مجله سازمان نظام پزشکی جمهوری اسلامی ایران
سال سی و ششم شماره 1 (پیاپی 141، بهار 1397)

In occupational health field, the role of occupational risk factors in disease development is very important. Estimation of job role in disease development in the presence of multiple risk factors is essential in legal and judicial issues especially in legal medicine commissions and in response to inquiry of insurer organizations. In Iran, there is no unique method for estimation of job role in disease development and it seems that an academic and executive defect exists in regard to this issue. In this article, we introduce an epidemiological method for estimation of job role in a disease in the presence of multiple risk factors. We hope that this article acts as a prologue for compilation of scientific documents with unique approach in our country.

Nowadays, conventional contractual responsibility based on charges cannot fully attend to the newly risen issues, and creating fairness between the rights of the manufacturers and the consumers is almost a lost cause. According to Article 433 and 2 of the Law on the Protection of Consumer Rights, in the event of a fault, partial, the sufferer has the right to terminate the transaction or to maintain a lender and obtain an order. However, if the transaction is general, the replacement of the good with a healthy sample or its' return is the right of the consumer. Otherwise, it must be compensated according to the civil general rules or general rules of liability. Subsequently, the Consumer Protection Legislation, which was signed into a law in 2009 and the medical equipment bylaw ratified in 2015, are the earnest steps on the way of introducing new acts to the Iranian legal system which efficiently could deal with flaws in products and services. The object of the current paper is an evaluation of liability arisen out of any flaw in consumer products and surveying the related legal principles. Documentary to the article 25 of the Medical Devices and Supplies Regulations of 1394, only the lack of conformity of the product with the manufacturer's claim requires a compensation for damages, and the protection of consumer rights does not require a contract or proof of fault. Accordingly, the responsibility in the bylaw is based on sole responsibility and beyond the responsibilities set forth in civil law and public rules or general rules that are envisaged in Iranian law. Therefore, the basis of danger in the law and the law of loss in Imam's jurisprudence is more consistent with this article. In this study, descriptive-analytical method has been used. So, after referring to written sources in medical law, civil and criminal law and jurisprudence of Imamiyeh, the logical method and rational reasoning, the collected data were analyzed .

Evidence based dentistry is a method of integrating research knowledge into daily clinical practice. This study was done with the aim of analysis of general dentists’ knowledge and attitude in regard to evidence based dentistry in Ardabil city. In this cross-sectional study, knowledge and attitude of general dentists were assessed by means of a self-administered questionnaire. The percentage of dentists’ answers to knowledge and attitude questions were reported and its correlations with age, sex, years of practice, place of practice and education were analyzed by -test, Pearson’s correlation coefficient and Analysis of variance, respectively. The average score of knowledge of Ardabil dentists was 9.17±4.36 and the average score of attitude was 23.53±4.8. There were no statistical correlations between the scores of knowledge and attitude with age (knowledge: p=0.13, attitude: p=0.06), sex (knowledge: p=0.25, attitude: p=0.31), place of practice (knowledge: p=0.25, attitude: p= 0.66), years of practice (knowledge: p=0.13, attitude: p=0.06) and the university of graduation (knowledge: p=0.15, attitude: p=0.69). Overall knowledge of Ardabil’s general dentists in regard to evidence based dentistry was not satisfactory but there were no negative attitudes in this respect.

Employee burnout results in decreased human power and efficiency. In caring professions such as medical profession, constant stress causes employee burnout. We aimed to assess employee burnout in rural family physicians in the city of Mashhad in 2014. In a cross sectional study, 120 rural family physicians were studied. All participants completed a questionnaire using the Maslach Burnout Inventory, to determine the prevalence and severity of employee burnout. In regard to frequency, rural family physicians showed low emotional exhaustion (56.2%), high personal accomplishment (39.3%) and depersonalization (74.2%). Furthermore severity of medium emotional exhaustion, high personal accomplishment and medium depersonalization were 67.4, 50.6 and 47.2%, respectively. Emotional exhaustion was the independent variable most strongly associated with marital and employment status. Official rural family physicians showed more emotional exhaustion. As work environment affects family physician`s mental health, preventive procedures must be taken in order to prevent from employee burnout. These may include developing strategies for decreasing stressful factors such as spiritual management support, physician’s involvement in decision making, reduce working hours, increase salaries and implement a uniform policymaking among various family physician staff.

Tuberculosis patients may suffer psychological problems like cognitive distortions, which result in incorrect processing of information. Rational Emotional Behavioral Therapy (REBT) is one of the most important psychotherapy approaches in this context which focuses on empowering people. Therefore, the aim of the current study was to recognize cognitive distortions of tuberculosis patients and plan REBT for them. The study was an interventional self-controlled study. Ninety patients were allocated in two groups randomly. Both experimental and control groups completed questionnaires regarding demographic information and cognitive distortions as pre-test. REBT intervention was done just on the experimental group. The cognitive distortions questionnaire was completed by both groups after the intervention was done, again. Researcher-made demographic questionnaire and cognitive distortions questionnaire were the instruments used in this study. There were significant reductions in “all or nothing thinking” and mental filter (P≤0.05), overgeneralization, minimizing the positive, fortune telling, emotional reasoning and labeling (P≤0.01) sub scales in the post-test phase in the experimental group. Most of the cognitive distortion sub-scales were reduced significantly after executing the REBT. Performing psychotherapy for physical patients and paying simultaneous attention to their psychological and physical problems will help in holistic treatment.

The purpose of this study was to evaluate the effectiveness of training program based on the meaning of life on nurses’ subjective well-being. The statistical population of the present study consisted of all nurses working in governmental hospitals of Kermanshah city in 2017. At first, through random cluster sampling method, one hospital was selected, and then 30 nurses of that hospital were chosen and randomly assigned into experimental and control groups (15 individuals per each group). The experimental group received eight 90-minute sessions (two sessions each week) of training program based on the meaning of life. Keyes and Magiarmo Subjective Well-being Questionnaire was administered to both experimental and control groups as pre-test and post-test. The data were analyzed by multivariate covariance analysis. The results indicated that the mean score of the subjective well-being in experimental group significantly increased compared to control group in the post-test stage. The training program based on the meaning of life was effective in nurses’ subjective well-being.

One of the causes of health inequalities in deprived areas is lack of equitable distribution of human resources, especially physicians. Retention of general practitioners and specialists in deprived areas is one of the service packages of health system reform plan to deprived areas in order to prevent physician shortages. Thus, this study was conducted to evaluate the satisfaction of retaining physicians in underserved areas of Yazd province in the implementation of healthcare reform. The present study was conducted as a cross-sectional one. The study population included all physicians participating in the persistence project of Yazd province in the first quarter of 2016; of whom 94 physicians who participated in the study were randomly selected. The data collection tool was questionnaire and data analysis software SPSS 21 was used using descriptive statistics, frequency and percent. During the study, 63.4% of physicians were involved in the persistence project on a voluntary basis. 47.1% of them were satisfied with their income after implementation of the transformation plan and 75.4% were satisfied with the facilities placed at their disposal. Finally, 52.1% of retaining physicians were very satisfied and 23.4% was fairly satisfied with the implementation of the healthcare reform plan. Considering that the overall aim of the program which is the benefit of the public health services through the constant presence of specialist physicians in the hospitals affiliated to the Ministry of Health and Medical Education, the results showed that the main indicators of the program has been in relatively good condition.