مجله فرهنگ و ارتقای سلامت (فرهنگستان علوم پزشکی جمهوری اسلامی ایران)
سال هفتم شماره 2 (پیاپی 22، تابستان 1402)

Editor-in-Chief of the Lancet Medical Journal
Respectfully, following the letter dated November 14, 2022, and referring to your Lancet magazine article regarding Miss. Mahsa Amini, we are very disappointed to see the republishing of completely false information about the Islamic Republic of Iran, especially regarding doctors and the health service delivery system, in a magazine that is known as a scientific magazine. Unfortunately, your article does not have any scientific documentation. Once again I wish you, who claim to include real and scientific content in your magazine, would address the issue of the cruel sanctions imposed by the United States and the West against the children, women, and men of Iran, and what serious damage it has caused to the health of the people. I wish you had for once exposed the enormous support of Western countries and the US for Saddam Hussein, who committed unique and historical crimes with chemical weapons against our people, including Iranian and Iraqi Kurds residing relatively close to where Mahsa Amini lived. All carried out amidst the deadly silence of western dominated scientific and international bodies. It seems that there are material and political interests in writing such false reports, which question the scientific value of that journal. As I wrote to you in the previous letter, if the accusations mentioned in that article were supposed to be based on science, they would at least been quoted from sources that are not so utterly hostile to our people and country. The Academy of Medical Sciences of the Islamic Republic of Iran, which consists of educated scientists and leading professors of the country's medical sciences universities, considers the contents of the article to be completely false and based on the material and political interests of those involved in its publication. The contents of the article are an insult to the community of health care and services providers, especially doctors, who have shown their unparalleled services to the people during the war imposed by Saddam against Iran, as well as during the cruel sanctions of the United States and Western countries that remained in place during the Covid-19 pandemic. We expect a correction from the magazine regarding the falsehoods in the article as swiftly as possible.

The darooyar strategy, was performed to compensate the lack of drugs in the country, to correct the drug consumption and reduce induced demand. It was designed base on general policies of the health system for resource management with the help of insurance system, faced many challenges after implemetation. This statement presents these challenges and practical solutions.

Improving comprehensive health (physical, mental, social, and spiritual) requires continuous efforts to improve the culture and health literacy of individuals and society, from before marriage, sperm coagulation, fetal period, infancy, childhood to old age. The strategies, actions and approaches of this very important issue have been reviewed in this policy brief.

Nowadays information technologies are an important source for health information and health utilization. Use of this route needs a special skill and knowledge which is referred to as digital health literacy. It is estimated that most of the communities lack this capacity. Promoting digital health literacy in this regard should be one of the priorities of health systems.

In this scoping review, Persian and English literature was searched with specific keywords including “digital health” or “electronic health” in past 10 years, and articles which presented specific solutions for promoting digital health literacy, were summarized.

The following strategies were suggested for improving digital health literacy. Increasing social trust to digital health, multi-dimensional and multi-sectoral governance planning, timely financing based on priorities, comprehensive digital services, active presence in the social media supported by heath system, stewardship of ministries of health and medical education on digital health and digital health literacy, collaboration with nongovernmental organizations and charities in capacity building for digital literacy.

Digital health consider as an important tool for improving the health of community and access to universal health coverage. These mandates increasing digital health literacy which could be achieved through targeted plans and by community participation.

The electronic health record includes the health information of people, which is collected and organized from different sources, including information systems of different levels of care. Considering the importance of organizing the information of this file and the access to its information for authorized users, its implementation method is of the highest level. The present study was conducted with the aim of investigating its development process and providing development solutions for electronic health records

The present study is a combined review-descriptive-analytical type, the review part of which was conducted by searching the database of scientific articles using key words related to electronic health records. Also, this search was completed according to the free search results in common search engines and its study.

The review of articles and documents of 13 countries including England, America, Australia, Russia, Taiwan, France, Iceland, Uruguay, Austria, Turkey, Saudi Arabia, Norway and Brazil showed that based on the structure and formation of the service provision system and laws. Existing, top-down, bottom-down, and middle-of-the-road reviews were used to implement electronic health records.

Service delivery, coordination between decision sources, integration of different service delivery information systems, and existing laws related to integration and information sharing are factors that affect the implementation of electronic health programs.

Telemedicine or remote medicine refers to provision of medical services using information and communication technology, where the provider and recipient of the health service are geographically far from each other. In this study, the clinical, ethical, legal, as well as security and confidentiality aspects of health information in telemedicine have been discussed.

The present article is a narrative review paper that has been prepared based on the authors' experiences and a review of relevant literature.

Physician training on patient safety in telemedicine, preparing patients to accept this kind of technology, and building medical equipment related to remote clinical examinations are very important issues that must be addressed for the successful implementation of telemedicine. Creating medical information infrastructure, including legal infrastructure and obtaining necessary licenses and obligations, can provide a suitable platform for legal and ethical issues in telemedicine and play a significant role in its successful implementation and increased acceptance.

Telemedicine is proposed as a potent solution for improving healthcare access in remote regions, reducing expenses, and addressing challenges related to patient travel. To promote adoption of telemedicine, it is crucial to focus on creating well-defined regulations, implementing quality control systems, fostering interactive platforms, considering ethical and legal aspects, providing comprehensive training, and formulating policies to facilitate the integration of telemedicine services.

One of the most important novel solutions in managing the health system is implemention of an e-prescription system. Implementing a comprehensive e-prescription system faces technical, executive, policy, and governance challenges. The aim of this manuscript is introducing tailored solutions for each challenge.

This research was carried out by purposeful and rapid review of valid and scientific articles.

Challenges and potential solutions were reviewed: standardization, enabling digital identity and signatures, networking infrastructure, a national insurance rules engine, integration with electronic health records, training, and governance structures.

Despite the efforts made, there are still many questions regarding cost-benefit and public satisfaction of the current system, requiring further national research.

Rapid advancement of industry and technology in recent decades has led to emergence of the concept of smart hospitals. New technologies are used in smart hospitals to improve healthcare quality, safety, and productivity. This study was conducted to investigate the prerequisites and challenges of implementing smart hospitals in Iran.

This analytical review was conducted in the summer of 2023. For this purpose, relevant articles about smart hospitals were searched in PubMed, Scopus, and SID databases. Subsequently, the prerequisites and challenges of implementing smart hospitals in Iran were identified and extracted via reviewing and analyzing these articles,. Finally, the obtained results were categorized and presented in this paper.

The most important technological and infrastructural prerequisitesinclude full implementation of electronic health records, utilizing artificial intelligence and machine learning algorithms, establishing clinical decision support systems, deploying the internet of things and sensors, developing proper networking and hardware infrastructure, and adopting international standards. Also, existing challenges comprise cultural and organizational resistance, lack of financial resources, shortage of skilled workforce, poor technical infrastructure, and limitations due to sanctions.

Implementing smart hospitals in Iran requires providing infrastructure and fulfilling technological prerequisites as well as overcoming the existing challenges. Given the current situation, it is suggested that this objective be achieves gradually with a focus on certain areas or processes. Moreover, meticulous strategic planning involving all stakeholders is essential.

Expansion of digital technologies in healthcare, necessitates improving the level of knowledge and skill of using these technologies. The present study was conducted with the aim of determining the content of the digital health education program and the skills required by different groups.

This was a review study, which included a search in Pubmed, Web of Science, and Scopus focusing on studies published from 2000 to 2022. The search for obtaining relevant studies was performed in September 2022. The content of the selected studies was analyzed based on the objectives of the study, and data was extracted using a form.

After retrieving the articles, 54 out of the 97 articles were selected and analyzed based on the inclusion criteria. Finally, the types of required knowledge and skills, as well as challenges of digital health education was presented based on different target groups.

To benefit fromdigital health, it is necessary to train and empower different user groups for effective and efficient use of digital health technologies. Formulating a strategic plan for digital health education, along with creating continuous training courses, including the content of digital health education in the curriculum of health providers and managers, as well as promoting it through professional technical centers and institutions are necessary for citizens.

Clinical practice guidelines (CPGs) are currently the optimal way to transfer information to healthcare professionals to ensure that their clinical actions are evidence-based. However, the process of developing and implementing these CPGs faces challenges. Artificial Intelligence (AI), particularly machine learning, natural language processing, and decision support systems, can be employed as effective solutions to transform the development and implementation process of CPGs and address the challenges in this field. This study aimed to investigate the role of AI in the development and implementation of CPGs.

In this review study, PubMed and Google Scholar databases were searched using selected keywords, including clinical practice guidelines, artificial intelligence, machine learning, and clinical decision support systems, and their English equivalents, from 2013 to 2023.

AI has the potential to revolutionize the development and implementation process of CPGs. The reviewed studies demonstrated that AI can be used in data analysis, evidence synthesis, decision support, customization, continuous updating, and quality assurance of CPGs. Challenges and ethical considerations in this field, such as data quality, transparency and interpretability, accountability, inclusiveness, ethical considerations, legal and regulatory frameworks, also need to be addressed.

AI has the potential to improve the traditional approach of CPGs development and implementation. Advanced research and collaboration between AI experts, healthcare professionals, and policymakers are necessary to refine and optimize the role of AI in clinical guidelines. This collaborative effort will ensure that AI remains a valuable tool in improving patient outcomes, promoting evidence-based decision-making, and shaping the future of health and treatment.

In recent years, the process of immigration of students, professors and healthcare professionals has significantly accelerated. In this research, the trend and causes of migration of talents and professionals are studied with a multidimensional perspective. Subsequently, policies related to expansion of the country's higher education system, governmental support for research and development, and creation and intensification of migration drivers will be studied as examples.

The data collection method of this study is both quantitative and qualitative, including review of articles, books, documents, and national and international databases as well as the opinions of the elite panel using content analysis method.

Simultaneous with the cultural and social developments of the last twenty years, the inefficient adopted policies related to non-futuristic expansion of the capacity of universities and higher education centers without considering improvement of the quality of education and research, have caused an important part of human resources and the country's budget to not be exploited. Implementation of these policies has impeded scientific, social, economic and political growth for at least two decades, and on the other hand, has turned the country's development opportunity into a driver and intensifier of the factors affecting immigration.

The country should carry out fundamental revisions in some past policies and programs, especially in terms of education, research, and technology, in order to achieve desirable economic-social development and scientific authority. Delay in this matter will undoubtedly lead to irreparable losses for the country.

People with disabilities are among the most vulnerable groups in the society, which are usually ignored. In this documentary, the current situation and challenges are described, and at the end, seven recommendations are presented in order to solve the challenges.

Responding to needs of individuals with disabilities, especially providing them with health services, is one of the most important obligations of governments. In this policy brief, challenges of rehabilitation services for persons with disabilities are examined and solutions to develop and expand the coverage and increase the responsiveness of the health system regarding these services are suggested.

This study was conducted with the aim of analyzing existing challenges and identifying solutions to improve food and nutrition security in Iran.

The present study is a review through the review of existing scientific texts in the field of food security and food and nutrition policy by examining reliable sources in domestic and foreign databases such as PubMed, google scholar, SID, WOS and using the keywords of food security, Nutrition security, food security challenges, solutions, Iran, world, food security, nutrition security, challenges, solutions were done.

Agriculture, natural disasters, political, economic, and social factors, and diet quality index affect food security. Paying attention to the quality of people's diets, implementing food enrichment and supplemental aid policies, and providing suitable alternatives for food that are less accessible to the vulnerable and deprived. It is necessary to implement the appropriate solutions provided and provide proper nutrition education by reputable organizations.

The concept of sustainable development has recently received much attention from countries, especially developing countries such as Iran. One of the main pillars of sustainable development is food security, which requires comprehensive measures to eradicate hunger and food insecurity in the country.

This study aims to identify necessary competencies for managers in the healthcare system and design a competency model. Additionally, this research prioritizes the identified competencies. The unique feature of this study is focus on medical universities and providing practical solutions to enhance the competency of managers in this field.

This research was conducted in two phases. In the first phase, necessary competencies for managers were identified using interviews with experts and literature review. Subsequently, a competency model was designed. In the second phase, using the best-worst method, identified competencies were prioritized.

After reviewing literature and interviewing healthcare experts and managers, 59 variables were identified as final competencies in a four-level competency pyramid for managers. At the base level are foundational competencies, followed by maintenance and enhancement competencies, and at the highest level are advanced competencies. Among foundational competencies, responsibility, systems thinking, and teamwork were identified as important variables. Among maintenance and enhancement competencies, problem-solving ability was found to be crucial. Planning and organizing as well as human resource management were important variables among enhancement competencies. Finally, continuous improvement attitude was identified as the most important variable among advanced competencies.

Foundational competencies are generally related to personal characteristics of individuals and are the basis of manager success. Absence of maintenance competencies leads to failure of managers, and their presence alone is not necessary for success. Enhancement competencies includes managerial and job-specific competencie, the presence of which helps improve performance and increase effectiveness. Advanced competencies as the highest level of competency lead to ultimate success of managers in the organization.

Social health is a dimension of health that affects other aspects. Social health deals with people's relationships with each other and their interactions in the society, but there is not a single approved definition by all international organizations. Due to diversity of definitions for social health, various indicators have been introduced to measure it. The purpose of this article is to introduce macro social health indicators.

The research approach in this study is a mixed method. Initially, a list of indicators was extracted via systematic review. In the qualitative phase, the prepared list was evaluated and scored by experts in the field of social health (as members of the scientific committee). Prioritization was achieved based on average scores.

Finally, 50 articles were included in the study. Priority macro indicators of social health include the following:Number of prisoners, divorce number (ratio of divorce to marriage), poverty, suicide, school drop-out rate, child labor rate, youth incarceration rate, homicide, security, environmental performance index, social capital, equality of income opportunities )Gini index), legalism (rule of law), social justice feeling, political participation index (e.g., vote in presidential elections).

Using the list of macro indicator priorities and conducting periodical surveys, policy makers and scientific societies could have a true picture of social health and its trend. Social healthpromoting programs could then be designed accordingly.

The pharmaceutical system plays an important role in ensuring the health of society, including providing access to medicines, ensuring the quality and safety of medicines, managing and monitoring the rational use of medicines and providing pharmaceutical services, Conflict of interest can have a negative effect on each of these roles.

We used the qualitative research method and the interview tool to collect information about various models of conflict of interest. Expert people in the pharmaceutical system were selected with the Purposive sampling, and a semi-structured interview was conducted with them. After 42 interviews, the collected data reached saturation stage and qualitative analysis was used to analyze the textual data.

  Different models of conflict of interests such as receiving gifts, secondary employment, financial and non-financial interests, conflict between economic interests and professional duties, history of activity in the pharmaceutical industry and friendly communication were identified in the field of personal conflict of interests and models such as conflict of duties, conflict of interests resulting from political and social pressures were in the field of institutional conflict of interests in different parts of the pharmaceutical system.

Iran's pharmaceutical system is faced with instances of personal and institutional conflict of interests in various sectors. The types of personal conflict of interest are very similar to the types of personal conflict of interest in other studies, while the types of institutional conflict of interest have few similarities, which are rooted in the pharmaceutical laws and structures of different countries.

Discipleship and scientific education as a tradition derived from the lives of the Imams (peace be upon them), with the lofty goals of dynamic student-teacher relationships in the higher education system, which is the most important pillar and axis in the development and scientific and human excellence of the higher education system. , is congruent and it is necessary to identify and present this matter by examining different dimensions of the subject. Therefore, the current research aims to answer the question, what are the dimensions, components and indicators of student upbringing of faculty members in universities? It was done and presented in the form of research findings.

The research has been compiled using metacomposite method. The research sample included 17 works of 17 Iranian religious thinkers that were related to the study and became the basis for extracting the findings.

After reviewing and analyzing the works, 22 indicators were identified and classified under 8 dimensions in the form of 19 components. In this, the spiritual dimension and the behavioral dimension are especially important.

The special attention and attention of policy makers and higher education planners to the dimensions, components and indicators resulting from this research will improve the performance of university faculty members, who play the biggest role in improving the quality of education, research and social services, and it requires an effective flow of remembering and learning and educating students in the form of discipleship in all dimensions in higher education.

The inability of couples to resolve conflicts and deal with them appropriately may lead people to divorce. This study was conducted with the aim of determining factors affecting divorce in Iran during the last 10 years.

In this study, a systematic review was done. All the articles in the last decade (2010 to 2020) about the causes of divorce in Iran in Persian and English and in the databases PubMed, Scopus, Web of Science, Google Scholar and Megiran, ISC, SID were indexed using Persian and English keywords. From all the articles found, following the data entry and exit criteria, 27 articles were finally extracted and analyzed using the PRISMA guidelines.

The obtained results can be classified in several categories. These classes include demographic factors, economic factors, cultural-social factors, personality factors, factors related to incompatibility between couples, family factors and biological-psychological factors. In addition, 20 of the most important causes of divorce in the last 10 years were: male unemployment, lack of moral understanding, infertility, cultural and religious differences, involvement of family members, mental illnesses, drug and alcohol addiction, financial problems and insufficient income, from forced and forced marriage, sexual dissatisfaction, domestic violence, indifference to spouse, infidelity, remarriage, physical diseases, unrealistic expectations, immorality, foul language and obscenity, legal and judicial problems, lack of trust in each other, and moral corruption and illicit pleasures.

The findings of this research can help health policy makers to reduce divorce as a serious social harm by developing detailed programs.

Despite numerous laws and regulations related to access to information and transparency, there are many problems in their implementation. The purpose of this study was to investigate and analyze the challenges facing laws and documents related to transparency in the health system of Iran.

Documents, laws and regulations related to issues of access to information, transparency, and disclosure of information from various fields were collected and analyzed using the READ approach. After systematic naming of documents and laws, their information was entered in a table, after which different parts of each document were carefully analyzed and compared.

There are numerous documents, laws and regulations on the issue of access to information and transparency, but the lack of enforcement for these laws and regulations has caused inefficiency. Some of these documents, laws and guidelines are in conflict with each other and some have shortcomings. Often, there is a long time gap between the drafting of the bill, the approval of the law and enforcement of executive instructions. Sometimes, unawarness of the method of identifying and separating privacy information and personal information causes problems in implementation.

Attention to enforcement while developing transparency and access to information is a fundamental necessity, in order to prevent introduction of a multitude of ineffective laws. Drafting of laws and regulations in terms of form and content should be in such a way that the possibility of misunderstanding and violation of them is minimized. Approval of bills and executive regulations must be achieved at the appointed time, so that the laws are implemented at the right time and have the required effectiveness

Educational and psychological interventions have a wide contribution to mental health in the elderly. The current research was about the effectiveness of psychological and educational interventions in the field of old age in experimental evidence.

The type of study was applied and qualitative, and meta-synthesis technique was used. Using the targeted method, the integration approach, and Sandelowski and Barroso's (2007) model, 100 articles were selected; after the evaluation criteria, 79 final articles were selected. The scope of research articles was between 2016 and 2021 for foreign research and 1391 to 1401 for domestic articles. The findings were analyzed and implemented in the form of categories, concepts, and codes.

The results showed cognitive effectiveness (improving brain-neural functions, attention and concentration, learning and memory, functional and performance, reaction and response) psychological effectiveness (improving psychological processes, cognition, and belief, emotion and emotions, behavioral domain) effectiveness in disorders (improvement of clinical symptoms, mood and anxiety symptoms), physical effectiveness (improvement of body organ activity, physical performance) effectiveness on quality of life (levels of quality of life, dimensions of quality of life), social effectiveness (improvement of interpersonal interaction, family dimension, social dimension), emotional effectiveness (improving emotional processes, improving expression and management) and effectiveness in the field of illness (improving adaptation to illness, chronic and incurable diseases), occupational effectiveness (improving adaptation to work) themes of the effectiveness interventions constitute

The findings of the research show that interventions have been able to show their effectiveness for the elderly in important areas.

Via presenting commands and prohibitions and with a multidimensional attitude, Islam provides a tool for self-control and self-determination by the individual in addition to creating a meaning of life for the individual as a purposeful being. Man lives in a structure related to God, himself, the world and others, and accepts responsibility for these dimensions. In addition to the importance of satisfying individual needs and personal growth and development, man also considers himself responsible for the society and existence. Thus, in every moment of his life, he equips himself with an executive order to create an efficient, logical and rational path to achieve happiness and perfection with a deep attitude and predicting his performance and its effect. The aim of this research is to examine the relationship between the religious rules of the holy Shariah and aspects of health, with an emphasis on spiritual health.

The study method is combined, library and field.

The average collective scores show that attention to and observance of Sharia rules have an acceptable level among the target community. The highest collective average score of 4.7 was related to the subject of God's satisfaction.

This study showed that wherever Sharia areas are established in the society and a model has been set for them, attention and commitment to the rules has increased. In contrast, when leaders of the society fail to model and promote Sharia rules, their observance in the target society is less palatable. Upbringing, belonging to the mind and accepting the orders of religion, as a framework in creating a source of internal control, guides the person's performance and brings peace and satisfaction to him. The result of these discussions leads us to the positive effect of observing the Sharia rules on the existential health, especially the spiritual health of individuals.

Corona virus crisis is an important issue, with numerous dimensions in social, governmental, security and media aspects, in addition to the individual dimension. Among these, the mission of the government is of special importance. This research seeks to provide a suitable basis against the damages caused by the corona virus, via examining various philosophical bases and legal documents of the government's civil responsibility.

This research is theoretical, and the research method is descriptive and analytical. Collection of information is library-based, and achieved by referring to documents, books and articles.

Theories such as public interest, guarantee of rights, guarantee of legitimacy, insurance obligations, and social sponsorship comprise the most important philosophical foundations of government legitimacy; In addition, the legal documentation of the government's civil liability in the face of the Corona crisis is based on the Constitution, common law, the rules of the National Anti-Corona Headquarters and international law. With regard to this type of damages, we will have no choice but to resort to philosophical foundations that lead to public law and distributive justice.

One of the most important results of this study is to pay attention to new solutions in the field of unavoidable damages, such as damages caused by natural disasters, such as corona. In this regard, the public natural disaster insurance fund of the country is one of the important and mandatory needs.

The field of health is one of the main axes of the development of any country, and continuous education in various fields of health will lead to an increase in awareness and a change in the attitude of that society. The present study has examined the health-oriented programs produced by Qazvin TV channel (Apple and Sib Salamat) with the aim of presenting the pathology of medical and health-oriented television programs from the perspective of personal and social health.

This study is based on quantitative content analysis (the unit of analysis is equal to the record unit) of each item of the program called "Sib and Sib Salamat". The statistical population of this research is 12 health-oriented programs produced by Qazvin network, which were selected and analyzed using the direct observation technique. Accordingly, first the health-oriented programs of this network were extracted, coded, observed and then analyzed based on the identified categories.

The findings showed that the general analysis of the coded categories of the information variable compared to the topic of the program is the highest. The lowest frequency was related to the variable of entertainment compared with the topic of the program. Regarding selection of the topics presented in the program from among the four dimensions of health (physical, psychological, social, and spiritual), more attention has been paid to the aspect of "physical health".

The results of this study demonstrated that use of informative entertainment formats in the field of health education, balanced attention to the four dimensions, and better effect based on the audience persuasion theory should be emphasized.

Physical activity plays a protective role against diseases via reducing risk factors. The purpose of this research is to investigate the effect of two types of intense interval training (HIIT) and continuous aerobics on the pulmonary and cardiorespiratory functions of wrestlers who had recovered from corona disease.

This research was carried out using a semi-experimental method and a clinical trial in the form of pre-test and post-test. Accordingly, using Morgan's table, 45 participants were invited to a briefing session and then randomly divided into three experimental groups: experimental group 1 (continuous aerobic exercise 15 participants), experimental group 2 (intermittent high-intensity exercise 15 participants) and control group 3 (15 participants without training).

The present study showed significant difference in FVC, FEV1, PIF, systolic blood pressure, diastolic blood pressure, heart rate, time to fatigue, VO2max, and pressure perception scale between the three groups. Meanwhile, the differences between the three groups were not significant in the VC variable,. A significant difference was also observed between the average of the studied variables in group 1 and group 2 of the research in post-test compared to the pre-test, which was more remarkable in the intense interval training group compared to the continuous training.

Considering the effectiveness and improvement in physical fitness indicators of HIIT compared to continuous training, HIIT can be viewed as a cost-effective option for improving cardiorespiratory fitness and lung function. A health improvement strategy was employed.

The study of retirement of professional athletes and its consequences in recent years has attracted the attention of researchers. Disease monitoring and epidemiological studies are one of the basic elements of comprehensive efforts to protect the health of athletes.

A researcher-made questionnaire was used to record musculoskeletal diseases in volleyball, football and basketball sports. In this questionnaire, important and severe musculoskeletal diseases were recorded based on priority. Registration of diseases was according to the region and type of disease.

The rate of musculoskeletal diseases per 1000 hours of training among the studied groups showed that veteran basketball athletes per 1000 hours of training (2.40±1.30) were less than volleyball athletes (3.46±1.17) and football (3.98±0.84), had musculoskeletal diseases. The most common area of the disease in all three disciplines studied was the knee (9.4% of all recorded diseases). Musculoskeletal pain was also shown as the most common disease in athletes (15.69% of all recorded diseases).

The changes that occur in the muscular-skeletal structure of people with age can make people prone to musculoskeletal diseases, and this possibility is more in people who engage in sports for the elderly than in other people. Considering that the data collection of the present study included 2 years of the corona disease pandemic, it is possible that this had an effect on the results of the research and caused changes in the type of activities and even the lifestyle of the athletes. Brought therefore, the need to study the epidemiology of musculoskeletal diseases in the post-corona era is felt.

Soon, Razi vaccine and serum research institute, which is located in Karaj city, will enter its second century of activity. For this reason, I want to show in this article that this important institution, which is one of Iran's civilized healthcare institutions, has been able to create a scientific tradition for itself, and because it has created this tradition for itself, the place of this institution in the structure of health and The treatment of Iran should be examined.

This is a historical essay written in a library review. This article is the second article that I have written about the theory of civilizational institutions of health and treatment in Iran.

How this institute was set up at the end of the Qajar rule over Iran and the efforts that were made to strengthen it, the achievements of this institute, which is a large collection of vaccines and serums that are used for animals and humans, the completion of the institute over time. And turning it into a very important institution for the production of various vaccines and serums are the things I have written in this article. This article has a historical structure.

The death of many cows in Iran due to rinderpest (cattle plague) in Iran in 1919 caused the government of Iran to set up the Razi Vaccine and Serum Research Institute. Soon, the institute was ordered to make vaccines and sera for humans as well. This institution, like many other institutions in Iran, was built as a result of the request of the community. The institution is soon to enter its second century of activity while it has a strong academic tradition of its own. Hence, it is necessary to look to the future and play an important role in the knowledge of immunology for people in the country.