Journal of Evidence Based Health Policy, Management and Economics
Volume:6 Issue: 1, Mar 2022

Evidence-based medicine is considered as a new and reliable approach which has new discussions on judgment to find the best evidence or qualitative evidence. This study was designed in Bushehr province for designing, implementing, and evaluating physician empowerment courses in evidence-based MRI prescriptions in the training hospitals of Bushehr University of Medical Sciences in 2021.

The present study was an educational scholarship which was conducted in Bushehr province. This study was performed in two phases in accordance with Glassic criteria. A number of five workshops were designed and conducted by researchers using the ADDIE Model in systemic educational design. The course was designed through the review of texts and interviews with experts and in-depth group discussions (FGD) with the presence of seven experts. After that, this training course was evaluated and the end-of-course test was performed using the Kirkpatrick model. In order to evaluate the reaction of participants during the training course, a questionnaire was designed and its face validity and content validity were approved by experts. In addition, a four-choice test was designed based on the presented scientific content to evaluate the learning level of participants. A number of 40 questions were designed for five workshops. Descriptive statistics (frequency, mean) were used in SPSS22 for data analysis.

In terms of gender, 53.7 % were male and 46.3 % were female. In terms of age, 24.4 % were in the age group of 31-35 years. In terms of improving awareness, 34.1 % of participants were at a very good level after the empowerment course. Learning findings indicated that 85.7 % of participants in the final test received a passing score while 14.3 % failed.

In general, the findings of the study indicated that holding an empowerment course for physicians in Bushehr improved their awareness and knowledge. In fact, such improvement in awareness and knowledge can reduce unnecessary prescriptions and treatment costs but improve the quality of services.

Given the role of job involvement in job satisfaction and improving the organizational performance of the staff, the present study was conducted to evaluate the effect of Iran's Health Transformation Plan (HTP) on job involvement of the clinical faculty members.

This descriptive study was conducted in the academic year of 2018-2019 and in educational hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences in Iran, and finally, 90 clinical faculty members participated in this study by using a convenience sampling method. To collect data, a researcher-made questionnaire was based on the standard Lodahl and Kejner's job involvement questionnaire. The data were analyzed using descriptive statistics (mean, standard deviation, percentage), inferential statistics (independent t-test and analysis of variance), and SPSS22 software.

The results revealed that the level of Iran's Health Transformation
Plan on job involvement of the clinical faculty members was moderate
(48.73 ± 14.40).Variables such as gender, age, education, academic rank, employment history, and having a private clinic and hospital where faculty members work, did not have a significant effect on their job involvement.
(P-value > 0.05)

The HTP is currently one of the most important and costly health care reforms in Iran, and for better success and the staff's satisfaction, it is recommended to pay more attention to effective and influential factors in improving and increasing job involvement of service providers, especially clinical faculty members in their periodic evaluation.

The health insurance ecosystem involves all the organizations and institutions which act as ecosystem actors in accordance with the objectives, values and functions of the ecosystem as its elements. Comprehensive understanding of the elements and actors of this ecosystem can be effective in improving its current status and in the future. Thus, the present study aimed to discuss the key elements (objectives, values and functions), as well as the actors of the health insurance ecosystem by a systematic review method.

This systematic review study was conducted in January 2021 using the six-step Walsh and Downe technique in the form of meta-synthesis. The question proposed a search strategy using the SPIDER framework, and the search was done in PubMed, Scopus, Web of Science ,Cochrane and Persian database of Magiran without considering a specific time and place. Content analysis method and MAXQDA 2020 were used to combine the findings. the Mixed Methods Appraisal Tool (MMAT) evaluation checklist version 2018 was used to evaluate quality of studies.

1410 articles were found in major databases, and 10 papers were found by manual searching using the search strategy. In addition, 612 duplicate records were removed from the search results after entering the results in EndNote X7 software. Ultimately, 9 studies reached the stage of quality evaluation and meta-synthesis. The selected studies were reviewed one by one, and their key concepts and themes were identified using content analysis method. Finally, the list of actors and key elements of the health insurance ecosystem was made.

Establishing fair participation and financial protection were identified as the most important key elements in the health insurance ecosystem, achieved through governance functions, resource supply, and service delivery in the context of an integrated and transparent structure. Applying governance is the most important role of ecosystem, forming the necessary participation and coordination between the actors in different roles, and regulating the interactions between them through mechanisms such as tariffs and the payment system. The role played by many actors with different roles or different roles by one actor in the ecosystem results in complexity and conflict of interest.

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

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

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

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

The main purpose of a health system is to provide quality care services, and providing orderly, high-quality, safe, and economic services requires skillful and knowledgeable nurses. Critical Care M.Sc. curriculum in Iran was revised in June 2010. Studies show   that, since specialized associations such as the World Health Organization have demanded the improvement of educational standards for the graduates of this major, educational planner have tried to design a successful and efficient curriculum through examining other successful educational systems in the world. By comparing different educational systems, quality of educational programs can be improved. In addition, comparative studies are one of the most dynamic scientific approaches adopted by educational planners in various countries, such that it is considered a prerequisite for designing modern educational systems. In light of this, the present study tried to compare Critical Care M.Sc. curriculum in Iran with that of the university of Glasgow. It is one of the oldest universities in the UK, the fourth oldest and of the top 100 universities in the world.

This was a comparative and descriptive study conducted in 2020 to compare the Critical Care M.Sc. curriculum in Iran with a corresponding one in the university of Glasgow through Beredy model.

Although Critical Care M.Sc. Curriculum in Iran is in an acceptable position compared to the university of Glasgow's evidence-based education approach, the focus on academic writing skills for improving the graduates’ skill of writing research papers, and the availability of a part time program were of the advantages of Critical Clinical Care curriculum at the university of Glasgow. On the other hand, lack of a specific and strategic programing, and ambiguities about missions of the graduates were the weaknesses. The curriculum in Iran was clear about the philosophy, mission, and perspective, while job opportunities of the graduates in clinical settings were not clear. This was one of the reasons for the reluctance of the graduates to enter clinical environment, which was a disadvantage of the program in Iran.

Although Critical Care M.S Curriculum in Iran is in an acceptable position compared to the one in the University of Glasgow's evidence-based approach, Focus on the academic writing skills for improving the graduates’ skills of writing research papers, and availability of a part time program were of the advantages of the critical clinical care program at the University of Glasgow. On the other hand, lack of a strategic programing and the ambiguities about missions of the graduates were the weaknesses. The curriculum in Iran was clear about the philosophy, mission, and perspective, while the job opportunities of the graduates in clinical setting were not clear. This is one of the reasons for the reluctance of graduates to enter clinical environment, which is a disadvantage of the program in Iran

Organizational culture can affect the levels of entrepreneurship and innovation through identifying the social capital dimensions and enhance the ability of staff to accept challenges. This study aimed to examine the impact of organizational culture on entrepreneurial behavior with the mediating role of social capital among the staff working in Qazvin University of Medical Sciences.

This was an cross-sectional analytical study conducted among the staff of Qazvin University of Medical Sciences in 2020. Sample size was calculated by Cochran formula considering type I error and the accuracy of 5 % and was equal to 122 individuals. Addressing sample attrition, the final size considered to be 143 people by calculating 15 % increase. The standard questionnaires of entrepreneurial behavior were applied to collect the data. Descriptive statistical tests were used in order to analyze the data; moreover, correlation coefficients were applied to examine the relationship between the main variables of the study. Furthermore, the Structural Equation Analysis (SEM) test was used by LISREL and SPSS software to test the research hypotheses.

The estimated coefficient reported for the relationship between organizational culture and entrepreneurial behavior was 23 %; while it was reported to be 12 % for the relationship between social capital and behavior. Furthermore, the hypothesis that social capital mediates the relationship between organizational culture and entrepreneurial behavior was confirmed (T statistic = 3.310, Std. Error = 0.110, P-value < 0.001 ).

The results of the present study necessitate further attention to university environments and higher education institutions for creating an entrepreneurship culture by establishing a flexible structure with participatory and supportive management in order to empower human resources and encourage them to promote social capital. Holding discussion sessions with staff and using their pure ideas and avoiding the implementation of strict regulations in addition to creating a participatory atmosphere can play important role in this regard.

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

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

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

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