This cross-sectional study was conducted from October 2018 to February 2019 with 170 infertile couples visiting infertility centers in Sari, Iran. The data collection instruments included the social capital integrated questionnaire, an emotional adjustment scale and a demographic-reproductive checklist. Results: All the social capital dimensions, except for the groups and networks dimension, had a score of higher than 50 (more than the mean score). Based on ANCOVA and the multiple linear regression results, the dimension of trust and solidarity had a significant negative relationship with emotional adjustment (p = 0.01), but no significant relationship was observed between the other social capital dimensions and emotional adjustment. Conclusion: The trust and solidarity dimension had a significant relationship with emotional adjustment in infertile couples. Accordingly, increasing mutual trust between neighborhood residents can strengthen social capital, and in turn, improve emotional adjustment in infertile couples. Key words: Social capital, Emotional adjustment, Infertility

Association between dietary satisfaction and depression, anxiety and stress in obese and overweight patients during the coronavirus pandemic

Background & aim: The coronavirus disease-2019 (COVID-19) pandemic is a global health threat. The aim of this study was to evaluate the association between D-Sat and depression, anxiety and stress in obese patients during the coronavirus pandemic. Methods: A cross-sectional study in 228 obese and overweight women on a weight loss diet was conducted through the use of two questionnaires. General characteristics, anthropometric indices, D-Sat and mental status were assessed in these patients. Results: The greatest weight loss (WL) and waist circumference (WC) change was associated with the highest tertile of the D-Sat score in the first four months of the coronavirus pandemic (P < 0.05). Participants with the highest tertile of all D-sat score compared to those with the lowest had an 84 decrease in odds of depression. The highest tertile was also associated with decreased odds of anxiety (OR: 0.32 95CI: 0.14; 0.68) The adjusted odds of stress score were negatively associated to the highest tertile of the D-Sat score (OR: 0.09, 95CI (0.03, 0.23). WL was inversely related to stress (P < 0.05). Participants with higher WL and WC reduction had fewer depressive symptoms (P < 0.05). Sleep time and family income were associated with obesity. Conclusions: D-Sat and positive personal and family dynamics can improve the mental status of obese and overweight patients during quarantine

Effects of Hip Exercises on the pain Severity in Patients with Patellofemoral Pain Syndrome

Introduction: Patellofemoral pain syndrome is associated with a decrease in hip muscles strength, especially abductor and external rotator muscles. Hip abductors with femoral control have an effect on the frontal plane on the knee valgus, and the increased hip abduction capacity helps these patients. The aim of this study was to determine the effect of abductor and adductor exercises in addition to the knee exercises in knee joint pain in patients with Patellofemoral pain syndrome. Method: This is a clinical trial study conducted on patients suffering from patellar-femoral pain syndrome who visited the Sports Medicine department of the Imam Khomeini Hospital Clinic. The NRPS questionnaire was used to evaluate the patients’ pain severity SPSS version 16 was used for statistical analysis of the data. Results: The mean age of the patients in abductor group was 33.4±6.1 and in adductor group was 33.7±7.3, but this difference was not significant (P=0.1). The results of this study showed that in the abductor and adductor group, the results of all of the statistical tests on the change in the Scores of the questionnaires and tests after 6 weeks of training exercises were statistically significant (P&lt;0.05). the comparison of the scores between the two groups showed only the difference between the mean scores of Step down between the two groups of adductor and abductor, which was statistical significance after exercises (P=0.03). Conclusion: Based on the presented study, 6 weeks of abductor and adductor muscle exercises, and specially abductor muscles, helps reduce pain and the improve joint function in patients suffering from patellofemoral pain syndrome