journal of research in health sciences

The Journal of Research in Health Sciences (JRHS) serves as the official publication of the School of Public Health at Hamadan University of Medical Sciences and is released on a quarterly basis. Since 2017, JRHS has transitioned to an electronic format.

JRHS is a rigorously peer-reviewed scientific journal with a multidisciplinary focus within the realm of public health. It welcomes contributions from diverse fields including Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine.

It is important to note that we do not accept submissions related to clinical trials, animal studies, qualitative studies, health insurance, or hospital management. Additionally, we do not consider research findings from laboratory and chemical studies in the domains of ergonomics, occupational health, and environmental health for publication.

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JRHS  is indexed by:

Web of Science  – IF:  1.768

Emerging Sources Citation Index (ESCI)

PubMed Central (PMC)

Scopus    – CiteScore: 2.70

WHO-EMRO Index Medicus

Index Copernicus International

CABI (Centre for Agriculture and Biosciences International)

ISC (Islamic World Science Citation Center)

Iranian Magazine Database

SID (Scientific Information Database)

JRHS  is also approved by the  Iranian Committee on Publishing of Biomedical Journal  of the Ministry of Health and Medical Education.

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Research Methods in Medicine & Health Sciences

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• Description
• Aims and Scope
• Editorial Board
• Submission Guidelines

Research Methods in Medicine & Health Sciences is a peer reviewed journal, publishing rigorous research on established “gold standard” methods and new cutting edge research methods in the health sciences and clinical medicine. The journal is structured around the following sections: Research Concepts and Theory; Epidemiology and Study Design; Experimental Study Methodology; Observational Study Methodology: Systematic Review and Meta-analysis; Measurement Tools; Data Collection and Curation; Statistics and Data Analysis; Ethical and Legal Considerations in Research and Medicine; and Journalology. State- of-the art papers are selectively commissioned by expert Topic Editors for consideration in the journal and ad hoc submissions are also welcome. The journal will be built up over time to become a comprehensive resource for all relevant methods for medicine and health sciences written by experts in the field.

This Journal is a member of the Committee on Publication Ethics .

There are no fees payable to submit or publish in this Journal. Open Access options are available - see section 3.3 below.

This Journal recommends that authors follow the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals formulated by the International Committee of Medical Journal Editors (ICMJE).

Please read the guidelines below then visit the Journal’s submission site  https://mc.manuscriptcentral.com/rmm  to upload your manuscript. Please note that manuscripts not conforming to these guidelines may be returned. Remember you can log in to the submission site at any time to check on the progress of your paper through the peer review process.

Only manuscripts of sufficient quality that meet the aims and scope of Research Methods in Medicine & Health Sciences will be reviewed. 

Research Methods in Medicine & Health Sciences is freely available to view and has no article processing fees for authors. Accepted peer-reviewed articles are made freely available immediately upon publication, and are published under a Creative Commons license. For general information on open access at Sage please visit the Open Access page or view our Open Access FAQs .

As part of the submission process you will be required to warrant that you are submitting your original work, that you have the rights in the work, and that you have obtained and can supply all necessary permissions for the reproduction of any copyright works not owned by you, that you are submitting the work for first publication in the Journal and that it is not being considered for publication elsewhere and has not already been published elsewhere. Please see our guidelines on prior publication and note that Research Methods in Medicine & Health Sciences  does not accept submissions of papers that have been posted on pre-print servers .

• What do we publish? 1.1 Aims & Scope 1.2 Article types 1.3 Writing your paper
• Editorial policies 2.1 Peer review policy 2.2 Authorship 2.3 Acknowledgements 2.4 Funding 2.5 Declaration of conflicting interests 2.6 Research ethics and patient consent 2.7 Clinical Trials 2.8 Reporting guidelines 2.9 Research Data
• Publishing policies 3.1 Publication ethics 3.2 Contributor's publishing agreement 3.3 Open access and author archiving
• Preparing your manuscript 4.1 Formatting 4.2 Artwork, figures and other graphics 4.3 Supplemental material 4.4 Reference style 4.5 English language editing services
• Submitting your manuscript 5.1 ORCID 5.2 Information required for completing your submission 5.3 Permissions
• On acceptance and publication 6.1 Sage Production 6.2 Online First publication 6.3 Access to your published article 6.4 Promoting your article
• Further information 7.1 Appealing the publication decision

1. What do we publish?

1.1 Aims & Scope

Before submitting your manuscript to Research Methods in Medicine & Health Sciences , please ensure you have read the Aims & Scope .

1.2 Article Types

The Journal commissions papers on “gold standard” methods and cutting edge research methods. Research Methods in Medicine & Health Sciences accepts the following article types:

• Original Article
• Letter to the Editor

Please also include an abstract of no more than 250 words with your submission. 

1.3 Writing your paper

The Sage Author Gateway has some general advice and on  how to get published , plus links to further resources. Sage Author Services also offers authors a variety of ways to improve and enhance their article including English language editing, plagiarism detection, and video abstract and infographic preparation.

1.3.1 Make your article discoverable

For information and guidance on how to make your article more discoverable, visit our Gateway page on How to Help Readers Find Your Article Online .

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2. Editorial policies

2.1 Peer review policy

Research Methods in Medicine & Health Sciences operates a conventional single-blind reviewing policy in which the reviewer’s name is always concealed from the submitting author.   Research Methods in Medicine & Health Sciences is committed to delivering high quality, fast peer-review for your paper, and as such has partnered with Publons. Publons is a third party service that seeks to track, verify and give credit for peer review. Reviewers for Research Methods in Medicine & Health Sciences can opt in to Publons in order to claim their reviews or have them automatically verified and added to their reviewer profile. Reviewers claiming credit for their review will be associated with the relevant journal, but the article name, reviewer’s decision and the content of their review is not published on the site. For more information visit the Publons website.

The Editor or members of the Editorial Board may occasionally submit their own manuscripts for possible publication in the journal. In these cases, the peer review process will be managed by alternative members of the Board and the submitting Editor/Board member will have no involvement in the decision-making process. 

2.2 Authorship

Papers should only be submitted for consideration once consent is given by all contributing authors. Those submitting papers should carefully check that all those whose work contributed to the paper are acknowledged as contributing authors.  The list of authors should include all those who can legitimately claim authorship. This is all those who:

(i)    Made a substantial contribution to the concept or design of the work; or acquisition, analysis or interpretation of data, (ii)    Drafted the article or revised it critically for important intellectual content, (iii)    Approved the version to be published,  (iv)    Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content.

Authors should meet the conditions of all of the points above. When a large, multicentre group has conducted the work, the group should identify the individuals who accept direct responsibility for the manuscript. These individuals should fully meet the criteria for authorship. 

Acquisition of funding, collection of data, or general supervision of the research group alone does not constitute authorship, although all contributors who do not meet the criteria for authorship should be listed in the Acknowledgments section. Please refer to the  International Committee of Medical Journal Editors (ICMJE) authorship guidelines for more information on authorship.

        Please note that AI chatbots, for example ChatGPT, should not be listed as authors. For more information see the policy on Use of ChatGPT and generative AI tools .

2.3 Acknowledgements

All contributors who do not meet the criteria for authorship should be listed in an Acknowledgements section. Examples of those who might be acknowledged include a person who provided purely technical help, or a department chair who provided only general support.

Any acknowledgements should appear first at the end of your article prior to your Declaration of Conflicting Interests (if applicable), any notes and your References.

2.3.1 Writing assistance

Individuals who provided writing assistance, e.g. from a specialist communications company, do not qualify as authors and so should be included in the Acknowledgements section. Authors must disclose any writing assistance – including the individual’s name, company and level of input – and identify the entity that paid for this assistance. It is not necessary to disclose use of language polishing services.

2.4 Funding

Research Methods in Medicine & Health Sciences requires all authors to acknowledge their funding in a consistent fashion under a separate heading.  Please visit the Funding Acknowledgements page on the Sage Journal Author Gateway to confirm the format of the acknowledgment text in the event of funding, or state that: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

2.5 Declaration of conflicting interests

It is the policy of Research Methods in Medicine & Health Sciences to require a declaration of conflicting interests from all authors enabling a statement to be carried within the paginated pages of all published articles. 

Please ensure that a ‘Declaration of Conflicting Interests’ statement is included at the end of your manuscript, after any acknowledgements and prior to the references. If no conflict exists, please state that ‘The Author(s) declare(s) that there is no conflict of interest’. For guidance on conflict of interest statements, please see the ICMJE recommendations here .

2.6 Research ethics and patient consent

Medical research involving human subjects must be conducted according to the World Medical Association Declaration of Helsinki

Submitted manuscripts should conform to the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals , and all papers reporting animal and/or human studies must state in the methods section that the relevant Ethics Committee or Institutional Review Board provided (or waived) approval. Please ensure that you have provided the full name and institution of the review committee, in addition to the approval number.

For research articles, authors are also required to state in the methods section whether participants provided informed consent and whether the consent was written or verbal.

Information on informed consent to report individual cases or case series should be included in the manuscript text. A statement is required regarding whether written informed consent for patient information and images to be published was provided by the patient(s) or a legally authorized representative. Please do not submit the patient’s actual written informed consent with your article, as this in itself breaches the patient’s confidentiality. The Journal requests that you confirm to us, in writing, that you have obtained written informed consent but the written consent itself should be held by the authors/investigators themselves, for example in a patient’s hospital record. The confirmatory letter may be uploaded with your submission as a separate file.

Please also refer to the ICMJE Recommendations for the Protection of Research Participants  

2.7 Clinical trials

Research Methods in Medicine & Health Sciences  endorses the ICMJE requirement that clinical trials are registered in a WHO-approved public trials registry at or before the time of first patient enrolment. However, consistent with the AllTrials campaign , retrospectively registered trials will be considered if the justification for late registration is acceptable. The trial registry name and URL, and registration number must be included at the end of the abstract.

2.8 Reporting guidelines

The relevant EQUATOR Network reporting guidelines should be followed depending on the type of study. For example, all randomized controlled trials submitted for publication should include a completed CONSORT flow chart as a cited figure and the completed CONSORT checklist should be uploaded with your submission as a supplementary file. Systematic reviews and meta-analyses should include the completed PRISMA flow chart as a cited figure and the completed PRISMA checklist should be uploaded with your submission as a supplementary file. The EQUATOR wizard can help you identify the appropriate guideline. 

Other resources can be found at NLM’s Research Reporting Guidelines and Initiatives

2.9 Research Data

The journal is committed to facilitating openness, transparency and reproducibility of research, and has the following research data sharing policy. For more information, including FAQs please visit the Sage Research Data policy pages .

Subject to appropriate ethical and legal considerations, authors are encouraged to:

• share your research data in a relevant public data repository
• include a data availability statement linking to your data. If it is not possible to share your data, we encourage you to consider using the statement to explain why it cannot be shared.
• cite this data in your research

3. Publishing Policies

3.1 Publication ethics

Sage is committed to upholding the integrity of the academic record. We encourage authors to refer to the Committee on Publication Ethics’ International Standards for Authors and view the Publication Ethics page on the Sage Author Gateway .

3.1.1 Plagiarism

Research Methods in Medicine & Health Sciences and Sage take issues of copyright infringement, plagiarism or other breaches of best practice in publication very seriously. We seek to protect the rights of our authors and we always investigate claims of plagiarism or misuse of published articles. Equally, we seek to protect the reputation of the journal against malpractice. Submitted articles may be checked with duplication-checking software. Where an article, for example, is found to have plagiarised other work or included third-party copyright material without permission or with insufficient acknowledgement, or where the authorship of the article is contested, we reserve the right to take action including, but not limited to: publishing an erratum or corrigendum (correction); retracting the article; taking up the matter with the head of department or dean of the author's institution and/or relevant academic bodies or societies; or taking appropriate legal action.

3.1.2 Prior publication

If material has been previously published it is not generally acceptable for publication in a Sage journal. However, there are certain circumstances where previously published material can be considered for publication. Please refer to the guidance on the Sage Author Gateway or if in doubt, contact the Editor at the address given below.

3.2 Contributor's publishing agreement

Before publication, Sage requires the author as the rights holder to sign a Journal Contributor’s Publishing Agreement. Sage’s Journal Contributor’s Publishing Agreement is an exclusive licence agreement which means that the author retains copyright in the work but grants Sage the sole and exclusive right and licence to publish for the full legal term of copyright. Exceptions may exist where an assignment of copyright is required or preferred by a proprietor other than Sage. In this case copyright in the work will be assigned from the author to the society. For more information please visit the Sage Author Gateway .

3.3 Open access and author archiving

Research Methods in Medicine & Health Sciences  offers optional open access publishing via the Sage Choice programme and Open Access agreements, where authors can publish open access either discounted or free of charge depending on the agreement with Sage. Find out if your institution is participating by visiting Open Access Agreements at Sage . For more information on Open Access publishing options at Sage please visit Sage Open Access . For information on funding body compliance, and depositing your article in repositories, please visit Sage’s Author Archiving and Re-Use Guidelines and Publishing Policies .

4. Preparing your manuscript for submission

4.1 Formatting

The preferred format for your manuscript is Word. A Word template is available on the Manuscript Submission Guidelines page of our Author Gateway.

4.2 Artwork, figures and other graphics

For guidance on the preparation of illustrations, pictures and graphs in electronic format, please visit Sage’s Manuscript Submission Guidelines.

4.3 Supplemental material

This journal is able to host additional materials online (e.g. datasets, podcasts, videos, images etc.) alongside the full-text of the article. For more information please refer to our guidelines on submitting supplementary files .

4.4 Reference style

Research Methods in Medicine & Health Sciences adheres to the Sage Vancouver reference style. View the Sage Vancouver guidelines to ensure your manuscript conforms to this reference style.

If you use EndNote to manage references, you can download the Sage Vancouver EndNote output file

4.5 English language Editing Services

Authors seeking assistance with English language editing, translation, or figure and manuscript formatting to fit the journal’s specifications should consider using Sage Language Services . Visit Sage Language Services on our Journal Author Gateway for further information.

5. Submitting your manuscript

Journal of Information Technology is hosted on Sage Track, a web based online submission and peer review system powered by ScholarOne™ Manuscripts. Visit https://mc.manuscriptcentral.com/rmm to login and submit your article online.

IMPORTANT: Please check whether you already have an account in the system before trying to create a new one. If you have reviewed or authored for the journal in the past year it is likely that you will have had an account created.  For further guidance on submitting your manuscript online please visit ScholarOne Online Help.

As part of our commitment to ensuring an ethical, transparent and fair peer review process Sage is a supporting member of ORCID, the Open Researcher and Contributor ID . ORCID provides a unique and persistent digital identifier that distinguishes researchers from every other researcher, even those who share the same name, and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between researchers and their professional activities, ensuring that their work is recognized. 

The collection of ORCID IDs from corresponding authors is now part of the submission process of this journal. If you already have an ORCID ID you will be asked to associate that to your submission during the online submission process. We also strongly encourage all co-authors to link their ORCID ID to their accounts in our online peer review platforms. It takes seconds to do: click the link when prompted, sign into your ORCID account and our systems are automatically updated. Your ORCID ID will become part of your accepted publication’s metadata, making your work attributable to you and only you. Your ORCID ID is published with your article so that fellow researchers reading your work can link to your ORCID profile and from there link to your other publications.

If you do not already have an ORCID ID please follow this link to create one or visit our ORCID homepage to learn more.

5.2 Information required for completing your submission

You will be asked to provide contact details and academic affiliations for all co-authors via the submission system and identify who is to be the corresponding author. These details must match what appears on your manuscript. The affiliation listed in the manuscript should be the institution where the research was conducted. If an author has moved to a new institution since completing the research, the new affiliation can be included in a manuscript note at the end of the paper. At this stage please ensure you have included all the required statements and declarations and uploaded any additional supplementary files (including reporting guidelines where relevant).

5.3 Permissions

Please also ensure that you have obtained any necessary permission from copyright holders for reproducing any illustrations, tables, figures or lengthy quotations previously published elsewhere. For further information including guidance on fair dealing for criticism and review, please see the Copyright and Permissions page on the Sage Author Gateway .

6. On acceptance and publication

6.1 Sage Production

Your Sage Production Editor will keep you informed as to your article’s progress throughout the production process. Proofs will be made available to the corresponding author via our editing portal Sage Edit or by email, and corrections should be made directly or notified to us promptly. Authors are reminded to check their proofs carefully to confirm that all author information, including names, affiliations, sequence and contact details are correct, and that Funding and Conflict of Interest statements, if any, are accurate.

6.2 Online First publication

Online First allows final articles (completed and approved articles awaiting assignment to a future issue) to be published online prior to their inclusion in a journal issue, which significantly reduces the lead time between submission and publication. Visit the Sage Journals help page for more details, including how to cite Online First articles.

6.3 Access to your published article

Sage provides authors with online access to their final article.

6.4 Promoting your article

Publication is not the end of the process! You can help disseminate your paper and ensure it is as widely read and cited as possible. The Sage Author Gateway has numerous resources to help you promote your work. Visit the Promote Your Article page on the Gateway for tips and advice. In addition, Sage is partnered with Kudos, a free service that allows authors to explain, enrich, share, and measure the impact of their article. Find out how to maximise your article’s impact with Kudos .

7. Further information

Any correspondence, queries or additional requests for information on the manuscript submission process should be sent to the  Research Methods in Medicine & Health Sciences  editorial office as follows: 

Joel Gagnier, Editor-in-Chief: [email protected]  

7.1 Appealing the publication decision

Editors have very broad discretion in determining whether an article is an appropriate fit for their journal. Many manuscripts are declined with a very general statement of the rejection decision. These decisions are not eligible for formal appeal unless the author believes the decision to reject the manuscript was based on an error in the review of the article, in which case the author may appeal the decision by providing the Editor with a detailed written description of the error they believe occurred.

If an author believes the decision regarding their manuscript was affected by a publication ethics breach, the author may contact the publisher with a detailed written description of their concern, and information supporting the concern, at [email protected]  

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Journal of Health Sciences

Subject Area and Category

• Medicine (miscellaneous)
• Nursing (miscellaneous)

University of Sarajevo - Faculty of Health Studies

Publication type

19868049, 22327576

Information

How to publish in this journal

[email protected]

The set of journals have been ranked according to their SJR and divided into four equal groups, four quartiles. Q1 (green) comprises the quarter of the journals with the highest values, Q2 (yellow) the second highest values, Q3 (orange) the third highest values and Q4 (red) the lowest values.

The SJR is a size-independent prestige indicator that ranks journals by their 'average prestige per article'. It is based on the idea that 'all citations are not created equal'. SJR is a measure of scientific influence of journals that accounts for both the number of citations received by a journal and the importance or prestige of the journals where such citations come from It measures the scientific influence of the average article in a journal, it expresses how central to the global scientific discussion an average article of the journal is.

Evolution of the number of published documents. All types of documents are considered, including citable and non citable documents.

This indicator counts the number of citations received by documents from a journal and divides them by the total number of documents published in that journal. The chart shows the evolution of the average number of times documents published in a journal in the past two, three and four years have been cited in the current year. The two years line is equivalent to journal impact factor ™ (Thomson Reuters) metric.

Evolution of the total number of citations and journal's self-citations received by a journal's published documents during the three previous years. Journal Self-citation is defined as the number of citation from a journal citing article to articles published by the same journal.

Evolution of the number of total citation per document and external citation per document (i.e. journal self-citations removed) received by a journal's published documents during the three previous years. External citations are calculated by subtracting the number of self-citations from the total number of citations received by the journal’s documents.

International Collaboration accounts for the articles that have been produced by researchers from several countries. The chart shows the ratio of a journal's documents signed by researchers from more than one country; that is including more than one country address.

Not every article in a journal is considered primary research and therefore "citable", this chart shows the ratio of a journal's articles including substantial research (research articles, conference papers and reviews) in three year windows vs. those documents other than research articles, reviews and conference papers.

Ratio of a journal's items, grouped in three years windows, that have been cited at least once vs. those not cited during the following year.

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IMPACT FACTOR: 5.24 IFS 4,7 / UIF 3,8

ISSN 2523-1251 (Online) ISSN 2523-1243 (Print)

Journal of Research in Health Science Volume 8 issue 1-2 2024

Journal of Research in Health Science Volume 7 issue 3-4 2023

Journal of Research in Health Science Volume 7 issue 1-2 2023

Journal of Research in Health Science Volume 6 issue 1-2 2022

Journal of research in health science volume 5 issue 1-2 2021.

Journal of Research in Health Science Volume 9-10 issue 4 2020

Journal of Research in Health Science Volume 7-8 issue 4 2020

Journal of Research in Health Science Volume 5-6 issue 4 2020

Journal of research in health science volume 3-4 issue 4 2020.

Research Transparency in 59 Fields of Medical and Health Sciences: A Meta-Research Study

• Find this author on Google Scholar
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• ORCID record for Ahmad Sofi-Mahmudi
• For correspondence: [email protected]
• ORCID record for Eero Raittio
• ORCID record for Sergio E. Uribe
• ORCID record for Sahar Khademioore
• ORCID record for Dena Zeraatkar
• ORCID record for Lawrence Mbuagbaw
• ORCID record for Lex M. Bouter
• ORCID record for Karen A. Robinson
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Background: Transparency in research is crucial as it allows for the scrutiny and replication of findings, fosters confidence in scientific outcomes, and ultimately contributes to the advancement of knowledge and the betterment of society. Aim: We aimed to assess adherence to five practices promoting transparency in scientific publications (data availability, code availability, protocol registration, conflicts of interest (COI) and funding disclosures) from open-access articles published in medical journals. Methods: We searched and exported all open-access articles from Science Citation Index Expanded (SCIE)-indexed journals through the Europe PubMed Central database published until March 16, 2024. Basic journal- and article-related information was retrieved from the database. We used R to produce descriptive statistics. Results: The analysis included 2,189,542 open-access articles from SCIE-indexed medical journals. Of these, 87.5% (95% CI: 87.4%-87.5%) disclosed COI and 80.1% (95% CI: 80.0%-80.1%) disclosed funding. Protocol registration was present in 6.6% (95% CI: 6.6%-6.6%), data sharing in 7.6% (95% CI: 7.6%-7.6%), and code sharing in 1.4% (95% CI: 1.4%-1.4%) of the articles. More than 76.0% adhered to at least two transparency practices, while full adherence to all five practices was less than 0.02%. The data showed an increasing trend in adherence to transparency practices since the late 2000s. COI and funding were disclosed more often in lower impact factor journals whereas protocol registration and data and code sharing were more prevalent in higher impact factor journals (all had P-values<0.001). Also, articles that did not disclose their COI had higher median citations. Among all fields, Rheumatology (97.2%), Neuroimaging (94.6%), Anesthesiology (32.4%), Genetics & Heredity (36.7%), and Neuroimaging (12.5%) showed the highest level of transparency in COI and funding disclosure, protocol registration, and data and code sharing, respectively. Whereas Medicine, Legal (61.5%), Andrology (59.0%), Materials Science, Biomaterials (0.3%), Surgery (1.5%), and Nursing (<0.01%) showed the lowest adherence. Conclusion: While most articles and fields had a COI disclosure, adherence to other transparent practices was far from acceptable. To increase protocol registration, data, and code sharing, much stronger commitment is needed from all stakeholders.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Data Availability

All the code and data associated with the study were shared through both its OSF repository (https://osf.io/zbc6p/) and GitHub (https://github.com/choxos/medical-transparency) when the manuscript was submitted.

https://osf.io/zbc6p/

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Supplementary Material

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International Journal of Research in Health Sciences

• Published by
• Dr.Sushma Madireddy
• Year publication
• Article Publishing Frequency
• Abbreviation
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• Journal Website
• http://ijrhs.com
• Editor in Chief
• Dr.Shankar Reddy Dudala
• All articles
• Date added to OAJI
• 14 Mar 2014
• Free access
• Full text language
• Journal discipline
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Treating gum disease after heart rhythm ablation reduces risk of AFib recurrence, study finds

by American Heart Association

Treating gum disease in the three months after a procedure to correct an irregular heartbeat known as atrial fibrillation (AFib) may lower oral inflammation and may reduce AFib recurrence, according to new research published today in the Journal of the American Heart Association .

According to the U.S. Centers for Disease Control and Prevention (CDC), about half of American adults ages 30 or older have some form of periodontal or gum disease , with the incidence increasing with age.

This study is among the first to investigate the potential impact of gum disease treatment on AFib. AFib is a condition in which the heart beats irregularly, increasing the risk of stroke by five-fold. More than 12 million people in the U.S. are expected to have AFib by 2030, according to the American Heart Association's 2024 Heart Disease and Stroke Statistics .

"Gum disease can be modified by dental intervention. Proper management of gum disease appears to improve the prognosis of AFib, and many people around the world could benefit from it," said lead study author Shunsuke Miyauchi, M.D., Ph.D., an assistant professor at the Health Service Center at Hiroshima University in Japan who engages in general cardiology, arrhythmia practice and research.

Researchers followed 97 patients who had undergone the non-surgical procedure to correct AFib (radiofrequency catheter ablation) and received treatment for gum inflammation , along with 191 ablation patients who did not receive treatment for gum disease. Catheter ablation is a procedure that uses radiofrequency energy to destroy a small area of heart tissue causing rapid and irregular heartbeats. This study found that an index measuring the severity of gum inflammation was associated with the return of AFib.

After the ablation procedure, during the average follow-up period of between 8.5 months to 2 years, researchers found:

• AFib recurred among 24% of all participants throughout the follow-up period.
• Patients with severe gum inflammation who had it treated after heart catheter ablation were 61% less likely to have a recurrence of AFib, compared to ablation patients who did not have treatment for severe gum inflammation.
• Patients who had recurrences of AFib had more severe gum disease than those who did not have recurrences.
• Having gum disease, being female, experiencing irregular heartbeat for more than two years and left atrial volume were predictors for AFib recurrences. Left atrial volume often leads to AFib recurrence as it includes thickening and scarring of connective tissues, Miyauchi explained.

Miyauchi noted, "While the main findings were consistent with their expectations, we were surprised how useful a quantitative index of gum disease, known as periodontal inflamed surface area or PISA, could be in cardiovascular clinical practice."

While the American Heart Association does not recognize oral health as a risk factor for heart disease , it recognizes that oral health can be an indicator of overall health and well-being. Bacteria from inflamed teeth and gums may travel through the bloodstream to the rest of the body, including the heart and brain. Chronic gum inflammation may be associated with other systemic health conditions, including coronary artery disease, stroke and Type 2 diabetes.

Study details and background:

• A total of 288 adults (66% men; 34% women) being treated for AFib were enrolled in this study.
• The single center study was conducted from April 1, 2020 to July 31, 2022, at Hiroshima University Hospital in Hiroshima, Japan, and all participants were Asian.
• Enrollees were examined by a dentist before undergoing catheter ablation for AFib.

"We are now working on further research to reveal the mechanism underlying the relationship between gum disease and AFib," Miyauchi said.

The study's limitations include: a small number of patients enrolled from a single center; patients were not randomized to receive dental treatment; periodontal status was not followed up after the initial examination among the participants who did not receive gum disease treatment; and inflammatory markers were not reassessed after the ablation procedure.

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Science, health, and public trust.

April 3, 2024

Communicating trustworthiness and fostering trust

By John C. Besley, Ph.D., Ellis N. Brandt Professor, Michigan State University*

Trust in people, organizations, and groups forms the basis for many of our daily actions. We trust pilots when we travel on the planes they fly, doctors when we take the pills they prescribe, and agriculture companies when we eat the food they sell.

Unfortunately, health communicators can’t simply expect trust from their audiences. But complaining about possible losses in reported confidence will not build trust. What health communicators can do is provide real reasons for why a person should see scientists, doctors, and research entities as trustworthy in specific contexts.

How can communicators convey why scientists or claims should be considered trustworthy? Researchers have spent a great deal of effort parsing the dimensions of trustworthiness beliefs. This work can help communicators decide what to try to communicate to help build trust.

One of the most common models of trust from organizational psychology distinguishes between beliefs about:

• ability (i.e., expertise),
• benevolence (i.e., goodwill, caring, pro-social motives), and
• integrity (i.e., honesty, morality, authenticity).

This type of model provides a framework for research that suggests  people generally see scientists as having substantial expertise but are less sure about scientists’ motives and integrity. This means health communicators likely need to focus on figuring out how to communicate the benevolence and integrity of the scientists they feature.

While different scholars use differently terminology (e.g., warmth and competence ), a common element of various trust models is distinguishing between trustworthiness beliefs (i.e., perceptions) and behavioral trust (i.e., acting on trust by getting on a plane or taking a pill). The expectation is that communicating meaningful trustworthiness information can help foster trustworthiness beliefs and that, over time, these trustworthiness beliefs can help foster behavioral trust.

A key here is remembering that communication isn’t just about message design. There are myriad aspects of communication. We communicate through how we behave, what we say, the tone and style, who communicates, when the communication occurs, and the mode of communication.

In planning, we have found that communicators can build behavioral trust by asking specific questions keeping these principles in mind. For example, ask “how could we communicate our eagerness to listen?” rather than vague questions like “how can we build trust?”

Paying attention to these trustworthiness dimensions can also help with ongoing evaluation. Too few organizations collect regular, actionable information about how key audiences perceive them. For example, finding out if a priority group sees a scientist as skilled, caring, and honest will tell you more than simply asking that group whether they trust them. Communicators can then use data about these types of perceptions to help them develop strategies for more effective communication.

It is easy to talk abstractly about trust, but communicators must think about trust in more nuanced ways. They need to ask how intended audiences perceive the research they cover. This will give them insights into how to do the hard work of behaving and communicating in ways that earn trustworthiness. Only by doing this can we build the capacity to persuade people to behave in more evidence-based and intentional ways.

*Besley is co-author of Strategic Science Communication (JHUP 2022).

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Estimating the Loss in Expectation of Life and Relative Survival Rate among Hemodialysis Patients in Iran

Navisa sadat seyedghasemi.

1 Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2 Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran

Abbas Bahrampour

3 Adjunct Professor of Griffith University, Brisbane, QLD, Australia

Abbas Etminan

4 Physiology Research Center, Departments of Nephrology, Urology and Renal Transplantation, Kerman University of Medical Sciences, Kerman, Iran

AliAkbar Haghdoost

5 HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

Mohammad Reza Baneshi

Background: Information regarding the prognosis and burden of diseases can be used by policymakers to determine competing health priorities. We aimed to assess the Relative Survival Rate (RSR) and loss of expectation of life (LEL) to evaluate the prognosis and burden of diseases in Hemodialysis (HD) patients.

Study design: A retrospective cohort study.

Methods: We recruited 648 HD patients referred to three referral centers in Kerman City, Iran, from 2008 to 2019. RSR, was defined as the ratio of the observed and the expected survival rates of general population for persons of the same age and sex as patients in the current study. LEL was determined as the difference between corresponding life expectancies (LE). The extended Cox proportional hazard model was used to identify variables associated with the outcome.

Results: Variables associated with outcome were diabetic status and age. In the 5th year of the follow-up study, the overall RSR was 0.57. In general, for HD patients, the estimation of LE and LEL was 22.6 and 12.36 year, respectively.

Conclusion: HD patients, especially older patients, showed a very poor prognosis, with a large amount of lost life expectancy. Therefore, they need more care and attention from health authorities. It is suggested to estimate the cost of eliminating the risk factors causing kidney diseases.

Introduction

End-stage renal disease (ESRD) is the worst stage of chronic kidney disease (CKD). A person with ESRD will need to have treatment to replace a damaged kidney to stay alive. Renal replacement therapy (RRT) includes hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation 1 , 2 . ESRD causes disturbance in life (perhaps even more than any other chronic illnesses) mainly due to severe metabolic and cardiovascular complications 3 . The growth of ESRD is a worldwide challenge 4 . In Iran, the annual number of patients with ESRD increased by 130% between 2000 and 2006 5 , 6 . Based on the data available in the 2018 annual report accessible on the US Renal Data System, the crude incidence rate of treated ESRD and the prevalence of treated ESRD were 81 per million probabilities/year and 654 per million population, respectively, in Iran 7 . Using 1995-2013 statistics, the overall trend of survival probabilities in ESRD patients has slightly decreased in Iran 8 . About half of the patients with ESRD in Iran are treated with hemodialysis 2 .

Survival statistics (e.g., Cause-specific survival and overall survival) as well as loss of expectation of life (LEL) were used to provide information regarding the prognosis and burden of diseases. This information can be used by policymakers to determine competing health priorities 9 .

Cause-specific (or net) survival represents the survival associated with a specific cause. The main limitation of this method is that it relies on reliable causes of mortality. ESRD rarely is considered a cause of death; rather, it commonly is considered as a factor that enhances the effect of other causes, such as infections and heart diseases.

On the other hand, the RS method compares the overall survival of the patients with that of the general population. It matches the two populations by key variables such as age and sex. In the RS method, the overall survival rate of patients (i.e. when all deaths are considered events) is compared with the expected survival rate (in the absence of that specified disease) 9 - 11 . In conditions where estimating the cause-specific survival is not possible, the relative survival (RS), which requires no further information regarding the cause of death, is a preferable method 9 , 10 .

Another useful statistic to compare survival experience of patients with that of the general population is LEL, defined as the difference between life expectancy (LE) of patients and expected value in general population 12 , 13 . Both expected survival rate and anticipated LE can usually be obtained from national or regional life tables 9 - 11 .

In our extensive search, we could not find any information regarding the RSR and LEL of Iranian ESRD patients. We aimed to determine the variables associated with survival of ESRD patients, and to provide an estimate of their RSR and LEL statistics.

In this retrospective study, we enrolled 801 HD patients from Mar 2008 to Jan 2019 in Kerman City, the capital of the largest province located in the southeastern part of Iran. Kerman is the 9 th most populated province of Iran and covers more than 11% of its land 14 . Since Kerman is close to the country average, in terms of healthcare and human development indicators, it can be considered as a sample representing the entire country 15 - 17 .

Data were extracted from the patients’ records at three referent hemodialysis centers. The exclusion criteria were as follows: (1) individuals less than 18 yr;) 2) individuals who died in the first three months after dialysis treatment starts; and )3) patients with incomplete information on age, sex, and starting date of dialysis.

The main outcome of this study was death. For cases who died, the follow-up time was defined as the difference between date hemodialysis started and death date. For censored cases, difference between starting hemodialysis date and last observation date was calculated (i.e. Jan 6 th , 2019). The independent variables were main causes of ESRD, sex, blood group, diabetic status, and age at the beginning of hemodialysis.

In terms of age, patients were categorized into six groups: 18-34 yr: 35-44 yr: 45–54 yr: 55-64 yr: and ≥65 yr. The primary cause of ESRD was determined by ICD-10-CM diagnosis codes. As diabetes is a significant matter that affects the survival rate of HD patients, patients were placed into two groups of diabetics and non-diabetics from the very beginning of their hemodialysis.

A Cox Proportional Hazard (PH) model was developed to investigate the association between independent variables and the outcome. PH assumption was checked using interaction with time terms to the model and Shoenfeld residuals. In the case that data did not satisfy the PH assumption, results of the extended Cox model were reported.

To calculate the RSR, patients were matched with general population in terms of age, gender, and year of diagnosis. The relative survival rate (RSR) was calculated as the overall (or all-cause) survival rate of HD patients (shown by S(t)), divided by the expected survival rate (shown by S*(t)):

We obtained S(t) using Kaplan-Meier method. S*t was estimated using Hakulinen method 18 .

The difference between RSR(t) and S(t) showed the fraction of the death rate due to other causes than hemodialysis 19 .

LE over (0, t) period was calculated as t- mean survival time. The mean survival time was calculated as the area under the K-M survival curve. LEL was calculated as the difference between expected life expectancy of general population (LE*) and that of patients (LE) 20 :

Applying Hakama and Hakulinen method 18 , 20 , S*t and LE* were obtained by linking HD patients by sex, age, and year to the Kerman province (2008–2019) life tables. Adopting the methodology provided by the World Human Mortality Database, life table of general population has been prepared by the first author of this manuscript.

This method requires two types of data including mortality and general population statistics gathered from two sources: the death registry of Health Deputy of Kerman University of Medical Sciences, and the census data of the Statistical Centre of Iran, respectively.

All analyses were performed in the R Software, Release 3.5.3, by using survival and survMisc packages.

Of the 801 patients, 153 cases were excluded as they did not meet the inclusion criteria, and the sample analysis was set at 648 cases. During the study, 54 (8.3%) patients received a renal transplant.

We classified patients based on their cause of ESRD. About 80% of patients had a history of either diabetes or hypertension: Diabetes and hypertension (30.7%), diabetes alone (27.2%), and hypertension alone (23%).

The mean age at the start of hemodialysis treatment was 58.29 ±15.011 (58.7m±15.3 for males and 57.6 ±14.6 for females) ( Table 1 ).

a Percentage of deaths from causes other than those associated with or due to hemodialysis at 5th year of follow up; 5-year RSR minus 5-year survival rates

Patients were mostly male (61%) and the most frequent age group was 55-64 yr ( Table 2 ). The blood group of 20 patients was not registered in hospital records. The most prevalent blood group was O (36.6%) followed by A (28.5%). Only 8.4% of patients had AB blood group ( Table 2 ).

a Median for subgroups whose survival rate was no less than 0.5, it is impossible to calculate the median survival time.

Total person-year at risk was 1775. During the study period, 234 patients died (36.1 %) which gave a crude mortality rate of 13.18 deaths/100 patient-years (95% CI: 12.02, 15.55).

By comparing the survival rate of ESDR patients with that of the general population, patients experienced poor survival rates ( Figure 1 ). The percentage point difference between the survival rate of the general population and that of the patients at 1th and 5th years was 16% (0.98 vs. 0.82) and 41.4% (0.95 vs. 0.54), respectively ( Table 1 ). Only 3% of deaths (57% minus 54%) that occurred during the first 5 years of hemodialysis were due to causes other than hemodialysis. Stratifying the analysis by age, corresponding figures for those aged between 18 to 35 and those aged more than 65 were 0.3% and 4.8% respectively ( Table 1 ).

Survival rate curve observed in ESRD patients on hemodialysis versus the survival rate curve of the general population

Figure 2 suggests that in all age groups, patients had poorer survival than their counterparts in the general population. Moreover, the older the age, the worsen RS.

Relative survival rate by age category

The LE and LEL for patients were 22.56 and 12.36 yr, respectively. Subgroup analysis revealed that LEL in the youngest and oldest age groups was 15.26 and 11 yr, respectively ( Table 1 , Figure 3 ). As demonstrated in Table 2 , LEL for females was greater than that of males (13.5 vs. 15.6 years). Moreover, LEL for diabetics and non-diabetics were 12.9 and 11.8 yr, respectively.

Comparison of LE in HD patients and their respective reference populations by age groups

The median survival time was 6 years. Moreover, 5-yr KM survival rate was 54.0% (55% in males and 52% in females). As the participants’ age increased, the 5-year survival rate decreased. The percentage point difference, in terms of 5-year KM survival, between blood groups A and AB was as high as 0.23 (0.57 versus 0.34). The corresponding figure between diabetic and non-diabetic patients was 0.09 (0.50 versus 0.59) ( Table 2 ).

The only variable that does not satisfy the PH assumption was the diabetic status ( Table 2 , P =0.030). The Kaplan–Meier curves (not shown in the results) showed that the survival rate of diabetics and non-diabetic patients were more or less the same in the first five years of hemodialysis. However, after the 5th year, non-diabetic patients had a higher survival rate. To assess the impact of this variable on the outcome, an interaction term between diabetes status and time was added in the multifactorial Cox model.

Relative to those aged 34 yr or less, individuals whose age was between 55 and 64 were about two times more likely to die ( Table 2 ). Blood groups and sex were not significantly associated with the outcome. Although the hazard of death for diabetic patients was 40% less than non-diabetic cases at the beginning of the study, the hazard rate of death in diabetics relative to non-diabetics increased to 2.13 in the 5th year (95% CI: 1.07, 3.57).

Our results provide important results from policy-making and clinical perspective. At the end of the fifth year of hemodialysis, the patients' survival rate was less than what was expected for the general population by 43.4%. The estimation of LEL revealed that 12 life-years could be gained from successful prevention of causes of ESRD. The highest burden of disease has been observed in females and young patients. Patient with diabetes and patients who are over 65 yr old had the highest risk of death and the worst prognosis of ESRD.

Our data demonstrated that the survival rate during the first five years was 53.89%. Based on previous studies carried out in various areas of Iran, the 5-year survival rate of dialysis patients was calculated at 18.4% in the northern part of Iran, 16% in the western, and 48.6% in the southern 21 - 23 . In another study, the five-year survival rate for ESRD patients in the USA, Japan, and Europe is reported to be 41%, 60%, and, 48%, respectively 2 . The observed differences between the survival rates of ESRD patients in several areas might be due to differences in age distribution of patients and access to health facilities.

The use of arteriovenous fistula in the USA was lower than in Europe and Japan. Furthermore, the survival of dialysis patients in Japan substantially was higher than other parts of the world. They justified that’s findings by fewer number of transplant recipients and lower background general population mortality rates in Japan 2 .

The overall mortality rate in our study was 13.18 per 100 person-years. This rate is less than that of the Italian Dialysis and Transplantation Registry (IDTR) patients (15.68 per 100 person-years) whose median age was 70 24 . Diversity in population age structure might justify part of the observed differences. Patients who participated in IDTR study were older than our sample, and this may partially justify the differences.

As RSR adjusts the survival estimations for important potential confounders like age and sex, it is possible to compare the prognosis of patients in different countries with different population structures. The 5-yr RSR for the cases in our study and the IDTR patients was 56.56% and 55.6%, respectively 24 , indicating that the prognosis of patients is similar in both societies.

One of the main results of the present study was the reverse association between age and RSR. An increase in age was associated with decrease in RSR. This finding is in line with other studies 24 - 29 . It suggests that the prognosis of many diseases is worse in older patients than in younger patients.

In line with another study 24 , RSR in the fifth year was a little higher in males than in females. According to the life tables proposed by the authors of this manuscript, one reason may perhaps be that the survival rate in the general population of Kerman was higher in females than in males.

According to the calculated percent of deaths from other causes at 5th year of follow up, deaths due to causes other than ESRD were much more frequent in males than in females. A possible explanation for this finding might be that male patients on hemodialysis have a higher prevalence of co-morbidities and other chronic diseases than female patients.

This study indicates that a HD patient could be alive for about 22.6 yr with hemodialysis therapy and lose 12.36 yr of LE on average. This finding is similar to the study conducted in Taiwan 30 . Another study on American adults who received RRT, stated that “LEL decreased from 23.6 yr in 1977 to 19.7 yr in 2007” 31 .

In our study, the higher the age of the patient the less the LEL. This result may reflect that the burden of disease of ESRD in younger patients is more than that in older patients. This trend has also been observed in numerous cancer cases and other diseases 32 - 34 . Increase in age was associated with decrease in RSR but decrease in LEL. The same pattern has been reported for cancer patients 11 , 35 , 36 . Although seemingly paradoxical, this finding is explained by the higher LE in the younger general population relative to the older general population. In other words, since young patients have more years to lose than old patients, LEL in young patients is greater than that in elderlies.

Similar to other studies, our results showed that female patients lose more years than male patients 24 , 31 , 32 . Even though the LE for females is more than that of males in the general population, the LE for female HD patients is less than that of male HD patients. This is an example of reverse epidemiology that may be found in dialysis patients.

In this study, the estimation of the LEL for diabetic HD patients was 13 years. Since diabetics’ life table in the general population was not available, it was not possible to determine how many years of LEL was due to diabetes and how many years of LEL was due to hemodialysis. According to the findings of previous studies, individuals who have diabetes live an average of 6-8 years less than others 37 - 39 ; thus, it may be inferred that among the diabetic HD patients in the current study, 5 to 7 years of the estimated LEL is due to hemodialysis.

Although the LE for diabetic patients was 9 yr less than the non- diabetic patients, the LEL for diabetics was just one year more than that of non-diabetics. The reason is that the diabetics were older than the non-diabetics at the beginning of hemodialysis; therefore, diabetics have fewer years to lose than non-diabetics (anticipated LE was 31.6 yr in diabetics vs. 39.5 yr in non-diabetics).

According to the result of the multifactorial Cox proportional-hazard model, diabetes status and age variables were important predictors of mortality, as previous studies have shown 23 , 30 , 40 .

By using the Kaplan-Meier curves and Cox model, we demonstrated that the survival rate of patients with diabetes had significant differences after the fifth year of hemodialysis compared to patients without diabetes. Beladi Mousavi et al. analyzed the survival of 185 adult HD patients in Ahvaz, Iran. They found that the survival rates of diabetic patients were significantly less than that of non-diabetic patients in the third and fifth years of follow up period 23 .

Although Kerman is a city whose healthcare and developmental indicators are quite close to the average of that of Iran 15 - 17 , generalizability of the results to the whole country should be with caution. Moreover, we have information of a limited number of independent variables. Therefore, information on major independent variables such as socioeconomic status and healthy behaviors on survival remains to be addressed.

Despite these limitations, this study presented beneficial information on patients’ prognosis and the burden of disease through RSR and LEL. To our knowledge, this is the first in Iran to measure the prognosis of HD patients by determining its relationship to the background survival rate of the general population.

HD patients, especially older patients, showed a very poor prognosis, with a large amount of lost life expectancy. Therefore, they need more care and attention from health authorities. It is suggested to estimate the cost of eliminating the risk factors causing kidney diseases. Additionally, the attempt to estimate the cost of eliminating the risk factors causing kidney diseases would be a valuable effort.

Acknowledgements

This study was a part of an Ph.D. thesis by Navisa Sadat Seyedghasemi, supported by Kerman University of Medical Sciences and Samen al-Hojaj Special Patients Medical Center, Shafa Hospital, and Javadolaemeh Clinic.

Conflict of interest

None declared.

No funding was received.

• The Hemodialysis patients' survival rate was less than what was expected for the general population by 43.4%.
• The life expectancy of Hemodialysis patients was averagely 12 yr less than that of the general population.
• In Hemodialysis patients, the highest lost life expectancy belonged to females and youth.
• In Hemodialysis patients, patients with diabetes and patients over 65 yr of age had the poorest prognosis.

Citation: Seyedghasemi NS, Bahrampour A, Etminan A, Haghdoost AA, Baneshi MR. Estimating the Loss in Expectation of Life and Relative Survival Rate among Hemodialysis Patients in Iran. J Res Health Sci. 2020; 20(3): e00487.

New approach needed to save Australia's non-perennial rivers

N on-perennial rivers, which stop flowing at some point each year, dominate surface water movement across Australia, yet monitoring the continued health of these vital waterways demands a new type of research attention.

More than 70% of this nation's rivers are non-perennial due to a combination of ancient landscape, dry climates, highly variable rainfall regimes, and human interventions that have altered riverine environments.

An extensive review of current research incorporating geomorphology, hydrology, biogeochemistry, ecology and Indigenous knowledges identifies prevailing factors that shape water and energy flows in Australia's non-perennial rivers—but the review also points to research deficiencies that must be addressed if these river systems are to be preserved and protected.

The research, "Australian non-perennial rivers: Global lessons and research opportunities," has been published in the Journal of Hydrology .

"Australia relies on our rivers, and has a strong history of research to understand river flows and ecosystems and the human impacts on them. Now, we must address emerging threats to river systems due to climate change and other anthropogenic impacts," says lead author of the review, Dr. Margaret Shanafield, from Flinders University's College of Science and Engineering.

"We have to work together to tackle emerging threats to our rivers. If we are going to plug gaps in existing knowledge, which this review identifies, then a new style of inter-disciplinary scientific research is necessary to achieve the required outcomes."

While dominant research themes in Australia focus on drought, floods, salinity, dryland ecology and water management, four other areas of research attention are urgently needed, namely:

• Integrating Indigenous and western scientific knowledge;
• Quantifying climate change impacts on hydrological and biological function;
• Clarifying the meaning and measurement of "restoration" of non-perennial systems;
• Understanding the role of groundwater.

Addressing these areas through multi-disciplinary efforts supported by technological advances will provide a map for improved water research outcomes that the rest of the world can follow.

"Australia is globally unique in its spread and diversity of non-perennial rivers spanning climates and landforms—but most, if not all, of the classes of non-perennial rivers found in Australia also occur in other regions of the world with similar climates and geology," says Dr. Shanafield.

"Therefore, the evolving body of knowledge about Australian rivers provides a foundation for comparison with other dryland areas globally where recognition of the importance of non-perennial rivers is expanding."

The review authors are concerned that Australian non-perennial river research has been driven by the needs of its inhabitants for survival, agriculture, resource economics, environmental concern and politics.

"Considering the continent's ancient geological history and its harsh, arid climate, it comes as no surprise that significant attention has been directed toward water resource management during drought periods, the reduction of salinization, and gaining insights into the intricate dynamics of the transient rivers that are a defining feature of central Australia," says the review.

"The prevalence of prolonged drought periods has had a marked impact on driving research—so it is critical to address the knowledge gaps this review has identified, given that increasing trends in hydrological droughts are projected to negatively impact streamflow not just in Australia, but also in South America, southern Africa, and the Mediterranean."

The review authors—a multi-disciplinary collective of scientists from across more than two dozen institutions and government departments—say more investment in long-term hydrological monitoring is desperately needed to increase water management knowledge that can address the competing water needs of communities, agriculture, mining and ecosystems in a dry environment—not only in Australia, but throughout the world.

"We anticipate that changing global water fluxes and continued groundwater pumping will cause more of the world's rivers to become non-perennial, accelerating our need to understand these systems across many disciplines," says Dr. Shanafield.

"In turn, a more thorough understanding will help to underpin science-driven management of non-perennial rivers to both meet the needs of a growing Australian population while protecting the integrity of ecological systems."

More information: Margaret Shanafield et al, Australian non-perennial rivers: Global lessons and research opportunities, Journal of Hydrology (2024). DOI: 10.1016/j.jhydrol.2024.130939

Provided by Flinders University