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جستجوی مقالات مرتبط با کلیدواژه « germany » در نشریات گروه « پزشکی »

  • Fatemeh Afagh Abedi Mamaghani *, Farhad Shahram, Fereydoun Davatchi, Christos C Zouboulis
    Adamantiades-Behçet’s disease (ABD) is a chronic, recurrent inflammatory disease with an unclear aetiology. Major and minor clinical signs characterize ABD. Major signs generally comprise oral and genital aphthae and skin and eye manifestations. Minor signs include joint, neurological, and gastrointestinal symptoms and vascular involvement. This work aims to compare the prevalence and clinical manifestations of ABD using available study results from Iran and Germany.This report is based on statistical data from Iran and Germany. A long-term study over 35 years from the Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, and a large German epidemiological study dealing with data from the German Registry for ABD and data on the disease in Europe are the information sources. Additionally, data from recent ABD studies listed in PubMed are used.Although the prevalence of ABD in Iran, with 80 patients per 100,000 inhabitants, is markedly higher than in Germany, with 4.2 patients per 100,000 inhabitants, the male-to-female ratio and age of onset are similar in the two populations. In Iran, the male-to-female ratio is 1.3:1, and the average onset age is 26 ± 11.3 years. In Germany, the male-to-female ratio is 1.4:1, and the average onset age is 27.7 ± 11.6 years. The incidence of the disease is decreasing, both in Iran and other parts of the world.Recurrent oral aphthae were the most common onset manifestation in patients of both Iran (82.7%) and Germany (84.5%), with ocular manifestations more common onset signs in Iran (8.7%) than in Germany (5.1%). Except for recurrent genital ulcers, which were more common in women in both countries, all other clinical signs – except oral aphthae – were more common in male patients in both countries. Minor clinical signs differed.A markedly different prevalence was observed in the study populations of Iran and Germany, with the disease being more common in Iran. However, despite the different origins, demographics and major clinical signs of ABD were similar in both countries. ABD is most frequently detected in young patients.
    Keywords: Adamantiades-Behçet’s disease, Epidemiology, clinical signs, Iran, Germany}
  • مریم زارعی، حمید قاسمی*، رضا نیک بخش
    زمینه و هدف

    به وجود آوردن شرایط مناسب برای تحرک بیشتر (ورزش های تفریحی و اوقات فراغت) که از یک طرف موجب سرگرمی و پرکردن اوقات فراغت سالمندان می شود و از طرف دیگر نیاز مبرم آنها به تحرک را برطرف سازد، از ضروری ترین تدابیری است که باید در برنامه ریزی های مربوط به گذران اوقات سالمندان اندیشه شود. لذا با توجه به اهمیت این موضوع هدف از پژوهش حاضر مطالعه تطبیقی فعالیت های ورزشی تفریحی سالمندان کشورهای آلمان و ایران براساس مدل بردی بود.

    روش کار

    این پژوهش از نوع کیفی-کاربردی و با رویکرد تطبیقی چهارمرحله ای بردی شامل چهار مرحله توصیف، تفسیر، همجواری و مقایسه بود. جامعه آماری پژوهش را اسناد، منابع و کتب مرجع موجود داخلی و خارجی در حوزه موضوع، سالمندان ایرانی و آلمانی را تشکیل دادند. ابزار گردآوری اطلاعات از طریق چک لیست انجام شد. چک لیست مربوط به مقایسه تطبیقی فعالیت های ورزشی - تفریحی سالمندان ایران و آلمان بود.

    یافته ها

    براساس نتایج تحقیق در خصوص مقایسه هر پنج بعد برنامه ریزی، نیروی انسانی، امکانات، ساختار و ویژگی های درمانی دو کشور ایران و آلمان، مشخص گردید که تفاوت های زیادی در ایران و آلمان وجود دارد. ساختار موردنظر مدل ایرانی بیشتر با نقش برجسته مسایل برنامه ریزی و مالی استوار و دغدغه بیشتر سالمندان ایرانی، معیشتی  در صورتی که در مدل آلمان، بیشتر تاکید بر نیروی انسانی است.

    نتیجه گیری

    با توجه به نتایج پیشنهاد می شود که در برنامه ریزی های آتی ورزش همگانی کشور، توجه خاصی به ورزش سالمندان شود و قوانین و مقررات حمایتی از ورزش سالمندان تدوین شود.

    کلید واژگان: مطالعه تطبیقی, فعالیت های ورزشی تفریحی, سالمندان, آلمان, ایران, مدل بردی}
    Maryam Zarei, Hamid Ghasemi*, Reza Nikbakhsh
    Background & Aims

    Creating suitable conditions for more mobility (recreational sports and leisure) which on the one hand entertains and fills the leisure time of the elderly and on the other hand eliminates their urgent need for mobility, is one of the most essential these are just some of the goal setting shareware that you can use. Therefore, due to the importance of this issue, the purpose of this study was a comparative study of recreational sports activities for the elderly in Germany and Iran based on the Brady model.There is virtually no planned evaluation of sports offers. Suggestions and criticisms are discussed irregularly in conversations between coaches and adult athletes. The results of the discussion are rarely recorded and are primarily related only to the quality of the coach. Theoretically, some possibilities have been shown for how service quality can be evaluated and improved. Unfortunately, these methods are not fully applicable in the elderly. On the one hand, this is because older people only want to give verbal feedback and sports providers do not have the resources to install a quality management system. However, there are ways to do the evaluation with relatively little effort. So the question is, how should sports and recreational activities be planned to attract older people? The necessity of conducting this study is determined by the demographic transition and the unpreparedness of the society to face the sudden increase of the elderly population, which is related to the specific characteristics of population transfer. Along with all the issues, it seems that the changes caused by the population transition in Iran have caused the new social structures to be unable to meet the needs and requirements of the elderly. The aging of the Iranian population and addressing the issue of the elderly, including sports and physical activity in their spare time, is an inevitable necessity. Therefore, it is hoped that the possible results of the research can help planners and policy makers to encourage participation in sports and physical activity of the elderly. Managers and policy makers can increase the level of participation in sports activities in the elderly community by considering the factors raised in the research and providing conditions for the implementation of programs according to the factors raised and removing barriers to participation in sports activities.

    Methods

    This was a qualitative-applied research with Brady four stages of a comparative approach. The statistical population of the research consists of existing domestic and foreign documents, sources and reference books in the field of Iranian and German elderly. Checklist related to the comparative comparison of sports and recreational activities of the elderly in Iran and Germany, which was in all five dimensions of planning, facilities, manpower, structure and demographic characteristics. The studied variables in each dimension were selected by a survey of supervisors and consultants as well as a study of the present theoretical foundations on the research topic.

    Results

    Based on the results of research on comparing all five dimensions of planning, manpower, facilities, structure and medical characteristics of Iran and Germany, it was found that there are many differences between Iran and Germany. The structure of the Iranian model was based more on the prominent role of planning and financial issues, and the main concern of the Iranian elderly was livelihood, while in the German model, more emphasis was on manpower. Planning in sports and recreational activities in Iran and Germany was reviewed and compared: Comparison of planning approaches in recreational sports activities for the elderly in Iran and Germany in 12 Variables Was categorized: Poverty of the elderly, Elderly care volunteers, Daily schedule of life in a nursing home, Planning, Guardian of Aging Sports, Type of sports activity, Type of recreational activity, life style, Alone in old age, Type of activities, Media, Hiring the elderly. Comparison of facilities in recreational sports activities for the elderly in Iran and Germany in 6 Variables Was categorized: Elderly recreational sports centers, Access to sports venues, Existence of sports facilities for the elderly, standard facilities, urban environment, Sports services for the elderly. Comparison of manpower in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized: Manpower training, Characteristics of manpower, Manpower services, Duties of manpower. Comparison of structure in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized: Pension system, pension fund, German sports structure, Family structure. Comparison of demographic characteristics in recreational sports activities for the elderly in Iran and Germany in 4 Variables Was categorized:  Life expectancy, marital status, Job, Income, Insurance status.

    Conclusion

    The structure of sports and recreational activities in Iran and Germany was examined and compared, the results of which showed that there are differences between Iran and Germany in the dimensions of the pension system, pension fund, German sports structure and family structure. The structure of German sports is very similar to the federal structure that characterizes the Federal Republic of Germany. This feature makes German sports have an independent structure. Since the merger of the German National Olympic Committee Duster Sport Bando in May 2006 and the establishment of the German Olympic Confederation, it has become the only German umbrella organization. At the German macro level, both the federal government (through the Ministry of the Interior) and the 16 state governments (for example, through the Ministry of the Interior or the Ministry of Culture of the state government) are responsible for policy-making in the sport of the region under their control. As a result, there is no independent ministry called the Ministry of Sports in Germany. But in the Iranian state system, there is the Ministry of Sports and Youth. The industrial, economic and political structures of society in today's world are interrelated with sport; On the other hand, the industrial and economic development of Germany has affected the promotion of sports quality in society as a whole and even sports for the elderly, and in return, attention to sports at the educational, public, championship and professional levels Industrial, economic and social prosperity. At the same time, when young people and adults join sports and participate in sports programs, this participation can continue into old age and help the development of old sports. According to the results suggested that in the future planning of public sports in the country, special attention should be paid to sports for the elderly and rules and regulations should be developed to support sports for the elderly, as well as training specialized and trained sports coaches for public sports programs. According to the results of the research on the difference between planning approaches in recreational sports activities for the elderly in Iran and Germany, it is suggested to reduce sports costs by paying subsidies to institutions that deal with sports and community health. Since most seniors do not include any monthly expenses for exercise in the household budget, it is necessary to plan for short-term and long-term education of seniors and their families about the positive benefits of exercise for the elderly and the need to do it under any circumstances. The results also showed that the facilities of recreational sports activities for the elderly in Iran and Germany are different, so that sports managers and officials have made special planning and investment on this factor and by providing sports programs and facilities to the elderly, the level of motivation Increase them to participate in physical activity. Also, considering that most sports services are provided by private sports clubs, strengthening these clubs in various ways, as well as supporting them, can play an important role in the success of public sports programs. The results of the present study showed that the dimensions of manpower in recreational sports activities for the elderly in Iran and Germany are different. Also, by creating and developing volunteer centers and training them, provide the ground for the development of efficient human resources in this field, and at the end of the present study showed that the structure is different in recreational sports activities for the elderly in Iran and Germany, accordingly. It is suggested that in the future planning of public sports in the country, special attention be paid to sports for the elderly and rules and regulations be developed to support sports for the elderly, as well as the training of specialized and trained sports coaches for public sports programs.

    Keywords: Comparative study, Recreational sports activities, Elderly, Germany, Iran, Brady model}
  • Ruth Waitzberg *, Nora Gottlieb, Wilm Quentin, Reinhard Busse, Dan Greenberg
    Background

    Hospital professionals are “dual agents” who may face dilemmas between their commitment to patients’ clinical needs and hospitals’ financial sustainability. This study examines whether and how hospital professionals balance or reconcile clinical and economic considerations in their decision-making in two countries with activity-based payment systems.

    Methods

    We conducted 46 semi-structured interviews with hospital managers, chief physicians and practicing physicians in five German and five Israeli hospitals in 2018/2019. We used thematic analysis to identify common topics and patterns of meaning.

    Results

    Hospital professionals report many situations in which activity-based payment incentivizes proper treatment, and clinical and economic considerations are aligned. This is the case when efficiency can be improved, eg, by curbing unnecessary expenditures or specializing in certain procedures. When considerations are misaligned, hospital professionals have developed a range of strategies that may contribute to balancing competing considerations. These include ‘reshaping management,’ such as better planning of the entire course of treatment and improvement of the coding; and ‘reframing decision-making,’ which involves working with averages and developing tool-kits for decision-making.

    Conclusion

    Misalignment of economic and clinical considerations does not necessarily have negative implications, if professionals manage to balance and reconcile them. Context is important in determining if considerations can be reconciled or not. Reconciling strategies are fragile and can be easily disrupted depending on context. Creating tool-kits for better decision-making, planning the treatment course in advance, working with averages, and having interdisciplinary teams to think together about ways to improve efficiency can help mitigate dilemmas of hospital professionals.

    Keywords: Dual Agency, Dilemma, Reconciliation Strategies, Israel, Germany, Activity-Based Payments}
  • Bettina Zimmermann *, Amelia Fiske, Stuart Mclennan, Anna Sierawska, Nora Hangel, Alena Buyx
    Background

    In contrast to neighboring countries, German and Swiss authorities refrained from general curfews during the first pandemic wave in spring 2020, calling for solidarity and personal responsibility instead. Using a qualitative methodology, this study aims to explore why people in Germany and Switzerland were motivated to comply with policy measures during the first wave of the coronavirus disease 2019 (COVID-19) pandemic, and what factors hindered or limited their motivation. While quantitative surveys can measure the level of compliance, or broadly ask what motives people had for compliance, we here strive to explain why and how these motives lead to compliance.

    Methods

    This publication has been made possible by the joint work of the members of the “Solidarity in times of pandemics” (SolPan) research commons. Seventy-seven semi- structured qualitative interviews were conducted with members of the general public in Germany (n = 46) and the German-speaking part of Switzerland (n = 31) in April 2020. Interviews were transcribed and analyzed following a grounded theory approach.

    Results

    Three themes were identified that summarize factors contributing to compliant or noncompliant behavior. (1) Social cohesion was, on the one hand, an important motivator for compliance, but at the same time related to conflicting needs, illustrating the limits of compliance. (2) Consequences were considered on both the individual level (eg, consequences of individual infection) and societal level (eg, the societal and economic consequences of restrictions). (3) While for some participants following the rules was perceived as a matter of principle, others stressed the importance of making their own risk assessment, which was often associated with with a need for evidence on the effectiveness and reasons behind measures.

    Conclusion

    A variety of motives contribute to COVID-19 related compliance. Authorities should seek to address these multi-faceted aspects to support motivation for compliance in a large proportion of the population.

    Keywords: COVID-19, Adherence, Germany, Switzerland, Qualitative Research}
  • Nora Gottlieb *, Vanessa Ohm, Miriam Knörnschild
    Background

    In debates on asylum-seekers’ access to healthcare it is frequently claimed that restrictions are necessary to prevent unduly high health service utilization and costs. Within Germany, healthcare provision for asylum-seekers varies across the different states. Berlin’s authorities removed some barriers to healthcare for asylum-seekers by introducing an electronic health insurance card (HIC) in 2016. We used the HIC introduction in Berlin as an opportunity to investigate the effects of improved healthcare access for asylum-seekers on the local health system.

    Methods

    The study applied a mixed-methods design. A cost analysis compared expenses for outpatient and inpatient health services for asylum-seekers before and after the HIC introduction, based on aggregate claims data and information on expenses for humanitarian healthcare provision that were retrieved from the Berlin authorities. Semi- structured interviews with 12 key informants explored organizational effects like administrative workloads and ethical dilemmas for staff. We performed a content analysis and used respondent validation to enhance the accuracy and trustworthiness of our results.

    Results

    The HIC has reduced bureaucratic complexity and administrative workloads; it has enabled unprecedented financial transparency and control; and it has mitigated ethical tensions. All the while, average per person expenses for outpatient health services have declined since the HIC introduction. However, our cost analysis also indicates a rise in the utilization and costs of inpatient care.

    Conclusion

    The HIC introduction in Berlin suggests that the removal of barriers to healthcare for asylum-seekers can create win-win-situations by reducing administrative workloads, advancing financial transparency, and mitigating ethical tensions, whilst cutting the costs of outpatient healthcare provision. Removing barriers to healthcare thus appears to be a more prudent policy choice than maintaining mechanisms of restriction and control. However, high inpatient care utilization and costs warrant further research.

    Keywords: Access to Healthcare, Asylum-Seekers, Cost Analysis, Germany, Health Policy, Mixed-Methods}
  • فریبا جعفری، اکبر نصراللهی کاسمانی*، علی اکبر فرهنگی، علی دلاور
    مقدمه

     این مقاله با توجه به کارکرد اخبار در انعکاس سیاست ها و عملکردهای موثر در بهبود سلامت عمومی، با هدف بررسی چگونگی پوشش محتوای اخبار سلامت به مقایسه ارزش گذاری های رسانه ای شبکه های تلویزیونی ایران و آلمان در اخبار کرونا می پردازد.

    روش پژوهش

    نوع پژوهش توصیفی با روش تحلیل محتواست. نمونه آماری شامل 62 بخش اخبار شبانگاهی می باشد که به صورت غیرتصادفی و هدفمند از دو شبکه تلویزیونی ایران (یک، دو) و دو شبکه آلمان (ZDF ARD,) انتخاب شده اند. با انتخاب ابعاد و موضوعات پوشش خبرهای سلامت، کدنامه خبری تنظیم و 749 خبر از 18 فوریه تا 22 مارس 2020 با تاکید بر خبرهای مربوط به بیماری کرونا تمام شماری، کدگذاری، محاسبه (SPSS) و مقایسه گردید.

    یافته ها

    حدود یک سوم از کل اخبار شبکه های ایران (9/32 % و 4/28 %)، با الگویی مشابه دارای ارزش گذاری هایی بدون مرز روشن با عینیت خبر بوده اند. دو شبکه آلمان به وضوح بر"اخبار سخت" تمرکز کرده و بر "جدایی تفیسیر و خبر" تاکید دااشته اند.

    نتیجه گیری

    به نظر می رسد ارزش گذاری با رعایت جدایی بین خبر و تفسیر می تواند راهکاری مناسب برای افزایش اعتبار خبری باشد.

    کلید واژگان: اخبار سلامت, ارزش گذاری رسانه ای, ایران, آلمان, کووید-19}
    Fariba Jafari, Akbar Nasrollahi Kasmani *, AliAkbar Farhangi, Ali Delavar
    Introduction

    In light of the function of news in reflection of politics and practice relevant to health and with the aim of the analyses of health news coverage this article deals with a comparison of media valuations in Corona news of Iranian and German television programs. 

    Methods

    The study is descriptive with content analyses of newscasts. The sample comprises 62 news broadcasts of four networks that were chosen non randomly from two Iranian (Networks One and Two) and two German channels (ARD and ZDF). After the choice of dimensions and themes of the health news a code sheet was created by which 749 news related to health, mainly to Corona, and aired from February 18th to March 22nd, 2020 were encoded and analyzed (with SPSS).

    Results

    Almost a third of all health news on Iran's Networks One and Two (32.9% and 28.4%, respectively) featured ratings with no clear distinction from actual news content. The two German broadcasters generally concentrated on the hard facts and largely adhered to the separation rule between news and commentary.For news about health-related human and material capacities and shortages, the rate of positive ratings in Iranian networks was higher than for all health news (Network One 13.3% vs. 10.7% and Network Two 22.8% vs.11.5%).The main feature of political news related to health is the high proportion of negative ratings in Iranian channels and on ZDF.

    Conclusion

    To build confidence in the news, the separation between messages and comments can play an appropriate role.

    Keywords: Health News, Media Comment, Valuation, Iran, Germany, Covid-19}
  • Simona Rodat*
    Background

     The internet has become one of the most common informative media for health-related issues. Regarding older people, more research is needed to collect in-depth data on Internet use for health information. The present study aimed to provide an overview on health-related internet use by seniors in Germany.

    Methods

     This descriptive-analytical qualitative study was conducted on 10 German seniors aged 65-83 years. In order to obtain the required information, in-depth semi-structured interview was carried out between March-June 2017. The target population were recruited using snowball sampling strategy. The transcribed interviews were analysed using qualitative content analysis.

    Results

     The findings of the study revealed that seniors’ activity on the Internet include a variety of medical interests. Most of the interviewees access specific medical websites directly, without using search engines. Although about half of the respondents seemed to become online health information overload, most of them made claims about the ability to evaluate its reliability.

    Conclusions

     For most of the interviewees the health-related information on the Internet provides a basis of knowledge. Despite the fact that the seniors consider online information useful to make health-related decisions, most of them prefer to consult at least one doctor, still adhering to the physician-centred care model.

    Keywords: Medical information, Online information, Health-related internet use, Seniors, Germany}
  • Miriam Blümel *, Julia Röttger, Julia Köppen, Katharina Achstetter, Reinhard Busse

    Background Health system performance assessment (HSPA) is a major tool for evidence-based governance in health systems and patient/population-orientation is increasingly considered as an important aspect. The IPHA study aims (1) to undertake a comprehensive performance assessment of the German health system from a population perspective based on the intermediate and final dimensions defined by the World Health Organization (WHO) and (2) to identify differences in HSPA between (a) common user characteristics and (b) user types, which differ in their interactions and patterns of action within the health system.   Methods and Analysis A cross-sectional survey was conducted between October and December 2018 with statutorily and privately health insured to assess the German health system from a population perspective related to the past 12 months. The random sample consists of 32 000 persons insured by AOK Nordost and 20 000 persons insured by Debeka. Data from the survey will subsequently be linked with health insurance claims data at the individual level for each respondent who has given consent for data linkage. Claims data covers the time period January 1, 2017 to June 30, 2018. The combination of the 2 data sources allows to identify associations between insured patient characteristics and differences in the assessment of health system performance. The survey consists of 71 items measuring all final and intermediate health system goals defined by the WHO and user characteristics like health literacy, self-efficacy, the attention an individual pays to his or her health or disease, the personal network, autonomy, compliance and sociodemographics. The claims data contains information on morbidity, care delivery, service utilization, (co)payments and sociodemography.   Discussion The study represents a promising attempt to perform a holistic HSPA using a population perspective. For this purpose, a questionnaire was designed that contains both validated and new items in order to collect data on all relevant health system dimensions. In particular, linking survey data on HSPA with claims data is of high potential for assessing and analysing determinants of health system performance from the population perspective.

    Keywords: Health System Performance Assessment, Population Perspective, Germany, Data Linkage, Claims Data}
  • Boleslav Lichterman*

    The aim of this paper is to compare “Zapiski Vracha” (“Confessions of a Physician”, first published in 1901) by Vikenty Veresaev to “Aerztliche Ethik” (“Doctors’ Ethics”, first published in 1902; two Russian editions were published in 1903 and 1904) by Albert Moll. It starts with an overview of medical ethics in Russia at the turn of the 20th century in relation to zemstvo medicine, followed by reception of Veresaev’s “Confessions of a Physician” by Russian and German physicians, and of Moll’s “Doctors’ Ethics” in Russia. Comparison of these two books may serve as a good example of a search for common philosophical foundations of medical ethics as well as the impact of national cultural traditions.

    Keywords: History of medical ethics, Russia, Germany, V.Veresaev, A. Moll}
  • مصطفی مدرس موسوی، سجاد سحاب نگاه، علی گرجی*
    مقدمه
    همایش التهاب سیستم عصبی سومین سری از رویدادهای سالانه است که بررسی و تجزیه و تحلیل بحث طیف بیماری های التهاب عصبی را تسهیل می کند. همایش التهاب سیستم عصبی بر روی اختلالات التهاب عصبی از قبیل مالتیپل اسکلروز، تومورهای مغزی، صرع و اختلالات تحلیل برنده سیستم عصبی تمرکز دارد. همایش در 23-21 خرداد 1398 توسط دانشگاه علوم پزشکی مشهد و دانشگاه مونستر برگزار شد که هدف آن روشن ساختن علت بیماری های التهاب عصبی و کشف مسیرهای جدید درمان بود.
    نتیجه گیری
     ما در مورد جنبه های اصلی التهاب عصبی و بیماری های تحلیل برنده عصبی توسط یک برنامه علمی جامع با تمرکز بر وضعیت پایه و بالینی، تا مرحله پیشرفته درمان بحث کردیم. در این همایش 334 عنوان علمی ارائه و بحث گردید.
    کلید واژگان: بیماری های سیستم عصبی, التهاب, همایش, ایران, آلمان}
    Mostafa Modarres Mousavi, Sajad Sahab Negah, Ali Gorji*
    Introduction
    Neuroinflammation congress was the third in a series of annual events aimed to facilitate the investigative and analytical discussions on a range of neuroinflammatory diseases. The neuroinflammation congress focused on various neuroinflammatory disorders, including multiple sclerosis, brain tumors, epilepsy, and neurodegenerative diseases. The conference was held in June 11-13, 2019 and organized by Mashhad University of Medical Sciences and Munster University, which aimed to shed light on the causes of neuroinflammatory diseases and uncover new treatment pathways.
    Conclusion
    Through a comprehensive scientific program with a broad basic and clinical aspects, we discussed the basic aspects of neuroinflammation and neurodegeneration up to the state-of-the-art treatments. In this congress, 334 scientific topics were presented and discussed.
    Keywords: Nervous System Diseases, Inflammation, Congress, Iran, Germany}
  • سیما ابراهیمیان، امید ساعد*
    زمینه و هدف

    به منظور کاهش مشکلات اخلاقی در کار روانشناسان، نظام‌نامه‌های اخلاقی با تعیین کدهای اخلاقی، قواعدی را برای رفتار روانشناسان وضع کردند. بررسی نظام‌نامه‌های اخلاقی سایر کشورها، در تعیین نقاط ضعف کدهای اخلاقی انجمنی که روانشناس در آن به فعالیت می‌پردازد، سودمند است. هدف مطالعه حاضر مقایسه نظام‌نامه‌های اخلاقی سه کشور ایران، آمریکا و آلمان بود.

    مواد و روش‌ها

    ابتدا نظام‌نامه‌های اخلاق حرفه‌ای هر سه کشور از سازمان‌های متولی آن‌ها استخراج شد. در گام دوم، تفاوت‌ها و شباهت‌های آن‌ها از لحاظ ساختاری بررسی شد و در نهایت هر سه نظام‌نامه از حیث محتوا و دستورالعمل‌های اجرایی مورد تحلیل قرار گرفتند.

    یافته‌ها

    بررسی ساختاری نظام‌نامه‌ها نشان داد که مقدمه و اصول عمومی در هر سه نظام‌نامه مشترک است. در نظام‌نامه آلمان بخش مجزایی به کدهای اخلاقی پژوهش و انتشار اختصاص ‌یافته است و سایر کدهای اخلاقی که در دو نظام‌نامه دیگر در قالب استانداردهای اخلاقی مطرح شده‌اند، در این نظام‌نامه در بخش مجزایی تحت عنوان «روانشناسی در عمل» آورده شده است. همچنین مقایسه محتوایی نظام‌نامه‌ها نشان داد که اصول عمومی نظام‌نامه‌های ایران و آمریکا به اهداف آرمانی اشاره دارند که به نوبه خود قواعد قابل اجرایی نیستند، در حالی که در نظام‌نامه آلمان اصول عمومی، شرایط و مقرراتی است که یک روانشناس برای داشتن هویت حرفه‌ای در انجمن روانشناسان حرفه‌ای آلمان باید داشته باشد.

    ملاحظات اخلاقی

    صداقت و امانت‌داری در گزارش متون، استناددهی به منابع و پرهیز از هر گونه سوگیری رعایت گردید.

    نتیجه‌گیری

    تفاوت‌های موجود بین نظام‌نامه‌ها را می‌توان با تفاوت در اولویت‌های پژوهشی سازمان‌های متولی، چندفرهنگی و چندایالتی‌بودن این کشورها و تفاوت‌های موجود در پیشرفت‌های تکنولوژیکی آن‌ها، توجیه کرد.

    کلید واژگان: مطالعه تطبیقی, نظام نامه, اخلاق حرفه ای, ایران, ایالت متحده آمریکا, آلمان}
    Sima Ebrahimian, Omid Saed*
    Backgroundand Aim

    In order to minimize ethical problems in the work of psychologists, the code of ethics have established rules for psychologists' behavior by specifying ethical codes. Examining the code of ethics in other countries is helpful in determining the weakness points of the ethical codes of an association in which a psychologist works. The purpose of this study is to compare the code of ethics in three countries of Iran, United States and Germany.Materialsand

    Methods

    First, the professional code of ethics in all three countries were extracted from their relevant organizations. In the second step, their differences and similarities were examined in terms of the code structure. Finally, all three code of ethics were analyzed in terms of content and executive procedures.

    Findings

    The structural analysis of the code of ethics showed that the introduction and general principles are common in all three code of ethics. In the German code of ethics, a separate section is devoted to the ethical codes for research and publication, and other ethical codes, which have been raised in other two code of ethics in the form of ethical standards, are listed in the separate section under the heading "Psychology in practice". Also, the content comparison of code of ethics showed that general principles of the Iranian and United States code of ethics point to ideal goals that areunderpinned by ethical standards and, in their turn, are not enforceable rules, while in the German code of ethics, the general principles are the conditions and regulations that a psychologist has for have a professional identity in the German Professional Psychologists Association.EthicalConsiderations:Integrity and honesty in reporting, documenting and citing of resources were observed.

    Conclusion

    The differences between the codes of ethics can be explained by the difference in the research priorities of the relevant organizations, multicultural and multi-national of these countries and the differences in their technological advances.

    Keywords: Comparative Study, code of ethics, professional ethics, Iran, United States, Germany}
  • Louis Jacob, Mara John, Matthias Kalder, Karel Kostev
    Background and
    Purpose
    To the best of our knowledge, no information is available regarding the treatment of vulvovaginal candidiasis in gynecological practices. The goal of this study was to analyze the prevalence of vulvovaginal candidiasis (VVC) and the drugs prescribed for the treatment of this condition in women followed in gynecological practices in Germany.
    Materials And Methods
    All the women followed in 262 gynecological practices between November 2014 and October 2016 were included in this study. The first outcome was the prevalence of patients diagnosed with VVC during this period.
    The second outcome was the prevalence of women with VVC who received an appropriate vaginal or systemic antimycotic prescription within 30 days after their first VVC diagnosis. Covariables included the use of gynecological/systemic antibiotics, consumption of oral/vaginal contraceptives, cancer, pregnancy, diabetes, and psychiatric diseases including depression, anxiety, and adjustment and somatoform disorders.
    Results
    Between 2014 and 2016, 954,186 women were followed in gynecological practices, and 50,279 (5.3%) women were diagnosed with VVC during the same period. The use of gynecological antibiotics (OR=2.88), systemic antibiotics (OR=1.45), oral contraceptives (OR=1.74), and vaginal contraceptives (OR=1.84) were associated with an increase in the risk of VVC diagnosis. Cancer (OR=1.20) and pregnancy (OR=1.59) were additional risk factors. Approximately 75% of women diagnosed with VVC received an antimycotic prescription. The three most frequently prescribed drugs were clotrimazole (72%), fluconazole (14%), and nystatin (6%).
    Conclusion
    More than 5% of women were diagnosed with VVC and the majority of them received an appropriate prescription.
    Keywords: Germany, Gynecological practices, Prescription, Prevalence, Vulvovaginal candidiasis}
  • Oliver Razum*, Judith Wenner, Kayvan Bozorgmehr
    Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call “globalization within.” Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof.
    Keywords: Germany, Refugee, Access to Healthcare, Homogeneity, Equity}
  • Alireza Irajpour, Mousa Alavi*
    Background
    Literature shows that interprofessional collaboration (IPC) is a challenging phenomenon both in theory and practice, and it is affected by socio-cultural contexts in which the health professionals (HPs) play their roles. Considering some evidences on the similarities and differences between eastern and western socio-cultural contexts, this study aims to explore and describe the socio-cultural factors infl uencing IPC in these two contexts.
    Materials And Methods
    This was a pilot qualitative descriptive study that was conducted in 2012–2013. Data were collected through conducting one-to-one and group interviews as face-to-face and written in terviews (narratives) with purposeful samples of HPs from various disciplines including nurses, medical doctors (MDs) from variety of specialities, social workers, and psychologists from health system in Iran and Germany. Other methods of data collection were taking fi eld notes and reviewing related literature. The qualitative content analyses method was employed to derive the common categories and themes.
    Results
    Totally 22 participants took part in the study. Moreover, researchers had a 10 day period of fi eld observation in Germany (health systems affi liated with Albert Ludwigs University of Freiburg). Qualitative data analysis revealed three themes and related subthemes. The themes were: (1) Interaction beyond boundaries, (2) motivation to engage in IPC, and (3) readiness to approaching toward IPC.
    Conclusions
    The results of the study emphasized that in both eastern and western contexts, organizational, professional, and community socio-cultural textures, mainly in terms of attitudes toward other people, other professions, and IPC, play their role as important factors. We suggest future researches about each of the emerged themes.
    Keywords: Germany, interprofessional collaboration, Iran, nursing profession, socio, cultural}
  • Peter Schwandt, Arnold Von Eckardstein, Gerda-Maria Haas
    Background
    Age‑ and gender‑specific percentiles of body mass index in children and adolescents are a cornerstone categorizing overweight and obesity in youths worldwide. Since corresponding worldwide growth curves of percent body fat (% BF) are missing, the purpose was to contribute smoothed percentiles of percentage body fat from a large urban sample of German youths and to include them in actual national and international percentile curves.
    Methods
    We estimated % BF in 22 113 German youths aged 3 to 18 years participating in yearly cross‑sectional surveys of the PEP Family Heart Study Nuremberg between 1993 and 2007. Percentage body fat was calculated from skinfold thickness using Slaughter equations. Ten smoothed percentile curves were constructed for % BF using the LMS method significant.
    Results
    The age‑ and gender‑specific reference curves demonstrate a continuous age‑dependent increase of percentage body fat from age 3 to 18 years in girls; whereas in boys, the percentile curves steeply increase from 5 to 11 years and thereafter slightly decrease. The shape of the percentile curves, the maxima among boys at puberty and the median % BF at age 18 years are consistent with most of the current growth curves. % BF in urban studies seems to be lower than in national surveys.
    Conclusions
    More than these nine studies should contribute to worldwide-standardized growth charts for % BF to better define overweight and obesity in youth.
    Keywords: Youths, Germany, international comparison, percentage body fat, reference curves}
  • غلامحسین احمدزاده، آزاده ملکیان، حمید افشار، محسن معروفی، محمد اربابی، علی اکبر نجاتی صفا*

    این مقاله ابتدا به مروری بر تاریخچه پزشکی روان‌تنی و روان‌پزشکی رابط- مشاور در جهان و ایران می‌پردازد و سپس الگوهای مختلف ارایه خدمات پزشکی روان‌تنی و روان‌پزشکی رابط- مشاور به صورت کوتاه ارایه می‌کند. همچنین پس از نگاهی اجمالی به وضعیت کنونی این رشته در دنیا به شرح مفصل‌تری پیرامون خاستگاه، شکل‌گیری و وضعیت کنونی پزشکی روان‌تنی در کشور آلمان به عنوان یکی از کشورهای اروپایی فعال در این حوزه ارایه می‌دهد. کشور آلمان با ارایه مدلی دوگانه و متفاوت در این زمینه با بسیاری از کشورهای جهان متفاوت است.

    کلید واژگان: آلمان, ایران, پزشکی روان تنی, روان پزشکی رابط-مشاور}
    Gholam-Hossein Ahmadzadeh, Azadeh Malekian, Hamid Afshar, Mohsen Maroufi, Mohammad Arbabi, Ali-Akbar Nejatisafa *

    This review tried to describe the historical development of consultation-liaison (CL) psychiatry andpsychosomatic medicine in the world and Iran. It also aimed to present a classification of different models of patient care and service delivery in CL psychiatry. It finally provided some explanation about the status of psychosomatic medicine and CL psychiatry in Germany as a different model in comparison with other parts of the world.

    Keywords: Consultation, liaison psychiatry, Germany, Iran, Psychosomatic medicine}
  • صفا الحسنی *

    اخلاق زیستی طی دو دهه گذشته شاهد سکولاریزه شدن بوده است و دراین ارتباط متعاقبا نفوذ افکار مذهبی در اخلاق زیستی کاهش یافته است. اخلاق زیستی امروزه دیگر همانند سابق تحت اقتدار مذهب و پزشکی سنتی قرار ندارد. متاسفانه این مبحث تحت غلبه بیشتری از مفاهیم فلسفی، اجتماعی و قانونی قرار گرفته است. در ممالک اسلامی دین هنوز تاثیر بسزایی در جنبه های مختلف رفتاری، کرداری و سیاسی مردم دارد. از آنجا که علم بدون اعتقاد مخرب روح انسانی است، بنابراین تعجبی ندارد که همواره شاهد تعامل و ارتباط متقابل علم و دین از آغاز تاریخ بشریت با یکدیگر باشیم. قرآن کریم مردم را به ازدواج، تشکیل خانواده و ازدیاد نسل ترغیب کرده است. آیه ای از قرآن می فرماید: ما رسولان خود را فرستادیم و قبل از آن همسر و فرزندان را برای آنان مقرر کردیم.(قرآن کریم سوره الرعد آیه 38). آیه دیگری می فرماید: و خداوند برای شما همدم هایی از جنس خودتان آفرید و بواسطه وصلت شما، پسران و دختران و نوه ها را موجودی بخشید و برای شما از بهترین ها روزی مقرر فرمود.(قرآن کریم سوره النحل آیه 72).
    در مورد ناباروری در بین زوجین خداوند می فرماید: خداوند دختر و پسر را به هر که بخواهد ارزانی می دارد و عقیم می گذارد هر کس را اراده فرماید.(قرآن کریم سوره شورا آیه50-49)پیشرفت های صورت پذیرفته در تکنولوژی تولید مثل و لقاح خارج رحمی، جدا ساختن رابطه جنسی از تولیدمثل را ممکن ساخته است. این پیشرفت ها زنان را قادر ساخته است تا بتوانند بدون داشتن رابطه جنسی از طریق طبیعی و یا لقاح آزمایشگاهی حامله شوند. همچنین در ادامه این روش های درمانی، امکان استفاده از باروری شخص ثالث از طریق تخمک، اسپرم و یا رحم غیر فراهم آمده است. دستورالعمل های اصلی باروری کمکی یا لقاح خارج رحمی از دیدگاه اهل سنت در جهان اسلام، عبارتند ازاینکه: انجام ART برای زوجین و به عنوان یک روش درمانی تنها در زمانی مقدور خواهد بود که عقد ازدواج آنان اعتبار قانونی داشته و فقط از گامت زوجین در تشکیل جنین استفاده گردد. قراردادازدواج بواسطه طلاق یا مرگ همسر باطل می گردد و لذا استفاده از گامت همسر متوفی یا مطلقه ممنوع است. اهل سنت اهدای اسپرم و تخمک را به جهت اختلاط نسل ممنوع می دانند. سابقا فتوایی وجود داشت که اهداء تخمک یا جنین را در خانواده ای که مرد دو همسر و یا بیشتر داشت (Bigamy) مجاز می دانست. در حالیکه اکنون این فتوا تغییر یافته است و امکان جابجایی گامت از همسران متعدد یک فرد نیز مجاز نیست. از سال 1991 در آلمان قانونی تصویب شد که بکارگیری روش های کمک باروری را قانونمندنمود. این قانون اهداء تخمک و جنین را مجاز ندانسته در حالیکه استفاده از اهداء اسپرم مجازشناخته شد. اهداء تخمک و جنین صرفا به دلیل مشکلات قانونی احتمالی متعاقب آن مردود دانسته شده است. این محدودیت ها فقط جنبه قانونی داشته و بر مبنای اصول دینی یا اخلاقی نیست.

    کلید واژگان: اهدای گامت, اسلام, قانون, آلمان}
    Al-Hasani S.*
    Objective(s)

    The last two decades have witnessed the secularization of bioethics. The religious influence on bioethics subsequently declined. Bioethics today is no longer dominated by religion and medical traditions as it used to be in the past. Unfortunately, it has become dominated more by philosophical, social and legal concepts. In the Islamic countries, religion still influences a lot of behaviors, practices and policies. Science without conscience ruins the soul. It is therefore not surprising that science and religion have been interrelated since the beginning of human history. The Holy Quraan encouraged marriage, family formation and reproduction. The Verse says: “We did send apostles, before thee, and appointed for them wives and children (Sura Al Ra´d, 13:38, Holy Quraan). Another Verse says: “And Allah has made for you mates of your own nature, and made for you, out of them, sons and daughters and grandchildren, and provided for you sustenance of the best (Sura Al-Nahl, 16:27, Holy Quraan). Regarding infertility among many couples it says: “He bestows (children) male and female, according to His will (and Plan), or He bestows both males and females, and He leaves barren whom He will (Sura Al-Shura, 42:49-50, Holy Quraan). Through the advances in assisted reproduction, it became possible to separate the bonding of reproduction from sexual act. These advances enabled women to conceive without having sex, either in vivo or in-vitro. This enables also the involvement of a third party in the process of reproduction whether by providing an oocyte, a sperm, an embryo or a uterus. In the Suni Muslim world, the basic guidelines for assisted reproduction are as follows. If ART is indicated in a married coupleas a necessary line of treatment, it is permitted during validity of marriage contract with no mixing of genes. If the marriage contract has come to an end because of divorce or death of the husband, artifical reproduction cannot be performed on the female partner even using sperms of the former husband. Besides, the oocyte and sperm donation are also not allowed because of mixing the genes. In case of Bigamy (in case of marriage of two wifes or more), there was a Fatwa allowing the oocyte or embryo donation within the same family, but this Fatwa was retarded and now even in Bigamy this possibility is not permitted.

    Conclusion

    In Germany there is a law, which was legislated in 1991 which regulates the assisted reproduction technology. The law does not allow the oocyte and embryo donation while sperm donation in case of artificial insemination is allowed. The oocyte and embryo donations are not permitted just because of the possible legal problems which might follow this procedure. But this restriction in the law is not based on the religious or moral issue.

    Keywords: Gamete donation, Islam, Law, Germany}
نکته
  • نتایج بر اساس تاریخ انتشار مرتب شده‌اند.
  • کلیدواژه مورد نظر شما تنها در فیلد کلیدواژگان مقالات جستجو شده‌است. به منظور حذف نتایج غیر مرتبط، جستجو تنها در مقالات مجلاتی انجام شده که با مجله ماخذ هم موضوع هستند.
  • در صورتی که می‌خواهید جستجو را در همه موضوعات و با شرایط دیگر تکرار کنید به صفحه جستجوی پیشرفته مجلات مراجعه کنید.
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