Physicians' Perspectives Toward Shared Decision Making in Developing Countries.

Aims: To evaluate Iranian physicians’ perspectives on shared decision making by validating and translating the physician version of a shared decision making questionnaire (SDM-Q-DOC). Place and Duration: Iranian Evidence-Based Medicine Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran, from June 2012 to July 2013. Methods: The physician version of a shared decision making questionnaire (SDM-QDOC) was translated and validated through a pilot study among urologists in one of the hospitals of Tabriz University of Medical Sciences. A validated questionnaire was handed out among Iranian physicians in three main hospitals of Urmia. The results were analyzed using factorial analysis SPSS 16 software. To assess reliability, Cronbach’s alpha coefficient was calculated. Pearson correlation coefficient was used to assess testretest value. Results: The Persian version of the questionnaire showed an acceptable level of reliability (Cronbach alpha=0.901). In the implementation phase, Iranian physicians were generally in favor of the SDM process ( mean score=74.4%) but their perspective on different phases of SDM were different, with 93% answering questions evaluating physicians’ clinical explanations to their patients and only 68% agreeing with questions evaluating physicians’ attitudes regarding involving patients in the last treatment option. Conclusion: The physician version of SDM-Q-DOC is a valid and reliable questionnaire assessing physicians’ attitudes toward the SDM process. In this study, Iranian physicians showed a positive view to SDM.

The effect of Nigella sativa extract on tracheal responsiveness and lung inflammation in ovalbumin-sensitized guinea pigs

OBJECTIVE: To examine the preventive effect of a hydro-ethanolic extract of Nigella sativa on the tracheal responsiveness and white blood cell count in the lung lavage fluid of sensitized guinea pigs. METHODS: Three groups of guinea pigs sensitized to intraperitoneally injected and inhaled ovalbumin were given drinking water alone (group S), drinking water containing a low concentration of N. sativa extract (group S+LNS) or drinking water containing a high concentration of N. sativa extract (group S+HNS). The tracheal responses of control animals (group C) and the three groups of sensitized guinea pigs (n = 7 for all groups) to methacholine were measured by the assessment of the tracheal smooth muscle response to increasing concentrations of methacholine, and the effective concentration causing 50 percent of the maximum response (EC50) was determined. Tracheal responses to 0.1 percent ovalbumin and white blood cell counts in the lung lavage fluid were also examined. RESULTS: The tracheal response of the group S guinea pigs to both methacholine and ovalbumin was significantly higher than the response of the controls (p<0.01 for both cases). The tracheal responses of the S+LNS and S+HNS groups to both methacholine and ovalbumin were significantly decreased compared to those of the S group (p<0.05 to p<0.01). The total white blood cell and eosinophil counts in the lung lavage fluid of group S were significantly higher than those of group C (p<0.01). The white blood cell counts in both treated groups showed significant improvements (p<0.01 for both cases). CONCLUSIONS: These results demonstrate the preventive effect of the N. sativa extract on the tracheal response and lung inflammation in sensitized guinea pigs.