hamid reza dehghan

Depression is one of the most common psychiatric disorders and a mood disorder that manifests itself with symptoms such as low mood, loss of feeling, emptiness, mental and motor slowness, sadness, hopelessness, boredom, loneliness, they show guilt and inability to concentrate and thoughts related to death. The aim of the present study was the effectiveness of spiritual therapy on negative self-esteem thoughts and life satisfaction of university depressed students. The method of this research was semi-experimental with a pre-test and post-test design with a control group. The statistical population of this research included all depressed male and female students. The sample of this research included 36 depressed students (18 students in the experimental group and 18 students in the control group) who were selected by simple random. The process of selecting the sample was as follows: first, the Beck depression questionnaire was administered among students, and among the 66 students who scored above 20 (cut point) and based on the entry criteria, 36 were randomly selected into two experimental and control groups. (each group consist of 18 individuals). The experimental group was exposed to 10 sessions of spiritual training, and during this time, the control group did not receive any treatment. Beck depression questionnaire, negative spontaneous thoughts questionnaire and life satisfaction scale were used to collect data. The results of multivariate analysis of covariance (MANOVA) showed that spiritual therapy training was associated with a decrease in self-negative thoughts and an increase in life satisfaction of depressed students (p<0.001). Based on the findings of this research, it can be concluded that spiritual therapy actually reduces negative emotions such as depression through secret and need with God and solitude with the Almighty, and as a result improves life satisfaction in a person.

The development of mobile apps in healthcare facilities helps users perform self-care effectively.

This study aimed to evaluate the quality, functionality, and features of Persian language diabetes mobile apps.

Persian language diabetes self-management mobile apps were searched in the Android and iOS App Stores using relevant keywords such as "diabetes" and "blood sugar." Twelve apps met the inclusion criteria. Nine evaluators assessed the apps' quality based on the Mobile App Rating Scale (MARS), their functionality according to the IMS institute for healthcare informatics app functionality scoring system, and their features and content using a checklist.

The mean MARS score of the apps was 3.02 out of 5. Among the four dimensions of engagement, aesthetics, functionality, and information quality, functionality had the highest mean ± SD score (3.64 ± 1.13). Most of the apps used 5 - 7 out of the 11 defined functionalities. All self-management apps included the functionality of monitoring blood glucose levels, and the majority had health status monitoring features.

The mobile apps had several drawbacks, including a lack of engagement strategies, insufficient evidence-based information for patients, limited guideline-based self-management functionalities, failure to evaluate clinical effectiveness in trials, and an absence of mutual communication with healthcare providers.

The aim of the present study was the effectiveness of cognitive therapy-based emotion regulation on problem solving and social competence of adolescents with behavioral disorders.The method of experimental research was of experimental type and pretest-posttest design with control group. The statistical population of the research included all the high school students of Nowshahr city in the academic year2016-2017whose number is2060.The research sample consisted of 36 students with behavioral disorders who were randomly selected among the students with behavioral disorders and were randomly assigned to two experimental and control groups.To collect data, the revised checklist of behavioral problems(RBPC)the short form of the social problem solving questionnaire(SPSI-R)and the social adequacy test(Flener et al,1990)were used. The results of covariance analysis showed that the cognitive therapy-based emotion regulation in the experimental group was associated with an increase in positive and logical problem solving and a decrease in negative, impulsive and avoidant problem solving and an increase in the social competence of adolescents with behavioral disorders(P<0/001).Based on the findings of this research, it can be concluded that by correcting the misbehavior cognition's and the methods of expression of emotions and problem solving style in adolescents with behavioral disorders, it improved the social adequacy in interacting with themselves, peers and other people;This, in turn, can affect their other relationships and correct their disordered behaviors.In the end, according to the findings of this research, it is suggested that the effectiveness of cognitive therapy based on emotion regulation on other disorders of children and adolescents should be considered.

The reduction of hospital admissions, emergency visits, and urgent surgeries during the COVID-19 pandemic were reported in various countries. The present study aimed to evaluate these changes in Iran.

A retrospective study of regional secondary utilization and mortality data from multiple official sources was performed.  The data were collected from hospitals located in the center of Iran (Yazd) between March 1st, 2020 (before COVID-19) and February 30th, 2021 (after COVID-19). The data were analyzed using Microsoft Excel® and SPSS24 The Mann-Whitney test was utilized to compare the variables’ changes before and after COVID-19 pandemic. Spearman's correlation coefficient was used to evaluate the connection between non-COVID-19 mortality and the quantity of urgent surgeries conducted in hospitals.

The percentage changes in hospital admissions, emergency department visits, and urgent surgeries following COVID-19 were 33.7%, 39%, and 23%, respectively. The correlation between the number of urgent surgeries and the non-COVID-19 mortality during the pandemic was negative(r=-0.9).

Our results provide empirical support for concerns about the widespread public health impact of the COVID-19 pandemic. The development of novel technologies including telemedicine, consultations and online visits, as well as the use of remote monitoring technology could lead to improved access to health care during a pandemic, particularly for vulnerable populations.

Non-Hodgkin lymphomas are a heterogeneous group of lymphoproliferative disorders with various behaviors and responses to treatment. As a primary extranodal NHL, the disease must be confined to one location, and bone marrow should not be involved. Primary uterine cervix lymphoma is a rare malignancy as well as a rare site of extranodal lymphoma. Because of the rarity of the disease, there is no standard treatment guideline for women with primary uterine cervix lymphoma. Patients mostly present with abnormal uterine bleeding, vaginal discharge or pelvic pain. Typically, a pap smear may not show the malignant cells in the specimen. When the diagnosis is made, management may be debated due to its rarity and lack of standard treatment. Surgery, chemotherapy, chemo-immunotherapy and radiotherapy, either alone or in combination, are the treatment options.  Most patients respond well to chemotherapy and radiation therapy. The prognosis is usually favorable. Here, we report a case of primary cervical lymphoma in a 50-year-old woman who presented with abnormal vaginal bleeding. She was treated with radiotherapy and chemo-immunotherapy and remained disease-free after nine months of treatment.

Hemorrhoids are swollen veins in the lower rectum and anus, rarely dangerous, and typically treated within a few weeks. However, urgent medical care is required to avoid exacerbation of the condition. This study aimed to compare minimally invasive laser surgery with other common hemorrhoid surgical techniques and investigate the main outcome of these techniques.

Data sources: 

Four databases of PubMed (185), Scopus (59), ISI (143), CRD (10), and other resources (12) were explored.Study selection: All studies on laser surgery for patients with Grade 2 or 3 hemorrhoids examining pain outcome, reduction of hemorrhoids grade, and patient's quality of life after laser surgery were enrolled in this review.

Finally, 25 eligible articles were enrolled in the study. The results indicated that hemorrhoid was improved in the laser surgery group within the follow-up period with a higher average of quality-of-life self-assessment compared to other techniques. Overall satisfaction was higher in the laser group.

The evidence favored laser treatment in all studies, either clinical trials or studies without control groups. Ingeneral, laser surgery is considered an immune treatment for hemorrhoids with fewer postoperative complications such as bleeding, discomfort, and pain. Therefore, other than the cost, the rest of the evidence was in favor of laser surgery, and the laser technique is an appropriate alternative to conventional methods.

The purpose of the research is to study the lived experiences of teachers, parents and professionals regarding the challenges governing the parent-teacher association meetings and to provide solutions. Qualitative and phenomenological methods were used in this research. The interviewees of the research included all teachers, parents and specialists of Ardabil city in the academic year of 2022-2023. To select the participants, targeted and saturation sampling was used and 21 teachers, 16 parents and 19 specialists were selected. Data were collected using interviews with open and semi-structured questions. Validity and reliability of interviews were determined through triangulation technique, member control technique, parallel accurate information acquisition technique and researchers' self-review. In the interview with the teachers, the majority of them emphasized and provided solutions to the challenges in the parent-teacher association meetings. The parents also listed the challenges and solutions for these meetings and finally, after explaining the reasons for holding or not holding parent-teacher meetings and the topics and content required to be presented in these meetings, for the proper implementation of the meetings, the experts introduced methods and requirements such as the use of electronic devices, the requirements for discussions in the meeting, the manners of participating in the meetings, and the use of the necessary facilities.

The aim of the present study was to investigate the effectiveness of impulse control training on problem solving, frustration and social competence of adolescents with behavioral disorders. The experimental research method was of experimental type with a pre-test-post-test design with a control group.The statistical population of the research included all the students of Nowshahr high school in the academic year of2018-2019, whose number was2060. The research sample consisted of36 students with behavioral disorder who were randomly selected from among the students with behavioral disorder and replaced by simple random in two experimental and control groups.To collect data, the revised checklist of behavioral problems,the short form of the social problem solving questionnaire, the frustration questionnaire and the social adequacy test were used.The results of covariance analysis showed that impulse control training in the experimental group has been associated with an increase in positive and logical problem solving and a decrease in negative,impulsive,avoidant problem solving,frustration,and an increase in the social competence of adolescents with behavioral disorders.

Impulse control training gives adolescents with behavioral disorders the ability to control their destructive behavior, which can reduce their impulsive and destructive behavior and increase correct problem-solving skills,which in turn It can improve relationships with peers in the long term,which ultimately reduces their sense of frustration,which results in an increase in their sense of social competence.In the end, based on the findings of this research, it is suggested that the effectiveness of impulse control training on other interpersonal and academic problems and adolescents be investigated.

High-risk behaviors have devastating physical, psychological, and social consequences for the adolescents. This study aimed to investigate the effectiveness of compassionate mind-based cognitive therapy on behavioral inhibition-activation systems and the theory of mind of adolescents with high-risk behaviors.

The study design was quasi-experimental with control and intervention groups and a follow-up phase.The statistical population included all high school boys with high-risk behaviors in Tabriz. The sample consisted of 30 students who were purposefully selected, and randomly allocated into experimental and control groups. High-Risk Behaviors Questionnaire, Brain-Behavioral Systems Scale, and the Theory of Mind Questionnaire were used to collect data. Data were analyzed using multivariate analysis of variance test and employing SPSS-24 software.

Compassion-focused cognitive therapy decreased activation, increased inhibition, and improved theory of mind among adolescents with high-risk behaviors (P<0.01).

Basedon the findings of this study, it can be concluded that cognitive therapy based on compassionate mind through the component of mindfulness by reducing rumination, leads to a reduction of negative emotions and thus reduces high-risk behaviors in adolescents. Thus, it can be said that treatment based on Compassion can be used as an effective treatment to improve adolescent psychological problems with high-risk behaviors.

The aim of this study was to compare theory of mind, Positive and negative cognitive emotion regulation and aggression in students with and without behavioral problems. The study followed a causal-comparative design and all the juveniles between 15 and 18 years of age of Noshahr city composed the statistical population. The sample consisted of 74 adolescents (37 adolescent behavioral problems and 37 normal adolescents). The behavioral problems questionnaire was first performed on 400 high school students in Nowshahr city, and 71 students obtained the required score, 37 of them using Random sampling method was used and 37 adolescents were matched for comparison with this group. In addition to Quay and Peterson Revised Behavior Problem Checklist (1987), Baron-Cohen Reading the mind in the eyes test (2001), cognitive emotion regulation test (2001) and Buss & Perry aggression test (1992) was utilized for data collection. The results of multivariate analysis of variance (MANOVA) showed that there were significant differences between the two groups of juveniles in the theory of mind, positive emotion regulation, and physical aggression variables. Where, the theory of mind and positive cognitive emotion regulation variables negatively, and negative cognitive emotion regulation variable positively predicted the aggression in the juveniles. Conclusion Lack of understanding the mental states of others seems to cause problems in regulating emotion and as a result aggressive behavior and behavioral problems in adolescents.

Breast cancer is an uncontrolled and unnatural proliferation of cells in different breast tissues. The first measure to diagnose breast cancer is an examination by a surgeon followed by mammography, sonography, sampling, and other diagnosing methods. Given that there are several methods to diagnose breast cancer, and most of them are quite expensive, the present systematic review compares the expenses and effectiveness of different methods to diagnose breast cancer.

The study was carried out as a systematic review through searching databases, i.e., PubMed, Web of Science, Magiran, Scopus, and Embase for articles published from March 1999 to May 31, 2017. The research articles regarding health technology assessment and economic assessment (n = 8) were examined.

Generally, conducting MRI screening and digital mammography every six months after the age of 30 are proved to be the most efficient and economical methods to screen carriers of BRCA (BReast CAncer) mutated genes. Besides, implementing both the techniques simultaneously was more cost-efficient with BRCA1 compared to BRCA2. Some studies have revealed that genetic tests and Oncotype tests, in particular, were the most cost-efficient methods to diagnose the disease, especially in its early stages.

Consequently, indexing gene expression in individuals with BRCA gene mutation is revealed to more cost-efficient.

The results of this study can be used as a guide to provide valid evidence for the decision of senior managers of the Ministry of Health and large hospitals to use common technologies used in distance care for patients with CHF and other chronic diseases. This study will also provide a new understanding of the various studies that have been conducted to help patients with chronic failure by different types of remote care technologies in terms of effectiveness, safety, technology, and economic costs.

Psychologists consider self-injurious behaviors as a self-help activity that helps a person temporarily calm down, and is in fact an aggressive behavior that can lead to suicide as long as it is not treated. The aim of this study was to investigate the effectiveness of transcranial direct current stimulation on brain-behavioral systems and dark personality traits of adolescent with self-injurious behaviors.

 The method of the present study was quasi-experimental with pre-test and post-test design with control and follow-up groups. The statistical population of the study included all male high school students with self-injurious behaviors in Tabriz in the academic year 2019. The sample consisted of 30 students with self-injurious behaviors (includes 15 people in each group). The sample selection method was that first 30 students with self-injurious behaviors were purposefully selected and screened and randomly assigned in two groups. The self-injurious questionnaire, brain-behavioral systems scale and dark personality traits questionnaire were used to collect data. The experimental group was exposed to direct transcranial electrical stimulation for 20 sessions every other day. Data were analyzed using multivariate analysis of variance test and employing SPSS-24 software.

The results showed that transcranial direct current stimulation caused decreased behavioral activation (P<0.001) increased behavioral inhibition(P<0.001) and decreased antisocial behavior(P<0.001) in adolescents with self-injurious behaviors.

According to the findings of this study, it was found that direct transcranial electrical stimulation had an effect on brain-behavioral systems and dark personality traits of students with self-injurious behaviors.

Diabetes is one of the most serious health challenges of the 21st century. The number of adults with diabetes has roughly tripled in the last 20 years. The increased burden of chronic diseases and scarce health resources compel healthcare systems to make modern patients more self-sufficient by requiring them to play a more active part in the treatment and management of their disease. Tele-home-care is a method of distance intervention through the transmission of electronic data for follow-up, education, prevention, clinical decision-making, and treatment modulation that has a high potential for the population with diabetes. Previous studies have not systematically evaluated the effects of different features of long-distance caregiving on diabetes at different stages of disease severity.

The present study describes a protocol for a systematic review and meta-analysis for summarizing the evidence comparing telehomecare interventions on diabetes management and its complications.

PubMed, Scopus, ISI Web of Science, Cochrane databases, HTA (Health Technology Assessment), NHS EED (NHS Economic Evaluation Database), DARE (Database of Abstract of  Reviews of Effects), Embase, and SID will be searched using medical subject heading (MeSH) keywords. Controlled clinical trials in patients with type 1 diabetes, type 2 diabetes, and gestational diabetes will be selected based on predefined eligibility criteria. The risk of bias in studies will be checked using the JADAD score. The mean difference and its standard deviation will be calculated to be used as effect size. A random-effects meta-analysis was performed to pool the results. Subgroup analysis and meta-regression will be conducted to explore the possible sources of heterogeneity.

The systematic review and meta-analysis provided by the results of a systematic review can be useful to endocrinologists, physicians, public health policymakers, and the general population.

 Chronic obstructive pulmonary disease (COPD) is considered the fourth main cause of mortality worldwide, affecting 10% of adults aged up to 40 years. Due to the growing elderly population and smoking, the global burden of COPD is expected to increase in the general population. Telemedicine may help patients with COPD to decrease exacerbation episodes and the associated costs. Moreover, Telehomecare (THC) may be considered as an alternative to cut down hospitalization costs and increase the patients’ comfort.

 This study explains the methodology of a systematic review and meta-analysis designed to evaluate the impact of THC interventions on the control and management of COPD and its complications.

 To review all published studies comparing THC interventions in controlling COPD and its complications, all studies published in PubMed, Google Scholar, Scopus, ISI Web of Science, Cochrane databases, HTA EED, DARE, Embase, SID, Magiran will be searched until the end of 2021.  Randomized controlled trials (RCTs), cluster RCTs, controlled clinical trials comparing telehealth with standard monitoring of COPD patients were included. Independent reviewers will review the abstracts and full-texts of all relevant studies for eligibility, risk of bias, and data extraction using structured forms. The meta-analysis will be performed for adequately homogenous studies regarding their populations, interventions, and objectives.

 The results of this systematic review and meta-analysis will provide useful information on the impacts of THC on COPD control. The evidence provided by this systematic review can be helpful for clinical specialists, public health policymakers, and the general population.

Context: 

Student assessment is an essential part of higher education. Many different technology-based assessment methods have been formed with the increasing development of IT and its introduction into the education system. Online take-home exams are computer-based exams in which the examinees can take at a place of their own choice and on their own computers. Despite its benefits, this method is faced with certain problems. The present study investigates the challenges in holding take-home computer-based exams in medical sciences and various solutions proposed to use this method more extensively in Iran in situations of crisis.

Evidence Acquisition: 

The present review article was drafted upon a search conducted in Scopus, Google Scholar, and Google’s general search engine using the following keywords and search strategies: "Take-home exam", OR "Take-home assessment", OR, "Online exam", OR "Online assessment", AND "Higher education". The content of the related documents published from 2009 to 2020, including articles, books, and web pages, was selected and assessed, and 35 articles were finally used to accomplish the study objectives.

 Online take-home exams have many advantages, including reduced human errors, rapid scoring, and reduced stress on the examinees. Nonetheless, one of the limitations of this examination method is that the examinees may not meet all the criteria required for taking exams at home. The obvious risk is students’ unethical conduct and cheating, which composes a major challenge of this examination modality.

 The reliability and correctness of exams can be improved using combination techniques, question banks, and giving random equivalent questions to each candidate that are not necessarily similar, and also mixing up the questions and their answers, which can provide a tool for preventing or limiting cheating. Online monitoring systems are also one of the strategies proposed for ongoing monitoring of online exams by an invigilator that are generally developed through artificial intelligence.

Academic burnout is a serious threat that can affect any student’s academic life, especially nursing students. Sleep quality and a healthy lifestyle are variables are related to academic burnout. This study aimed to predict undergraduate nursing students’ academic burnout based on sleep quality and lifestyle.

The study was descriptive and correlational in design. The statistical population included all undergraduate nursing students of the Razi School of Nursing and Midwifery at the Kerman University of Medical Sciences (Kerman, Iran; 2016-2017 academic year). Of 270 students,143 students were selected using a random cluster sampling method. The Academic Burnout Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the LifeStyle Inventory were used to collect data. A linear regression analysis using the enter method was employed for data analysis.

There was a significantly positive correlation between students’ academic burnout and total PSQI score (P = 0.000, r = 0.547) and some of its sub-scales, including subjective sleep quality (P = 0.000, r = 0.607), sleep latency (P = 0.019, r = 0.196), sleep duration (P = 0.014, r = 0.206), sleep disturbance (P = 0.000, r = 0.346), and daytime dysfunction due to sleepiness (P = 0.000, r = 0.654). Conversely, the relationship between students’ academic burnout and healthy lifestyle was negatively significant (P = 0.000, r = -0.507). Thus, the potential for undergraduate nursing students’ academic burnout can be predicted by sleep quality and lifestyle (P = 0.000, F = 23.480).

By improving sleep quality and living a healthier lifestyle, students may be less likely to experience academic burnout.

In 1988, a new conception for endometrial cancer staging was introduced by Fédération Internationale de Gynecologie et d'Obstétrique (FIGO). In addition to pathologic development, peritoneal cytology played an important role in the staging. The goal of peritoneal cytology was to identify hidden and microscopic extensions outside the uterus. In 2009, the system was reviewed; one of the changes was removing the peritoneal cytology. The aim of this review is to evaluate the effect of peritoneal cytology on the survival of patients with endometrial cancer.

This protocol is reported based on the PRISMA-P guideline. We will search "endometrial cancer," "peritoneal washing," and any other relevant words on PubMed, Cochran, EMBASE, and Scopus databases. The eligibility criteria are: All original studies performed on patients with endometrial cancer, evaluated survival, and performed peritoneal washing cytology. Only one of the non-English studies with the same respect will be included according to the research team's opinion. Also, the most recent paper among multiple articles about a single study is chosen. It should be noted that there will not be any restrictions regarding the language and publication date. For quality assessment, we will use the quality in prognosis (QUIPS) tool.  If possible, a meta-analysis will also be performed using a rndom effects model, and overall survival rates and confidence intervals will be reported. Heterogeneity will be tested by using the I2 index and Cochrane's Q test. Subgroup analysis will be performed to handle the heterogeneity. The publication bias will be assessed in the presence of 10 or more relevant articles. If there is no chance of meta-analysis, the result will be reported qualitatively.

The resulting review will provide valuable information regarding the prognostic value of peritoneal cytology in patiens with endometrial cancer.

Multiple sclerosis (MS) is a disease that involves an individual's central nervous system and can affect many aspects of his/her life. This study was conducted to evaluate the safety and efficacy of fingolimod compared to placebo in the treatment of relapsing MS.

A detailed research was carried out on Medline, Web of Sciences, the Cochran Library, Embase, and Scopus databases within January-December 2020. The studies were evaluated regarding the effectiveness of the Expanded Disability Status Scale (EDSS) and the safety of complications. A random model with a 95% confidence interval was used for data analysis. To evaluate the heterogeneity of the studies I2 test was used in this research. The Cochrane risk of bias tool checklist was applied to assess the quality of the study methodology.

The results indicated that in 3 and 1 studies fingolimod was used at a dose of 1.25 and 0.5 mg, respectively. Based on the findings, the use of fingolimod at a dose of 0.59 mg was effective in improving patients. The patients receiving fingolimod 1.25 mg were more likely to have lymphopenia than patients taking placebo.

Finally, the findings of this study showed that the use of fingolimod was effective on the EDSS index, compared to placebo. Doctors can use this drug to improve EDSS and the quality of life of patients.

As one of the major public health concerns, the progressive increase in the suicide rate among children and adolescents is associated with biological, psychological and sociological aspects.

This study aimed investigating the demographic characteristics and the relationship between substance abuse, smoking and alcohol consumption by parents and children with suicide attempt history.

The present case-control study was conducted on suicide attempters aged 6-18 years in 2019 in Sanandaj, Iran. The sampling method was random and based on the chronological order of referrals to hospitals. 44 individuals including 26 girls and 18 boys in the case group and 42 individuals in the control group were matched in terms of age, sex, and rural or urban residence. Data were collected using a self-made checklist and the BECK suicide questionnaire. Statistical data were analyzed by SPSS-22 software.

The mean age of the subjects was 14.29 in the case group, and 13.5 years in the control group. Among suicide attempters, 13 were smokers, 12 were alcoholic consumers, and 7 were substance abusers. As opposed to the insignificant effect of maternal consumption of alcohol and substance, and smoking there were 28 smokers, 13 alcoholic consumers, and 10 substance abusers among fathers, indicating the significant role of fathers in the suicide attempts of children (P<0.05).

Due to the prevalence of suicide in Kurdistan and its concurrence with the use of drugs, cigarettes and alcohol, effective planning and intervention by policymakers and health and social authorities seem imperative.

The increasing advances in information technology and electronic devices, as well as limitations in traditional education persuade higher education systems to use virtual model as an alternative. The present systematic review aimed at evaluating the cost-effectiveness of both the traditional and virtual education models.

This was a systematic review study. For the purpose of data collection, articles published in the specialized English and Persian databases such MEDLINE (PubMed), Scopus, Science Direct , HTA, and Cochrane Irandoc, Magiran, and SID were retrieved from 2007 to 2017.. Related studies on health technologies and economic investigations were also reviewed. For this purpose, hierarchical search method and keywords“e-Learning” and “traditional education ” were used.

ten studies were included the results of these studies were slightly different. Most studies showed that the cost-effectiveness of virtual education alone or in combination with traditional education (blended model) was equal or greater than that of traditional education. The data analysis of the articles was performed by comparing cost, effectiveness(Min. SD,QASE), cost effectiveness(ICER)and average cost per student. Cost-effectiveness refers to achieving the highest output at the lowest cost. the economics of distance higher education The results showed that due to the use of multimedia, lack of space and time limitations, admission of a large number of students, And increasing student satisfaction، easy and fast access to information, and use of SCORM model in producing content and instruction, distance higher education reduces education costs, while compensating for the lack of human resources in the teaching-learning process.

For many years, the classical (traditional) insulin injection methods have been used. The first insulin pen was made in the 1980s. These types of pens are divided into two categories, namely analogue and vial-human. Analogue insulin pens are similar to human insulin pens in molecular structure and can lead to differences in pharmacokinetic and pharmacodynamic properties.

This was a systematic review conducted by searching Web of Science PubMed, SID, Embase, Scopus, and Magiran databases for articles published from the beginning of 2007 to June 2017. The related studies in the field of health technology and economic assessment were investigated.

Twenty studies were included; these studies indicated that there is no reason for the higher risk of rapid-acting insulin analogue pens in comparison with vial (human) and that analogue insulin pens significantly reduce the risk of hypoglycemia. Analogue insulin was compared to other existing insulins and was not found cost effectiveness (ICER: 642994$QALY), (ICER: 130865 $ QALY), (ICER: 87932$ QALY), but due to the increased quality of life and patient satisfaction compared to vial insulin pens, this type of pen has been used. Some studies have shown that aspart 30 insulin pens are more cost-effective than other analogues (ICER: 22488$QALY).

Although the use of analogue insulin is more expensive for diabetic patients, it is more effective than vial insulin. Thus, insurance companies are recommended to develop special plans for the three vulnerable groups of seniors, children, and pregnant women to provide them with analogue insulin.

Growth hormone deficiency (GHD) is one of the most important reasons of short stature in children, which can be treated by early diagnosis. Stature is a good measure for assessing a child's overall growth and health, and height can affect one's psychosocial and social well-being. Human Growth Hormone (HGH) has extensive effects on biological processes, and helps to influence height. Due to the high cost of growth hormone GH drugs, in most countries it is prescribed according to scientific indications.
Research

The present study is a systematic review. From the beginning of 2002 to February 2019, by searching Web of Science, PubMed, Scopus, SID, Embase and Magiran databases, related studies in the scope of health technology assessment and Economic evaluation were reviewed. Finally, 11 related studies were entered the study.

The use of GH therapy was effective in increasing the patients' life quality. The growth of children treated with GH was more than 2.5 cm per year more than untreated children. Furthermore, the results of the studies indicated the cost-effectiveness of using GH. So that the cost of each centimeter increase in height is on average US $ 20,000, and the incremental cost-effectiveness based on QALY's criteria in studies for various indications (Turner syndrome, idiopathic short stature, growth hormone deficiency, Prader Willi syndrome , Infants small for gestational age (SGA), chronic renal failure (CRF) and (SHOX-D) is different. The highest cost efficacy per kali is for growth hormone deficiency (from £ 20,000 to £ 30,000) and the lowest cost efficacy is for Prader Willi (from £ 55,000 to £ 135,000).

Considering the cost-effectiveness of using GH and the increase in height of treated children with GHD, compared to other children, it is recommended to use GH therapy for all children with GHD after doing the experiments. And it can attract health policy makers' interest.

Chronic diseases are the major cause of death and disability in the world. Despite the high prevalence and complications of chronic diseases, many of these diseases are preventable with simple ways. Health promoting behaviors is one of the best ways that people can protect their health. Since women are the main models of education and promotion of healthy lifestyle to the next generation the aim of this study was to investigate the health promoting behaviors of women of reproductive age in the city of Yazd. This cross-sectional descriptive study was conducted on 120 women aged 49-15 covered by Shahid Farshad health center in Yazd. Health-promoting behaviors questionnaire (HPLP-II) were used to collect information. The data tool was completed with self-report methods. Data were analyzed with spss16 software. The mean age of the women was 33.67± 7.43. The highest mean subscales was 26.60± 5.06 for spiritual growth and the lowest was 13.6± 3.6 for physical activity and 18.69± 3.7 for Stress Management. Significant relationship was observed between education with health promotion behaviors (P = 0.02) and responsibility for health subscales (P = 0.03). Also the direct and significant correlation was between interpersonal relationships with education level (P = 0.02) and the nutrition sub-scale with income level (P = 0.04). In the present study, despite the desirability of promoting women's health behaviors, health-promoting behaviors need to be upgraded, especially in the field of physical activity and stress management. As a result, the design of appropriate interventions to encourage health promotion behaviors is necessary.

Acute Heart Failure (AHF) is a common cause of hospitalization in many countries. Rehospitalization due to AHF is also a very important economic issue for health services. Registries for AHF have been made in many countries to characterize such patients, which have provided great information about these patients for better care. To date, there is insufficient information about these patients in Iran and their rehospitalization and short- and long-term follow-up is unclear.
This study aims to describe the results of a small registry of AHF (HFrEF) patients in Iran and their short-term follow-up.
Patients and This study aimed to describe the earliest results of the AHF registry, which was started from September 2015 in two hospitals (Afshar Heart Center in Yazd and Rajaie Heart Center in Tehran). All patients with diagnosis of AHF and HFrEF were enrolled into this registry. During six months, 352 patients with diagnosis of AHF and HFrEF were entered into this registry. The patients’ demographic, clinical, and Para clinical data were collected during hospitalization and they were followed up for all-cause mortality and hospitalization for three months. Patients suffering from heart failure with preserved ejection fraction were excluded because of their small number and incomplete data.
The mean age of the patients was 55 ± 16 years and 76% were male. Besides, 77% of the patients had acute decompensation of chronic heart failure and 17% had new-onset AHF. Etiology of heart failure was ischemic heart disease in 52% of the patients. Additionally, the mean left ventricular ejection fraction was 20%. Moreover, length of hospital stay was 10.5±10 days and in-hospital mortality rate was 9.7%.
This small and limited registry of patients with AHF (HFrEF) in Iran delineated these patients’ characteristics with some discrepancies and similarities with western registries. Thus, a larger nationwide registry is needed for further clarification of the issue.