فهرست مطالب mina anjomshoa

Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age.

TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs).

In 2017, there were 5.5 million (UI 4.9–6.2) transport-related incident cases in the EMR – a substantial increase from 1990 (2.8 million; UI 2.5–3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5–876.2) per 100000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3–1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100000, respectively. In 2017, there were 185.3 thousand (UI 170.8–200.6) transport-related fatalities in the EMR – a substantial increase since 1990 (140.4 thousand; UI 118.7–156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1–31.9) per 100000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8–47.3). In 2017, Somalia (54; UI 30–77.4) and Lebanon (7.1; UI 4.8–8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5–1651.3) per 100000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1–2,589.9). In 2017, the highest DALY rate was found in Pakistan (3454121; UI 2297890- 4342908) and the lowest was found in Bahrain (8616; UI 7670-9751).

The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently.

To explore impact of emergency medicine residency program on patient waiting times in emergency department (ED) and determine the associated factors.
A two-phased sequential exploratory mixed-methods approach was used. The first phase was comprised of retrospective before-after design of ED encounters for a 3-month period, six months before and six months after the introduction of an emergency medicine residency program in an Iranian teaching hospital. The second phase included semi-structured interviews with five individuals which purposively selected to participate in qualitative design. Quantitative data were analysed descriptively and qualitative data were analysed using an iterative framework approach.
The most patients were admitted to the hospital in night shift, both before and after the resident EMS. No statistically significant differences were found among all of the waiting times during the two time periods except for the average time interval between admission and physician start time (p This study has shown that intradisciplinary conflict would affect the outcomes of emergency medicine residency program and ED process. These new findings enhance the understanding of the nature of conflicts and will persuade policy makers that design a set of clinical practice guidelines to clarify the duties and responsibilities of parties involved in ED.

Equitable distribution of health care services is prerequisite of success to the national development programs. This study was conducted to assess the townships of Ilam province in terms of enjoyment of health care services.
This cross-sectional study was carried out in Ilam province using 14 health care services indices. Data were collected by a data collection form made by the researcher using statistical yearbook of Statistical Center of Iran (SCI) in 2011. Ilam townships were assessed with 5 methods using Microsoft Excel 2010 (disharmonious index of Morris; standardized score; Scalogram; Numerical Taxonomy; TOPSIS) and given the different methods did not reach a general consensus, Copeland's method was used.
Findings: The findings indicated that there existed unequal distribution of health care services across the townships of Ilam province. According to the Copeland method, Ilam and Malekshahi townships have been ranked the first and last regarding the enjoyment of health care services, respectively.
Discussion & As a result, health care services have been settled in the provincial center (Ilam Township). The policies leading to the development of health care services in large cities are the major important factors in the unequal distribution of health care services. The results of this study can provide illustration of current situation of enjoyment of the health care services and promote the evidence-informed decision making (in national and local levels) for policymakers.

In this paper، first، the theoretical basis and the application of decision support systems have been reviewed. Then the readiness of teaching hospitals to developing decision support system based on a survey of senior and intermediate managers were reviewed. This study was an analytical-descriptive and cross-sectional conducted in 2011. Statistical population included 44 senior and intermediate managers of teaching hospitals in Kerman University of Medical Sciences (kums). Because of the limited population census was used. Data was collected using «Assessing organizational readiness» questionnaire designed in the University of California. Face and content validity of the questionnaire was approved. Cronbach''s alpha coefficients were calculated to determine the reliability of the questionnaire. Data analysis was done descriptive statistics، ­­agreement tables and SPSS software. According to the results there was no significant statistical difference among the hospitals. 15/4 percent of hospital readiness for developing decision support system was weak، while 42/3 percent of this average preparation and only 42/3 percent have been good preparation. with regard to the importance of developing DSS in teaching hospitals and lack of complete preparedness it is recommended to eliminate barriers.

Being fair in distribution of health care services is the main factor in accessing and enjoying the health services. The aim of this study was to examine the regional disparities in health care services in West Azerbaijan province. This study was a descriptive analytical study which was carried out on different cities of West Azerbaijan province. Study sample included the towns of West Azerbaijan province, ranked based on 15 health indices. The indices were calculated using Shannon entropy. Finally, three methods (Standardized Score, Numerical Taxonomy, TOPSIS technique) were used to rank the cities of the West Azerbaijan in terms of accessing to health indices. The findings showed distinct regional disparities in health care services across West Azerbaijan province. Shannon entropy introduced the number of rural active health center per 1000 people as the most important indicator and the number of laboratory per 1000 people as the less important indicator. According to Copeland method, Urmia and Piranshahr cities were ranked as first and the last in terms of accessing to health care services respectively. There are significant differences of healthcare service access in the cities of the West Azerbaijan province. Therefore, policy makers should consider resource allocation according to the access to health care indices.

Equality in distribution of health facilities is the main indicator for increasing the availability of the facilities to the society. The aim of this study was to classify Bushehr province towns in health structural indicators using Numerical Taxonomy.

This was a descriptive cross sectional study that used 21 health structural indicators in the towns of Bushehr province. Data was collected from statistical yearbook. Data analysis was done using Numerical Taxonomy، Excel 2010 and SPSS/18.

There is large gap between townships of Bushehr province in terms of enjoyment of structural indicators of health services. Ganaveh township with 0. 477 score and Deyr township with 0. 973 score had the highest and lowest scores، respectively in regard to enjoyment of health structural indicators.

In order to improve less developed indicators and decrease differences in enjoyment of health services indicators among townships، especially in Deyr town، it is proposed that development-oriented planning must be carried out appropriately in these townships.

Identifying quality gap of services provided by hospital lead to preparing improvement projects and programs. This study intends to determine the quality gap in healthcare services provided by Shahid Elmi Field Hospital from the view point of Patients. In this cross-sectional study, 100 patients admitted to the hospital in 2011 were selected randomly for the study. The data gathered through SERVQUAL Standard Questioner. The content validity and reliability was confirmed by specialist opinions and Cronbach's alpha coefficient, respectively. Data analysis was conducted using descriptive statistics and two-sample t, Pearson correlation and ANOVA tests, using SPSS version 18. According to the patient's views, there is a positive quality gap in delivered services. The highest mean score of the negative and positive quality gap were related to Responsiveness (-0.02) and access (0.035) respectively. There was a significant relation between the frequency of referral and the quality empathy (p=0.05). According to the results, the delivered services of the studied Field hospital is higher than the expectations of patients. It is recommended that processes related to delivery of services, in all dimensions of services’ quality particularly responsiveness and assurance, should be identified and reengineered.

Background and Health indices, regarding to their role in the development of society, are one of the most important indices at national level. Success of national development programs is largely dependent on the establishment of appropriate goals at the health sector, among which access to healthcare facilities is an essential requirement. The aim of this study was to examine the disparities in health services access across the Kerman province. This was a cross-sectional study. Study sample included the cities of Kerman province, ranked based on 15 health indices. Data was collected from statistical yearbook. The indices were weighted using Shannon entropy, then using the TOPSIS technique and the result were classified into three categories in terms of the level of development across towns. The findings showed distinct regional disparities in health services across Kerman province and the significant difference was observed between the cities in terms of development. Shannon entropy introduced the number of pharmacologist per 10 thousand people as the most important indicator and the number of rural active health center per 1000 people as the less important indicator. According to TOPSIS, Kerman town (0.719) and Fahraj (0.1151) ranked the first and last in terms of access to health services respectively. There are significant differences between cities of Kerman province in terms of access to health care facilities and services. Therefore, it is recommended that officials and policy-makers determine resource allocation priorities according to the degree of development for a balanced and equitable distribution of health care facilities.