اباسط میرزایی

Nurses play a crucial role as one of the primary pillars of the healthcare system. The training of proficient nursing staff incurs significant costs for the healthcare system, and their departure leads to irreparable harm across various sectors of their home country. The purpose of this study was to determine and prioritize the factors affecting the migration of nurses based on the opinions of hospital managers.

This quantitative study utilized hierarchical analysis through Expert Choice software to examine the perspectives of nursing managers from selected hospitals in Tehran, employing a census approach with a 95% participation rate.

Out of 57 participants, the psychological factor emerged as the most influential, with a weight value of 0.746. Within the realm of psychological factors related to the country of origin, the absence of spiritual and psychological support in the workplace, with a weighted value of 0.458, was singled out as the primary cause. Gender discrimination within the country of origin, carrying a weighted value of 0.193, was highlighted as the foremost individual factor. Moreover, environmental factors in the destination country, with a weight value of 0.765, outweighed those in the country of origin.

Upon analysis of the data, psychological factors were identified as the top priority, followed by economic considerations. Thus, policymakers and managers are urged to implement innovative strategies, recognizing the importance of addressing both psychological well-being and economic stability.

Kidney transplantation is still the most important and main treatment for advanced kidney failure. However, some patients reject the transplant through an immune system reaction. Improvement of immunosuppression with drugs such as rituximab and bortezomib allows these patients to be eligible for transplantation. This study aims to determine the cost-effectiveness of rituximab versus bortezomib in kidney transplant patients at Farhikhtegan Hospital, Tehran.

The target statistical population in this research was inpatients receiving rituximab and bortezomib in 2022 in Farhikhtegan Hospital. Rituximab with a minimum dose of 375 mg/m2 was administered one day before transplantation. Bortezomib was administered at a dose of 1.3 mg/m2 on four occasions (usually days 1, 4, 8, and 11). The indicators related to the calculation of the cost of the disease and the parameters indicating the effectiveness were determined through library studies and interviews with experts, and finally, the aforementioned information was collected through the examination of the patient's records (hospital database). Cost indicators include the cost of a physician visit (first day, second day, general practitioner, emergency department, discharge day), medicine (main medicine, complementary medicine), hospital hoteling (nursing services, consumables, bed, radiology, ECG, critical care, physiotherapy, preparation of nutrition formulary, examination, and burial permit) and tests (all tests necessary to evaluate and monitor the patient). Efficacy indices included IgG class I, IgG class II, IgM class I, and IgM class II. The data analysis was conducted by SPSS software.

77 kidney transplant patients including 53 treated with bortezomib and 24 receiving rituximab with an average age of 41.01±8.50 years were studied. Our findings showed that the average cost of the bortezomib group was 19,548,230.86 tomans. Before taking bortezomib, the average level of class I and class II IgG was 68.16±6.34 and 67.11±4.96, respectively, which significantly decreased to 17.28±15.73 and 18.13±16.75 after treatment with bortezomib (P=0.000). The average IgM class I and class II before taking medicine were 5.69±1.30 and 5.54±0.95, respectively, which reached 5.43±0.79 and 5.13±0.39 after taking Bortezomib, respectively. This decrease was significant for IgM class II (P=0.000), but not significant for IgM class I (P=0.223). In patients receiving rituximab, before taking the drug, the average level of class I and class II IgG was 71.66±7.86 and 67.83±4.53, respectively, which significantly decreased to 13.95±13.82 and 15.83±14.15 after treatment with rituximab (P=0.000). The average IgM class I and class II before taking rituximab was 5.70±1.23 and 5.45±0.97, respectively, after taking the drug, it decreased to 5.41±0.65 and 5.16±0.38, respectively, and this decrease was not statistically significant (P>0.05). The average cost of the rituximab group was 28,261,539.29 Tomans and caused a significant decrease in the average level of IgG class I and II. The incremental cost-effectiveness rate (ICER) was 1770997.65, which was lower than the threshold defined by WHO.

The results of our study showed that rituximab is cost-effective compared to bortezomib

Efficiency and optimization of the hospital bed is one of the things that is very critical to create an efficient management. In this study, the utilization capacity of a hospital bed in a military hospital in Tehran was investigated using machine learning.

The present study was carried out descriptively in 1401. By using the statistical data of the military hospital, field survey and placing it in the proposed index of this study, the utilization capacity of the hospital bed for the beds of the special care departments of the hospital (ICU1, ICU2, ICU3 and NICU) was calculated and analyzed.

The findings of the present study showed that the percentage of bed occupancy of the whole hospital is close to the minimum standard, but there is an obvious difference in the percentage of beds occupied by the departments, as a result, it seems that in terms of distribution between the departments taking measures to improve the percentage of bed occupancy, reduce the extra load of some departments and increase the working capacity of departments with low bed occupancy percentage.

The proposed formula presented in this study will help managers in increasing the efficiency of the hospital by measuring the utilization of the available capacity and identifying the reasons for not using the maximum capacity to reach the optimal utilization capacity.

This article highlights the importance and necessity of studying the challenges and opportunities presented by emerging technologies in the field of strategic management. With the rapid pace of technological advancements, businesses are faced with unparalleled opportunities for innovation and development. However, these opportunities also bring challenges, including the need for continuous adaptation to new technologies and managing the changes they bring. From autonomous surgery to automation in manufacturing, emerging technologies have profound impacts on management and entrepreneurial approaches. Utilizing various case analyses, this article delves into the role of technology in shaping entrepreneurial ecosystems and strategic management, highlighting the importance of continual learning and flexibility for success in these dynamic environments. Ultimately, the article underscores the significance of collaboration between organizations, governments, and other stakeholders to promote responsible and sustainable innovation.

The transition from the global epidemic of Corona; Gaining a new experience on a wide and unprecedented scale in the last few centuries in global health made possible the public vaccination of this disease. Examining and analyzing the process of acceptance of vaccination by people will be one of the very important principles in the future research of similar epidemic disease management, policy making and planning in future epidemics.

Methods and Materials: 

The current research is a review-narrative study that was conducted between December 2019 and January 2022. The English language databases Scopus, EMBASE, Google Scholar and Persian SID databases were used to search for the required information. The search strategy was implemented using related keywords and related operators. In addition, criteria were defined for the entry and exit of studies into the research. Finally, to extract information related to studies, forms based on standard indicators were compiled and used.

After checking the databases, a total of 17100 articles were retrieved in the databases, after checking the title and abstract of the articles in the screening phase and removing the articles with no thematic connection, finally, the full text of 27 articles, were included in the study based on the inclusion criteria. The findings of this research showed that the average amount of willingness to pay was higher in high and middle income countries, also there is a direct and significant relationship between people’s willingness to pay for vaccination and the increase in monthly income.

In global epidemics, planning to make vaccines free for low-income people in the society and donating free vaccines to low-income countries, by global organizations in charge of health, can be among the suggested solutions for to streamline vaccination programs. In addition, planning to increase awareness and promote the beliefs of the people of these countries regarding the benefits of vaccination by policy makers and the use of health belief models can be effective in improving the acceptance of vaccination in people.

Nurses are among the basic factors of health systems. Migration is one of the factors of reduction and loss of this value.

In this systematic review, PubMed, Scopus, Web of Science, SID, MagIran and Google Scholar databases were searched without time limit and based on the prism method, and in order to evaluate the quality of the articles from the critical evaluation checklists of the Joanna Briggs Institute(JBI) was used.

First, 265 articles were extracted, after screening and removing duplicate articles, unrelated, without complete text, the qualitative evaluation stage was performed, and finally 17 articles were included in the study, 7 articles with qualitative-quantitative method and 10 articles as Qualitative and content analysis was performed. No intervention was reported in the articles and no study prioritized the identified effective factors. The causes affecting migration were classified into two main categories: causes related to the country of origin (push factors) and causes related to the destination country (pull factors). The factors in the countries of origin and destination were counted in three areas: individual factors, social factors and cultural factors. Income, job position, job security, continuing education facilities and educational technology, team relations and facilities in the work environment and family status were identified as the most important factors affecting migration

Young nurses from third world countries, such as East Asian countries and India, had a high desire to immigrate. Considering that multi-dimensional causes, including psychological, subsistence and economic causes are effective on migrant nurses, for the possibility of effective management of this phenomenon, special attention and structural reforms in the social, cultural, political and economic dimensions of immigrant-first countries are necessary and it is needed.

Background & objectives: 

According to the recommendation of the World Health Organization, health insurance is an effective tool to achieve the global goal of universal health care coverage. The present study was conducted to design and determine a valid and reliable questionnaire to measure universal health insurance coverage in Iran.

 This descriptive-applied study was conducted in 2022. Based on the data obtained from the review and comparative study, an initial questionnaire was prepared based on the balanced scorecard model. Content validity was measured using a panel of 15 experts and content validity ratio (CVR) and content validity index (CVI) for each question. The test-retest method was used in a sample of 30 people to determine the reliability. Data were analyzed using Excel and SPSS 20 software. 

 Validity assessment was done in two stages. The final questionnaire was approved with a total content validity index score of 0.85 and a content validity ratio of 0.67. The results of Spearman's correlation coefficients for the four dimensions of the questionnaire showed the acceptable reliability of the questionnaire components. 

 Considering that the designed questionnaire was approved in terms of validity and reliability, it can be a suitable tool for determining the requirements for achieving universal health insurance coverage in Iran.

 Balanced Scorecard (BSC) is a performance appraisal method that offers a broad perspective in identifying the strengths and weaknesses of the organization's activities and is a prerequisite for strategic management. Performance evaluation as a control tool has always been considered by managers. Therefore, this study was conducted to apply the BSC approach to evaluate the performance of Rasoul Akram Hospital in Abdanan, Iran.

 The statistical population of this survey study included all staff of Rasoul Akram Hospital, Abdanan, Iran, in 2021. According to Cochran's formula and sample size of 204, the collected data were obtained from both documentary and field methods. A researcher-made questionnaire was used to assess each component of the research. The confirmatory factor analysis was used as the statistical method for data analysis, followed by SEM structural equations and t-test in SPSS software (version 22).

 The examination of hypotheses indicates a direct relationship of performance with the implementation of BSC, factors related to internal processes, and the customer-oriented dimension (P<0.05). However, organizational performance showed no significant relationship with the dimensions of growth, learning, and finance. The hospital under study obtained the highest BSC scores in terms of internal processes (3.41±0.44). On the other hand, the lowest scores were obtained regarding financial (02.85±0.23), growth and learning (02.85±0.23), as well as customer dimensions (0.09±1.05) in descending order.

 The results show that the implementation of the BSC model is directly related to organizational performance, and there is a significant and effective relationship between the four dimensions of the scorecard on organizational performance. The results also revealed that the most important aspect of the BSC is the process. Accordingly, four dimensions of financial, customer, internal processes, as well as growth and learning have been upgraded from the dimensions of Rasoul Akram Hospital BSC

One of the important factors on the efficiency and productivity of employees in the organization is the quality of work life. The main purpose of this study is to investigate the factors affecting the quality of work life of nurses and its relationship with the lifestyle of nurses in hospitals under the auspices of Tabriz University of Medical Sciences during the Covid 19 epidemic.

The present study was a descriptive-analytical study that was performed on 330 nurses of Sina and Imam Reza hospitals in Tabriz who were randomly selected. The data of the study were collected using the standard questionnaire of quality of life of the payer and Jazayeri (1398) and the standard questionnaire of the lifestyle of Kern et al. (2016). The data were presented using descriptive and analytical statistics and Pearson statistical tests, confirmatory factor analysis method. SPSS, Amos software was used to analyze the data.

The results of data analysis showed that managerial, structural, economic, social, cultural and psychological factors affect the quality of work life of nurses. There is also a positive and significant relationship between lifestyle and quality of work life of nurses during the Covid epidemic (PV <0.05).

One of the important issues of the Covid 19 epidemic period is the factors that determine the quality of working life. Because nurses face a number of special problems during the Covid 19 era, these problems can be prevented by lifestyle modification. Therefore, it is suggested that health managers and policy makers plan on a healthy lifestyle to improve the quality of life of nurses during the Covid 19 epidemic.

Today, the digital revolution has affected all behaviors and lifestyles. From a health care perspective, the Internet of Things is any device that can collect data on people's health, including smart bands, digital drugs, and surgical devices. Implantation or other portable devices that can measure health data and internet connection. Accordingly, one of the most applications of IoT technology in the field of health has been reported. In the end, it can be said that the Internet of Things will have a broad impact on the performance of hospitals. But the important thing about the implementation of this system in the hospital is the hope that by using the Internet of Things in hospitals, social justice in the field of health, which is one of the most important demands of the community, will be established, while The set of activities of hospitals should be minimized and controlled from the existing anomalies. Given the importance of this issue, it is expected that all health centers can use the use of the Internet of Things in their overall performance and, accordingly, lead the health of the community to effectiveness and efficiency.

Corona virus was first detected in Wuhan, China. The occurrence of this pandemic and the measures taken to control and cut the transmission chain of this disease sometimes lead to numerous psychological problems that will have long-term effects and its consequences continue. The impact of the spread of infectious diseases on mental disorders is in several ways. . It can affect pre-existing mental illness. It can cause new psychological symptoms in people following the interaction of immune and mental illness. Causes suffering in the caregivers of injured people and causes stigma.

The present study is a review of studies on the consequences and presentation of psychological interventions during coronavirus pneumonia from March 2017 to September 2016 using the keywords Corona virus, pneumonia, psychological interventions in crises, mental health, Covid-19, pandemic and searched the reputable sites of Pabmed, Science Direct, Scopus, Google Scholar, ProQuest, as well as internal databases such as Jihad Daneshgahi, Iranmodex and Magiran. In addition, articles published online by the China National Health Commission, the National Center for Disease Control and Prevention, and the World Health Organization were reviewed.

A review of 48 final articles showed that during the Covid-19 pandemic, negative psychological effects such as post-traumatic stress disorder, depression, anxiety, stress, sleep disorders and anger in the treatment staff and other people with Covid-19 Was significantly increased. Also, by reviewing reliable sources, it was found that the psychological consequences of Covid-19 disease are different in medical and healthcare personnel, ordinary people, patients, patients' families and children.

In the perspective of health psychology, care strategies for a variety of individuals and, ultimately, reducing the effects of quarantine are presented. According to a review of studies, it was found that in general, during the Covid-19 pandemic, we see a decrease in mental health of people, especially medical staff affected by this disease, and it is necessary to make rapid, continuous and timely psychological interventions.

Background and Examining challenges and solutions to improve productivity in hospitals and medical centers and using various resources for effective production and supply of goods and services requires knowledge and the use of economic and social legalities and tools. Today, the role of productivity in development programs is considered one of the development indicators. If we consider the goal of applying economics to be the optimal allocation of resources, we can safely say that productivity is one of the most important evaluation indicators in order to achieve this goal. The current research is a review. Using the terms productivity, hospital management, stress, cost, productivity and effectiveness in Proquest, Pubmed, Database, (SID) Scientific Information, Ovid, Google Scholar, Science direct, Iranmedex, Springer and Scopus databases, articles that were published in English or Farsi about productivity were collected. The review of articles showed that efficiency and effectiveness are two important and effective factors in productivity. Improving productivity should be considered as a result of various factors, including a suitable organizational structure, efficient implementation methods, healthy work tools and equipment, a balanced work environment, and, most importantly, qualified and competent human resources. In this regard, it is necessary to conduct investigations in the hospital to identify effective factors and determine solutions to improve productivity.

The effects of COVID-19 not only disrupt patients' lives, but also affect caregivers. The aim of this study was to determine the effect of tele-nursing on the care burden of family caregivers of COVID-19 patients discharged from 22 Bahman Khaf Hospital.

This quasi-experimental study was performed on 120 family caregivers of COVID-19 patients from the beginning of May 2020 to the end of October 2020. Samples were selected by Convenience Sampling and were randomly divided into two equal groups (intervention and control). In the intervention group, training was performed through care load-based tele-nursing for a period of one month while no intervention was performed for the control group. Both groups completed the Zarit Care Questionnaire before and one month after the intervention.

In the experimental group, the mean score of total care pressure and its components after the intervention was significantly lower than before (p <0.001), but in the control group, the mean score of total care pressure and its components (except objective pressure before and after the intervention) was not significantly different (P> 0.05).

Tele-nursing training reduces the burden of care in family caregivers of COVID-19 patients. Therefore, it is suggested that health managers, by creating appropriate policies, put the implementation of the tele-nursing process in the family caregivers of COVID-19 patients on their agenda.

Increasing pressure on available capitals in health care section, especially hospitals, underlines the need for analyzing different strategies in economic terms. One of the solutions for the optimal use of financial resources and potentials in hospitals and healthcare centers is using components of the marketing mix. This study endeavored to determine the related factors on patients' preference in choosing a hospital based on the mixed marketing model.

This study was conducted in Farhikhtegan Hospital in Tehran, Iran, in 2020. Simple random sampling was employed to select the sample from among 243 inpatients, outpatients, and clients of the hospital. A bi-part researcher-made questionnaire was used to gather the data (demographics and seven aspects of marketing mix); whose validity and reliability were deemed appropriate. Regarding the data analysis, one-sample t-test and Friedman test were used to rank dimensions and components and the analysis of variance (ANOVA) was used to compare the views of different classes of society.

All seven dimensions of the mixed marketing had a significant and different effect on the preference of the patients in choosing the Farhikhtegan Hospital. Manpower and promotion dimensions were the most and the least important dimensions, respectively. Among the mixed marketing components, sufficient expertise, family income, hospital’s reputation, physicians’ attitude, pacing of services’ provision, doctors' advice and degree of diversity, novelty, and advanced equipment came out to be the most effective components of each dimension of mixed marketing.

Considering the changes in the needs of the audiences in the health field, hospital managers can identify the patients' needs in accordance with the principles of marketing mix. Regarding the importance of manpower in the findings of this study, managers can attract the attention of patients with culture making and preparing practical guidance in appropriate treatment of employees.

With its widespread prevalence, COVID-19 has not only disrupted patients’ lives but has also affected family caregivers. This study intends to determine the moderating role of resilience and its relationship with perceived stress and caring burden in family caregivers of COVID-19 patients in the 22nd Bahman Hospital of Khaf, eastern Iran.

This is a descriptive-analytical cross-sectional study. The sample comprised 210 family caregivers of COVID-19 patients, who were selected by the census method. The questionnaires of perceived stress, caring burden, and resilience were employed for data collection. The collected data were analyzed in SPSS-16 software using an independent t-test, one-way analysis of variance, and regression.

The results revealed a significantly positive relationship between perceived stress and caring burden (p <0.001). There was a significantly negative association between resilience and caring burden (p <0.001). Besides, the interaction effect of perceived stress and resilience on the burden of care was positive and significant (p = 0.05).

Considering the significant role of family caregivers of COVID-19 patients in maintaining and promoting the health of the patients, holding resilience-focused counseling training for all family caregivers of COVID-19 patients, with the aim of reducing stress and caring burden, can be a strategy to be employed by policymakers, managers, and health planners.

One of the main functions of the health system is to provide quality services. Customer satisfaction is at the heart of any organization, and is the ultimate goal of any organizational strategy. Patient satisfaction is a concept that has become very important in medical care today, and plays an important role in the health care process. Measuring the quality of services is a basic precondition for improving quality. The aim of this study was to evaluate the quality of services, using the analysis of the importance of performance in comprehensive health service centers.

This study was a descriptive survey, and its statistical population included all people with hypertension under the auspices of Pakdasht Comprehensive Health Service Centers (under the auspices of Shahid Beheshti University of Medical Sciences), Tehran, Iran. 320 people aged 30 years and older with hypertension were selected using classical systematic two-stage cluster sampling method. To compare the difference between mean performance and importance, t-test with a significance level of 95% was used.

There was a significant difference between importance and performance in all dimensions. (P < 0.050). Dimensions of respect (2.89%), continuation of service (2.68%), access and trust (2.57%), importance and proportions of authority (2.72%), access and trust (2.33%), and safety and prevention (2.19%) had the highest level of performance. The average importance of the requested services to people with hypertension was 70%, and the average performance of the received services was 59%. Overall, the quality of care provided to people with hypertension was low.

It seems that there is a large gap between the expectations of patients with hypertension from services and their perceptions of services received (i.e., performance). All dimensions of quality show that quality improvement in all dimensions is necessary. The results of this study can be useful in health policies to promote the quality of service delivery.

Resistant and extensive resistant tuberculosis is one of the most important infectious diseases and the most important challenge in the treatment of tuberculosis. The aim of this study was to evaluate the direct treatment costs of patients with resistant and extensive resistant tuberculosis and the risk factors for developing resistance to the treatment of this disease.

This descriptive-analytical study estimated the treatment costs of resistant and extensive resistant tuberculosis in elderly patients referred to Masih Daneshvari Hospital during 2009-2010 and then the risk factors for resistance in these patients were investigated. For this purpose, 268 refractory tuberculosis patients were randomly selected. Data were analyzed using SPSS software version 17 using descriptive statistics and Pearson and Spearman tests and t-test.

The mean age and length of stay of patients were 59.96±15.45 years and 43.17± 5.8 days, respectively. 97.01% of patients had a history of tuberculosis. The average cost of medicine, diagnostic services and hospital services was estimated at 594.81, 1387.31 and 10972.28 rail millions, respectively. The relationship between direct costs of treatment and age, length of hospital stay and occupation was statistically significant (P≤0.05) but its relationship with education level and gender was not significant (P˃0.05).

Considering that hospitalization and prolongation of hospitalization costs a lot of money, so it is suggested that following the correct treatment protocols and principles of DOTs, these costs can be reduced and on the other hand follow up patients with a history of disease to prevent the spread and recurrence. Recurrence of the disease seems necessary.

Iran has been one of the countries hardest hit by the health crisis caused by the COVID-19 pandemic. The pandemic of this disease has put considerable physical and emotional on frontline healthcare workers that can impair the quality of services provided to patients. Therefore, this study aimed to investigate the effect of caring for COVID 19 patients on productivity and burnout of nurses.

The present study is a descriptive-analytical cross-sectional study that was conducted in 1399 in Farhikhtegan Hospital in Tehran. 120 nurses with at least six months of experience, no use of psychotropic drugs in the past year and no managerial position were selected by available sampling method. Data was collected using the Maslach Burnout Questionnaire and Hersey and Goldsmith Human Resources Productivity Questionnaire and they were analyzed using descriptive statistics, one-way analysis of variance, Pearson correlation test, and independent t-test and SPSS version 22.

productivity in nurses caring for COVID 19 patients (61.11± 9.7) was less than productivity of other nurses (79.7± 7.7) and Job burnout in nurses caring for COVID 19 patients (66.07± 13.13) was more than Job burnout of other nurses (45.7± 11.07). There was meaningful difference in nurseschr('39') productivity in caring conditions for COVID19 patients. There was meaningful inverse relationship between burnout and employee productivity (r = -0.58) and (P < 0.001).

Caring for COVID 19 patients reduces the productivity and increases the burnout of nurses. Managers need to adopt the supportive, encouragement, and training interventions to increase the productivity and job burnout of nurses in health crisis.

Patientschr('39') health and recovery progress are affected by the quality of services provided by nurses and their commitment. Since part of the nurses’ commitment and quality of work is affected by organizational justice and workplace well-being, the present study was done to determine the relationship between organizational justice and workplace well-being in nurses.

In this descriptive-analytical study done in a cross-sectional manner in 2019, 225 nurses from two public hospitals and two private hospitals in Gonbad-e-kavus city were selected through simple random sampling. Data gathering tools were organizational justice and well-being questionnaires. Data were analyzed using Spearman statistical test and through SPSS statistical software version 22.

Organizational justice in the studied public and private hospitals was at a moderate level and workplace well-being in the studied private and public hospitals was good. There was a significant and positive relationship between the mean score of organizational justice and workplace well-being in public hospitals (P=0.006).

Conducting interpersonal and social interaction training courses for all nursing staff in all health departments is essential to enhance well-being at work. There is also a need to periodically evaluate the status of organizational justice based on standards to address shortcomings or deficiencies.

The mechanism to reimburse the cost of treatment is one of the important factors that directly and indirectly in financial management and cost control, the hospital is impressive. This study was conducted to investigate the relationship run the system of payments, DRG and reduce the cost of treatment in military hospitals in Tehran city is done. A descriptive - analytical Study was conducted at Tehran Military Hospitals in 2018. In this study, first, the actual cost of services and the length of residence of the records were extracted from the hospital information system, then the average cost and residence of the patient for each
surgical procedure were determined and compared with the cost and average of the patient's residence determined in the global system of Iran. Finally, Significance difference between mean cost and average patient's residence was evaluated using t-test in version 16 of SPSS software. About a quarter of the records of patients admitted to the study, the records of global. In the hospitals 64% cases Global, Group actions, etc 16% cases in the group of surgical procedures, and 20% of the cases in Group surgery eye. In 95% records, including the cost of surgery with Global to
benefit the hospital, that 97% of this difference is the cost, were significantly meaningful. According to reduce the duration of stay of patients in Surgery Global, reload in current repayment system and implement a system of repayment prospective for other diagnosis, and surgery is recommended.

Human resources play a major role in achieving utilization, as the main goal of the organization. In the field of health, the productivity of nurses, as one of the most hard-working individuals in the organization affects total productivity and leads to changes in the quality and cost of services. This study was conducted to investigate the relationship between occupational stress and productivity among nurses of selected hospitals of Islamic Azad University in 2017. This survey was an applied descriptive research with a sample size of 125 nurses which were selected randomly. The data were gathered by a questionnaire. Using correlation analysis, the research hypotheses were tested. It was found that nurses' occupational stress had a significant negative relationship (r = -0.365) with their productivity (p<0.05), and had no significant relationship with education level and age. Based on the correlation analysis, there is an indirect relationship between occupational stress and productivity. Therefore, it can be stated that if nurses' occupational stress increases, there's a 0.95 probability that their productivity decreases. The literature review are in line with the findings of the present research.

Given the prevalence of Internet use worldwide and its existing risks to societies especially the youngsters, information literacy can affect the use of Internet. Hence, the objective of present study is to assess the relationship between information literacy and Internet addiction and then to investigate the relationship between Internet addiction and general health of students in Iran University of Medical Sciences.
It is an analytical cross-sectional study which was conducted during 2016 on students in Iran University of Medical Sciences (Tehran, Iran). The sample size for the surveyed community of 6,500 university students was 362 from the Cochran sample size formula. Then, using a simple random sampling method, from each of the colleges, the sample size was selected according to the student population. Three questionnaires of information literacy, Yang's Internet addiction, and general health scale (GHQ-28) were distributed among students. Finally, 365 questionnaires were collected and analyzed.
29.9% of students were about to be addicted to the Internet, 1.3% had symptoms of Internet addiction and 68.8% had no addiction. In terms of information literacy, most of the students were in moderate level (60.5% moderate, 3.3% low, and 36.2% high information literacy level). There was a significant inverse relationship between increasing of information literacy and the Internet addiction (r = -0.45 and p According to the findings of this study, it was perceived that the higher the information literacy, the lower the level of Internet addiction; besides, reduction of internet addiction increased the general health of students. Therefore, considering the importance of students as the leading group in societies, and favorable consequences of increased information literacy, universitie's authorities have to develop and run specific programs within the educational and research schedule in order to increase the student's information literacy. Accordingly, undesirable outcomes of Internet use would be diminished and general health of society would be improved.

Today, the health system is one of the largest sections of the economy throughout the world. Therefore, the managers and policymakers of the health and treatment sections should be trained by exploiting the financial assessment indices and also by acquiring the knowledge via training the indices and sufficient recognition of hospital function. The purpose of the present study is determination of the effective and trainable financial indices in assessment of function of the Iran University of Medical Science hospitals for providing a systematic educational training to evaluating the financial function of hospitals. the present study is a combinational method including systematic review analysis and analytical hierarchy method which was confirmed by using of the suggested paradigm for analytical hierarchy process (AHP) after extracting the indices of the function assessment of hospital. The experts consisted of 162 subjects.
Findings: the indices were determined for nine groups including trainable indices for managers, cash, investment, quick ratio (acid test ratio), income, expense, exploitation, the proportion of management efficacy and other financial ratios that can be used for educational periods for managers. In addition, subscale of each of them was prioritized and measured. From the above indices, the profitability index had the highest priority which acquired the first rank with 0.246 scores for training and the least priority was related to the factor of contingency measures with 0.010 scores. The indices of cash, profitability, and investment had the highest scale in the educational needs of managers. The indices of the financial function defines the financial status of the hospitals and also it determines the strengths and weaknesses of the hospitals for strategic decision making, and it is fundamental for comparison between different hospitals.

Aim and Urinary tract infections (UTIs) are widespread health concerns which differ according to geography and regions. Bacterial Urinary tract infections associated with an enlarged antimicrobial resistant species are found in all age groups.The aim of this study was to ascertain the antimicrobial resistance pattern of strains isolated from patients with Urinary Tract Infection (UTI) and the emergence of multidrug resistant bacterial strains. Midstream urine samples were collected from 2235 patients and analyzed for isolation and identification of Multidrug Resistant (MDR) strains. The MDR strains were recognized by the Kirby Bauer method according to National Committee of Clinical Laboratory Standards. Female patients constituted 308 (62%) in the study. This result indicates that E.coli is the predominant pathogen causing UTI, followed by Klebsiella, Streptococcus viridans, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Proteus and Pseudomonas. Bacterial isolates from patients with UTI showed high levels of single and multiple antimicrobial resistances against commonly prescribed drugs. The present study confirms that bacterial resistance would be a serious problem in the country. Therefore, antimicrobial surveillance and in vitro susceptibility testing with strict adherence to antibiotic policy may facilitate to control the spreading of drug resistant microbes.

Undesirable exploitation of natural resources, resource shortage and increased hospital costs has resulted in increase in the hospital expenditure over revenue or made costs scale heavier than the income scale. The present research has been done by the aim of studying the effect of combining hospital wards on current expenses of Bou Ali Medical & Teaching Center by the means of increasing the efficacy of hospital wards.

The study was carried out in Tehran at Bou Ali Teaching Hospital, Medical and Treatment Center in male surgical ward with male medical ward and female surgical ward with obstetrics ward. The instrument of data gathering included designated forms that were collected from available hospital documents and records. In the method of data analysis, Wilcoxon test and descriptive statistics indices with 95% confidence coefficient were used.

The average of ongoing expenditures in 2007 and 2008, before the combination of hospital wards was 31393.2 $ and after the combination it was 1957558.6 $. A meaningful relationship between the ongoing expenditures in the two past periods before and after the combination of hospital wards was shown.

Due to the increase of expenses, reaching a maximum production with minimum expenses is compulsory. In the novel challenge, the strategy of combining the resource and efficient exploitation of present resources could help hospital management in preventing resource loss, increase of expenses and financial crises.