فهرست مطالب mohammad reza amiresmaili

Neonatal mortality remains a critical global challenge, with preventable instances prevailing. The initial stride in mitigating neonatal mortality involves elucidating its underlying causes.

This study utilized an umbrella review approach to discern factors associated with neonatal mortality. Five international databases, namely Pub Med, Web of Science, Scopus, CINAHL, and EMBASE, were meticu-lously searched to achieve this.

The initial search yielded 12,631 articles using a search strategy centered onkeywords related to factors contributing to neonatal mortality. Ultimately, 95 articles met the criteria incorporated into this study.

This study endeavors to identify the primary risk factors contributing to neonatal mortality. The discerned risk factors have been systematically categorized into four groups: maternal factors, neonatal factors, aspects linked to healthcare systems, and socio-economic factors. As such, it is imperative for policymakers to take heed of these identified risk factors and formulate comprehensive strategies encompassing both long-term and short-term initiatives. Effective interventions spanning various sectors are crucial for the prevention of ne-onatal mortality.

It is now confirmed that mental health promotion policies need innovations beyond the scope of the health sector. In this study, an attempt was made to identify the most effective stakeholders of the public sector in the field of mental health promotion in Iran to help the policy-makers and to encourage inter-sectoral collaboration and further involvement of these effective sectors in mental health promotion plans.  

This was a mixed-methods study. From the first step (literature review and a survey), the names of public agencies affected by mental health promotion were extracted. In the next step, a checklist for identifying the main stakeholders was developed. The data of this step were analyzed by the simple additive weighting method. Ultimately, a table was plotted in the form of institutional mapping in order to summarize the organizations affecting each risk factor of mental health promotion.  

The Islamic Consultative Assembly, the Ministry of Interior, the Islamic Republic of Iran Broadcasting, the Ministry of Cooperatives, Labor, and Social Welfare, and the Ministry of Education were identified as the five institutions with the greatest impacts on the social determinants of mental health in Iran.   

Significant impacts can be exerted by institutions such as the Islamic Consultative Assembly (as the legislator), the Ministry of Interior, and its subsidiary entities such as municipalities and governors (as the administrators of homeland security and support for safe and appropriate urban and local facilities), the Islamic Republic of Iran Broadcasting (as the national media), the Ministry of Cooperatives, Labor, and Social Welfare (as the institution in charge of employment, job security, and social welfare), and the Ministry of Education (as the educational institution of the country).

The increase in the average age of the population, the decrease in the size of the household and rising in the number of working women impose an increasing burden on home caregivers in Iran. The aim of this study was to measure care burden of informal caregivers in Iran through systematic review and meta‑analysis of existing literature.

A systematic review was conducted by using national and international databases of Scopus, PubMed, Embase, Web of Science, SID, Magiran, and IranDoc papers in English and Persian language up to the first half of 2020. In this meta‑analysis, we calculated the pooled care burden and 95% confidence intervals in Statistical Software For Data Science (STATA) V.15.

Forty‑four papers were included in the current study based on inclusion and exclusion criteria comprising of 8626 samples. Pooled mean of Burden of Care was 52.01 (95% CI: 48.21‑55.82). Highest pooled mean(SD) of care burden (64.37) was related to caregivers of schizophrenia patients (95% CI: 56.09–72.64). Highest care burden (53.45) was observed in most deprived areas (95%CI = 47.05–59.86). A statistically significant relationship was observed between caregivers gender and care burden (p < 0.05).

The reported care burden of informal caregivers requires the establishment of a support system to control mental and physical stress. Due to the dispersion and cultural diversity in Iran, more studies are needed to obtain more accurate data.

Disability induced by severe diseases reduces life quality among elders, and leads to increased use of medications and increase in drug misuse. This study was done to determine the relation between the number of inappropriate medications used and life quality of elderly people living in Kerman during 2014.

This descriptive and analytical cross-sectional study was conducted on 150 elderly people in Kerman, Iran. The participants were selected by simple random sampling. The elderly health assessment questionnaire and Beers Criteria were used for data collection. Data were analyzed using SPSS (version 16) and running test, Fischer’s Exact test, and logistic regression. The model fitness was evaluated by the Hosmer and Lemeshow Test.

The risk of low life quality in elders using 3 to 4 inappropriate medications was 9.98 times more than elders using no unauthorized medication. The most frequent inappropriate medications were Aspirin and Alprazolam. A significant relation was observed between low life quality and number of inappropriate medications used by elders; that is, taking a higher number of inappropriate medications was associated with lower life quality.

Many elderly people use inappropriate medications, which can have a serious adverse impact on their quality of life

Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies.

A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi‑structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria.

The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained “clothing, nutrition, building, place of residence and lifestyle,” and under the category of governance actions, the “managerial, research, health, organizational” subcategories were obtained.

According to the results of the conceptual‑operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.

"Conflict of interest" or "competing interest" occurs when the author or sponsor of the study has a financial, commercial, legal, or professional relationship with the organization, individuals, study samples, or research environment, so as the results of that study are influenced. When the authors of a study seek to publish research, they must fully disclose what was mentioned above. Conflicts of interest can occur both financially and non-financially. In some cases, non-financial conflicts of interest are even more important than financial ones. Such conflicts originate from personal, political, academic, ideological, or religious issues (1). Although there is no single definition of conflict of interest in the scientific community, almost all reputable journals ask authors to disclose conflict of interest at the time of submitting their articles. However, various studies have shown that accurate disclosure of conflicts of interest is significantly rare (2-4).   In general, conflict of interest occurs in different forms, intentionally and unintentionally. Although conflict of interest in the field of medicine and equipment is significantly observed and its importance has been emphasized, there are new dimensions of conflict of interest that have not yet been addressed, including:1) Conflict of interest among managers and officials of organizations: Some ministers and managers of different departments in the field of health provide research on their performance and the indicators of their organizations, and have no reference to conflict of interest in their articles. Obviously, when a person conducts research on the performance and performance indicators of his organization, he may present a better image of the organization intentionally or unintentionally, which is in turn a kind of conflict of interest. 2) The relationship between the author / authors and the journal: When the journal editor and the author / authors of an article have relationships as colleagues, friends, or student and teacher, conflicts of interest may occur and cause the author’s / authors’ article to be easily accepted and go through a convenient and fast reviewing process, which will ultimately result in low quality the article(s). Conflicts of interest give rise to personal / organizational, political, religious, ideological, academic, or intellectual interests that may affect the published content, and may ultimately show the research methods, data interpretation, and conclusion biased and endanger human health and the environment. Thus, it should be noted that conflicts of interest might occur in different parts of any research, whether on the part of the research executive or sponsor or organization managers, etc. Therefore, informing people in this field can increase the quality of and confidence in the study results. health and the environment. Thus, it should be noted that conflicts of interest might occur in different parts of any research, whether on the part of the research executive or sponsor or organization managers, etc. Therefore, informing people in this field can increase the quality of and confidence in the study results. Ethical Considerations Compliance with ethical guidelines There were no ethical considerations to be considered in this research. Funding This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. Authors' contributions Both authors equally contributed to preparing this article. Conflict of interest The authors declared no conflict of interest.

In Iran, the inequitable distribution of health‑care staff, especially dental practitioners between rural and urban areas has a major impact on the delivery of care for those living in rural communities. This study investigated the factors affecting the retention of dental practitioners to stay in the rural areas.

This is a cross‑sectional study conducted in 2019. All dental practitioners working in health services centers covering a population lower than 20,000 people in Kerman province participated in this study (n = 81). A researcher‑designed questionnaire was used for the data collection. The data were analyzed using the descriptive statistics and logistic regression through the SPSS software.

The mean age of the participants was 29.2 ± 6.5 and 39.5% were female. The results showed that about two‑thirds of native dentists (with local origin), 73.3% of married dentists, and all dental practitioners who had no children or had a child under the age of six were willing to continue working with their current Comprehensive centers of health services compared to other dentists. Univariate and multivariate logistic regression showed that there was a significant relationship among dentists’ age, monthly salary, and facilities available in the area (place of residence, availability of vehicles, etc.), view of dental practitioners on living in a rural area, and view of dentists’ families on living and working in the area (p ˂ 0.05).

More than half of the dental practitioners declared their willingness to stay in rural areas, although, in practice, this amount of presence in rural areas does not meet the needs of residents. Financial issues, amenities, and facilities in the rural areas can have a positive impact on the retention of dental practitioners.

The infinite and increasing need for health service providers along with limited health sources has led to an increase in health costs and, consequently, the transfer of government resources from other social services to the health sector. One of the hospital services that has increased the costs in hospitals is total knee arthroplasty. Knee joint is one of the important joints of the body that is affected by various inflammatory and erosive diseases, which ultimately causes destruction of the articular cartilage and loss of proper joint function. Today, we are faced with an increasing demand for total knee arthroplasty. Knowledge of the distribution and extent of TKA provides the basis for health managers to design and implement interventions to reduce TKA surgery.

This study is a cross-sectional study. 14329 records of total knee arthroplasty patients in Iran were selected by census method in 2019-2021. The data collection tool in this study was a standard checklist. Data were analyzed by SPSS version 24 software using descriptive statistics.

The mean age of the patients was 66.1 years. 81.31% of the patients were female. 87.4% of them lived in cities, 31.5% had supplementary insurance, and most of the patients (51.9%) had undergone total knee arthroplasty in private hospitals. Discussion and

The pattern of total knee arthroplasty in our country is similar to that of other countries; most surgeries are performed in private hospitals, which may generate induced demand. TKA is more prevalent in the urban population, and most people who have had surgery do not have supplementary insurance coverage, and the northern provinces have the highest TKA;  thus, the attention of researchers and policy makers to the field of health in identifying and preventing the factors leading to knee replacement will make the demands for total knee arthroplasty reasonable.

Given the importance of psychosocial health in the society there is a need for national and institutional plans for their implementation. This paper sought to assess  national laws and documents in this regard.

The contents of upstream documents and laws were done using websites of the Islamic Consultative Assembly, the Ministry of Health and other sites relating to mental health; assessment was done via the SDH approach.

The findings of the study in the form of a review showed weaknesses in implementation of principles to promote mental health in the society.

Methods to achieve and promote mental health are suggested.

Earthquake is the most catastrophic disaster that has harmful psychological, economic, social, political, and cultural effects on societies. Resilience or ability of a person for adapting to post-earthquake problems and crises is influenced by known and unknown factors. The present study aimed to explore experiences of Bam earthquake survivors about adolescents' resilience in that time. This is a qualitative study with a directed Content Analysis approach. The participants were a total of 34 individuals including; 10 teachers and 24 parents of the students who had earthquake experience in adolescent period. The subjects were selected based on a purposive method. The sampling was done until data saturation from the junior high schools in Bam city, Iran, in 2019. Data collected through in-depth and semi-structured interviews and analyzed by Granehim and Lundman method. Data analysis yielded 565 primary codes, 217 conceptual codes after integration, 25 subcategories, and 6 categories from the participants' experiences about their resilience against the disasters and earthquake. 6 categories include: disaster consequence, beliefs about resilience, beliefs about strengthening resilience, factors affecting resilience, consequences of facing disasters, the necessity of disaster preparedness. Participants stated different opinions and experiences about resilience and the factors that enhance or reduce it. They emphasized the necessity of preparedness and acquiring different skills for coping with disasters. Therefore, it is suggested that crisis management officials use these experiences to devise measures to prepare communities, before the occurrence of disasters, to support during and after disasters, to decrease the problems of future crises and to enhance resilience in communities, especially among adolescents as the next generation of society.

Context: 

Social networks can perform a peculiar role in people'scommunication in the case of crisis and disaster. These media are interactive, digital, or mobile-based tools. Accordingly, the present study aimed to assess the role of social media in earthquakes.

Evidence Acquisition:

In this current systematic review, a query was conducted on such databases as Embase, Web of Science, Scopus, and Cochrane for articles in English language, based on the required criteria from 2000 to 2019 regarding the role of social media in disaster. As a result, 13,924 studies were retrieved, among which 3,963 were deleted due to duplication. Finally, among 244 selected articles, 19 full-text articles were analyzed.

In the present research, 19 studies were thoroughly reviewed. The findings were assigned to four main categories (identification, notification, requests, as well as storage and retrieval of information) with 12 sub-topics. Most of the main topics and subsets were as follows: medical and food needs, information about the accident, as well as medical and relief services, efforts to save lives, the amount of damage, problems and limitations, post-crisis measures, such as keeping calm, reducing anxiety, avoiding high-risk areas, asking for financial assistance, as well as using the information to provide relief and map the affected areas and evacuation centers.

Considering the behavior of people in different geographical locations in the earthquake crisis, it seems that the case studyof how to use social media in disaster management carries profound implications for modeling and localizing the cases in related disaster management institutions of many different countries, such as Iran.

In this study, the basic criteria, models, and indicators of intersectoral collaboration in health promotion were investigated to facilitate the implementation of collaboration.

This scoping review was conducted using datasets of Embase, Web of Science, Scopus, and PubMed, and search engines of Google, Google Scholar, and ProQuest.

52 studies were included, and 32 codes in Micro, Meso, and Macro level, were obtained. Micro-level criteria had the highest frequency. Among the models used in the reviewed studies, social network analysis, Diagnosis of Sustainable Collaboration, Bergen, and logic models had the highest frequency. Among the indicators studied, the number of participants and the level of collaboration as well as its sustainability were the most frequent indicators.

The findings identified the most important and widely used criteria, models, and indicators of intersectoral collaboration in health promotion which can be useful for decision-makers and planners in the domain of health promotion, in designing, implementing, and evaluating collaborative programs.

The health systems around the world are facing significant pressure to control the costs and improve the health services delivered. A method to address this challenge is to express the potential savings and inefficiencies of hospitals. The hospitals should provide health care services with the acceptable quality and minimum cost. For this purpose, managers should have accurate information about the cost of the services they provide.

This is a cross-sectional retrospective study  carried out based on the data of financial year of 2017-2018. In this study, the cost structure of Shafa Hospital was analyzed and its unit cost of the final activity centers was calculated using top-down approach.

The total cost of the hospital in the studied period was US$ 29752539.1. The highest and lowest cost share was related to human resources and energy consumption (64.33% and 0.48%, respectively). The human resources, medicines, and consumables account for over 96% of the cost of the final clinical activity centers. The unit cost of the final activity centers varies so that among admission wards the unit cost of ICU is the highest (US$372.45) and the daily bed cost in the neurology ward is the lowest (US$118.9).

Clarification of the hospital cost structure can provide a comprehensive analysis of hospital costs for decision making and policy making. The unit cost of the final activity centers also provides insights into the hospital cost management planning.

Patients with hemophilia recieves coagulation factor replacement for lifetime. In iran, on-demand treatment method is used as standard. Clinical studies have shown significant improvements in clinical and economic outcomes as a result of the use of prophylaxis compared with other therapies. The aim of this study was to evaluate safety and efficacy of prophylaxis in patients with severe hemophilia type A and B.

This is a systematic review and meta-analysis in order to evaluate the safety and efficacy of prophylaxis treatment in patients with severe hemophilia. To this response, all clinical trials, cohorts, and case-control studies which have been investigated, published 1970 to sep 2017 and the results have been analyzed in STATA.

1439 studies were found in primary search and 17 of them had inclusion criteria. The mean annual bleeding  rate in prophylays treatment was 2.8 times per person/year. This study also showed that in prophylaxis, the average incidence of adverse effects was 0.13 cases, and the severe adverse effects was 0.06 cases per person/year.
Discussion and

The analysis of the studies entered in this evaluation showed that the adverse effects were significantly lower in patients treated with prophylaxis than in patients treated with on-demand treatment. This difference was observed in severe adverse effect but it was not statistically significant and this shows that prophilaxis is safer than on-demand method. The lower annual bleeding rate in prophylaxis compared with the on-demand treatment method is also a sign of the effectiveness of prophilaxis.

Introduction:

Urban health centers provide primary health services in cities. In recent years, comprehensive urban health services centers have undergone changes in structure, function, and area of activity; however, these changes cannot address all the problems in this area. This study endeavored to identify the challenges facing Integrated Health Services after implementing health transformation plan.

Methods:

 In this qualitative case study, the target population was managers and staff of Kerman City comprehensive health services centers in Iran. Semi-structured interview was conducted with 8 managers and 7 staff members of Kerman comprehensive health centers. The interview guide was employed to gather information, including some general questions based on the literature review, and to clarify specific topics. The content analysis method based on Colaizzi’s seven stages of rapeseed was used to obtain data as well.

Results:

 In this study, after analyzing the challenges of comprehensive urban health centers, four main themes of human, organizational, functional, and clients were identified.

Conclusion:

It is possible to offset these problems through strategies such as reforming the payment system and incentive system, expanding physical departments of the centers, reviewing programs, and effective implementation of family physician plans.

Iranian universities optimistically can be regarded as second‑generation research‑centered universities which train people who can only fill the predefined occupational gaps. These universities are doing very little to become third‑generation universities. It seems that medical science universities have a huge capacity to create and expand entrepreneurship in health care because of their diverse activities in health services. The present study aimed to investigate the effective factors affecting the Iranian medical universities transition to third‑generation universities.

The present study is a qualitative study which was carried out in Kerman University of Medical Sciences. The study population was the faculty members of Kerman University of Medical Sciences who had been selected by purposeful sampling method. For this purpose, 13 faculty members of Kerman University of Medical Sciences who were interested in the topic were interviewed. To collect data, a number of general questions were asked from the participants to clarify specific topics. The interviews lasted between 20 and 45 min. The descriptive phenomenology method was used for data analysis based on the Colaizzi’s seven steps.

In the present study, five main themes include; reforming the bureaucracy, paying attention to the empowerment of university personnel, improving the status of graduates, reviewing the status of education and research, and connecting with the industry and making a profit were identified.

We can use strategies such as reduction of bureaucracy, privatization, reduction of management pyramid, culture building, creation of appropriate reward system, and taking a role model from successful people.

Incidence and prevalence of type 2 diabetes are one of the major challenges of Iran health system. Despite policies on diabetes prevention and control, Iran is faced with many problems in prevention and control of this disease at the executive level. This study seeks to identify the problems of Type 2 diabetes prevention and control program in Iran.

In this qualitative study, 17 participants were interviewed purposefully. The semi‑structured interview guide was designed based on literature review and four initial in‑depth interviews. Framework analysis method was used for the analysis of qualitative data.

Six themes and 29 subthemes explaining the problems of type 2 diabetes prevention and control program were identified: Referral system, human resources, infrastructure, cultural problems, access, and intersectoral coordination issues.

Despite the well‑developed policy of type 2 diabetes prevention and control, the implementation is faced with some problems which endangers the effectiveness of the plan. Any attempt to improve the successful implementation of the type 2 diabetes prevention and control program requires effective measures, deep understanding of the problems and solving them.

Health services utilization is a complex behavioral phenomenon affected by multiple factors including availability, distance, cost and quality of health services as well as personal attitudes, cultural beliefs, and socioeconomic characteristics. This study aimed to assess the status of health‑care utilization among dwellers of slums in one of the Iran’s big cities.

This was a cross‑sectional study in which 559 slums people were selected using a random clustered sampling method. Data on health services utilization were collected using health equity assessment and response tool questionnaire. Data analysis was performed using descriptive statistics and logistic regression analysis through SPSS ver. 22.

In this study, 42.5% (238) people who required outpatient services. 21% (118) of them were able to use them. Furthermore, among the families, who needed outpatient services during the past month, 15% (38) were able to use the services for at least once. Regarding inpatient services, 62% (349) of people needed hospitalization, of which 31% (175) were able to be hospitalized. Age (P = 0.2), gender (P = 0 <001), marital status (P = 0 <001), income status (P = 0.1), and education (P = 0.21) determined utilization of outpatient services; however, inpatient services utilization was affected by age (P = 0.03), gender (P = 0.02), marital status (P = 0 <001), and income status (P = 0.32). The final model of multiple regression showed that, there was a relationship between age (odds ratio [OR] =1.7, confidence interval [CI] 95% = 0.47–0.88), marital status (OR = 2.78, CI 95% = 0.64–1.2), and the use of inpatient services.

The utilization of health services in slum areas is not desirable. As it was showed that the utilization of health services in slums people is a multifactorial event; thus, proper planning and policy for this increasingly demand are essential.

In Iran, the private dental sector is the main provider of dental services, however, the price of services that are charged by them is unclear. This study aimed at evaluating the factors affecting fee-setting for dental services delivered by dentists in the private sector and the relative value of services. In this cross-sectional study, the census sampling method was used among dentists working in the private sector of Kerman city, Iran. The data were collected through a researcher-made questionnaire, the validity and reliability of which were established. Descriptive statistics and Pearson’s correlation coefficient were used to analyze the data. Of the 252 qualified dentists, 147 (58%) participated in this study, of whom 61.5% stated they had reduced their prices to attract more patients and 67.4% mentioned that there is a competition between dentists in attracting more patients. The tariffs applied by the dentists were within the range of government approved tariffs. After the dentist’s wage (42.3%), the most important factors that affected tariff setting included office rent (18.6%), raw materials (15.2%) and staff’s salary (12.6%). Disease severity, dentistry error, dentist’s skill and visit time length should be considered in determining the relative value of services and setting a justified and fair tariff. It is necessary to take appropriate measures by dental health authorities to increase the competition between private dentists in order to decrease prices in favor of patients. Also, due to differences in performance, experience and materials used by dentists and other factors, it is necessary to set maximum and minimum values for tariffs.

Training of human resources, especially nurses, is a profitable investment for hospitals with major economic return if properly planned and implemented. The present study aimed to evaluate the effectiveness of a cardiopulmonary resuscitation (CPR) course as an in-service training program, based on the Kirkpatrik model. This interventional study was conducted at Afzalipour Hospital of Kerman, Iran from October 2014 to May 2015. The study sample consisted of 45 nurses, including 20 nurses in the case group and 25 nurses in the control group. The case group participated in a four-hour CPR training workshop. The Kirkpatrick model was used to determine the effectiveness of the CPR course. Data were collected using three questionnaires and hospital records. The participants were satisfied with the training course, and a significant difference was observed in the mean score of three intervals of learning levels evaluation (P < 0.0001). Based on the findings, CPR training affected the learning level of nurses from the case group; however, the average learning score was not significantly different between the two groups (P = 0.26). In addition, the difference in the mean score of behavior level was not significant before and after training (P = 0.91). The results of Chi-square test also showed that CPR training did not affect the forth level (P = 0.54). Finally, the overall effectiveness of the CPR training course was estimated at 32.51%. This study indicated that effectiveness of in-service training is not at a desirable level. Since organizations allocate a lot of their resources to such training courses every year, it is essential to reconsider planning and implementation processes.

Identifying the factors affecting utilization of dental services is one of the best ways to improve the health status. This study aimed to investigate the effective factors on utilization of dental services. In this cross-sectional study, 1185 household heads were selected randomly, and using a researcher-made questionnaire based on World Health Organization (WHO) Global Health Survey and Andersen behavioral model, and through multivariate logistic regression, the predictors of visiting a dentist during 1 year ago were investigated in 2017. The households’ income inequality in utilization of dental services was analyzed using concentration indices (CIs) and Pearson chi2 in STATA software. The predictor of dental visit during 1 year ago for men was having decayed teeth [odds ratio (OR) = 1.3, P = 0.030], and the predictors for women were lower ages (OR = 0.8, P = 0.001 for 19-29 years old and so on), having 32 natural teeth (OR = 0.7, P = 0.020), and employment (OR = 1.3, P = 0.048). The common predictors were increase in education level (OR = 1.4, P = 0.001 for men, and OR = 1.7, P = 0.001 for women with university degree), brushing (OR = 1.9; P = 0.001 for women, and OR = 1.3; P = 0.040 for men), and having supplementary insurance (OR = 1.7,
P = 0.001 for men, and OR = 1.9, P = 0.001 for women). Being burdensome of dental care costs during 3 years ago (CI: -0.074, P = 0.001), avoiding visiting a dentist during 1 (CI: -0.501, P = 0.001) and 3 (CI: -0.501, P = 0.001) years ago because of its costs, and failure to do all dentistry recommendations during 3 years ago (CI: -0.516, P = 0.001) happen more frequently among the poor. Moreover, the poor used all dental services such as scaling (CI: -0.638, P = 0.001), filling (CI: -0.458, P = 0.001), and root canal (CI: -0.524, P = 0.001) less than the rich. Dental health status is negatively affected by population socio-economic situation; therefore, it is necessary to implement policies to improve access to dental services among the undeserved.

The relationship between households’ socioeconomic situation (SES) and children dental caries has been assessed in many Iranian studies to evaluate the effect of public dental care programs supporting the poor. Hence, this study through systematic review and meta‑analysis has presented a conclusion in this regard. Domestic and foreign databases were searched using keywords designed by concept map. Time limit to search the databases included articles published from 1994 to 2017. Twenty‑five articles were entered to the fnal step of the study, in which 49 relationships between SES and dental caries were assessed. Heterogeneity between studies was assessed using I2. Publication bias has been assessed using funnel plot and Egger’s test. The data were assessed by STATA 13.1. Odds ratio and mean difference of children dental caries in high SES households in comparison with low SES households were 0.41 (confdence interval [CI]: 0.30, 0.52) and -0.49 (CI: -0.85, -0.13), respectively. The CI in both cases did not include “null or no effect line,” so there was a signifcant inverse relation between SES and dental caries. Despite the emphasis on upstream documents on equity in access to dental health services, there was high difference between SES groups in this regard. It is necessary to revise dental health programs at the country level to decrease these differences.

Clinical laboratories need to manage resources properly and scientifically to survive in today's highly competitive environment. In this context, scientific-economic principles should be considered to determine the profitability or loss of laboratories. Thus, in this study, the net profit of laboratory services was measured based on scientific-economic principles.

This was an applied research with descriptive-retrospective approach. A laboratory was selected from 61 laboratories of Kerman, Iran, which performed the highest number of tests among the laboratories of this city. In addition, due to easy access, it was the most visited laboratory by patients. The present study had 2 main phases: (1) measuring the price of services and (2) calculating the net profit of the studied laboratory. Data analysis was performed using activity- based costing (ABC) as an econometric model and Excel software.

The highest charges were related to direct costs (78.28%); consumable goods (47.26%) and professional and logistic human resources (46.31%) had the highest share of these costs. In the test groups, the most expensive tests belonged to the hormones (23.03%) and clinical chemistry (20.84%). Total cost, revenue, and the net profit of the studied laboratory were 641 645, 1 390 942, and 749 297 USD, respectively. After doing sensitivity analysis (50% increase in the frequency of tests), the following values were obtained: 987 071, 2 086 413, and 1 099 342, respectively.

Some test groups in the studied laboratory were not profitable, and this was due to the high cost of these tests and illogical tariffs. One way to overcome this problem is to increase the frequency of laboratory tests.