Ethical considerations of community-based participatory research: contextual underpinnings for developing countries

The nature of community-based participatory research [CBPR] poses distinctive ethical challenges. In the absence of organized guidelines, a remarkable amount of researchers' time and energy will be spent tackling these ethical challenges. The study aimed to explore ethical issues and principles potentially arising when conducting CBPR. This qualitative study conducted in CBPR Center of Tehran University of Medical Sciences. Required data were gathered through systematic literature review and semi-structured interviews. Representatives of community, academia, and nongovernmental organizations [NGOs] participated in our study. Ten interviews with representatives of partner organizations, four group interviews with academic staff, and four with representatives of community were conducted. Repeated thematic analysis was used to elicit ethics-related overarching themes from transcribed interviews. As recommendations, these themes were then organized into a set of CBPR-related ethical issues and principles. Four CBPR ethical guidelines [including 173 articles] were selected from a systematic review. Overarching themes relating to ethical principles which emerged from interviews were as follows: Trust, transparency and accountability, equity and inclusion, power imbalance, tolerance and conflict management, and attention to cultural sensitivity. Practical principles that emerged included: Consensus rather than informed consent, ownership of data and research achievements, and sustainability and maintenance of relationships. According to findings and in comparison to international guidelines, the present study put more emphasis on cultural sensitivity and sustainability as CBPR ethical tangles. Community-based participatory research ethical challenges are of the same kind in most parts of the world. However, some discrepancies exist that calls for local scrutiny. Future use and critic of current explored ethical issues and principles are highly encouraged

Survival rate of childhood leukemia in Shiraz, southern Iran

Leukemia is the most prevalent type of cancer in children. The aim of this study Was to estimate the 5-year survival rates of Acute Lymphoblastic Leukemia [ALL] and Acute Myeloblastic Leukemia [AML] as well as factors influencing them. This is a nonrandomized retrospective study conducted on 280 patients with ALL and AML. They were all below 15 years old children admitted to Shahid Faghihi hospital, Shiraz, Iran from 2004 to 2008.The survival rates were estimated by applying the Kaplan-Meier method. In addition, the log rank test was used to estimate the statistical significance of differences in the survival probability. Cox regression model was applied to conduct multivariate analysis for adjusting confounding variable. All analyses were performed in SPSS statistical software [version 16]. P-values less than 0.05 were considered as statistically significant. The mean [ +/- standard deviation] of the observation period was 28.2 +/- 16.1 months. In this period, 50 [24.7%] patients [47 ALL and 15 AML] passed away. The cumulative rate of survival in this study was 53.3 +/- 0.1 percent. This probability was 56.6 +/- 0.1% and 44.2 +/- 0.1% for ALL and AML patients, respectively, which indicates no statistically significant difference between them [P=0.8]. According to Cox model, there was a significant relationship among the variables of platelet count and relapse with the survival rate. Platelet count was identified as a positive prognostic factor of the survival rate in ALL patients. However, on the base of our results and other studies, incidence of relapse and the number of relapses are significant factors of survival rates of leukemia

Social health status in Iran: an empirical study

As social health is a condition-driven, dynamic and fluid concept, it seems necessary to construct and obtain a national and relevant concept of it for every society. Providing an empirical back up for Iran's concept of social health was the aim of the present study. This study is an ecologic study in which available data for 30 provinces of Iran in 2007 were analyzed. In order to prove construct validity and obtain a social health index, an exploratory factor analysis was conducted on six indicators of population growth, willful murder, poverty, unemployment, insurance coverage and literacy. Following the factor analysis, two factors of Diathesis [made up of high population growth, poverty, low insurance coverage and illiteracy] and Problem [made up of unemployment and willful murder] were extracted. The diathesis and problem explained 48.6 and 19.6% of social health variance respectively. From provinces, Sistan and Balu-chistan had the highest rate of poverty and violence and the lowest rate of literacy and insurance coverage. In terms of social health index, Tehran, Semnan, Isfahan, Bushehr and Mazandaran had the highest ranks while Sistan and Balu-chistan, Lurestan, Kohkiloyeh and Kermanshah occupied the lowest ones. There are some differences and similarities between Iranian concept of social health and that of other societies. However, a matter that makes our concept special and different is its attention to population. the increase in literacy rate and insurance coverage along with reduction of poverty, violence and unemployment rates can be the main intervention strategies to improve social health status in Iran

introduction to common systematic errors in medical research

Considering the continuous increase in number of published articles by Iranian researchers in recent years, the matter of quality in design, implementation, analysis and publication of articles is receiving its relevant attention. Of issues in quality of articles and studies are methodological errors. There are different kinds of errors that a researcher may fall into during various phases of a study. Of these errors systematic ones [or biases] can be counted. In this paper we aim to shortly introduce various sorts of biases that might happen in medical research. These biases are of two categories; selection and information biases.

Graft survival rate in pediatric renal transplantation: a single center experience

Renal transplantation is the best option for treatment of the end-stage renal diseases and has more advantages than dialysis. The objective of this study was to determine the ten-year graft survival rate of renal transplantation and its contributing factors among a group of Iranian patients aged 18 years or younger. In a retrospective cohort we aimed to study the ten-year graft survival rate of renal transplantation and its contributing factors among pediatric patients who have been transplanted from March 1999 to March 2009 in Shiraz Namazi Hospital Transplantation Center, southern Iran. Kaplan-Meier method was used to determine the survival rate, log rank test to compare survival curves, and Cox regression model to determine hazard ratios and to model variables affecting survival. The 1, 3, 5, 7 and 10 year-graft survival rates were 96.8, 88.8, 82.8, 78.1, 78.1 percent, respectively. Cox regression model revealed that the duration of hospitalization was one of the important factors in graft survival rate in renal transplantation. In this study, the 10 year-graft survival rate for pediatric renal transplantation was 78.1%. Graft survival was significantly related to hospital stay after the operation. Donor source, cold ischemia time, immunosuppressive drugs regimen, time to diuresis, and cause of ESRD did not influence the survival rate.