Search results

The purpose of this paper is to answer the question of how scientific excellency can be achieved. The origin of scientific excellency in Iran, national and international experiences concerning the subject has been investigated to review the literature. The authors also designed a process and then a model to test the course. Guilan University of Medical Sciences was selected as a case study for the research.

The approach used in this paper is from Future Studies, with emphasis on the “Participatory Learning and Action” method. It means that different stakeholders, including the strategic council members, managers, faculty members, students, alumni and non-academic staff, have been involved in different parts of the process.

After semantic analysis of scientific excellency in the theoretical field; the examination of national and international experiences in universities; the analysis of higher-level documents of the Ministry of Health and Medical Education as well as strategic documents of the university; the determination of the strengths and weaknesses of the Guilan University of Medical Sciences in online survey; the completion of the scientific excellency canvas in the expert panel and finally obtaining other stakeholders, a conceptual model was designed for achieving scientific excellency.

The study of the actions, policies and trends of pioneering universities indicates that it is important to consider issues such as the internationalization of education and research and the modification of university structures. To achieve a superior national and international status, the university must specifically enhance a range of different aspects, from intangible aspects, such as motivation of employees to tangible aspects, such as human resources, structure and facilities.

Scientific excellency is going to be one of main streams between universities to attract top students and researchers from all over the world. There has been little academic attempt on scientific excellency. In this research, first the authors examined the concept of scientific excellency, criteria and measurement in higher education, then based on that case study and participatory action learning method, a conceptual framework to achieve scientific excellency in Iran’s higher education system was proposed.

Mental health is an inevitable and vital dimension when it comes to providing a global definition for the appropriate health status. This highlights the importance of investigating factors influencing utilization and out-of-pocket payments (OOP) for mental health services. Thus, the purpose of this paper is to assess the determinants of the utilization and OOP for psychiatric healthcare in Iran.

A total of 39,864 households were included in this cross-sectional study. Data on the utilization and OOP for psychiatric healthcare as well as all their determinants (e.g. wealth index of households, geographical area, household size, etc.) were extracted from the Household Income and Expenditure Survey (HIES). The HIES was conducted by the Statistical Center of Iran in 2016. A zero-inflated Tobit model was used to identify the main factors affecting utilization and OOP for psychiatric healthcare utilization.

The average of utilization and OOP for psychiatric services was found to be 14.67 times per 1,000 households and $7.783 per month for service users, respectively. There were significant positive relationships between income and utilization (p=0.0002) and OOP (p<0.0001) for psychiatric services. Significant negative associations were found between the number of illiterate people in the household and OOP (coefficient=−1.56) and utilization (coefficient=−0.2002) for psychiatric services. Utilization and OOP for psychiatric services were statistically significantly higher among households with higher wealth status.

Despite the higher rate of mental disorders, the utilization of psychiatric services in Iran is very low. Due to financial barriers and insufficient insurance coverage, high socioeconomic status (SES) households utilize more psychiatric services than low-SES households. Thus, the integration of mental health services in public health programs is required to improve the utilization of psychiatric services in Iran.

Studying the relationship between crime and traffic accidents in different geographical regions is very critical since varying relationships have been reported to exist in diverse areas. The purpose of this paper is to determine the relationship between crime with injuries and deaths due to road traffic accidents in Iran.

In this study, macro-level panel data between 2007 and 2013 were used. The number of folders due to crimes in each province was used as explanatory variables to show the amount of crime in each province. The number of fatal and injury death was used as outcome variables. The models were estimated using fixed effect panel regression estimator.

The results of this study showed that the number of records in courts (Cr) had a significant positive relationship with fatal accidents (coefficient=0.006). In the injury accidents model, Cr coefficient was 0.008 and significant. In addition, GINI had positive relationship with fatal accidents (coefficient: 1.396), while it had no significant relationship with injury accidents.

A positive association was found between crime and mortalities and morbidities due to traffic accidents. Traffic accidents and crimes are derived from a similar nature. So traffic accidents could be categorized as crime and it is important to increase more prohibitions to decrease traffic accidents. Prevention programs should focus on population groups with high social distinction and criminals, especially traffic offenses.

It is argued that COVID-19 patients show various neuropsychiatric symptoms, including fatigue, depression and anxiety. On the other hand, epidemiological and experimental evidence indicated that green tea could potentially have antiviral effects and ameliorate psychiatric disorders. However, there is a lack of clinical evidence. The purpose of this study was to investigate whether drinking green tea can clinically improve psychiatric complications of COVID-19 infection.

This study included 40 patients with laboratory confirmed mild-to-moderate COVID-19 disorder in the current randomized open-label controlled trial. Patients were instructed to include three cups/day of green tea (intervention) or black tea (control) to their usual diet for four weeks immediately after diagnosis of the disease. At the study baseline and after the intervention, the enrolled patients’ fatigue, depression and anxiety were assessed by the Chalder Fatigue Scale, Beck Depression Inventory-Fast Screen and State-Trait Anxiety Inventory questionnaires.

A total of 19 COVID-19 cases in the intervention group (mean age = 52 years) and 14 cases (mean age = 50 years) in the control group completed the study. Analysis of covariance adjusted for baseline levels, and confounders revealed that those who consumed three cups/day of green tea compared to the patients who received black tea experienced significantly lower fatigue, depression and state and trait anxiety levels (adjusted means for fatigue = 12.3 vs 16.2 (P = 0.03), depression = 0.53 vs 1.8 (P = 0.01), 37.4 vs 45.5 (P < 0.01) and 37.9 vs 45.2 (P < 0.01)).

The open-label design may bias the evaluation of the self-reported status of fatigue, depression or anxiety as the main outcomes assessed. Moreover, as this study did not include patients with severe COVID-19, this might affect the generalizability of the present results. Thus, the recommendation of daily drinking green tea may be limited to the subjects diagnosed with mild-to-moderate type of infection or those with long-term neuropsychiatric complications owing to COVID-19. Besides, considering the ethical issues, this study could not exclude the drug therapy’s confounding effects; thereby, this point should be considered when interpreting the current results. Besides, it is worth noting that Guilan province in the north of Iran is recognized as a tea (and particularly green tea) producing region; thereby, it is an available and relatively inexpensive product. Considering this issue, the recommendation to consume this medicinal plant in adjunct to the routine treatment approach among patients with mild-to-moderate COVID-19 based on its beneficial effects may be widely accepted.

Green tea consumption could be considered an option to combat COVID-19 associated psychological complications, including fatigue, depression and anxiety among patients suffering from mild-to-moderate type of this viral infection.

To the best of the authors’ knowledge, in this study, for the first time, the effects of green tea compared to black tea on COVID-19 associated fatigue, depression and anxiety status within an open-label controlled trial have been investigated.

As a human right, people need to arrive early at the hospitals when they are injured in traffic accidents. Both the mean and equality of the time of arriving at the hospital are important. This study aimed to investigate inequality in arrival time of emergent traffic accident patients to the hospital in 2018–2019 in a city in the North of Iran.

The authors extracted the data from the Guilan province trauma system databank in Poursina Hospital in Rasht in 2018 and 2019. The Gini coefficient was used to calculate inequality, and a regression model was estimated for determining the reason for inequality in time to receive hospital services.

The study showed that patients’ arrival time from the time of the accident to the time of arrival to the hospital was 64.48 ± 47.63 min (minimum of 9 min and maximum 462 min). Gini coefficient was 0.31 (p <0.001), which does not show high inequality. Regression results showed that the transfer time of patients by car was 40 min longer (p-value <0.001) than ambulances (p = 0.036). In children, the transfer time was 42 min less (p = 0.003). Other variables did not explain the inequality (p > 0.05).

According to the time of arrival of patients and Gini index, in Rasht, inequality in providing services is not in a bad condition. This indicates that the emergency department does not systematically transport people to the hospital late.

Equal distribution of health human resources is a major issue to achieve human rights in healthcare. Rural family physicians (RFPs) as a part of health human resources play an important role in delivering health services, so the purpose of this paper is to calculate amount of inequity in distribution of RFPs in Iran.

In this study, the authors tried to find inequity in the distribution of RFPs in the provinces of Iran. For this purpose, inequity indices containing concentration curves and indices were calculated by ranking health-adjusted life expectancy (HALE). Furthermore, a regression model was estimated to find the pattern and influencing factors of inequity in the distribution of RFPs.

The number of male RFPs was significantly higher in Sistan va Baloochestan, and in the same line, the number of female RFPs was higher in Zanjan province. Concentration index of total RFPs was 0.0568 (not significant) (males= 0.041, females= 0.0718). The results of regression model showed that HALE and per capita GDP did not have any significant relationship with RFPs distribution (HALE p=0.753, GDP p=0.792).

The RFP plan was successful in enhancing equal access to physician and health care services relatively. However, gender imbalance in distribution of RFPs was high especially in less-developed regions.

This study aims to calculate the inequity in out of pocket expenditures and utilization of laboratory tests in Iran. Equal access to health services is an important part of human rights in health care. Out-of-pocket payment is a part of financial access to health care. In this study, the authors tried to find inequity in out-of-pocket payments and utilization of medical laboratory tests (MLTs) as a part of human rights in Iran in 2016.

Gini and concentration indices were calculated for this purpose, and regression models were estimated to show the relationship between different factors and utilization and out-of-pocket.

The average out-of-pocket payment for all of the households was US$1.56 (urban areas: 1.97 and rural areas: 1.31). Moreover, the average utilization of MLTs was 0.079 (urban areas: 0.0908 and rural areas: 0.0753). Gini and concentration indices for out-of-pocket payments were 0.522 and 0.0701, respectively.

Out-of-pocket and utilization were low in lower in less developed regions of ease and southeast regions of the country and were related to access to health insurance, income and wealth deciles.

Deficiencies or imbalances in dietary fat intake may influence on mental and neurological functions of children with autism spectrum disorders (ASD). This study aims to compare body mass index (BMI) and the amount of fatty acids intake in the autistic patients with the comparison group.

This case-control was carried out on 200 randomly selected children from 5 to 15 years old (100 autistic patients as the case group and 100 healthy children as the comparison group) in Tehran, Iran. The food frequency questionnaire (FFQ) was used to assess the intake of calorie, macronutrients and different types of dietary fatty acids including saturated fatty acids (SFA), monounsaturated fatty acids (MUFAs), poly unsaturated fatty acids (PUFAs), linoleic acid (LA), α-Linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and trans fatty acids.

The autistic patients had higher BMI, birth weight and mother’s BMI compared to the comparison group (All p < 0.01). No significant difference was found in the amount of dietary calorie, protein, carbohydrate and total fat intake between two groups. The risk of ASD was associated with higher intake of MUFAs (OR: 3.18, CI%:1.13–4.56, p = 0.04), PUFAs (OR: 4.12, CI95%: 2.01–6.25, p < 0.01) and LA (OR: 4.76, CI95%: 1.34–14.32, p < 0.01).

The autistic children had higher BMI and higher intake of unsaturated fatty acids except for omega-3 fatty acids. Further longitudinal studies are warranted.

In May 2014, a new reform in the health sector of Iran was implemented called “health evolution plan.” In the first phase of this reform, the government reduced out-of-pocket payments for service delivery by paying subsidies to the services and after that a revision was done to the medical services values book to improve equity and increase motivation of health professions. One of the affected services in this reform was coronary artery bypass surgery. The purpose of this paper is to show the effects of HEP on costs of coronary artery bypass surgery.

A before-after study was done for this purpose and 167 patients’ total costs and out-of-pocket payments were calculated for the years 2013 (before) and 2014 (after) the reform in three private hospitals of Rasht city, Iran. Econometrics models were estimated after adjustment of confounding variables.

The results of this study showed that surgery costs increased significantly from $1,643.3 to 2,119.5. Nursing and other costs increased significantly from $290.3 to 414.2 and anesthetize costs increased from $619.2 to 947.01. The results of regression model showed that total costs increased $3,008.6 after adjustment of confounders (p-value=0.037). However, no significant changes were found for out-of-pocket payments and out-of-pocket percentage.

The study findings revealed that HTP was not successful enough in financial protection in the private sector.

Based on the developmental process of pharmacy in medical relationships, it is essential to pay attention to ethical issues in this field and develop a good pharmacist–patient relationship. The present study aimed to mention the frequency of ethical challenges of pharmacy in Iran as a fundamental step towards designing a practical ethical guideline for professionals.

In this observational study, data were collected using a two-part questionnaire with 64 items developed after examining relevant texts and conducting unstructured interviews with pharmacy specialists. The first part determined the frequency of ethical challenges that the pharmacist confronts, using 43 short scenarios, whereas the second part comprised 21 questions with short answers. For validation, the questionnaire was sent to 20 medical ethics specialists who were familiar with issues in pharmacy ethics.

Data were collected from 48 members of the Iranian Association of Pharmacists (Working Group of Hospital Pharmacists). and the frequency of ethical challenges was determined. The most frequent issues were patient's request for over-the-counter drugs, asking about their lab results, asking drug for another person and returning the drug.

One of the limitation of our study is its population, there were hospital pharmacist, other pharmacist such as community pharmacist may face different challenges.

The finding of this study could lead the policymakers to develop ethical guidelines for pharmacy practices.

The pharmacist–patient relationship is one of the important aspects of health system, and therefore regulating this relationship based on the professional ethics guidelines could have a positive impact on therapeutic relationships.

Results showed that designing codes of ethics and practical guidelines based on the frequency of the noted challenges enhances the quality of treatment, improves the pharmacist–patient relationship, increases the level of cooperation and decreases patient complaints.