Determinants of social accountability in Iranian nursing and midwifery schools: a Delphi study

Background: Revising the medical education programs to meet the needs of society has become both a necessity and an important priority due to the considerable increase of population, changing patterns of diseases, and new health priorities. While this necessity has been highlighted in Iran's Fifth Development Plan as well as its National 2025 Vision Plan, the determinants of social accountability have not been explained yet. This study aimed to develop determinants of social accountability in the Iranian Nursing and Midwifery Schools

Methods: This classic Delphi study included thirty experts in Nursing and Midwifery Education, Research and Services selected based on purposive sampling and three rounds of Delphi technique and conducted in Nursing and Midwifery School of Mashhad University of Medical Sciences. The primary data were collected using an initial structured questionnaire prepared through extensive review of literature. SPSS 11.5 software was used to analyze the data. The interquartile deviation and percentage of agreement were also used to study the consensus of opinion by experts

Results: Finding obtained from the rounds of Delphi resulted in selecting 69 determinants out of the initial pool of 128 primary determinants of social accountability. The items were selected based on experts' consensus and categorized under three main activities of Nursing and Midwifery School, namely education, research, and service.

Conclusion: Social accountability determinants were explained by 69 items for Schools of Nursing and Midwifery in Iran. The proposed determinants can be used by managers and authorities of Nursing and Midwifery School, policy makers, and evaluating institutions associated with them to ensure realizing social accountability goals

Malondialdehyde-modified LDL IgG antibody levels and indices of cardiac function in valvular heart and coronary artery disease patients

To compare the changes in anti-malondialde-hyde-modified low-density lipoprotein [MDA-LDL] IgG levels among patients undergoing off-pump and on-pump coronary artery bypass grafting [CABG] or valvuloplasty. A total of 38, 39 and 34 patients who underwent off-pump CABG, on-pump CABG and valvuloplasty, respectively, were enrolled in this study. Serum anti-MDA-LDL IgG values were measured 24 h before and after the operative procedures and at discharge. Echocardiogra-phy was also done before surgery and before discharge. The results were compared with values from 50 healthy controls. In all patients, a reduction in antibody titers was observed post-operatively. However, the decrease was significant only in the off-pump CABG - before surgery: 42.33 [25.83-58.51], after surgery: 30.86 [16.36-51.33] and at discharge: 10.96 [6.82-23.57; p = 0.027]. There was a significant positive association between anti-MDA-LDL IgG levels and ejection fraction [r = 0.248, p = 0.036] and a negative association with E/E', a marker of pulmonary capillary wedge pressure, in the coronary patients [r = -0.345, p = 0.012], but no significant associations were found in patients with valvular heart disease. Serum anti-MDA-LDL IgG levels were associated with cardiac function indices in coronary patients undergoing CABG

structural equation model to predict the social-cognitive determinants related to physical activity in Iranian women with diabetes mellitus

Lifestyle-modification programs including physical activity are essential for both treatment and prevention of Type 2 Diabetes Mellitus [T2DM]. However, factors associated with physical activity among patients are poorly understood. This study applied Social-Cognitive Theory [SCT] for predicting determinants of physical activity among women with T2DM in Iran, 2013. In this cross-sectional study, partial least square path modeling [PLS-PM] was used as an estimation technique for structural equation model. This model specified hypotheses between components of Social-cognitive Theory on physical activity behavior. A random sample of 300 women with T2DM was selected, and completed SCT constructs instrument. Data were analyzed using statistical software WarpPLS Ver. 4.0. The model explained 26% of the variance in physical activity. Self-regulation, task self-efficacy and barrier self-efficacy were significantly direct predictors of physical activity among women with T2DM. Task self-efficacy, social support and modeling had significantly indirect effects on physical activity behavior [P<0.001]. Our findings showed evidence for adequacy of a theoretical framework that could be used to predict physical activity behavior among women with T2DM