مجله فرهنگ و ارتقای سلامت (فرهنگستان علوم پزشکی جمهوری اسلامی ایران)
سال هفتم شماره 3 (پیاپی 23، پاییز 1402)

All governments should plan and for the comprehensive health of all people. For this purpose, in this documentary, the most important priorities of the health system have been emphasized: Addressing social determinant of health, development of health equity, correct and accurate implementation of all clauses of the general health policies, and collaboration between all relevant departments.

11 Oct. 2023
Professor Richard Horton,
Editor-in-Chief of the Lancet Medical Journal

Palestine-never forget
Following the publication of your article on September 16, 2023 in the Lancet entitled "Mahsa Amini - never forget," which contained completely false information about the death of a citizen of this country as well as health care personnel, doctors and specialists of our country have written a response. I sent it to you on the 18th of September for publication, but you did not respond. Now that I am writing a second letter for the scientific medical journal Lancet, the world is witnessing the unprecedented crime of the racist settler apartheid regime against the defenseless people of Palestine. I am writing this for you, which, unlike your undocumented article, is based on numerous documents and is completely verifiable. My evidence consists of hundreds of videos and written observations of thousands of people who have documented the crimes of this colonial regime against the Palestinian people over the years. In this article, I list some of the crimes of the Zionist regime that have been carefully recorded in history. I do this because you have ignored everything that has happened over past decades, and not a single word has been written about these crimes against humanity in your magazine. However, there is no doubt that the scientists and people of Iran and the world will not forget these crimes.
I will review some of the crimes of the regime based on last year's statistics:
1300 Palestinian villages destroyed since 1948.
800,000 people out of a population of 2.5 million displaced from Palestinian villages.
70 mass killings since the occupation (Sabra and Shatila, etc.).
More than 15,000 Palestinian martyrs since the occupation.
6.7 million Palestinian refugees across the world.
28.7 percent of Palestinian refugees live in 58 camps. 10 camps in Jordan, 9 camps in Syria, 12 camps in Lebanon, 19 camps in the West Bank, and 8 camps in the Gaza Strip.
2 thousand martyrs and 10 thousand wounded just in the 51-day war.

As this article is being written, Gaza is under the complete siege of the apartheid regime, and children, women, and defenseless people are continuously and blindly being bombed. Thousands of children, women, and men have been killed or injured. The regime has also cut off water and electricity, and the entry of any kind of aid, including food, medicine, and medical equipment, into Gaza is prohibited. I hope Lancet medical magazine, by including my letter as the president of the Iranian Academy of Medical Sciences, will record this unique tragedy and crime of the century, which continues amidst the silence of the western scientific and medical community. If you choose not publish, be sure that your indifference will be recorded in history.
                                                                                                   Yours sincerely,
                                                                                          Seyed Alireza Marandi, M.D.
                                                                                  President Academy of Medical Sciences

His Excellency, Antonio Guterres,
During the past forty days, the countries of the world have witnessed the great crime of the Zionist apartheid regime, which may be unprecedented in history. The unique nature of this catastrophe is that defenseless children, women and men are completely surrounded in their own land and in a very small area and are bombarded with all kinds of bombs and weapons of mass destruction in front of the eyes of billions of people across the world. Residential buildings, hospitals, schools, and refugee camps in this small piece of land have been destroyed by bombs equivalent to more than several atomic bombs that the criminal American regime used against Japanese citizens in Hiroshima. So far, the bombings has left more than 12,000 dead, more than 5,000 of whom were children and more than 3,000 were defenseless women, and more than 30,000 people who are besieged in their land have been severely injured. All these have taken place as access to water, electricity, food, and medicine has been cut off by the criminal Zionist regime for these oppressed people. Doctors and medical staff do not have any safe places left to treat the injured either.
Your Excellency,
These unique historical crimes are all happening as you are the representative of the countries of the world as the head of the United Nations, and it is unfortunate that you have not taken any effective measures to prevent these crimes. These dark days will be recorded in history. The least you can do is to stand among the oppressed and helpless people of Gaza and on behalf of the international community order international aid to be sent to Gaza. Doctors across the world, with the support of UN forces, are ready to go by land, sea, and air to Gaza and treat these oppressed people. 
Your Excellency,
At this critical historical moment, every fearless and effective action you take to prevent the crimes of the Zionist apartheid regime will be recorded in the minds of the people of the world and in history. Another course of action is for you to resign as the Secretary General, so that at least you will not be complicit in the continuation of these crimes.


Yours sincerely,
Seyed Alireza Marandi, M.D.
President Academy of Medical Sciences
Islamic Republic of Iran
16 Nov.2023

His Excellency, Antonio Guterres,
Excellency,
As you know, in a criminal and unprecedented act, the colonial apartheid regime has ordered the complete siege of Gaza. It has cut off all water and electricity supplies as well as the entry of food and medicine into Gaza. Meanwhile, under these extreme circumstances, defenseless Palestinian women and children have been massacred through the relentless carpet bombing of residential buildings. This criminal behavior is taking place amidst the silence of Western controlled human rights organizations, especially those affiliated to the United Nations.
Your Excellency, Your responsibility as the Secretary General of the United Nations makes you legally and morally responsible to provide a safe path for the transfer of medical assistance and the treatment of a defenseless and oppressed Palestinian population. It is obvious that your response to these barbaric crimes of the Israeli regime will be recorded in history.

                                                                                                                                                         Yours sincerely,
                                                                                                                                                          Seyed Alireza Marandi, M.D.
                                                                                                                      President Academy of Medical Sciences Islamic Republic of Iran
                                                                                                                                                                     10 Oct. 2023

The emigration of intellectual capital has grown significantly in recent years. When the experts of the countries reach the production stage, by leaving the country, they transfer their intellectual and economic ability to the destination countries. One of the ways to reduce the damage caused by this phenomenon is brain rotation. The current study was carried out with the aim of investigating strategies to strengthen the circulation of brains and attract elites in the health system.

The present study was conducted as a scoping review. Search and analysis was done using Prisma protocol. The content of articles was analyzed through content analysis in thematic method using MAXQDa20 software. All the contents related to the desired concept were coded in the articles, then, based on the conceptual connection, they were placed in subcategories and categories, and finally they were placed in the main categories.

The initial result of the article search was 2574 articles. After removing duplicate items, 675 items were removed due to being unrelated and 13 articles were removed due to lack of access to the full text, and 33 articles were used for analysis. After summarizing, the codes were placed in 13 subcategories and 3 main categories, which include 1- governance reforms - macro policy making, 2- strengthening and reforming university policies, 3- cultural and social strategies.

The findings show that Iran can pay more attention to the rotation of brains and use the intellectual capital of Iranians abroad to a greater extent. This will be achieved when a written road map is prepared, approved and implemented to strengthen communication and culture.

Development of Fellowship Education is constantly one of the strategies of medical education policy makers because of the key role of graduated fellowships in advanced health care. This study aimed to comprehensively analyzes the current status for Ophthalmic Fellowship Education in Iran.

In this applied qualitative foresight study, using purposive sampling, eleven experts and key informants of Iran’s Ophthalmic Fellowship Education, selected, and invited to participate in a panel of experts. A panel meeting for focused discussion was held on February2023. The data analyzed by thematic approach.

The identified strength points and challenges are presented in 23 main themes, and 65 subthemes. The seven main themes for strengths included, systematic management, successful policies in ophthalmology education, effectiveness of fellowship programs, increasing motivation for academic growth, faculty empowerment, improving access to advanced services, avoiding procedures with questionable indications.
Sixteen themes for challenges included: low educational quality in some centers, lack of community based education, weak professional ethics, low quality of research, lack of comprehensiveness, lack of futuristic approach in developing fellowships, lack of workforce planning, ineffective evaluation system , ineffective centralized admission system, unbalanced admission capacity, receiving fellowship degree to make extra income, performing ophthalmic procedures not related to their fellowship fields , refuse to operate high risk ophthalmic procedures, unattractive Tariffs, regional disparity of medical resources, shortage of advanced technological infrastructures.

Based on experts’ consensus, forward-looking planning is effective in order to maintain the achievements, solve the challenges and improve these courses in line with the desired perspective.

Identifying the challenges of research activities in the academic atmosphere of the health systems, plays an important role in qualitative and quantitative promotion of research in this era.

Studies investigating the research barriers in the medical universities of Iran were identified through a comprehensive search from national and international databanks such as: Magiran, SID, Pubmed, Google scholar search engine and were selected after investigation of titles, abstracts and full texts. Required information including different research challenges from the viewpoint of financial, organizational, individual, scientific and cultural aspects together with different related factors were extracted from the selected studies. In addition, the results of the review was presented in the committee of the Academy of Medical Sciences in the 8th Iranian academic study area and the opinions of the Committee members were collected by focus group discussion and used for final discussions. Research barriers in the medical universities were associated with different factors especially academic rank, academic degree and field of education.

Research barriers of the Iranian medical Universities and research centers were extracted from 41 eligible studies. According to the results, organizational and finantial challenges were on the top list of research barriers, while scientific and natural barriers were the least challenges. The main challenges among the academic members and research staff were financial, while students were faced mainly with the organizational barriers.

To overcome and manage the research problems, the old research challenges as well as new challenges should be particularly taken into account by the managers and policymakers.

During a crisis, especially an epidemic, children are more likely to suffer from psychological problems. This research was conducted with the aim of investigating the relationship between the corona pandemic and sleep quality and impulsivity and mental health of elementary school children.

The method of this research was correlational, and the statistical population of the research was all primary school students of two districts of Karaj city in the academic year of 2021-2021. In this research, 377 students were selected based on Cochran's formula, using multi-stage cluster sampling method. Data collection tools, World Health Organization (2020) epidemic questionnaires caused by the corona virus; The quality and habits of children's sleep was Owens et al. (2000) and children's impulsivity scale was Hirschfield (1965). Research data were analyzed with Pearson correlation and multiple regression using SPSS version 24 software.

The results showed that there is a significant relationship between the corona epidemic and sleep quality, impulsivity and mental health of primary school students (p<0.05).

Based on the findings, it can be concluded that the more restrictions caused by the corona virus pandemic, the more negative sleep habits, impulsiveness will increase and the mental health of students will decrease.

In Islam, many recommendations have been given to social relations between people. One of the most important of these relationships is establishing a constructive relationship between the members of the community and the patient; Because it is effective in laying the groundwork for the rehabilitation and treatment of the patient.

This research is done with descriptive analytical method and with conceptual and documentary analysis. Propositions that indicate the moral duties of people in the society from the point of view of traditions have been collected, compiled and explained.

According to the traditions, the moral duties of the people of the society were achieved in three areas: 1) medical staff, 2) nurses and patient caregivers, 3) visitors.

By complying with their ethical duties, the treatment staff calms the patient down and accelerates the treatment process. Nurses and caregivers should bear the patient's discomfort with love and try to treat him. Visiting staff bring peace and hope to the patient by visiting them, and they try to meet the patient's needs by being aware of them. When visiting the patient, the visitors are obliged to observe the etiquettes, which include: observing the visiting time, staying together for a short time, being kind to the patient, praying for the patient, visiting someone who has not visited, visiting different patients, holding hands with the patient and saying praise slowly.

The present study was conducted with the aim of determining the effectiveness of academically unproductive behaviors on the difficulty of emotion regulation, self-regulation and academic self-concept of students.

The research method was semi-experimental with a pre-test, post-test design with a control group. The statistical population was all the students of the Islamic Azad University, Sanandaj branch in the academic year of 2020-2021. 30 volunteers entered the study as they were available and were randomly replaced in two groups of 15 people, experimental and control. Data were collected using the difficulty of emotional regulation questionnaire by Gertz and Roemer (2004), academic self-regulation by Bouffard et al. (1995) and academic self-concept by Liu and Wang (2005). The experimental group received 10 sessions of 75 minutes (2 sessions per week) under the training package based on academically unproductive behaviors, and the control group did not receive any intervention. Statistical data analysis was done using multivariate covariance analysis method and SPSS version 23 software. The significance level of the tests was considered 0.05.

Findings showed that by controlling the effect of the pre-test, there is a significant difference between the post-test of the experimental group and the control group in difficulty in regulating emotions, academic self-regulation and academic self-concept of students (p<0.001).

Based on the results of the research, it can be said that the educational package based on academically unproductive behaviors is a suitable intervention method for improving the difficulty in regulating emotions and promoting academic self-regulation and academic self-concept of students.

Spiritual health is one of the four dimensions of human health, which plays an important role in ensuring human health due to its dominance over the dimensions of mental, social and physical health. Accurate knowledge of its components has a decisive role in promoting, restoring and stabilizing spiritual health. One of the key factors in achieving spiritual health is the fundamental concept of sincerity. The current research seeks to answer the following questions: How does sincerity affect spiritual health? What are the effects of promoting and strengthening spiritual health centered on sincerity?

The present research has been completed with the tools of document-library collection and descriptive-analytical method and the level of analysis of structuralist semantics and emphasis on companionship relationships.

The findings of the research indicate that the mechanism of achieving complete spiritual health with the catalysis of "sincerity" in order and longitudinal order consists of worship, having power and insight, special focus on resurrection, becoming pure for God and in the ultimate is to reach the position of "Mustafain al-akhyar". Based on these findings, the mechanism of converting hypocrisy into elementary faith with the catalysis of sincerity is repentance, correcting actions, clinging to God, the purity of religion for God, and finally, it is elementary faith. By passing through the "sincere" stage and using sincerity in all intentions, thoughts and actions, complete spiritual health is achieved with the concept of "purified".

The difference between Quranic spiritual health and other schools is the coefficient of sincerity in the four relationships of human beings and finally, in the light of sincerity, having a healthy heart and achieving a pure life.

Studies reveal the reduction of physical activity in most countries particularly in developing countries and women. Therefore, the present study was aimed to test the physical activity of overweigh and obese women who attended to a private nutrition clinic using social-ecological model in Gorgan city.

A cross-sectional survey was conducted on 200 women with overweight and obesity who attended to private nutrition clinic using convenient sampling method. To collect data, a three-part questionnaire was used including demographic characteristic, international physical activity questionnaire (IPAQ), and constructs of social-ecological model (perceived benefits and barriers, perceived self-efficacy and perceived support). Descriptive methods (mean and standard deviation) and inferential tests such as one-way ANOVA, Pearson correlation and tukey tests were carried out.

The mean score of physical activity of women per week was 2057.29 ± 1027.3 MET- Minute. Constructs such as perceived benefits (p=0.039), self-efficacy (p=0.047) and environment (p=0.031) were effective factors in the moderate physical activity. While, in the severe physical activity, friends support (p=0.017) was also remarkable factors such as aforementioned factors.

Improving people's self-efficacy status and also providing individuals access to a safe environment to perform physical activities can be useful and beneficial in order to improve model constructs including perceived barriers and physical environment.

In honor of the esteemed professors and pioneers in the field of science who have made significant contributions to knowledge and the country, it is important to document their biographies and personalities in a documentary format. This will ensure that they are remembered in the history of the country and serve as role models for future generations.
This paper focuses on the life of Dr. Vardges Nahapetian, a physician and biostatistics specialist who is credited with founding the field of biostatistics in Iran. His impact on public health in the country, including the establishment of the Department of Biostatistics and Epidemiology at the University of Tehran, is discussed. Information about Dr. Vardges Nahapetian's valuable contributions to the field of biostatistics can provide valuable insights for the scientific community in Iran

With advancement of artificial intelligence technologies in health, its positive impact on improving health and treatment indicators have increased. This research examines the role of artificial intelligence, especially based on machine learning, in optimizing care processes and trends.

This study is designed as a narrative review. for this purpose, an extensive search has been conducted in reliable scientific databases such as Pubmed, Web of Science, and Scopus. The search was conducted using keywords such as ' Internet of Medical Things', integration of artificial intelligence with 'biomolecules', 'diabetes', 'cancer', and 'robotic surgery'. The articles found were about 92 articles, of which 40 articles related to the research were selected.

This study shows that the use of artificial intelligence in the field of health, including disease diagnosis, clinical predictions, hospital administration healthcare resource optimization, is increasing, this trend leads to an increase in the efficiency and quality of health services, however there are also challenges.

Artificial intelligence technologies are known as technological milestones in the field of health, which not only help to modify and improve treatment processes, but are also effective in fields such as monitoring vital signs and surgery. Despite challenges such as heterogeneity and data management, the ability of these technologies to predict diseases has changed the healthcare landscape. Success in this field requires multidisciplinary, forward-looking approaches and wise strategies.

The current study was designed to investigate PM2.5 status in Tehran from 2011 to 2022.

Hourly data of particulate matter (PM2.5) concentrations in the air of Tehran city were examined from all air quality monitoring stations belonging to the Department of Environmental and the Air Quality Control Company. The health effects of this air pollutant were estimated, including the number of attributed deaths, using BenMAP-CE and the latest version of AirQ+ software. Additionally, the economic costs associated with health impacts were calculated using the Value of Statistical Life approach.

During the 12-year period under study (from 2011 to the end of 2022), PM2.5 concentrations in of Tehran city consistently exceeded the established standards by a significant margin. The annual values were approximately 5 to 8 times higher than the new guidelines of the World Health Organization and 2.5 to 3.5 times higher than the national standards. As a result, the citizens of Tehran have been exposed to a considerably high level of this cancer-causing risk factor. The number of deaths attributed to PM2.5 in the year 2022 reached around 9,241 (with a range of 8,583 to 9,647) in individuals over 25 years of age. Furthermore, the economic loss resulting from these deaths due to PM2.5 in the ambient air of Tehran in the year 2022 were estimated to be around 2.5 billion dollars.

Considering the undesirable air quality in Tehran city, planning and implementing scientific and practical programs to reduce air pollutant concentrations in this city are considered vital necessities.

Planning for the disabled ensures attention to their needs, the importance of providing for them, creating equal opportunities to achieve economic-social benefits, and generally eliminating health discrimination and achieving health justice.
"Development of a comprehensive care and support program for veterans and the disabled community of the country with the aim of improving their health and empowering them" as the third sub-policy of the eighth policy of the country's health system is emphasized by the Supreme Leader in 2013.

This study is of applied and qualitative type. To develop a program, in addition to studying the texts related to the current domestic and foreign situation regarding disabled people; Thirty people with different disabilities and twenty veterans were asked about their problems and wishes. Also, to obtain program components including strategies; Actions; the indicators, the duration of the program and the number of its phases were determined through the rain of thoughts and questions from fifteen experts with important management responsibilities in the field of rehabilitation.

The proposed program was designed in two three-year phases and includes 5 strategies and 24 measures. The strategies of the program include: being seen in the society, creating a network of disabled people's networks, using information and communication technology, community-oriented rehabilitation, and ensuring the implementation of laws and respect for the rights of the disabled.

Disabled people are very dear children of the society and should be given special attention in terms of support and empowerment. The existence of a support program for the underprivileged people of the country and its implementation as a stimulating and effective factor will provide the growth and excellence of the society and economic prosperity.

Natural childbirth after caesarean section can prevent the recurrence of caesarean section and its many complications, so this study was conducted with the aim of examining the explaining the lived experiences and psychological function of these mothers.

This research was conducted with a qualitative approach of hermeneutic phenomenology. Participants included 17 women with a history of natural childbirth after cesarean section, who were selected purposefully from among women in hospitals and medical centers in Tehran, Karaj, Mashhad, and Qom. The research tool was an unstructured interview, and the process of completing the interviews continued until data saturation was reached. Dikelman et al.'s seven-step model was used to collect and analyze data.

In the data analysis, the main theme was identified as post-traumatic growth, which indicates the improvement of psychological function. This theme was formed by five sub-themes of threat perception and effective coping strategies, replacing successful identity instead of failed identity, understanding experiences and strengthening spiritual beliefs, developing and improving interpersonal emotional relationships, and strengthening self-efficacy beliefs.

Based on the data analysis, it was concluded that women with vaginal delivery after caesarean section were able to cope with it successfully and reach higher levels of psychological performance and positive change in cognition and emotion and then behavior by using personal and social resources to fight against mental barriers and internal and external challenges of natural childbirth after caesarean section.

 Biopharmaceutical products, characterized by strategic importance and substantial added value, have garnered significant attention from global governments and investors. In Iran's scientific roadmap, the ambitious goal of attaining a three percent share in the global market by the year 2025 has been established, necessitating the formulation and implementation of targeted strategies.

 This research employs a comprehensive mixed-methods approach, encompassing both quantitative and qualitative components. Quantitatively, official annual statistics from the Food and Drug Administration are analyzed to evaluate the growth trend of domestic biopharmaceutical production and imports. The qualitative phase involves in-depth semi-structured interviews with 25 industry experts.

 Analysis reveals a gradual progression towards the targeted horizon, with a noteworthy 68.3% growth compared to the global market, representing 0.5% of the 3% target for the year 2025.

 Despite this, challenges persist, impeding the realization of the established objective. Overcoming these obstacles and implementing the proposed solutions are imperative for expediting progress. The study anticipates Iran surmounting these barriers and securing a 3% share in the global biopharmaceutical market in the foreseeable future.