فهرست مطالب علی ماهر

Induced demand is a major challenge for financing health promotion. Experts have highlighted the important role of health insurance as a driver of demand for doctors even in emerging and advanced world economies. Therefore, the importance of conducting review studies in the country to obtain methods for identifying induced demand is not hidden from anyone.

In this study, articles were searched from English PubMed, Scopus, ProQuest, Cochrane and Web of Science databases.

The findings showed that about 90% of the studies proved the induced demand in diagnostic and therapeutic services with statistical analysis methods and investigating the relationship of variables, and the issue of induced demand is still an important issue in the world.

The structure of insurances is quite effective in the formation of induced demand due to the fundamental role they play in paying health service providers, and the research methods of these articles provide effective perspectives for the country's health policy makers in recognizing and controlling induced demand.

"Health communication" is one of the interdisciplinary fields of communication science and medicine, and its theoretical foundations and concepts are based on communication science and its subgroups. Since the advent of media such as radio and television, a lot of health policymakers and community health advocates believe that providing information through the media automatically changes attitudes first and then modifies behaviors. The present study aims to examine the satisfaction of the community with the sima health network in Iran.

This study is based on the method of scrolling and designing a quantitative questionnaire by the researcher and the so-called "researcher questionnaire". The questionnaire is designed for the people's group (as contacts and viewers of sima, including all segments of society), and the selection of people in a simple random way with the statistical community is 401 examples. The data was extracted, classified and analyzed with the help of SPSS software.

Nearly half of the society studied does not want to watch Sima in Iran, and 44 percent of respondents cited the use of social networks as the reason for the lack of interest in Sima Health Network, and this lack of satisfaction is not limited to age, gender, or education.

Among the statistical community studied, the causes of lack of interest in Sima, especially the Sima Health Network, vary, and the highest percentage of lack of interest in Sima, especially the Health Network, is the use of social media. The most important proposals of this study mentioned the effective and continuous communication and interaction of the country's medical universities with the policymaking councils of the Sima Health Network and the effective use of doctors and specialists in this field.

The rapid growth of technology, demographic changes, increasing patients’ demand, and changes in the nature of diseases, increased competition among hospitals and healthcare providers, and constraints in budget allocation necessitate adopting a novel approach to the management of medical centers based on international standards.

This qualitative study was conducted in two stages by a content analysis approach in the year 2022 in teaching hospitals affiliated with the Islamic Azad University nationwide. The statistical population in the first stage included all studies addressing various aspects of the factors affecting the optimal management of hospitals. In the second stage, it included 10 executive managers of hospitals purposively selected as experts until reaching data saturation. The validity and reliability of the interviews were confirmed using the Lincoln and Guba methods. The data analysis method involved a comprehensive review of studies to identify factors affecting the optimal management of hospitals and a contractual content analysis to identify, analyze, and report themes.

In the first stage, a comprehensive review of studies was conducted, encompassing a total of 96 research papers, including 36 in Persian and 60 in English. Following the examination of the titles and abstracts of these research papers and aligning them with the predefined inclusion and exclusion criteria, a total of 18 studies were selected for final analysis, comprising 11 in Persian and 7 in English. After identifying the factors affecting the optimal management of hospitals, three main dimensions were extracted, including strategic planning (12 components), reengineering (8 components), and supply chain engineering (14 components) for the optimal management of hospitals affiliated with the Islamic Azad University using the content analysis method.

Managers should implement each of the identified components of strategic planning, reengineering, and supply chain engineering for the optimal management of hospitals in line with the hospitals’ structure. By examining the excellence and efficiency of hospitals over time, as well as evaluating the trends of each of them, they should take steps towards adopting reform policies and their experiences should be utilized in other hospitals.

Due to the very weak coverage of basic treatment in the dental insurance sector, such services are considered as luxury services for people and the indicators of oral and dental health in Iran are not very favorable. With regard to the supplementary excess treatment coverage by commercial insurances, in this research, the factors affecting the use of dental services were investigated.

The research method was descriptive, analytical and cross-sectional, the statistical population of the present study included patients referred to Tehran clinics in 2022. The sample size in this study was equal to 383 people who were selected by cluster sampling method. The information was collected through a questionnaire and the data were analyzed at the level of descriptive and inferential statistics, one population and binomial t-tests and Friedman’s test.

There is a relationship between insurance coverage of dental services and oral health of people (P=0.000; t=23.99). There is a relationship between the amount of patients' out-of-pocket payments for dental services and oral health status (P=0.000; t=16.117). The amount of insurance payment for dental services has an effect on the amount of use of dental services (P=0.000; t=29.73). The demographic characteristics of the insured (DMFT index, age, gender, education level, marital status) have an effect on the use of dental services (P=0.000; t=33.04).

Due to the relationship between insurance coverage, payment amount, age and education level of people with oral and dental health, the officials and practitioners of oral and dental health should consider appropriate decision and policy regarding this matter.

Military dentistry combines patient-centered care with public health views to create services agile and comprehensive. The effect of oral disease on military personnel can significantly damage the individual's operational ability. A significant concern of various countries in providing universal health coverage is access to dental services and oral health care, which requires understanding the related barriers and facilitators. This study aimed to determine systematic relationships among determinants of access to preventive dental services.

This mixed-methods, descriptive-analytical study was carried out in 2021 using an operations research technique. In the qualitative phase, by the literature review and using the snowball method, an interview was done with ten experts in dental prevention and oral health. The conceptual research model based on the Saurman access model was designed into 30 sub-components and six main components by identifying and categorizing the obtained codes. In the quantitative stage, a 30-item questionnaire was designed using the Decision Making Trial and Evaluation Laboratory (DEMATEL) technique. The questionnaire was completed by 30 experts selected from medical sciences staff and line using purposive sampling. The data were analyzed in SPSS and DEMATEL through structural analysis of causal relationships.

A total of 30 variables were identified based on the qualitative findings. These variables were categorized into six components, including affordability, acceptability, accessibility, awareness and empowerment, adequacy, and availability based on the analytical framework of the study. The experts confirmed the proposed determinants of access to dental services and suggested no other component (P=0.0001). Analytical results indicated that "affordability" (impact factor=1.05) and "acceptability" (impact factor=0.37) affected access and were therefore assigned to the causes group. However, empowerment, accessibility, adequacy, and availability were influenced by access and were therefore assigned to the effects group. Finally, affordability (1.05, 11.88) and availability (-0.57 and 11.35) were identified as the most and most miniature essential components, respectively.

An essential factor in military personnel is "hidden" dental complications. By evaluating dental complications, this component is reduced approximately one-third. Identifying critical factors of access help design prevention interventions, health prevention, and promotion policies and removing barriers to public access to oral health care.

  With the outbreak of the COVID-19 pandemic, the performance of hospitals were affected, and changes were made in the utilization of hospital services. Analyzing hospital performance data during the COVID-19 pandemic can provide insights into service utilization patterns and care outcomes for managers and policymakers. This study was conducted to investigate the impact of COVID-19 on selected outcome indicators in the hospitals of Shahid Beheshti University of Medical Sciences, Tehran.

 This research was descriptive-analytical and of the time series analysis type. Six outcome indicators were considered: hospitalization rate, bed occupancy rate, the average length of stay, emergency visits, laboratory tests, and imaging requests. Related data from 12 affiliated hospitals from 2017-2019 (pre-COVID) and 2020 (post-COVID) were obtained from the hospital's intelligent management system. The data were analyzed using R software's interrupted time series analysis method.

 The hospitalization rate (P=0.015), bed occupancy rate (P=0.04), and the number of laboratory tests (P=0.003) significantly increased immediately after the outbreak of the pandemic. In contrast, emergency visits (P=0.034) have significantly decreased. The bed occupancy rate and the number of imaging requests showed no significant change. The decrease in emergency room visits within one year after the pandemic was significant, but the changes in other outcome indicators were non-significant (P>0.05).

 Understanding the changes and impact of a major event on hospital outcome indicators is necessary for decision-makers to effectively plan for resource allocation and effective pandemic response. The outbreak of COVID-19 has caused a change in performance and hospital outcomes by affecting the supply and demand of services. In a year after the pandemic's beginning, except for emergency visits, the other indicators have not experienced significant changes. Preservation of essential services such as emergency room visits is recommended in the strategy of rapid response to an epidemic outbreak and public campaigns to encourage people to seek medical care if needed in future waves of the pandemic.

Basic and supplementary insurances play an important role in achieving universal health coverage. In developing countries, complementary insurances have many structural and organizational problems and inadequacies. The present study was conducted with the aim of investigating the factors affecting the service packages of supplementary medical insurance.

The current research is of a qualitative type with a framework analysis method that was carried out in 1400. 11 experts of the insurance organization and experts in the health system were selected as the research samples by the purposeful sampling method. MAXQDA software was used for data analysis.

The dimensions of the complementary insurance model of treatment in Iran based on the analysis of the opinions of experts and experts in Iran include five main dimensions: "laws and regulations, coverage of services, strengthening and creating a competitive market, developing standards for the use of services and treatment guidelines; Development of complementary insurances.

Based on the findings, efforts to develop a comprehensive package of complementary treatment services in the country in order to increase people's access should be considered by policy makers and the financial capacity to manage and finance universal health coverage should be increased. It is expected that with the scientific development of supplementary medical insurance, it will contribute greatly to universal health coverage in the country.

The unit dose distribution system ensures the delivery of drugs from the hospital pharmacy to the ward for a specific patient. Facilitating the improvement process of patients and drug safety requires such research. However, two human factors affecting this process, including pharmacists and nurses, and the impact that the drug distribution system in the hospital has on their condition, have been studied as the purpose of this research.

This study was done by descriptive and analytical-comparative method. Data were collected from the staff of Urmia Women's Hospital in 2021, including 76 hospital staff, 11 pharmacists, and 32 nurses as a sample from three groups using three standard questionnaires. Data were analyzed by two dependent samples T-tests in SPSS-24 software.

Attention to pharmacists in the implementation of the unit-dose system by stimulating their interest in pharmaceutical sciences, being in the center of attention of colleagues, and increasing their desire to work in the hospital changed the level of job identity and, thus, it explained their appropriate professional position. Time saving, lack of differences in the counting of drugs, and the peace of mind of nurses after the implementation of the unit-dose plan increased the role of nurses in the main task of patient care by obtaining job satisfaction (3.29), which increased to above the average level ( P<0.001).

Success in the implementation of this project in the selected hospital is expected to improve the professional position of pharmacists in the hospital and increase the job satisfaction of nurses.

Evidence-based performance evaluation is the main issue in all organizational analyzes in healthcare, especially hospitals. The aim of this study is to evaluate evidence-based performance of Tehran University of Medical Sciences hospitals

The current research is applied, qualitative with a mixed approach. To identify and extract the components, an open interview was conducted with 14 experts familiar with evidencebased performance evaluation of teaching hospitals of Tehran University of Medical Sciences. The experts were selected using the snowball method, and the selection of experts continued until theoretical saturation was reached. Thematic analysis method was used to analyze the data from the interviews.

Evidence-based performance evaluation was presented in the form of thirteen main components. The approved components in this research were: clinical effectiveness, staff requirements, strategic planning, organizational mission statement, patientcentered, human resources empowerment, satisfaction, accountability governance, support services, service quality and safety, hospital management, accountability, Central employee.

Considering that it was found that the impact factor of all evidence-based performance evaluation components is acceptable, therefore, the managers of teaching hospitals of Tehran University of Medical Sciences should pay attention to the use of this research in order to create appropriate infrastructures for evidence-based performance evaluation.

Strategic purchasing is a key element and strategy for realizing universal health coverage. This study aimed to determine the factors influencing the strategic purchasing of health services for cardiovascular diseases.

In this mixed-methods (qualitative-quantitative) applied study, data were collected through semi-structured interviews and a matrix of pairwise comparisons. The study population consisted of managers and policy makers of basic insurance organizations, Ministry of Health, hospital managers, and university faculty members who were selected by the purposive sampling method.The data were analyzed via thematic analysis in MAXQDA and prioritized in MATLAB via the DEMATEL technique.

Stewardship and policy-making, financial, insurance-related, structural, behavioral, and social determinants of health were identified as influential factors. Patient-, provider-, and contract-related were identified as the influenced factors. The stewardship and policy-making element (1.32, 2.73) was the most influential factor, while the patient-related element (-1.30, 1.30) was the most influenced factor in strategic purchasing of cardiovascular health services.

Strategic purchasing of health services requires the widespread participation of all the stakeholders and players of the healthcare system. Having effective stewardship of the healthcare system, institutionalizing an evidence-based decision-making system, empowering and increasing citizens’ participation in health-related decision-making and policies, and providing stable financing are the most important factors influencing the implementation of the health service strategic purchasing.

Achieving public health coverage is a prerequisite for the sustainable development of countries, and this is highly dependent on patient financing in the form of health insurance. Therefore, improving the efficiency of health insurance through the consolidation of insurance funds is very important. The aim of this study was to structuring the barriers to the integration of health insurance in Iran using the Dematel approach.

The Mixed study was done in three stages qualitative, Delphi technique and systematic analysis of barriers to health insurance integration in Iran on experts and specialists in health insurance (12 samples in the interview and 68 samples in the quantitative phase). The data collection tool in the "Qualitative Stage" was the interview guide, in the "Delphi Stage" was a questionnaire in the Likert, and in the "Systematic Analysis Stage" was a pairwise comparison questionnaire. Qualitative phase analysis was performed by conceptual framework method, Delphi stage using SPSS software and simple sample type test and weighting of factors using FUZZY DEMATEL technique and MATLAB software.

Out of 36 identified barriers to health insurance integration in Iran, 28 barriers have been accepted in the Delphi phase. Among the factors accepted in the Delphi phase, the highest average was related to "political behavior and resistance to accepting the integration of insurance" and the lowest average was related to "family physician and referral system". The results of systematic relation analysis showed that "obstructing the structure of the health system" with coordinates (1.30 and 1.30) as the most effective barrier and "preventing cultural-economic infrastructure" with coordinates (1.11 and -1.11) were identified as the most effected barrier.

According to the results regarding the impact of financing and structural barriers, it is suggested that while performing accurate statistical and financial data calculations, the share of each insured group to accumulate funds be determined. Health and insurance policymakers need to anticipate sustainable financing. Also, to lay the foundation for the basic infrastructure of this system, in accordance with the conditions of the Ministry of Health and Social Insurance.

Aging is an important period of life which needs basic support. The purpose of this study is survey the methods and programs of providing services to the elderly in the countries studied and to find the best care method for planning to provide services to the elderly in Iran.

This is a narrative review that was conducted comparatively. The study was conducted in Italy, Sweden, Austria, the Netherlands, Norway, Germany, Japan, Turkey and Iran. More than 2,000 search articles were found and 170 related articles were selected. Finally, they were adapted and differences and similarities were determined and the initial model was formed.

In Italy, Sweden, Austria, the Netherlands, Norway, Germany and Japan, home care policies are successful, and countries that follow a policy of integrated services (social-health-treatment) are successful. . And providing care services for the elderly in these countries is free of charge and provides sustainable resources through insurance and taxes and public resources. In these countries, municipalities play a key role in helping to provide services to the elderly.

In Iran, due to the poor condition of elderly care, comprehensive planning and design of service packages for the elderly with sustainable financial resources such as long-term care insurance is inevitable.

The prevalence of COVID-19 disease has led to an international health emergency and hazard 
The disease has not been previously diagnosed in humans. Therefore, governments have made serious decisions to control and manage this crisis so that less harm is done to any society

This research is a review article based on library studies and internet searches in valid databases of Scopus, Web of Science, PubMed, Science Direct and Google Scholar.The number of 227 articles on how to manage the new coronavirus disease crisis in Iran and the world has been studied so far, which was finally 118 used. The articles on the World Health Organization and CDC website were also reviewed.

Iran and other countries around the world have designed policies based on countering COVID-19 before and after its entry. Managing this crisis requires professional efforts and inter-sectoral cooperation and government agencies.

The pandemic of COVID-19 disease is worrying. It is important to formulate appropriate policies and implement them properly. Iran and other countries in the world are working in this direction. Now more than ever, more coherent and practical measures are needed to control the spread of the disease.

Employee adherence to professional principles and behavior can have a significant impact in terms of enhancing employee productivity and changing the attitude of customers towards the organization. On the other hand, ethical behavior along with the responsibility of nurses and patient care personnel has an important role in improving and restoring their health and can increase their commitment to the organization. Organizational commitment is one of the most important concepts of any organization in any size and part. The success of the organization is the result of the commitment of the staff of the organization. In fact, it can be said that organizational commitment is one of the most important characteristics of organizations that makes them different.This study aimed at investigating the Effect of Spiritual Intelligence on Organizational Commitment according to Professional Ethics mediator in Ilam Health Center.

This practical study was conducted based on a descriptive design. The study population included Ilam Province Social Security Staff. The samples were selected using the Morgan table through a simple random sampling method. The data were collected using a questionnaire, and they were analyzed in SPSS software (version 21).

Effect of Spiritual Intelligence (P<0.50, β=0.179) was investigated on Organizational Commitment according to Professional Ethics mediator (P<0.50, β=0.346) in a Health Center in Ilam, Iran. Spiritual intelligence (P<0.50, β=0.520) had a significant impact on organizational commitment. The findings showed that higher spiritual intelligence among the employees led to higher levels of professional ethics, and therefore, their greater organizational commitment.

According to the results, higher capacity of spiritual intelligence in the organization results in greater level of organizational commitment. Moreover, higher levels of professional ethics in the organization leads to greater organizational commitment. It can be concluded that spiritual intelligence has a significant effect on professional ethics. In other words, regarding spiritual intelligence, professional ethics makes progress or regress. Given the positive relationship between spiritual intelligence and professional ethics and also the organizational commitment, it can be concluded that the health center should take steps towards making the employers more committed using the strategic education programs that include the essential principles of spiritual intelligence and professional ethics.

In crisis situations, such as natural disasters and warfare, using inactive means, it is possible to prevent financial losses to vital and military installations and human casualties, or to reduce the amount of such damage and losses to the minimum. Given the importance of health care centers, hospitals are one of these critical areas and the need for the facility to make non-operational defense strategies is essential. This study was to investigate the readiness of Tehran hospitals for passive defense in 1397. This cross-sectional descriptive study was conducted on 15 managers of hospitals in Tehran. The sampling method was census method and the data gathering tool was a researcher-made four-part questionnaire.Data analysis was performed using SPSS23 softwares and descriptive-analytic tests of Spearman correlation, univariate regression and t-test. Knowledge of physical characteristics 0.71, dispersion of 0.606, multiple outputs 0.587, open space, 0.518 The highest level of knowledge and awareness of shelter 0.138, depth and height of building 0.018, aerial access 0.016 showed the lowest level of awareness. The readiness of hospitals in Tehran was moderately low.

Occupational stress is inherent to all jobs, while it becomes more important in the jobs that involve humans. Evidence and studies suggest that the nursing profession is among the most stressful jobs. Considering the consequences of occupational stress on employeeschr('39') mental health, the feeling of mental health is widely affected by the perceptions of individuals toward events and occupational stressors. Stress diminishes attention, concentration, decision-making skills, and judgment and is also negatively correlated with the quality of care. In addition, stress leads to the increased incidence of mistakes and errors. Given the nature of the nursing profession, tendency to feeling the guilt of pathogen or diseases may adversely affect their health. In the occupations such as nursing in which the responsibility of the life and welfare of others is undertaken by nurses, guilt could be acute and significant, especially when several issues appear. However, few studies have been focused on the impact of guilt feelings on the wellbeing of nurses. Various studies have reported positive, significant correlations between guilt feelings and depression, anxiety, and stress. Therefore, the recognition and focus on solving the occupational issues of nursing staff as a great spectrum of healthcare providers are inherent to the national macro health planning. Stress, occupational stress, and their consequences on the physical, mental, and professional life of the nurses in healthcare organizations are among the issues that affect the goals and performance of these organizations. Therefore, obtaining more information about occupational stress, communications, and other related variables (e.g., guilt feelings) has attracted the attention of researchers.

This descriptive, applied research was conducted in the summer of 2018 at Mofid Childrenchr('39')s Hospital in Tehran, Iran. The sample population consisted of all the employed nurses of the hospital (n=260), and 141 nurses were selected via simple random sampling using the name lists by drawing lots as the samples and enrolled in the study. No inclusion and exclusion criteria were defined for sample selection. After obtaining the required permit, explaining the research objectives to the subjects, and obtaining oral informed consent, the questionnaires were distributed and completed in the presence of the researcher. All the items of the questionnaires were completed by the participants without attrition. The data collection tool consisted of three sections, including the demographic characteristics of female nurses (ward of employment, education level, employment status, work shifts, age, marital status, and work experience), Osipow job stress questionnaire, and the caregiver guilt questionnaire (CGQ). Osipow job stress questionnaire has been developed to measure the stressors in the workplace (especially in hospital and healthcare settings) with 60 items and six dimensions, including heavy workload (professional role workload), incompetence (role dichotomy), incompatibility (role duality), role range, sense of responsibility, and physical problems. The items of the questionnaire were scored based on a five-point Likert scale. The total score of each female nurse was calculated within the range of 60-300 and classified into four levels of below the natural level, natural level, medium level, and severe level. The CGQ had five dimensions and 22 items regarding the feelings of guilt about the mistakes of the care receiver, challenges and failures of care, self-care, neglect of other relatives, and negative feelings toward others. The questionnaire items were scored based on a five-point Likert scale. The total score of each nurse was calculated by summing up the scores within the range of 22-110. The degree of guilt was categorized as low, moderate, and high. The internal consistency of the questionnaires was also confirmed, with the Cronbachchr('39')s alpha estimated at 89% and 88%, respectively. Data analysis was performed in SPSS version 16 using descriptive and inferential statistics.

Statistical analysis was performed on 141 returned, intact questionnaires. The mean age of the nurses was 33 ± 7.03 years, and their mean work experience was 7.56 ± 5.21 years. The mean score of guilt feelings was 3.93 ± 0.64, and the mean score of occupational stress was 4.29 ± 0.51. According to the findings, the majority of the nurses (69.5%) had severe stress and severe guilt feelings (55.4%). In addition, positive, significant correlations were observed between occupational stress and its dimensions with guilt feelings and its dimensions among the nurses (P<0.05).

According to the results, occupational stress and guilt feelings were significantly correlated in the nurses, which could be due to work challenges, high stress of patient care, burnout, and guilt for the death of patients. The results of this study are consistent with the previous studies and theories regarding the impact of occupational stress on guilt feelings. Given the critical role of nursing staff in patients care and prevention of mortality, healthcare policymakers could take action to reduce the occupational stress of nurses by decreasing their working hours, eliminating continuous work shifts, increasing welfare services, and improving the conditions of the physical workplace. It is also suggested that nursing managers take measures considering factors such as the lack of emotional readiness, problems between colleagues, working schedules of nurses, and interactions with patients and their companions in order to reduce occupational stress and guilt feelings in nurses. Regarding the significant correlation between occupational stress and guilt, the application of job stress reduction techniques among the nurses of childrenchr('39')s hospitals is of paramount importance theoretically and operationally. Furthermore, the performance of nurses should be assessed in an environment with no stress and burnout, and the nurses with these issues must receive treatment immediately after they are identified, so that no harm would be done to their colleagues, family, and patients. The results of this study could be incorporated into nursing services (especially pediatric nursing) to attract the attention of the related authorities for awareness regarding the disruptive factors of mental health in nurses.

Health and medical problems of prisoners are health challenges. In an environment where the most important priority is maintaining order, control, and discipline, maintaining health and providing healthcare will have its own challenges. For this reason, some countries have transferred the responsibility for providing health services in prison to the Ministry of Health. We aimed to investigate the developments and changes in providing health services to prisoners and their different structures in different countries.

English language articles in Scopus, Google Scholar, and PubMed databases were searched. Advanced search options were used, initially based on the titles and keywords. Articles published until September 2019 were included using the following keywords: Prison, Jail, Primary care, Correlational health, Nursing, Prisoners, Health, and Healthcare.

Prison health was addressed not as an independent matter but as part of the duties of the Ministry of Health and the National Health System or the Ministry of Justice in each country. Reports from research carried out in France, Scotland, the Netherlands, Norway, Afghanistan, England-Wales, and New South Wales suggest a fundamental shift in the health care of prisoners in these countries and the process of transferring responsibility from the Ministry of Justice to the Department of Justice are among gained achievements.

The priority of the Department of Justice and the Prisons Organization is to maintain prison rules and regulations, so the quality of work and staff productivity will be greater when the responsibility of providing prison health services is transferred to the Ministry of Health and the National Health System. The opportunity for advanced research and training in this field will also increase.

Donors participation in the health sector is one of the sources of financing in the healthcare system. According to rising costs of the healthcare system in recent years and consequently increase in out of pockets of people, more attention has been paid to the charitable donations. In order to maintain and increase good support and participation in the health system, the need to identify and remove the barriers they face is essential for Efficient and effectiveness participation.

the present study according to purpose is applied, Descriptive research in terms of data collection and In terms of type of research data is qualitative. Required data were collected through semi-structured interviews with 41 health experts and beneficiaries using snowball sampling method.Conventional Content analysis was used to analyze the data.

Surveying and categorizing the interviews showed that Efficient and effectiveness participation of Donors in the healthcare system involves four main barriers: Lack of legal mechanisms, Lack of proper and continuous communication with the beneficiary, barriers in the field of management and effective allocation of resources, Lack of awareness of Donors from needs and barriers of the healthcare system and 18 subtheme.

By recognizing and solving these barriers, it has channeled the funds and contributions of the Donors towards the needs of the healthcare system with maximum effectiveness. Can be enhanced by strengthening institutions, structures and processes, Developing facilitator laws, Correct and constant communication with beneficiary and identifying priorities and needs and transferring them to the beneficiaries of health, can be facilitated and encouraged maximum donation.

Entrepreneurial University has an approach based on the relationship between industry and academia and is of great importance in Iran, which has a high number of educated and unemployed people. The growing population of the country, the demographic composition of the youth, the inability of the productive sectors to attract labor, the need to create job opportunities and factors such as these are the reasons why major policymakers are looking for solutions to solve this problem. Entrepreneurship is not an issue, because entrepreneurship plays an important role in the economic development of countries. The University of Entrepreneurship is a university where scientific entrepreneurship can create a force for economic growth and compete in global markets. The importance of moving towards the universities of the third millennium, according to the Ministry of Health, is such that it is considered as a contextual package for the development and innovation packages in medical sciences education based on the countrychr('39')s higher education program. Activities that universities can have in this regard can include a variety of disciplines such as counseling, education, research and development, technology transfer, ownership or participation in growth centers and scientific parks, which means that it is an accepted responsibility for development. There are districts in these universities. In fact, entrepreneurial universities are organizationally managed in a way that they have the flexibility to meet socio-economic needs and strategies to pay attention to environmental opportunities. In these universities, entrepreneurship has become part of the universitychr('39')s main strategy and the result is the development of entrepreneurial culture in the university. The aim of this study is to express the importance of the University of Entrepreneurship and to design the model of the third generation university in the Islamic Azad University of Medical Sciences in Iran.

This study was performed by mixed (qualitative-quantitative) research method. In terms of purpose, this research is a fundamental research that has been done based on a mixed research method. From a chronological point of view, this research is in the category of cross-sectional research. The study area is the Islamic Azad University of Iran. The statistical population of this study includes university experts in the field of entrepreneurship who work in free universities in Iran. The criterion for selecting experts in the study is the result of two characteristics of education and work experience. In this study, experts must have a PhD in Entrepreneurship. They also have at least ten years of experience in entrepreneurship-related fields. Based on this, 10 qualified people have participated in this study. Targeted sampling method has been used for sampling. This means that experts must have at least ten years of experience in education, counseling, and policy-making in the field of entrepreneurship, and must have scientific writings in the form of books and articles. First, thematic analysis was used to analyze specialized interviews. Then, using the fuzzy Delphi method, the identified factors are validated. MaxQDA software has been used to perform the content analysis. Fuzzy Delphi method calculations have been performed in Matlab software and structural-interpretive modeling has been performed in MicMac software. Data collection tools are interviews related to the qualitative part of research and standard Delphi questionnaire and structural-interpretive modeling. In the qualitative section, after conducting interviews with experts, the interview texts were coded in maxqda software and a number of indicators were extracted. Then, by compiling a fuzzy Delphi questionnaire and providing it to experts, the obtained indicators were validated and screened. In the prohibitions, using the ISM questionnaire, the main categories of research were leveled and effective and influential indicators were identified and the final research model was presented.

Based on the analysis of the interviews, the attraction of financial resources, innovation innovation, technological entrepreneurship management and the entrepreneurial approach of professors were identified as the main categories of the third generation university. Based on the results of fuzzy Delphi method, 33 indicators were selected to measure the categories and these factors were obtained using interpretive-structural modeling technique, analysis and finally communication and sequence of indicators. ‌ According to the leveling done, the final model of the university The third generation was designed at Islamic Azad University of Medical Sciences. Based on this model, entrepreneurial organizational culture is at the center of the model. This element is in dynamic interaction with attracting financial resources, innovation innovation, technological entrepreneurship management and entrepreneurial approach of university professors. It should be noted that the quality of peoplechr('39')s knowledge and the text and content of the courses have a direct impact on the entrepreneurial approach of university professors. On the other hand, policies and policies are effective in attracting university funding. Creating a science and technology park is an effective step in the development and flourishing of innovation, and ultimately a flexible organizational structure is essential for managing technological entrepreneurship. To achieve these ultimate goals, this model should emphasize the general level of studentschr('39') entrepreneurial skills and activities, studentschr('39') theoretical skills, professorschr('39') entrepreneurial knowledge, culture of accepting new ideas and plans, realization of knowledge-based development and commercialization of science, and establishment of student companies. Indicators of the general level of skills and entrepreneurial activities of students, professorschr('39') entrepreneurial knowledge, the culture of accepting ideas and new plans, and the realization of knowledge-based development have high influence and low dependence. These variables are identified as independent variables. The two indicators of studentschr('39') theoretical skills and lack of resistance to change and bureaucracy have high penetration power and dependency, and are considered to be the link variables. The characteristics of a flexible organizational culture, the re-engineering of structures, the existence of an entrepreneurial incentive reward system, and the holding of training courses have little influence and dependence. These autonomous variables have little effect on the system. Other variables are highly dependent and have little penetrating power, so they are dependent variables. Also, the variables of structure movement towards incubator and science and technology park, satisfaction and growth of science and technology park businesses, level of interactions of companies located in science and technology park, following new projects and registering them, innovation and creativity and culture in providing services and independence. The financial nature of the university and its self-government are the first level variables and as the most influential research variables. The variables of resistance to change and bureaucracy, the entrepreneurial experience of professors, the culture of supporting innovation and entrepreneurship, and the entrepreneurial approach of university presidents are the second level variables. The variables of absorption of the contributions of independent financial institutions, flexible organizational culture, reengineering of structures, pragmatic culture, and application of theories of the blue ocean are the third level variables. Variables for attracting government grants, adapting peoplechr('39')s abilities to the assigned tasks, facilitating rules and regulations in order to protect entrepreneurship, selecting operational managers, creative and innovative, participatory and team nature of courses, holding training courses and course topics based on current needs and society The title of level four variable has been identified. Variables include support for student innovation, adaptation of studentschr('39') ability to community needs, development of entrepreneurship and job creation by professors, the existence of an entrepreneurial incentive reward system, and entrepreneurial management strategies at the fifth level. Finally, the general level variables of studentschr('39') entrepreneurial skills and skills, studentschr('39') theoretical skills, professorschr('39') entrepreneurial knowledge, culture of accepting ideas and new plans, realization of knowledge-based development and commercialization of science and establishment of knowledge-based companies are the most basic elements of model.

Based on the achievements of this research, a flexible organizational structure is needed to implement the third generation university model. There should also be policy-making and academic policies to attract funding. Finally, while planning to improve the quality of peoplechr('39')s knowledge, the text and content of the courses, the creation of a science and technology park can be on the agenda.

Competency-based education seeks to bridge the gap between the labor market and the academic education system. Due to the problems of graduates of this field in the professional contexts, this study endeavored to up to date the curriculum of the field based on the expected job qualifications of the health system.

This qualitative and applied study with the focus-group discussion method was conducted in the Faculty of Management and Medical Education of Shahid Beheshti University of Medical Sciences in the academic year 2019. To discuss the group, 13 faculty members and experts, graduates as well as two hospital managers were selected to identify the differences between academic learning and the professional requirements, and then to evaluate the content and topics of the Master of Health Services Management course. At the end of the groupchr('39')s consensus, notes were taken on the agreed results.

 The data analysis revealed that the essential competencies are like this: leadership, effective teamwork, problem-solving, system thinking, and quality improvement. Changes were suggested in the content of existing courses, like working abilities with STATA software, expertise to design solutions by systems thinking methodologies, awareness of the ultimate challenges of the decisions without supporting evidence, and capacity to compare and criticize strategic planning process and outcomes.

Findings revealed that modifications to current courseschr('39') content were suggested by adding new curriculum approaches to cover the required skill set. Given changes in the formal curriculum is a time-consuming process, transforming the content of existing courses is recommended.

Given the importance of health as a valuable asset and achieving universal health coverage, Enjoyment the benefits of health insurance are essential to achieving health for all. So identifying and analyzing the benefits of integrating health insurance funds can be an effective step in this regard. This study aimed to analyze the Systematic Relationship of Health Insurance Integration Benefits in Iran.

This descriptive study was conducted on 68 health insurance experts in two stages of systematic identification and analysis of the benefits of health insurance integration in Iran. Data collection tool was a 40-item Likert-type questionnaire in the Delphi phase and a paired comparisons questionnaire in the systematic analysis stage. Delphi phase analysis was performed using SPSS software and one-sample t-test and factor weighting were performed using FUZZY DEMATEL technique using MATLAB software.

In total, 40 benefits were identified for integration of health insurance in Iran, and 29 benefits were accepted through Delphi phase. The results of Systematic Relationship Analysis also showed that the component of Stewardship with coordinates (1.31 and 1.31) as the most influential component and the component of operational processes with coordinates (0.959 and -0.959) as the most influential component.

Considering the importance of the Stewardship component, cost control and improving the efficiency of the health system in the current conditions of the country can be considered through the implementation of infrastructure reforms in the Stewardship. Also, achieving service-based benefits, general population coverage, financing, and operational processes can be achieved through medium-term and
long-term plans.

Lack of literacy and awareness of health literacy can increase anxiety and decrease the quality of life. The purpose of this study was to determine the correlation between health literacy and quality of Life with health anxiety in outpatient patients referred to Shahid Beheshti Specialized Polyclinic in Karaj.

This is a descriptive correlational study. The statistical population consisted of 2600 outpatients of Shahid Beheshti polyclinic outpatient clinic in Karaj, using Morgan table 335 patients were selected by random sampling. Research tools included the “Iranian Health Literacy Questionnaire,” the “World Health Organization Quality of Life Brief Version” (WHOQOL-BREF), and the “Health Anxiety Inventory” (HAI: Health). The validity of the questionnaires was determined by content and face validity. The reliability of the questionnaires was determined by Cronbach's alpha method. Data were analyzed by SPSS.25 and PLS3.5 Smart using partial least squares structural equation modeling.

There was a significant and negative correlation between health literacy and health anxiety (-0.470), and a significant and negative relationship between quality of life and health anxiety (-0.497), and a significant and positive correlation between health literacy and quality of life (0.749).

Health literacy and quality of life were positively and significantly correlated, health literacy and health anxiety were negatively and significantly correlated, quality of life and health anxiety were negatively and significantly correlated. It is recommended that hospital managers plan to improve the health literacy of patients to improve patients' quality of life and reduce health anxiety.

Universities have undergone various stages in their evolutionary development. At the heart of these developments is the debate on academic entrepreneurship under the auspices of a third generation university. The theoretical and practical importance of the subject on the one hand and the  lack of  infrastructure studies in third generation universities in the country have led to a fundamental study in the design of a third generation native university model.

In this study, a mixed method based approach was used. In the first step, the content analysis method was used to analyze specialized interviews, and in the second step, a final model was presented using structural-interpretive method. Data analysis was performed in qualitative phase with MAXQDA software and in quantitative phase with MICMAC software. The statistical population of this study includes experts of Islamic Azad University of Medical Sciences who were selected by purposeful sampling. The data collection tool was interview and questionnaire. To achieve the research objectives, a set of applied indicators were identified by analyzing interviews with experts.

The main themes of this research are fundraising, innovation, technological entrepreneurship management and professors' entrepreneurial approach. Then, these factors were analyzed using interpretive-structural modeling techniques, and eventually the relationship and sequence of indices were obtained. Due to the leveling of the final model of the third generation university was designed in Islamic Azad University of Medical Sciences.

Based on this pattern, entrepreneurial organizational culture is at the heart of the model. To achieve the ultimate goals of the model, emphasis must be placed on the general level of Students entrepreneurial skills and activities, Students theoretical skills, entrepreneurial knowledge of professors, the culture of accepting new ideas and projects, the realization of knowledge-based development and commercialization of science, and the establishment of knowledge-based companies..

Transformation in universities is a necessity in the path of community development. Due to a large number of students and the need to think about ways to facilitate their employment, this study aimed to develop an entrepreneurial university model at Islamic Azad University of Medical Sciences.

This study was qualitative-quantitative. In the qualitative section, ten experts in entrepreneurship in Islamic Azad University participated in semi-structured interviews. The content analysis method was used to analyze semi-structured interviews. Then, with the Maxqda software, the concepts were extracted from the interviews and the primary and sub-variables were obtained. In the quantitative section after extraction of final variables from qualitative analysis of interviews, the fuzzy Delphi method was used to survey the identified variables and select the final variables. For this purpose, several experts were confidentially sent the “Fuzzy Delphi Questionnaire” containing the criteria. Criteria with a mean score of less than seven were omitted. Fuzzy Delphi method calculations were performed by coding in the Matlab environment.

According to the experts' viewpoint, the entrepreneurship university model of Islamic Azad University of Medical Sciences was developed with two main variables including software factors (including six sub-variables) and hardware factors (including six sub-variables).

The Entrepreneurship University model of Islamic Azad University of Medical Sciences was developed with two main variables including software and hardware factors. Therefore, it is suggested that this model be used to provide the necessary infrastructure for university entrepreneurship.

Medical waste is among the environmental problems. Failure to manage these wastes leads to the prevalence of various diseases. This study aimed to rank the educational hospitals of SBUMS by assessing medical waste reduction. First, a review of past national and international studies was performed and accordingly, 12 criteria and 30 sub-criteria for reduction of medical waste production were selected. After developing a questionnaire based on such criteria, data was collected from six SBUMS hospitals. Then, TOPSIS and VIKOR techniques in MATLAB were used as ranking methods of hospitals. The combined results of TOPSIS and VIKOR methods using weighted average indicated that Hospital (C), Hospitals (B) and (A) were respectively ranked first, second and third in terms of waste management. Moreover, the effective measures to reduce the amount of waste production and to improve the waste management system include human resource, management support, proper management of supplies, proper model of service delivery, quality of supplies and equipment, and waste sorting at source. A combined method consisting of TOPSIS and VIKOR for evaluation of ranking of hospitals in terms of waste management can be a helpful tool in planning waste management, and can provide a basis for improving measures and promoting programs and activities.