فهرست مطالب masoumeh gholizadeh

Hypertension is one of the most important risk factors of cardiovascular morbidity and mortality that holds a unique place in population health and health care.

Given the exponential rise of high blood pressure as one of the major health problems, this study aimed to investigate the current situation and provide a strengths, weaknesses, opportunities, and threats (SWOT) analysis in the management of hypertension.

A qualitative study of 12 interviews was conducted with policymakers and managers. The sampling method was purposive sampling. Data collection was performed from January to July 2020. A thematic approach was used to analyze the data. The consolidated criteria for reporting qualitative research 32-item (COREQ-32) checklist was applied to ensure quality control in the study design, analysis, and data reporting.

A total of 12 factors were identified as SWOT. The most important strengths included universal coverage of health services, provision of team-based care, and self-care training. The weaknesses were related to the therapeutic approach, long-term planning, and continuity of programs. Cooperation of other sectors with the health system and the existence of health management training centers were noted as opportunities to better implement hypertension management programs and confront threats such as conflicts of interest between guilds and organizations and crises.

High blood pressure can be prevented. The present direction toward health-oriented policies can be changed in all sectors by taking advantage of the existing strengths and opportunities.  

Diabetes is a chronic illness which requires continuous self-care. Appropriate self-care can reduce the risks of developing complications and improve the Quality of Life (QoL). This study aimed to examine self-care and its association with quality of life in patients with type 2 diabetes (T2DM) in East Azerbaijan, Iran, in 2018.

This was a cross-sectional study. The statistical population included all patients with type 2 diabetes in East Azerbaijan, in 2018. 310 patients were included using consecutive sampling. The summary of Diabetes Self-Care Activities  Questionnaire (SDSCA) and the 12-Item Short Form Health Survey questionnaire (SF-12) were used for data collection. Data were analyzed using SPSS22.  Descriptive statistics such as mean, Standard Deviation (SD), frequency, and percentage were applied to describe the characteristics of the respondents. The Spearman correlation, Mann Whitney U and Kruskal–Wallis tests were applied for statistical analysis.

The mean scores of self-care and QoL were estimated to be 42.14 ± 61.63 and 53.25 ± 51.73, respectively. The highest mean of self-care and QoL was related to medications and social functioning which were 96.03 and 68.34. There was no correlation between the total mean score of self-care and QoL (P-value = 0.65). Moreover, a significant correlation was found between medication (insulin), exercise, blood-glucose testing and the total score of QoL (P-value < 0 .05).

The results indicated that self-care in patients with diabetes is poor, and the patients’ QoL is moderate. Therefore, it is suggested that managers of health centres take appropriate measures such as educational programs and executive interventions to enhance self-care in patients with diabetes. Moreover, to increase QoL, more attention should be paid to promote exercise and diet behaviours.

Human life is tied with the stress caused by economic, political, social, and cultural problems, which may lead to physical and mental diseases. In such stressful conditions, people make lifestyle changes that put themat high risk for developinghypertension.

Accordingly, this study investigated the prevention and management of hypertensionas a major public health challenge in Iran.

Semi-structured interviews were conducted with managers, health policymakers, social medicine specialists, and faculty members. All interviews were recorded, transcribed verbatim, and analyzedusingthematic content analysis.The MAXQDA18 software was applied to facilitate the organizationof codes and themes.

Interviews were conducted with 17 participants. The analyses resulted in five themes including, educationalpolicies,cultural policies,urban transport policies,organizational policies,and economic policies. A total of 13 subthemes were also extracted from the data.

Findings have indicated the stressors factors, stemming from macro-policies and mismanagement of government.To reduce the burden of hypertension and improve people's living conditions, health-oriented policies should be designed and implemented in all sectors.

Regular performance assessment is the basis of effective managerial decision making which is crucial for increasing the productivity of an organization. A distinct characteristic of an effective performance assessment is the implementation of various methods which are aimed at assessing the conformity with multiple indicators and criteria. The aim of the present comprehensive review was to extract the factors affecting the performance assessment of organization.

We conducted a comprehensive search in databases including PubMed, Embase, SID and Magiran in January 2020. Inclusion criteria were articles with the English language and full text available that were about influential factors. Two independent reviewers checked the research process, screening of articles.

Factors influencing an effective and efficient organizational performance assessment categorized in three themes and 22 sub-themes emerged. The themes included: “performance assessment indicators”, “performance assessment criteria” and “background factors in performance assessment”.

Indicators, criteria, and background factors provide a framework for assessing the organization's overall performance. An organization can manage its human resources effectively and efficiently by considering all the effective factors. Identification and classification of influential factors can be of help for managers and decision-makers in creating performance assessment system.

In May 2014, Iran launched the most far-reaching reform for the health sector, so-called Health Sector Evolution Plan (HSEP), since introduction of the primary health care network, with a systematic plan to bring about Universal Health Coverage. We aimed to analyze the time to first all-caused rehospitalization and all-caused 30-day readmission rate in the biggest referral hospital of Northwest of Iran before and after the reform.

We retrospectively analyzed discharge data for all hospitalization occurred in the six-year period of 2011-2017. The primary endpoints were readmission-free survival, and overall 30-day readmission rate. Using multivariate cox proportional hazards regression and logistic regression, we assessed between-period differences for readmission-free survival time and overall 30-day rehospitalization, respectively.        

Overall, 157969 admissions were included. After adjusting for available confounders including age; sex; ward of admission; length of stay; and admission in first/second half of year, the risk of being readmitted within 30 days after the reform was significantly higher (worse) compared to pre-reform hospitalization (odd ratio 1.22, P<0.001, 95% CI, 1.15-1.30 ). Adjusting for the same covariates, after-reform period also was slightly significantly associated with decreased (deteriorated) readmission-free time compared with pre-HSEP period (HR 1.06, P=0.005, 95% CI 1.01-1.11).

  HSEP seems insufficient to improve neither readmission rate, nor readmission-free time. It is advisable some complementary strategies to be incorporated in the HSEP, such as continuity of care promotion, self-care enhancement, effective information flow, and post-discharge follow up programs.

Dear editor, Recently, we read with great interest the article authored by Jadidi et al. [1] that was entitled“Is emergency medical services (EMS) in Islamic Republic of Iran practical and efficient in facingEbola?” and published in Bull Emerg Trauma in 2019, in 7th volume and 3rd issue. First of all, wewould like to extend our gratitude to the authors of this article. Although the mentioned study wasappropriate and valuable, there was a fundamental flaw in the method, which has led to an ambiguous interpretation of the findings. Therefore, the purpose of this letter is to raise concerns about the data collection instrument and emphasize the importance of reporting its validity and reliability in crosssectional studies.

Dear editor, Recently, Ayalew et al. have published an article, titled, “Drug related hospital admissions; Asystematic review of the recent literatures” in Bull Emerg Trauma in 2019, 7th volume and 4th issue that has been caught our attention [1]. Even though the results of the study are interesting, there are flaws due to the authors’ negligence in the method, which leads to ambiguity in the interpretation of the findings. Therefore, the points expressed in this letter indicate what are needed to be perused in reporting systematic reviews.

To identify prevalent domains related to the concept of assessing preparedness of non-hospital centers to provide primary emergency care in order to develop a comprehensive framework. Five databases including PubMed, Scopus, Web of science, Barakat Knowledge Network Systems (BKNS) and Scientific Information Database (SID) were searched in English and/or Persian languages with no time limit until March, 2018. Manual search and grey literature were also done. According to the eligibility criteria, all the studies were independently tracked by two researchers. Studies were appraised using the Mixed Methods Appraisal Tool (MMAT). The findings were synthesized through directed content analysis method. Out of 3014 studies, 15 studies were included for data synthesis. The synthesis of literature resulted in the emergence of 13 domains and 25 sub-domains. Then, they were categorized based on Donabedian’s triple model and a conceptual framework was developed. In this framework, 6 domains were put in input, 6 in processes, and 1 domain in outcome. Of the 15 included studies, 1 study considered 10 domains and 14 other studies considered 4 to 8 domains out of 13 synthesized domains. The most prevalent synthesized domains were “medical supplies and equipment” and “human resources”, which were considered in 15 studies. In this study, a conceptual framework was constructed that identifies elements that significantly affect the preparedness of these centers. This framework may assist managers to take a comprehensive approach to assess these centers.

Recognition and elimination of weaknesses in the internship courses of health service management are essential to improving their quality and efficacy. The present study aimed to evaluate the viewpoints of health service management students toward the challenges in the design and implementation of internship courses at the Faculty of Management and Information in Tabriz University of Medical Sciences, Iran.
This qualitative research was conducted on the health service management students at the Faculty of Management and Information in Tabriz University of Medical Sciences in 2014. Data were collected via focused group discussions attended by 8-10 individuals per session. Data analysis was performed using content analysis.
Challenges in internships 1-4 for bachelor’s degree students were assessed in three areas, including the problems relating to instructors, internship courses, and cartable from the perspective of the students. In total, 8 main themes and 30 subthemes were extracted in each area.
According to the results, the internship curricula of health service management students should be completely modified to eliminate the weaknesses. These changes must include the correction of the course design and syllabi and essential revision of the cartable based on the latest information on health systems and labor market needs.

Performance assessment tries to find the best, valid and cost-effective way of measuring performance and work satisfaction. There are several indicators for health systems performance evaluation which ignore the managerial aspect. We aimed at evaluating the validity and reliability of managerial performance assessment tool for Iranian hospitals.
The current study is a part of larger study which aims at developing a reliable and valid tool for managerial performance assessment tool. The intended tool has seven dimensions of planning, organizing, leadership, information management, resource management, clinical governance, and performance indicators. We conducted a 2-round Delphi study with 18 experts whom were selected purposefully to evaluate the validity of the tool. Reliability was assessed through implementing the tool in three randomly chosen hospitals of Tabriz. Content Validity Index (CVI) and Content Validity Ratio (CVR) along with internal consistency and Cronbach's alpha were calculated for this reason.
A checklist with 117 indicators was prepared. After determining the validity and reliability of checklist, scores for these indicators were calculated given the importance scores. The whole tool has the score of 1000. Cronbach's alpha coefficient was 0.76 for the whole checklist.
The validated tool in the current research can be used in performance assessment, evidence-based dismissal, installation, and upgrading of hospital managers in order to avoid non proper selection of these managers. Further researches are needed to apply this tool in managerial performance assessment of hospitals in order to measure probable bugs of this model.

Evaluating higher education is a systematic process for identifying student’s progress in order to reach predefined goals. In this study we aimed at evaluating educational program of Bachelor of Sciences in health services management using CIPP model in Tabriz.
Material and A descriptive-analytical study was conducted with the sample size of 94 people, of which 18 were faculty members, 55 were students and the others were graduated. A questionnaire was used to collect data which its validity and reliability were confirmed in Kerman University of Medical Sciences. We used SPSS software and descriptive and analytical statistics to analyze the data.
Total scores of the studied curriculum in aspects of context, input, process, and product were 64.96, 64.11, 63.45, and 63.97 percent, respectively. Generally, the curriculum was assessed as partly appropriate.
It seems that considering revision in some lessons and putting the major focus on teaching skills can improve the utility of the curriculum.