فهرست مطالب gh. mahmoodi

Pharmaceutical costs account for a major part of health-related costs, and the induced demand for medicine imposes a large financial and economic burden on individuals and the whole society. Therefore, the aim of the present study is to identify the factors effective in creating induced demand for medicine in Iran.

This study is based on grounded theory approach and it was conducted in 2022. The interview questions were semi-structured and asked by experts. The initial selection of the samples was based on targeted sampling from among experts and scholars in the field of medicine and treatment from all over the country. The snowball method was used to increase the sample volume until it reached sufficiency. This research was completed by interviewing 20 experts.

The key factors effective in creating induced demand were identified in the form of 4 themes, 8 categories and 31 subcategories. The extracted themes included social, structural-organizational, economic and beneficiary-related factors. Social factors included the categories of society's culture and pharmaceutical literacy, structural-organizational factors included the categories of regulatory mechanisms and educational and political factors, economic factors included the categories of payment and insurance systems, and finally the beneficiary-related factors included the categories of suppliers and demanders.

Based on the results of this study, several factors play a role in the creation of induced demand for medicine, and following these factors can help policymakers formulate appropriate strategies to reduce unnecessary medicine prescription.

Risk assessment is one of the most important strategies in estimating the risk of cardiovascular disease and controlling the risk factors. In Iran, half of all deaths and 79% of deaths due to non-communicable diseases are attributed to cardiovascular diseases. The aim of this study was to analyze the results of cardiovascular disease risk assessment program in Mazandaran province.

This cross-sectional study was performed in 2019 on 600 patients referred to comprehensive health centers of Noor and Mahmoudabad cities in Mazandaran province. The data collection tool was a checklist containing the risk factors studied in the SIB system. Descriptive statistics such as mean, standard deviation, frequency and percentage as well as analytical statistical tests such as chi-square, regression and analysis of variance were used using SPSS software version 19.

The prevalence of risk factors for cardiovascular disease including history of diabetes, history of hypertension, obesity, high cholesterol, family history of diabetes and heart disease were 36.5%, 45.5%, 42.3%, 34.8%, 23.5% and 10%, respectively. The four variables of age, history of diabetes and hypertension, and blood cholesterol levels were significantly associated with the 10-year risk of cardiovascular disease. With increasing one year of age, the 10-year risk level increased by 15% (p<0.001), and by seven times in people with a history of diabetes (p<0.001) and increased by 83% in people with a history of high blood pressure compared to others individuals (p=0.022).

The results of the study showed that in Mazandaran province, four variables of age, history of diabetes and hypertension and cholesterol levels are the most common factors that are associated with 10-year risk of cardiovascular disease.

Assessing health systems paves the way for reforms in structures and processes to achieve better results. Therefore, the present study was conducted to evaluate the implementation of family physician program in urban and rural areas of Mazandaran province using process approach.

This cross-sectional study was conducted in 2017 among 238 managers, health experts and health insurance experts who were selected by census from 12 cities. Data were collected and evaluated using a researcher-made questionnaire with high validity and reliability, which evaluates urban and rural family physician program in three domains of structure, process and outcomes.

The mean score of the domain of structure (4.27±27.38), process (4.33±0.41) and outcomes (4.31±0.39) of rural family physician program was significantly higher than urban family physician program (p<0.001). In the urban family physician program, the most important dimension in the domain of structure was equipment (3.35±0.76), in the domain of process was care for non-communicable diseases (3.15±1.06) and in the domain of outcomes was reasonable prescription of medicine (3.07±1.02). In the rural family physician program, the most important dimension in the domain of structure was physical space (4.41±0.60) and in the dimensions of process and outcomes, the health of mothers and children (4.20±0.90) and the improvement of health promotion indicators (4.33±0.76) were more important, respectively.

Based on the results of this study in three domains of structure, process and outcomes, the rural family physician program was relatively better than the urban family physician program.

Background and Ëducational anxiety leads to disorder in educational performance, damaging intelligence and learning capacity, lessening abstract thinking and talent. By causing economical crisis, leads to educational anxiety and bad effects on individuals, families and society. Different medicinal and non-medicinal treatment methods are proposed to cure anxiety. Ône of the non-medicinal treatments is assertive therapy. Because of contradictory results from the previous studies on assertive therapy, this study was designed and performed. Ïn a field study with control group, considering the given list of anxious students from Qaemshar township counseling committee of educational organization using questionnair consisting questions about the educational anxiety. 60 anxious students studying at Qaemshar township schools, after homogenization were selected randomly and divided in two case and control groups. Çase group was under assertive therapy for 90 minutes per week, while control group did not receive any treatment. Six weeks after study, their educational anxiety was evaluated. Ïndependent t-test result indicated that the educational anxiety in case and control group had significant difference at the beginning and 6 weeks after the Study (t=8.35, p=0.000) it also showed that the decrease of anxiety in case and control groups had significant difference 6 weeks after assertive therapy. Çonclusion: Ëducational anxiety has damaging effects on educational, social and occupational performance of the students. This study indicated that 70% of the case and control groups suffered severe anxiety at the beginning of study, therefore, application of assertive therapy is proposed to be used as a non-medicinal treatment procedure for decreasing the students’ anxiety.