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Background: Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and significant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses. Methods: All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta-analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015. Results: The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment. Conclusions: Due to high prevalence of these disorders among Iranian nurses, providing effective training in the field of ergonomics and undergoing appropriate exercises are necessary to control it. [ABSTRACT FROM AUTHOR]

Background: Nurses and other members of health care team provide mental patients with health services through interprofessional collaboration which is a main strategy to improve health services. Nevertheless, many difficulties are evidently influencing interprofessional collaboration in Iranian context. This paper presented the results of a study aimed to explore the context. Materials and Methods: A qualitative study was conducted using in-depth interviews to collect data from 20 health professionals and 4 clients or their family members who were selected purposefully from the health centers affiliated with Isfahan University of Medical Sciences. Themes were identified using latent qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency and transferability. The study lasted from 2010 to 2011. Findings: Some important challenges were identified as protecting professional territory, medical oriented approach and teamwork deficits. They were all under a main theme emphasizing professionals' divergent views. It could shed insight into underlying causes of collaboration gaps among nurses and other health professionals Conclusions: The three introduced themes implied difficulties mainly related to "divergences" among health professionals. Moreover, the difficulties revealed the need for training chiefly to improve their convergent shared views and approaches. Therefore, it is worthwhile to suggest interprofessional education for nurses and other professionals with special attention to improving interpersonal skills as well as mental health need-based services. [ABSTRACT FROM AUTHOR]

Introduction: The family may be negatively impacted by divorce and its adverse outcomes including psychological problems and disturbances in the structure and functioning of families. The present study aimed to determine the efficacy of an online family‑based cognitive behavioral therapy (CBT) intervention on psychological distress, family cohesion, and adaptability of divorced head-of-household women. Methods: In this randomized controlled trial, 100 divorced head-of-household women supported by the state welfare organization of Iran participated and were randomly divided into intervention group (n = 50) and active control group (n = 50). Participants in the intervention group received six educational app-based online sessions on family-based CBT. Participants in the control group received an online family-based CBT session and an online information on breast self-examination using the same app. Anxiety, depression, family adaptability, and cohesion were assessed before, immediately after, and 3 months after the intervention. Linear mixed‑effects modeling with random intercepts and slopes was used to analyze the data. Results: The mean and standard deviation of measures of anxiety, depression, cohesion, and adaptability scores immediately after the intervention (9.42 ± 1.78, 9.58 ± 2.21, 36.36 ± 3.78, and 36.30 ± 3.97, respectively) and 3 months after the intervention (9.90 ± 1.84, 9.40 ± 1.53, 36.38 ± 4.30, and 36.42 ± 4.38, respectively) in the intervention group differed significantly from those before the intervention (11.30 ± 1.77, 11.56 ± 1.31, 23.82 ± 3.78, and 23.80 ± 3.85, respectively). Changes in the mean scores of anxiety, depression, cohesion, and adaptability variables differed significantly before and immediately after the intervention and before and 3 months after the intervention. Conclusion: Online family‑based CBT appears efficacious in improving the psychological status of divorced head-of-household women and the cohesion and adaptability of their families. [ABSTRACT FROM AUTHOR]

In Iran, cardiovascular diseases are the most common causes of death. We aimed to perform a systematic review on the prevalence of acute myocardial infarction (AMI) in Iran based on Persian and English papers had been published from 1985 to 2015. Among 267 initially found articles, 142 were excluded; finally, a total number of 40 articles were found relevant which were reduced to 18. Smoking, hypertension, diabetes mellitus, and hypercholesterolemia were the most common risk factors for AMI. Premature MI prevalence was high in men, and smoking was the most common risk factor among young people. People in urban areas were more likely to experience AMI than rural people. The prevalence of AMI in Iran is high and has increased in recent years. Therefore, to restrain the rising trend of AMI, it is necessary to make the primary and secondary prevention efforts. [ABSTRACT FROM AUTHOR]

Iranian Blood Transfusion Organization (IBTO) established in 1975 has been the sole responsible entity for blood adequacy and safety in Iran. It has been the same in case of providing recovered plasma. At the same time, the first commercial plasma center was authorized by IBTO to operate in the capital Tehran to contribute to the main purpose that was the investment of the private sector in fulfilling fractionation purposes and the construction of a fractionation plant. The goal that unfortunately did not materialize. To make remedies based on a well-calculated plasma document, in 2015, a plasma program developed in Iran by IBTO by which new donor centers were opened or already blood center were equipped to allow for the collection of voluntary nonremunerated source plasma. It had in it capacities of plasma collection for IBTO recovered, commercial source, and IBTO voluntary source. The latter third was a gradually growing program that lasted just 3 years and showed progress but the managerial changes and invalid arbitrary and sudden decisions brought it to the end. Whilst the paid private centers grew and ruined the voluntary nonremunerated sense that IBTO always pursued and was against the Ministry of Health requirements for what the commercial private sectors should have abided by. Safe voluntary nonremunerated source plasma collection that almost all countries pursue to grow along with existing recovered plasma share was terminated with consequences that are detailed in the present article. [ABSTRACT FROM AUTHOR]

There are a number of medicinal combinations in the Iranian traditional medicine which are commonly used as tonic for liver. In this review, we have introduced some medicinal plants that are used mainly for the treatment of liver disorders in Iranian folk medicine, with focus on their hepatoprotective effects particularly against CC1 4 agent. In this study, online databases including Web of Science, PubMed, Scopus, and Science Direct were searched for papers published from January 1970 to December 2013. Search terms consisted of medicinal plants, traditional medicine, folk medicine, hepatoprotective, Iran, liver, therapeutic uses, compounds, antioxidant, CC1 4 , anti-inflammatory, and antihepatotoxic, hepatitis, alone or in combination. Allium hirtifolium Boiss., Apium graveolens L., Cynara scolymus, Berberis vulgaris L., Calendula officinalis, Nigella sativa L., Taraxacum officinale, Tragopogon porrifolius, Prangos ferulacea L., Allium sativum, Marrubium vulgare, Ammi majus L., Citrullus lanatus Thunb, Agrimonia eupatoria L. and Prunus armeniaca L. are some of the medicinal plants that have been used for the treatment of liver disorders in Iranian folk medicine. Out of several leads obtained from plants containing potential hepatoprotective agents, silymarin, β-sitosterol, betalain, neoandrographolide, phyllanthin, andrographolide, curcumin, picroside, hypophyllanthin, kutkoside, and glycyrrhizin have been demonstrated to have potent hepatoprotective properties. Despite encouraging data on possibility of new discoveries in the near future, the evidence on treating viral hepatitis or other chronic liver diseases by herbal medications is not adequate. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish a comprehensive screening and referral system for chronic non-communicable diseases (CNCD) in the routine primary health care, and to determine the prevalence of diabetes, pre-diabetes, metabolic syndrome, and dyslipidemia in adult population invited by public announcement to the Health clinics in Isfahan, Iran. Methods: This survey was conducted from March 2010, and the current paper presents data obtained until November 2011. To provide health services for prevention and control of CNCDs, with priority of type2 diabetes mellitus, Health clinics were established in different parts of Isfahan city with a population of approximately 2,100,000 in Iran. The general populations aged 30 years and above were invited to the Health clinics by public announcement. Results: A total of 198972 participants were screened. The mean age of participants was 47.8 years (48.5 men, 47.3 women), with a range of 1 to 95 years old and standard deviation of 12.3 years (12.7 men, 12.1 women). Overall, 22% of participants had impaired fasting glucose, 25% had hypercholesterolemia, 31% had hypertriglyceridemia, and 20% had metabolic syndrome. Conclusion: The high prevalence of dysglycemia and diabetes in our survey may serve as confirmatory evidence about the importance of mass screening and early diagnosis of CNCDs' risk factors. Our model of establishing Health clinics, as a comprehensive referral system in the routine primary health care can be adopted by Middle Eastern countries, where CNCDs notably diabetes are an emerging health problem. [ABSTRACT FROM AUTHOR]

Aim: Lean is a set of operating philosophies and methods that help create maximum value for patients by reducing waste and waits. It emphasizes the consideration of the customer's needs, employee involvement, and continuous improvement. The aim of this study was of factors affecting lean management in public hospitals in Kohgiluyeh and Boyerahmad and Bushehr provinces. Materials and Methods: This research was descriptive correlation study. The questionnaire was used to collect the data. Factor analysis and multiple regression analysis were conducted to understand the relationship between these factors and lean implementation success. With using 60 questions questionnaire, the content validity of the method developed by the researchers and expert judgment and Cronbach's alpha and test–retest reliability of the method was investigated, and the opinions of 500 primary health-care practitioners were collected. Then, a two-stage exploratory and confirmatory factor analysis and structural equation modeling with the use of statistical software SPSS for Window 17.0 software (SPSS Inc., lllinois, USA) (Leland Stanford Junior University) and AMOS 20 carried out to review and modify the conceptual model. Results: Exploratory factor analysis identified five factors of human, technology, management, processes, and relational that explains 58.5% of the total variance. Confirmatory factor analysis also showed that among identified factors, technology factor with 0.953 coefficient has greatest impact and management factor with 0.615 coefficient has the lowest impact on the pattern of lean management in public hospitals to improve the quality of services. Conclusions: The factors affecting the deployment of lean management in public hospitals and appropriate strategy for using the lean management to improve the delivery of primary health care and reduce waste. The results represent guidelines for using effective implementation of lean management to increase efficiency and ability to compete in the global market offers. [ABSTRACT FROM AUTHOR]

Aim: Epilepsy is increasingly developed worldwide, considered as one of the most important healthcare problems in the second half of 12th century. Methodology: This study is a quantitative-qualitative/cross sectional-practical method research. The conceptual model was derived from comparative studies of the United States, Australia, United Kingdom, Canada and the relevant experts' perspectives. The study population consisted of all professionals related to the healthcare management of epilepsy in all geographical regions of Iran. The obtained data were analyzed using software SPSS 16 and AMOS. Exploratory and confirmatory factor analysis were also performed, and the final model was obtained and its fitness was confirmed. Results: Nine factors were entirely identified for the final model of healthcare management of epileptic patients: Organizational structure of the leading policy, makers, methods of governmental interventions in financing resources, types of services necessary to provide patients, instances of epilepsy, monitoring, and controlling epilepsy healthcare services among which methods of governmental interventions in financing resources and monitoring and controlling epilepsy healthcare services had the minimum and maximum factor load value, respectively. Conclusion: As it can be observed from the study data, training and raising the public awareness toward epilepsy in the country is an essential tool to prevent these types of diseases, as identifying the initial main risks aiming at prohibition of epidemic diseases and also proper healthcare services in case of development are the most important initiations to be taken. [ABSTRACT FROM AUTHOR]

Background: Women's health is a key factor affecting the health of the whole population. Tackling inequality in determinants of health is recognized as the main path toward reducing the inequality in health outcomes. This study aimed to analyze the provincial inequality in determinants of women's health and health care in Iran. Methods: Using the Moss's model (2002) as a comprehensive framework of determinants of women's health, including "geopolitical environment," "culture, norms, sanctions," "women's roles in reproduction and production," "health-related mediators," and "health outcome" categories, we chose 13 indicators. Afterward, using data sources including the Iranian Multiple Indicators of Demographics and Health Survey, the National Organization for Civil Registration, and Statistics Centre of Iran, we analyzed provincial inequality in these indicators in Iran (2011). Gini coefficient and Lorenz curve were used for measuring inequality. Results: Gini coefficients calculated as follows; life satisfaction level (0.027), literate women (0.398), women with proper knowledge about HIV/AIDS prevention (0.483), unemployed women (0.380), women without an income (0.384), women who use at least one type of mass media (0.389), women who used computer or internet (0.467), women who had received pregnancy care from a skill birth attendant (SBA) (0.420), women who had delivered with the help of an SBA (0.426), women who currently smoke cigarettes (0.603), women who currently consume hookah (0.561), women with at least one chronic disease (0.438), and women's deaths in 2010 and 2011 (0.393 and 0.359, respectively). Conclusions: We found large provincial disparities in determinants of women's health in Iran. Determinants such as lifestyle, health behavior, health knowledge, and health-care services availability should be considered by health policymakers in addressing the inequality in women's health at a provincial level. [ABSTRACT FROM AUTHOR]

Background: Workplace violence is a serious and problematic phenomenon in health care settings. Research shows that health care workers are at the highest risk of such violence. The aim of this study was to address the frequency of physical violence against Iranian health personnel, their response to such violence, as well as the contributing factors to physical violence. Materials and Methods: A cross‑sectional study was conducted in 2011, in which 6500 out of 57,000 health personnel working in some teaching hospitals were selected using multi‑stage random sampling. Data were collected using the questionnaire of “Workplace Violence in the Health Sector” developed by the International Labor Organization, the International Council of Nurses, the World Health Organization, and the Public Services International. Results: The findings revealed that 23.5% of the participants were exposed to physical violence in the 12 months prior to the study. Nurses were the main victims of physical violence (78%) and patients' families were the main perpetrators of violence (56%). The most common reaction of victims to physical violence was asking the aggressor to stop violence (45%). Lack of people’s knowledge of employees' tasks was the most common contributing factor to physical violence (49.2%). Conclusions: Based on the results, legislating appropriate laws in order to prevent and control violence in the workplace is necessary. Moreover, developing educational programs to manage the incidence of physical violence should be on health centers' agenda. [ABSTRACT FROM AUTHOR]

Background: Dissatisfaction and tending to leave are some of the major nursing problems around the world. Professional commitment is a key factor in attracting and keeping the nurses in their profession. Commitment is a cultural dependent variable. Some organizational and socio-cultural factors are counted as the drivers of professional commitment. This study aimed to explore factors influencing the professional commitment in Iranian nurses. Materials and Methods: A qualitative content analysis was used to obtain rich data. We performed 21 in-depth face-to-face semi-structured interviews. The sampling was based on the maximum variation with the staff nurses and managers in 5 university affiliated hospitals. Constant comparative method used for data analysis Results: Two main categories were emerged: "Challenging with different feelings" and "Managers' role". Challenging with different feelings had two subcategories: "Burnout" and "sense of valuing". The other theme was composed of three subcategories: "Gratitude or punishment climate", "manager's view of caring" and "knowledge-based vs. routine-based nursing". Conclusions: Findings revealed the burnout as a common sense in nurses. They also sensed being valued because of having a chance to help others. Impediments in the health care system such as work overload and having more concern in the benefits of organization rather than patient's care and wellbeing lead to a sense of humiliation and frustration. Congruence between the managers and nurses' perceived values of the profession would be a main driver to the professional commitment. Making a sense of support and gratitude, valuing the care and promoting the knowledge-based practice were among the other important factors for making the professional commitment. [ABSTRACT FROM AUTHOR]

Background: Health care systems in rural areas face numerous challenges in meeting the community's needs and adequate attention has not been paid to this problem. The aim of this study was to describe the outcomes of health care process in rural society. Materials and Methods: Twenty-six participants including twenty-one rural health care providers and five clients were selected according to purposive sampling. The data were collected via semi-structured individual interviews and a mini focus group. Data were analyzed by using qualitative content analysis based on methods described by Granheme and Landman. Results: Data analysis eventually led to formation of one category of inefficiency in health care process in rural society including subcategories such as arbitrary self-therapy, slow care process, dissatisfaction with the care process, superficial caring, job stress and burn out of caregivers, and ineffective caring relationship. Conclusion: Outcomes in health care in rural society of Iran represents inefficiency of the current health care process. These outcomes are related to the cultural and social context of rural communities and the structure of the health system. These outcomes in health care in the rural society of Iran represent impairment of the current health care process. The necessity of modifying the existing care trend with new models designed to improve the health care process is felt. [ABSTRACT FROM AUTHOR]

Objectives: Maternal mortality, a preventable tragedy, is an indicator of development, poverty and democracy. Therefore, prevention of maternal deaths is one of the main goals in many countries. Iran is one of the developing countries which aim to reduce maternal mortality through introduction of a new policy at national level. This study aimed to explore the extent to which this policy is practiced at peripheral levels. Methods: The data were collected through interviews with relevant people, observation, and review of the documents. Results: The results showed that there is a gap between policy and practice which can be explained by inadequate training programs, inadequate collaboration, lack of guidelines and instigation of a specific investigation into maternal deaths. Conclusions: This study suggests a number of considerations such as an initiative to collaborate, developing a guideline and presenting training programs before such policies are launched. [ABSTRACT FROM AUTHOR]