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The Importance of Moving Towards Entrepreneur University in Health Section ضرورت حرکت به سمت دانشگاه کارآفرین در عرصه سلامت 2 1 نش و نوآوری به عنوان مهمترین عوامل در مناطق اقتصادی و صنعتی در نظر گرفته می شود (به ویژه در این سن که شامل تغییرات زیادی می شود). حرکت به سمت نوآوری ها و ایجاد تغییر در ترکیبات محصولات و خدمات به عنوان دادرسی و عملکرد مشاغل مبتنی بر دانش در نظر گرفته می شود. این نوع مشاغل با استفاده از دانش در محصولات و خدمات جدید ، بهبود سطح اقتصادی و رفاهی و ایجاد ارزش ها در جامعه نقش مهمی در کارآیی تولید دارند. 2 Knowledge and innovation are considered as the most crucial factors in the economic and industrial areas (especially, in this age which includes many changes). Moving towards innovations and making changes in the products and services combinations are considered as the proceedings and operations of the knowledge-based businesses. This type of businesses play an important role in the production efficiency, using knowledge in the new products and services, improving the economic and welfare levels and creating values in the society. 142 143 2022/01/19 1400/10/29 2022/09/19 1401/6/28 مهدی خیاطان Mahdi Khayatan Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran mehdikhayatan@gmail.com ولی بهره ور Vali Bahrevar MSc of Health Education & Promotion , Department of Health Education & Health Promotion, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran bahrevar91@yahoo.com سعید حسینی Saeed Hosseini Center for Healthcare Data Modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Iran saeed.hosseini2014@gmail.com Entrepreneurship Entrepreneur University Health کارآفرینی دانشگاه کارآفرین سلامت Salami R, Mirzayee H, Safardoust A. Towards The Knowledge Based Economics by Investigating the Internal Relationship Between the Dimensions of Input and Output of the Global Indicator of Innovation. Technology Development Quarterly. 2013;19(51):16-25.##Habibi m,siahmansouri y. Third generation universities through the development of academic centers. Transplanting Science journal.2012; 3(1):43-49.##Åstebro T, Bazzazian N, Braguinsky S. Startups by recent university graduates and their faculty: Implications for university entrepreneurship policy. Research policy. 2012;41(4):663-77.##Toushmali G, Alimohammadzadeh K, Maher A, Hoseini SM, Bahadori M. Designing a Third Generation University Model with a Combined Approach in Islamic Azad Universities of Medical Sciences. Journal of Medical Education and Development. 2019.##Abbasi H, Nasiri B, Sourani Yancheshmeh R, Mosleh M. Toward the third generation of medical universities, a strategy for knowledge-based economics. Journal of Medicine and Cultivation. 2018;27(Special Issue):179-89.##Taban M, Yassini A, Shiri A, Mohammadi E. Designing and explaining the pattern of scientific authority in higher education in Iran based on the biographies of the country's thinkers with a thematic analysis approach. Journal of Scientific Studies. 2017;2(6):21-40.##Khoundabi B, Vahdati M. Estimation of unemployment odds of 15 years or more persons. Ijoss Iranian Journal of Official Statistics Studies. 2017;27(2):167-88.##Premand P, Brodmann S, Almeida R, Grun R, Barouni M. Entrepreneurship education and entry into self-employment among university graduates. World Development. 2016;77:311-27.##Salami R, Mirzayee H, Safardoust A. Towards The Knowledge Based Economics by Investigating the Internal Relationship Between the Dimensions of Input and Output of the Global Indicator of Innovation. Technology Development Quarterly. 2013;19(51):16-25.##Habibi m,siahmansouri y. Third generation universities through the development of academic centers. Transplanting Science journal.2012; 3(1):43-49.##Åstebro T, Bazzazian N, Braguinsky S. Startups by recent university graduates and their faculty: Implications for university entrepreneurship policy. Research policy. 2012;41(4):663-77.##Toushmali G, Alimohammadzadeh K, Maher A, Hoseini SM, Bahadori M. Designing a Third Generation University Model with a Combined Approach in Islamic Azad Universities of Medical Sciences. Journal of Medical Education and Development. 2019.##Abbasi H, Nasiri B, Sourani Yancheshmeh R, Mosleh M. Toward the third generation of medical universities, a strategy for knowledge-based economics. Journal of Medicine and Cultivation. 2018;27(Special Issue):179-89.##Taban M, Yassini A, Shiri A, Mohammadi E. Designing and explaining the pattern of scientific authority in higher education in Iran based on the biographies of the country's thinkers with a thematic analysis approach. Journal of Scientific Studies. 2017;2(6):21-40.##Khoundabi B, Vahdati M. Estimation of unemployment odds of 15 years or more persons. Ijoss Iranian Journal of Official Statistics Studies. 2017;27(2):167-88.##Premand P, Brodmann S, Almeida R, Grun R, Barouni M. Entrepreneurship education and entry into self-employment among university graduates. World Development. 2016;77:311-27.## ##

The Impact of the Use of Electronic and Digital Devices before Bedtime on Sleep Sufficiency among Iraqi Young People 2 2 ABSTRACT Introduction: Young people often rely on electronic and digital media devices to accomplish many of their daily tasks, which may interfere with their daily physical activities. This study aims to find out the relationship between the use of electronic and digital devices before bedtime and sleep sufficiency among Iraqi young people. Methods: This was an analytical, cross-sectional study that was conducted on 383 young adults aged 18-25 years attending in Al-Tahrir Primary Health Care Center for immunization through purposive sampling technique from   September 15, 2019 to January 10, 2020. The tool was a researcher- made questionnaire. The SPSS 20 was used for statistical analysis, where the t-test was used to find a possible relationship between the variables. The descriptive statistics included percent, means and standard deviations, independent sample T-test was used to find a possible relationship between the variables. All statistical analysis was conducted in SPSS software version 20 with considering significant level of 5%. Results: Mean (SD) use of electronic or digital devices at night in terms of watching television, using play station, using computer, using cell phone for gaming, and using mobile for the Internet [2.8 (3.48), 1.20 (2.0), 2.13  (3.16), 5.37 (5.0) and 10.90 (6.08)] respectively. As a result, there was a significant difference regarding the use of the cell phone for games (P-value= 0.011) and for social media (P-value= 0.000). The mean use of cell phone per night was statistically higher (20.38 minutes) than those who reported having sufficient hours of sleep (10.38 minutes) (P- value=0.040). The study also observed that the mean number of cell phone calls (5.16) was statistically associated with inadequate sleep hours per night (P-value=0.022). Conclusions: This study found that most participants reported adequate sleep hours after electronic or digital devices were turned off. This is because the increase in the mean number of calls and the minutes during calls before going to sleep was significantly associated with a lack of sleep.   144 149 2022/01/192022/07/10 1401/4/19 2022/09/192022/09/20 1401/6/29 Aqeel Noaman Aqeel Noaman Department of Community Health Technologies, Middle Technical University (MTU), Diyala, Iraq Iraq aqeeltech.mtu@mtu.edu.iq Keywords: Sleep Insufficiency Calls Duration Electronic Devices Digital Devices. Bedtime Insufficient sleep Mobile calls Electronic devices Call minutes Internet Orzech KM, Grandner MA, Roane BM, et al. Digital media use in the 2 h before bedtime is associated with sleep variables in university students. Computers in Human Behavior. 2016;55:43-50.##Noaman AA. Impact of mobile phone usage on some health aspects of children and adolescents: Evidence based review article. The Journal of Medical Research. 2019;5(4):159-61.##Levenson JC, Shensa A, Sidani JE, et al. The association between social media use and sleep disturbance among young adults. Preventive Medicine. 2016;85:36-41.##Mark AE, Boyce WF, Janssen I. Television viewing, computer use and total screen time in Canadian youth. Paediatrics & Child Health. 2006;11(9):595-9##Bruni O, Sette S, Fontanesi L, et al. Technology use and sleep quality in preadolescence and adolescence. Journal of Clinical Sleep Medicine. 2015;11(12):1433-41.##Noaman AA. Exploring the Possibility of Headache Exposure among Mobile Phone Users Aged ( 18-25 ) Years. Diyala Journal of Medicine. 2018;15(2):80-6##Moulin KL, Chung C-J. Technology trumping sleep: Impact of electronic media and sleep in late adolescent students. Journal of Education and Learning.2016;6(1):294.##Run Zhi Zhu XLX. The influence of social media on sleep quality: A study of undergraduate students in Chongqing, Journal of Nursing & Care. 2015;04(03).##Mesquita G, Reimão R. Quality of sleep among university students: effects of nighttime computer and television use. Arquivos de Neuro-Psiquiatria.2010;68(5):720-5.##Gulden A, Kubra Y. Relationship between Social Media Use and Sleep Quality in University Students. Scholars Journal of Applied Medical Sciences. 2018; 6(8): 2960-2965.##Basti M, Madadizadeh F. A beginner's Guide to Sampling Methods in Medical Research. Critical Comments in Biomedicine. 2021 Sep 30;2(2).##Hasheminejad N, Dastaran S, Madadizadeh F, Feyzi V. Assessment of risk factors and prevalence of musculoskeletal disorders in barbers of Kerman city using REBA method. Occupational Hygine and Health Promotion Journal. 2017 Aug 10;1(1):10-8.##Yaqoot F, Suhail AR, Dake MN and Al Mamun A. Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study. Clinical Medicine & Research. 2016;14(3):138-144.##Hysing M, Pallesen S, Stormark KM, Jakobsen R, Lundervold AJ, Sivertsen B. Sleep and use of electronic devices in adolescence: results from a large population-based study. BMJ Open. 2015;5(1):e006748.##Bulck J Van Den. Adolescent Use of Mobile Phones for Calling and for Sending Text Messages After Lights Out : Results from a Prospective Cohort Study with a One-Year Follow-Up. SLEEP 2007;30(9): 1220-1223##Alshobaili FA, AlYousefi NA. The effect of smartphone usage at bedtime on sleep quality among Saudi non- medical staff at King Saud University Medical City Journal of Family Medicine and Primary Care.. 2019;8(6):1953-7.##Munezawa T, Kaneita Y, Osaki Y, Kanda H, Minowa M, Suzuki K, et al. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. Sleep [Internet]. 2011;34(8):1013-20.##Rod NH, Dissing AS, Clark A, Gerds TA, Lund R. Overnight smartphone use: A new public health challenge? A novel study design based on high-resolution smartphone data. PLoS One. 2018;13(10):e0204811.##Kokka I, Mourikis I, Nicolaides NC, Darviri C, Chrousos GP, Kanaka-Gantenbein C, et al. Exploring the effects of problematic internet use on adolescent sleep: A systematic review. International Journal of Environmental Research and Public Health. 2021;18(2):760.##Orzech KM, Grandner MA, Roane BM, et al. Digital media use in the 2 h before bedtime is associated with sleep variables in university students. Computers in Human Behavior. 2016;55:43-50.##Noaman AA. Impact of mobile phone usage on some health aspects of children and adolescents: Evidence based review article. The Journal of Medical Research. 2019;5(4):159-61.##Levenson JC, Shensa A, Sidani JE, et al. The association between social media use and sleep disturbance among young adults. Preventive Medicine. 2016;85:36-41.##Mark AE, Boyce WF, Janssen I. Television viewing, computer use and total screen time in Canadian youth. Paediatrics & Child Health. 2006;11(9):595-9##Bruni O, Sette S, Fontanesi L, et al. Technology use and sleep quality in preadolescence and adolescence. Journal of Clinical Sleep Medicine. 2015;11(12):1433-41.##Noaman AA. Exploring the Possibility of Headache Exposure among Mobile Phone Users Aged ( 18-25 ) Years. Diyala Journal of Medicine. 2018;15(2):80-6##Moulin KL, Chung C-J. Technology trumping sleep: Impact of electronic media and sleep in late adolescent students. Journal of Education and Learning.2016;6(1):294.##Run Zhi Zhu XLX. The influence of social media on sleep quality: A study of undergraduate students in Chongqing, Journal of Nursing & Care. 2015;04(03).##Mesquita G, Reimão R. Quality of sleep among university students: effects of nighttime computer and television use. Arquivos de Neuro-Psiquiatria.2010;68(5):720-5.##Gulden A, Kubra Y. Relationship between Social Media Use and Sleep Quality in University Students. Scholars Journal of Applied Medical Sciences. 2018; 6(8): 2960-2965.##Basti M, Madadizadeh F. A beginner's Guide to Sampling Methods in Medical Research. Critical Comments in Biomedicine. 2021 Sep 30;2(2).##Hasheminejad N, Dastaran S, Madadizadeh F, Feyzi V. Assessment of risk factors and prevalence of musculoskeletal disorders in barbers of Kerman city using REBA method. Occupational Hygine and Health Promotion Journal. 2017 Aug 10;1(1):10-8.##Yaqoot F, Suhail AR, Dake MN and Al Mamun A. Exploring Gender Difference in Sleep Quality of Young Adults: Findings from a Large Population Study. Clinical Medicine & Research. 2016;14(3):138-144.##Hysing M, Pallesen S, Stormark KM, Jakobsen R, Lundervold AJ, Sivertsen B. Sleep and use of electronic devices in adolescence: results from a large population-based study. BMJ Open. 2015;5(1):e006748.##Bulck J Van Den. Adolescent Use of Mobile Phones for Calling and for Sending Text Messages After Lights Out : Results from a Prospective Cohort Study with a One-Year Follow-Up. SLEEP 2007;30(9): 1220-1223##Alshobaili FA, AlYousefi NA. The effect of smartphone usage at bedtime on sleep quality among Saudi non- medical staff at King Saud University Medical City Journal of Family Medicine and Primary Care.. 2019;8(6):1953-7.##Munezawa T, Kaneita Y, Osaki Y, Kanda H, Minowa M, Suzuki K, et al. The association between use of mobile phones after lights out and sleep disturbances among Japanese adolescents: a nationwide cross-sectional survey. Sleep [Internet]. 2011;34(8):1013-20.##Rod NH, Dissing AS, Clark A, Gerds TA, Lund R. Overnight smartphone use: A new public health challenge? A novel study design based on high-resolution smartphone data. PLoS One. 2018;13(10):e0204811.##Kokka I, Mourikis I, Nicolaides NC, Darviri C, Chrousos GP, Kanaka-Gantenbein C, et al. Exploring the effects of problematic internet use on adolescent sleep: A systematic review. International Journal of Environmental Research and Public Health. 2021;18(2):760.## ##

Readability and Suitability Evaluation of Educational Media Regarding Men's Secondhand Smoke on Pregnant Wives ارزیابی میزان خوانایی و مناسب بودن رسانه آموزشی در خصوص دود دست دوم سیگار در مردان سیگاری بر میزان مواجهه همسران باردار 2 1 مقدمه: ابزارهای اندازه گیری برای سنجش مناسب بودن مواد آموزشی هستند. مناسب بودن یک رویکرد سیستماتیک برای ارزیابی عینی تناسب اطلاعات بهداشتی برای یک مخاطب خاص ارائه می دهد. مطالعه حاضر به منظور بررسی خوانایی و تناسب رسانه آموزشی در خصوص دود دست دوم سیگار در مردان سیگاریبر میزان مواجهه همسران باردار صورت گرفته است. روش کار: این مطالعه مقطعی از مهر تا آذر 1397 در شهر اصفهان انجام شد. شرکت کنندگان در دو گروه قرار گرفتند. اولین گروه از مخاطبان رسانه های آموزشی 20 نفر مرد سیگاری با همسر باردار بودند. گروه دوم 15 نفر از هیئت متخصصین بودند. رسانه های آموزشی مکتوب (پمفلت) مورد ارزیابی قرار گرفتند. خوانایی مطالب با "ارزیابی خوانایی مواد" (RAM) و مناسب بودن از طریق " ارزیابی تناسب مواد " (SAM) اندازه گیری شد. برای ارزیابی خوانایی رسانه از شاخص Gunning-Fog و برای ارزیابی سطح آموزشی رسانه از آزمون کلوز استفاده شد. برای تمامی متغیرها شاخص های توصیفی بیان شد. داده های جمع آوری شده با استفاده از نرم افزار SPSS18 مورد تجزیه و تحلیل قرار گرفت. نتایج: میانگین نمره خوانایی مطالب آموزشی برای جزوه 34/1±60/16 بود که قابل قبول می باشد (000/0=P، نمره>10). نتایج نشان داد که امتیاز SAM برای جزوه 85 درصد بود. مواد آموزشی برای رسانه ها در رتبه بندی SAM "عالی" بود. امتیاز شاخص Gunning-Fog برای جزوات6/9 و معادل پایه سوم راهنمایی کسب شد. براساس ارزشیابی با آزمون کلوز، سطح آموزشی جزوه به عنوان یک آموزش مستقل و بدون نیاز به معلم ارزیابی شد. نتیجه گیری: مواد چاپ شده پس از ارزیابی توسط RAM و چک لیست SAM، شاخص Gunning-Fog و آزمون کلوز به خوبی مطابقت داشتند. آنها با ویژگی های مردان سیگاری سازگار بودند. 2 Introduction: The tools for assessing the appropriateness of educational materials are measuring device. Suitability offers a systematic approach to objectively assessing the appropriateness of health information material for a specific audience. The present study is designed to evaluate the readability and suitability of educational media about regarding men's secondhand smoke (SHS) in the smoker men on their the exposure of pregnant wives. Methods: This analytical cross sectional study was done from October to December 2018 in Isfahan, Iran. Participants were in two groups. The first group of educational media audience consisted of 20 smokers with a pregnant wife. The second group was 15 people from the panel of experts. Written educational media (pamphlets) were evaluated. The readability of the material was measured by “readability assessment of materials” (RAM) and suitability was retrieved through “suitability assessment materials” (SAM).  The Gunning-Fog Index was used to assess the readability of the media and the cloze test was used to assess the educational level of the media. Descriptive indices were stated for all variables. The collected data were analyzed by SPSS18. Results: The readability mean score of the educational material was 16.60±1.34 for pamphlet, which was acceptable (score>10, P <0.001). Results showed the percentage points SAM score for the pamphlet was 85%. The educational material for media was “excellent” on the SAM rating. The score of the Gunning-Fog index for pamphlets was 9.6 and equivalent to the third grade of guidance was obtained. According to the evaluation by cloze test, pamphlet learning was assessed as an independent training without the need for a teacher. Conclusions: The printed materials were well-matched after evaluation by the RAM and the SAM checklist, the Gunning-Fog Index and the cloze test. They were consistent with the characteristics of smoker men.   150 157 2022/01/192022/07/102021/02/19 1399/12/1 2022/09/192022/09/202022/09/19 1401/6/28 زهره کریمیان کاکلکی Zohreh Karimiankakolaki PhD Health Education and Promotion, Department of Health, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran Iran zohrehkarimian68@gmail.com ویدا سادات انوشه Vida sadat Anoosheh PhD student in ergonomics, Shiraz University of Medical Sciences, Shiraz, Iran Iran Anooshehvida@gmail.com فاطمه علی اکبری Fatemeh Aliakbari Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran Iran aliakbarifa@gmail.com Readability Suitability Educational Media Secondhand Smoke Pregnant Women خوانایی مناسب بودن رسانه آموزشی دود دست دوم سیگار زنان باردار WHO. Secondhand Smoke (SHS) Facts. Available at: https://www.cdc.gov/tobacco/data_statistics/ fact_sheets/ secondhand_smoke/general_facts/ 2013 [##WHO. Tobacco Free Initiative (TFI) Second-hand tobacco smoke. Secondary Tobacco Free Initiative (TFI) Second-hand tobacco smoke. Available at: http://www.who.int/tobacco/research/secondhand_smoke/en/ 2015 [##Öberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet. 2011;377(9760):139-46.##WHO. Worldwide burden of disease from exposure to second-hand smoke. Available at: http://www.who.int/ quantifying_ehimpacts/publications/shsarticle2010/en/. 2011 [##Zhang L, Hsia J, Tu X, Xia Y, Zhang L, Bi Z, et al. Peer Reviewed: Exposure to Secondhand Tobacco Smoke and Interventions Among Pregnant Women in China: A Systematic Review. Preventing chronic disease. 2015;12(35):1-11.##Baheiraei A, Faghihi RS, Mirmohammad AM, Kazem NA. Predictors of home smoking ban in households in pregnant women. Payesh. 2012;11(4):511-17.##MazloomyMahmoodabad SS, Karimiankakolaki Z, Kazemi A, Mohammadi NK, Fallahzadeh H. Exposure to secondhand smoke in Iranian pregnant women at home and the related factors. Tobacco Prevention and Cessation. 2019;5(7):1-9.##Alemán A, Morello P, Colomar M, Llambi L, Berrueta M, Gibbons L, et al. Brief Counseling on Secondhand Smoke Exposure in Pregnant Women in Argentina and Uruguay. International Journal of Environmental Research and Public Health. 2016;14(1):28.##Alghamdi AS, Jokhadar HF, Alghamdi IM, Abdullah S, Alsohibani OJA, Wahabi HA. Socioeconomic Determinants of Exposure to Secondhand Smoke Among Pregnant Women. International Journal Of Womens Health And Reproduction Sciences. 2016;4(2):59-63.##Chi Y-C, Sha F, Yip PS, Chen J-L, Chen Y-Y. Randomized comparison of group versus individual educational interventions for pregnant women to reduce their secondhand smoke exposure. Medicine. 2016;95(40):1-7.##Goel P, Radotra A, Singh I, Aggarwal A, Dua D. Effects of passive smoking on outcome in pregnancy. Journal of postgraduate medicine. 2004;50(1):12.##Mojibyan M, Karimi M, Bidaki R, Rafiee P, Zare A. Exposure to second-hand smoke during pregnancy and preterm delivery. International journal of high risk behaviors & addiction. 2013;1(4):149.##Amasha HA, Jaradeh MS. Effect of active and passive smoking during pregnancy on its outcomes. 2014;6(2):335-52.##WHO. World Health Organization. Gender, Health, Tobacco and Equity. Available at: http://www.who.int/ tobacco/publications/gender/gender_tobacco_2010.pdf 2011 [##Kazemi A, Ramezanzadeh F, NasrEsfahani MH, Saboor-Yaraghi AA, Nejat S, Rahimi-Foroshani A. Impact of environmental tobacco smoke exposure in women on oxidative stress in the antral follicle and assisted reproduction outcomes. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2013;18(8):688.##Sarraf-Zadegan N, Boshtam M, Shahrokhi S, Naderi GA, Asgary S, Shahparian M, et al. Tobacco use among Iranian men, women and adolescents. European journal of public health. 2004;14(1):76-8.##Nichter M, Padmajam S, Nichter M, Sairu P, Aswathy S, Mini G, et al. Developing a smoke free homes initiative in Kerala, India. BMC public health. 2015;15(1):480.##Karimiankakolaki Z, MazloomyMahmoodabad SS, Kazemi A, Fallahzadeh H. Designing an educational intervention on second-hand smoke in smoker men on the exposure of pregnant wives: a protocol for a randomized controlled trial. Reproductive Health. 2019;16(11):1-5.##Fazlallahi S, Maleki Tavana M. Content analysis methodology with emphasis on readability techniques and determining the coefficient of conflict of texts. Research journal. 2010;2(1):71-94.##Bahariniya S, Ezatiasar M, Madadizadeh F. A Brief Review of the Types of Validity and Reliability of scales in Medical Research. Journal of Community Health Research. 2021 Mar 10;10(2):100-2.##Sadeghi R, MazloomyMahmoodabad SS, Fallahzadeh H, Rezaeian M, Bidaki R, Khanjani N. Readability and Suitability Assessment of Adolescent Education Material in Preventing Hookah Smoking. International Journal of High Risk Behaviors and Addiction. 2019;8(1):e83117.##Gunning R. The Technique of ClearWriting. 1952;36-37.##Christanti V, Naga DS, Benedicta C. Measuring Reading Difficulty Using Lexile Framework And Gunning Fog Index. Teknik dan Ilmu Komputer. 2017;6(22).##Hashemi M, Zangiabadi A, Shahdadi H, Sadeghi R. Using BASNEF Model: The Effect of an Educational Program on choice the mode of delivery in pregnant women in Sirjan, Iran. Transylvanian Review. 2017;1(4).##Okuhara T, Ishikawa H, Okada H, Kiuchi T. Readability, suitability and health content assessment of cancer screening announcements in municipal newspapers in Japan. Asian Pac J Cancer Prev. 2015;16(15):6719-27.##Walsh TM, Volsko TA. Readability assessment of internet-based consumer health information. Respiratory care. 2008;53(10):1310-5.##Garnweidner-Holme LM, Dolvik S, Frisvold C, Mosdøl A. Suitability assessment of printed dietary guidelines for pregnant women and parents of infants and toddlers from 7 European countries. Journal of nutrition education and behavior. 2016;48(2):146-51. e1.##Finnie RK, Felder TM, Linder SK, Mullen PD. Beyond reading level: a systematic review of the suitability of cancer education print and web-based materials. Journal of Cancer Education. 2010;25(4):497-505.##Vallance JK, Taylor LM, Lavallee C. Suitability and readability assessment of educational print resources related to physical activity: Implications and recommendations for practice. Patient Education and Counseling. 2008;72(2):342-9.##Kher A, Johnson S, Griffith R. Readability assessment of online patient education material on congestive heart failure. Advances in preventive medicine. 2017;2017(Article ID 9780317):1-8.##WHO. Secondhand Smoke (SHS) Facts. Available at: https://www.cdc.gov/tobacco/data_statistics/ fact_sheets/ secondhand_smoke/general_facts/ 2013 [##WHO. Tobacco Free Initiative (TFI) Second-hand tobacco smoke. Secondary Tobacco Free Initiative (TFI) Second-hand tobacco smoke. Available at: http://www.who.int/tobacco/research/secondhand_smoke/en/ 2015 [##Öberg M, Jaakkola MS, Woodward A, Peruga A, Prüss-Ustün A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. The Lancet. 2011;377(9760):139-46.##WHO. Worldwide burden of disease from exposure to second-hand smoke. Available at: http://www.who.int/ quantifying_ehimpacts/publications/shsarticle2010/en/. 2011 [##Zhang L, Hsia J, Tu X, Xia Y, Zhang L, Bi Z, et al. Peer Reviewed: Exposure to Secondhand Tobacco Smoke and Interventions Among Pregnant Women in China: A Systematic Review. 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Comparison of Different Decision Tree Algorithms for Classification of Retinopathy Patients in Yazd City, Central Part of Iran مقایسه الگوریتم های مختلف درخت تصمیم برای طبقه بندی ابتلا به رتینوپاتی در یزد، ایران 2 1 چکیده: اهداف: دیابت یکی از شایع ترین بیماری های ناشی از اختلالات متابولیک ناشی از اختلال در ترشح یا عملکرد انسولین است. شیوع دیابت به سرعت در حال افزایش است. هدف از این مطالعه بررسی عملکرد الگوریتم های  مختلف  درخت تصمیم در تشخیص رتینوپاتی دیابتی با استفاده از دادههای بیماران دیابتی مراجعه کننده به مرکز تحقیقات دیابت یزد از سال 1390 بود. در مجموع 2613 بیمار مراجعه کننده به مرکز تحقیقات و درمان شهر یزد در مرحله اول اطلاعات دموگرافیک دریافت و سپس توسط تیم پرستاری مورد آزمایش قرار گرفتند و فرم اطلاعات بیمار توسط پرستار مربوطه تکمیل شد. روش: این مطالعه از نوع تحلیلی و مقطعی بود. برای پردازش و مدل‌سازی داده‌ها از نرم‌افزار SPSS MODELER V 18.0 استفاده شد و شاخص‌های توصیفی میانگین، حالت، میانه، واریانس، درصد فراوانی، درصد داده‌های از دست رفته مشاهده شد و چهار مدل تشخیصی CHAID، درخت طبقه‌بندی و رگرسیون (C&R) ، QUEST و C5.0 مشاهده و مقایسه شدند. عملکرد این چهار مدل با استفاده از سه معیار آماری دقت(accuracy)، حساسیت(sensitivity) و ویژگی(specificity) ارزیابی شد. برای مقایسه دقیق تر مدل ها از نمودار Gains chart استفاده شد. یافته ها: در این مطالعه از بین کل متغیرهای دموگرافیک و بالینی، متغیرهایی مانند BMI، مدت بیماری، نوع داروی مصرفی، سن، فشار خون بالا، جنسیت، کلسترول، هموگلوبین A1c در مدل نهایی به عنوان متغیرهای وابسته با متغیرمستقل رتینوپاتی بررسی شد و بر اساس معیارهای به دست آمده در مدل CART دقت (71/75)، حساسیت (75/60)، ویژگی (57/14) و در مدل QUEST دقت (84/65)، حساسیت (65/86)، ویژگی (65/76) و در مدل CHAID دقت (69/33). حساسیت (67/35)، ویژگی (76/81) و همچنین در مدل CHAID  دقت (73/27)، حساسیت (79/65)، ویژگی (49/05) را نشان داد. نتیجه‌گیری: الگوریتم CHAID بر اساس معیارهای دقت، حساسیت، ویژگی و همچنین مقایسه نمودار GAINS برای چهار الگوریتم عملکرد بهتری را نشان داد.   2 Introduction: Diabetes is one of the most common diseases caused by metabolic disorders. It is the result of impaired secretion or function of insulin. The prevalence of diabetes is increasing rapidly. The aim of this study is to investigate the performance of different decision tree algorithms in the diagnosis of diabetic retinopathy. It was done using a database regarding diabetic patients. They were referred to Yazd Diabetes Research Center. Method: This study was analytical   cross-sectional. 2613 patients visited Yazd City's research and treatment center. Their demographic information was received in the first stage. Then, they were tested by the nursing team, and the patient's information form was completed by the respective nurse. After that, the descriptive indicators of mean, mode, median, variance, frequency, and percentage of missing data were observed. Four diagnostic models (Chadi), classification tree and regression (C and R), (Quest) and C 5.0 were compared. Authors evaluated the performance of these four models using three statistical criteria: accuracy, sensitivity, and specificity. Gains chart was used for more accurate comparison of models. SPSS MODELER V 18.0 software was used for data processing and modeling. The significance level was considered 5%. Result: In this study, among the demographic and clinical variables, BMI, duration of disease, type of drug used, age, hypertension, gender, cholesterol, and hemoglobin A1c were entered in the final model. The dependent variable of retinopathy was investigated. It was based on the obtained criteria of accuracy (71.75), sensitivity (75.60), specificity (57.14) in the CART model; accuracy (65.84), sensitivity (65.86), specificity (65.76) of the Quest model; accuracy (69.33), sensitivity (67.35), specificity (76.81) of Chaid model; and accuracy (73.27), sensitivity (79.65), specificity (49.05) of Chaid model. Conclusion: Based on the criteria of accuracy, sensitivity, specificity, and comparison of Gain Chart for four algorithms, Chaid algorithm showed better performance. Therefore, for further research, the authors suggest this algorithm 158 164 2022/01/192022/07/102021/02/192022/06/21 1401/3/31 2022/09/192022/09/202022/09/192022/09/19 1401/6/28 امین کرمی Amin Karami Shahid Sadoughi University of Medical Sciences and Health Services Iran amn.krm.rbt@gmail.com محسن عسکری شاهی mohsen Askarishahi Shahid Sadoughi University of Medical Sciences and Health Services Iran m.askari@ssu.ac.ir نسیم نمیرانیان Nasim Namiranian Shahid Sadoughi University of Medical Sciences and Health Services Iran namiranian.nasim@gmail.com Retinopathy Diabetes Decision Tree Yazd Data Mining رتینوپاتی دیابت درخت تصمیم یزد داده کاوی Elsalamony HA, Elsayad AM. Bank direct marketing based on neural network and C5. 0 Models. Int J Eng Adv Technol IJEAT. 2013;2(6).##Nisbet R, Elder J, Miner G. Handbook of statistical analysis and data mining applications: Academic Press; 2009.##Floares A, Birlutiu A, editors. Decision tree models for developing molecular classifiers for cancer diagnosis. The 2012 International Joint Conference on Neural Networks (IJCNN); 2012: IEEE.##Kass GV. An exploratory technique for investigating large quantities of categorical data. Journal of the Royal Statistical Society: Series C (Applied Statistics). 1980;29(2):119-27.##Hornik K, Stinchcombe M, White H. Universal approximation of an unknown mapping and its derivatives using multilayer feedforward networks. Neural networks. 1990;3(5):551-60.##Breiman L. Fried man JH, Olshen RA, Stone CJ. Classification and regression trees Belmont, California: Wadsworth International Group. 1984.##Lin C-L, Fan C-L. Evaluation of CART, CHAID, and QUEST algorithms: a case study of construction defects in Taiwan. Journal of Asian Architecture and Building Engineering. 2019;18(6):539-53.##Elsayad AM, Elsalamony H. Diagnosis of breast cancer using decision tree models and SVM. International Journal of Computer Applications. 2013;83(5).##Elsalamony HA, Elsayad AM. Bank direct marketing based on neural network and C5. 0 Models. Int J Eng Adv Technol IJEAT. 2013;2(6).##Nisbet R, Elder J, Miner G. Handbook of statistical analysis and data mining applications: Academic Press; 2009.##Floares A, Birlutiu A, editors. Decision tree models for developing molecular classifiers for cancer diagnosis. The 2012 International Joint Conference on Neural Networks (IJCNN); 2012: IEEE.##Kass GV. An exploratory technique for investigating large quantities of categorical data. Journal of the Royal Statistical Society: Series C (Applied Statistics). 1980;29(2):119-27.##Hornik K, Stinchcombe M, White H. Universal approximation of an unknown mapping and its derivatives using multilayer feedforward networks. Neural networks. 1990;3(5):551-60.##Breiman L. Fried man JH, Olshen RA, Stone CJ. Classification and regression trees Belmont, California: Wadsworth International Group. 1984.##Lin C-L, Fan C-L. Evaluation of CART, CHAID, and QUEST algorithms: a case study of construction defects in Taiwan. Journal of Asian Architecture and Building Engineering. 2019;18(6):539-53.##Elsayad AM, Elsalamony H. Diagnosis of breast cancer using decision tree models and SVM. International Journal of Computer Applications. 2013;83(5).## ##

Comparison of the Quality of Life of Addicts Participating in Either Narcotics Anonymous or, Therapeutic Community Group Sessions or Receiving Methadone-Therapy a Cohort Study in Mashhad in 2013 مقایسه کیفیت زندگی معتادان شرکت کننده در جلسات گروهی معتادان گمنام یا جامعه درمانی و یا دریافت کننده متادون درمانی در مشهد در سال 1392 2 1 مقدمه: بیماری‌ها و اختلالات مزمن و طولانی‌مدت مانند اعتیاد می‌تواند زندگی مبتلایان را با بحران مواجه کرده و کیفیت زندگی آنها را کاهش دهد. بنابراین، در این مطالعه تصمیم گرفتیم کیفیت زندگی افراد مبتلا به اختلالات مصرف مواد (SUD) را که تحت درمان با جلسات معتادان گمنام، اجتماع درمان مدار یا متادون درمانی قرار گرفتند، مقایسه کنیم. روش کار: این مطالعه همگروهی بر روی بیماران سم زدایی شده شرکت کننده در سه گروه معتادان گمنام، اجتماع درمان مدار و کلینیک های متادون درمانی انجام شد. کیفیت زندگی آزمودنی ها در ابتدا و 1.5 ماه پس از شروع درمان با پرسشنامه SF36 اندازه گیری شد. برای تجزیه و تحلیل داده‌ها از شاخص‌های توصیفی (میانگین (SD)، فراوانی (%))، آنالیز واریانس، آزمون تی زوجی، کای‌دو و آزمون تعقیبی توکی استفاده شد. داده ها در نرم افزار SPSS19 در سطح معنی داری 0.05 P< مورد تجزیه و تحلیل قرار گرفت. یافته‌ها: در مجموع 81 بیمار در سه گروه 27 نفری وارد مطالعه شدند. میانگین ± انحراف معیار سن 8/49±34/77 سال، سالهای مصرف 2/87±7/48، فراوانی مصرف روزانه2/14±3/85 و دفعات قطع مصرف 10/56±7/02 به دست آمد. از میان افرادی که در این مطالعه شرکت کردند، 57.5 درصد دارای تحصیلات متوسطه یا بالاتر بودند. 50.6 درصد شغل آزاد داشتند و 14.9 درصد بیکار بودند. میانگین (SD) نمره کیفیت زندگی در بین افراد مبتلا به SUD شرکت کننده در جلسات گروه معتادان گمنام (85.7) و اجتماع درمان مدار (73.3)، 1.5 ماه پس از شروع جلسات به طور معناداری افزایش یافت.( P <0.001). نتیجه گیری: نتایج این مطالعه حاکی از آن است که جلسات گروهی معتادان گمنام و اجتماع درمان مدار، در بهبود کیفیت زندگی افراد مبتلا به SUD موثر است. با این حال، این تأثیر در کسانی که در جلسات معتادان گمنام شرکت می کردند بیشتر بود. بنابراین پیشنهاد می شود افراد مبتلا به SUD در این جلسات شرکت کنند. 2 Background: Chronic and prolonged illnesses and disorders, such as addiction, lead to a crisis in the lives of people with disabilities and can lead to a decrease in their quality of life. Therefore, in this study, we decided to compare the quality of life of individuals with substance use disorders who participate in Narcotics Anonymous, therapeutic Community session with Methadone-treated groups. Methods: This cohort study was conducted on detoxified patients attending Narcotics anonymous, therapeutic community sessions and Methadone-treated place. Quality of life of subjects measured at baseline and 1.5 months after the start of treatment. Data were analyzed by SPSS19 software using ANOVA, paired t-test, Chi-square analysis. Results: The mean score of quality of life between three groups was not significantly different at the beginning of the study, but the mean score of quality of life among individuals with substance use disorders participating in the sessions of Narcotics anonymous and therapeutic community group increased significantly (P <0.001) 1.5 months after the start of treatment. Conclusion: The results of this study indicate that the presence of detoxified persons in sessions of Narcotics anonymous and therapeutic community was effective in improving their quality of life. However, this effect is greater in Narcotics Anonymous. Therefore it was suggested that individuals with substance use disorders participate in these meetings. 165 174 2022/01/192022/07/102021/02/192022/06/212020/10/9 1399/7/18 2022/09/192022/09/202022/09/192022/09/192022/09/19 1401/6/28 حمید بزازکاهانی Hamid Bazazkahani Instructor of Psychiatric Nursing - Faculty of nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran Bazazkh1@gmail.com امیررضا صالح مقدم Amirreza SalehMoghaddam Instructor in Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Iran salehmoghaddamar@mums.ac.ir سعید واقعی Saeed vaghee Evidence Based Care Research Centre, Instructor of Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Iran vaghees@mums.ac.ir اندیشه حامدی Andishe Hamedi Feculty of nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran Iran ahamedi1364@gmail.com Quality of life Self-Help Groups Therapeutic Community Methadone کیفیت زندگی گروه های خودیاری اجتماع درمان مدار متادون Zare F, Ameri H, Madadizadeh F, Reza Aghaei M. 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Substance use & misuse. 2017;52(11):1429-38.##Kreager DA, Schaefer DR, Davidson KM, et al. Evaluating peer-influence processes in a prison-based therapeutic community: a dynamic network approach. Drug and alcohol dependence. 2019;203:13-8.##Dashtgerd A. Bandura's Social Ccognitive Theory, the Effect of the Withdrawal in Patients Admitted to Addiction Clinic of Imam Reza Hospital in Mashhad in 2010. [Thesis]: Mashhad University of Medical Science. ; 2010.##Bahariniya S, Ezatiasar M, Madadizadeh F. A Brief Review of the Types of Validity and Reliability of scales in Medical Research. Journal of Community Health Research. 2021 Mar 10;10(2):100-2.##Brazier JE, Harper R, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992;305(6846):160-164. doi:10.1136/bmj.305.6846.160##Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21(2):271-292. doi:10.1016/s0167-6296(01)00130-8.##Linde L, Sørensen J, Østergaard M, et al. Health-related quality of life: validity, reliability, and responsiveness of SF-36, EQ-15D, EQ-5D, RAQoL, and HAQ in patients with rheumatoid arthritis. The Journal of Rheumatology. 2008;35(8):1528-37.##Zarebahramabadi M, Mohamadyfar MA, Erfani N,et al. The Comparison of the Effectiveness of Self-Acceptance Group Therapy By Draydan Method and NA Training on Addicts' Mental Health Components. Journal of Research on Addiction 2012 spring; 6(21): 81-99.##Beygi A, Mohammadyfar MA, Farahani MN, etal. The Comparative Study of Coping Styles and Hope among Narcotic Anonymous and Methadone Maintenance Treatment Members. Journal of Research on Addiction 2011 winter; 5(20): 55-72.##Sotodeh Asl N, Behnam B, Ghorbani R. Effectiveness of narcotics anonymous training programs in personality characters in substance abuse patients. Koomesh. 2013; 14 (3) :316-320 URL: http://koomeshjournal. semums.ac.ir/article-1-1674-en.html.##DeLucia C, Bergman BG, Beitra D, et al. Beyond abstinence: an examination of psychological well-being in members of narcotics Anonymous. J Happiness Stud. 2016;17(2):817-832.##Toumbourou JW, Hamilton M, U'Ren A. Narcotics Anonymous participation and changes in substance use and social support. J Subst Abus Treat. 2002;23(1):61-66##Jalali R, Moradi A, Dehghan F. The exploration of factors related to treatment retention in Narcotics Anonymous members: a qualitative study. Substance abuse treatment, prevention, and policy. 2019;14(1):1-9.##Majer JM, Jason LA, Aase DM, Droege JR, Ferrari JR. Categorical 12-step involvement and continuous abstinence at 2 years. Journal of substance abuse treatment. 2013;44(1):46-51.##Beygi A, FARAHANI M, MOHAMMADKHANI S, MOHAMMADIFAR MA. The Discriminative Role of Quality of Life and Hope in Narcotic Anonymous and Methadone Maintenance Groups. 2011;3(11):75-84.##BEYGI A. Piritual development, socio-religious performance and quality of life in narcotic anonymous. 2011;6(2):6-12.##HAJ HM, HASHEMI R. ADDICTS'QUALITY OF LIFE AND PSYCHOLOGICAL DISORDERS (DEPRESSION, ANXIETY, AND STRESS) IN TWO TREATMENT METHODS: NARCOTICS ANONYMOUS VS. METHADONE MAINTENANCE TREATMENT. RESEARCH ON ADDICTION. 2015 [cited 2022June14];9(35):119-136. Available from: https://www.sid.ir/en/journal/ViewPaper.aspx?id=486723##Aliverdinia A. The effectiveness of narcotics anonymouss' programs in the attitude of drug addicts. Iranian Social Studies. 2010;3(3):123-70.##Krentzman AR, Robinson EA, Moore BC, et al. How alcoholics anonymous (AA) and narcotics anonymous (NA) work: Cross-disciplinary perspectives. Alcoholism treatment quarterly. 2011;29(1):75-84.##Sadrosadat SJ, Kalateh ZM-R, Keldi A. A Study on the Association between Therapeutic Community Program and Social Relationship of Previously Addicated Persons. Journal of Rehabilitation. 2005;6(3):10-3.##Yarmohammadi Vasel M. The Efficacy of Therapeutic Community on Life Skills Improvement and Reduction of Relapse in Male Addicts. Journal of Kerman university of medical sciences 2011 autumn; 18(4): 358-368.##Karimnejad F, Maktabi G, Vatankhah M. Comparison between agreeableness trait of personality and spiritual health of the addicts living in community treatment centers (TC) and under methadone treatment addicts in Ahvaz, Iran. Bimonthly Journal of Hormozgan University of Medical Sciences. 2014;18(1):75-83.## ##

A Study of Training Needs Assessment of Doctors and Nurses and Approaches to Performance Improvement in a Tertiary Care Hospital: A Cross Sectional Study in Punjab, India. 2 2 Introduction: Training has a distinct role in the achievement of an organizational goal..  The present study  aimed  to identify the training needs of the doctors and nurses in the hospital and to prioritize these training needs. Methods: The study was   a cross sectional study which was conducted in Sri Guru Ram Das charitable Hospital Vallah, Amritsar, Punjab,India, among doctors and nurses from october to December 2019. A total of 100 doctors and nurses through Convenient Sampling were interviewed after taking informed consent. The World Health Organization–adopted Hennessy Hicks Training Needs Analysis Questionnaire, a self-reported close-ended structured questionnaire with a core set of  30 items was used. The data was analyzed using SPSS 20 version. Descriptive statistics mean and  (SD) were calculated for quantitative data and frequency ( percentages) for qualitative data. independent sample  t-test was applied to compare importance and performance scores among doctors and nurses. p value less than 0.05 and 0.01 were considered significant and highly significant respectively. Results: There is maximum training need in research activities (average difference score of 1.5) followed by the supervisory /managerial tasks (1.2) and clinical tasks (1.1). For research activities mean (SD) difference of average score for importance and performance was 2.0 (  1.10)  among doctors and 1.6 among nurses  (0.72) while for administrative tasks it was 1.5 ( 1.10) and 0.6 (0.96) for doctors and nurses respectively. For supervisosry tasks it was 1.4 (  0.94) among doctors and 0.9(SD 0.78) among nurses.( p value for research activities,  administrative tasks and supervisory task was .03, .000 and .003 respectively) Conclusions: Among all the categories of activities, maximum training need was found for research activities followed by the supervisory /managerial tasks and clinical tasks 175 182 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/24 1400/3/3 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/19 1401/6/28 Amanpreet Kaur Amanpreet Kaur Professor, Department of Community Medicine, SGRDIMSAR, Amritsar India prettyaman@rediffmail.com Jagdeep Singh Jagdeep Singh Consultant Gastroenterologist, Fortis Escorts Hospital, Amritsar Iran Jagdeepsingharora@rediffmail.com TNA(Training Needs Assessment) Doctors Nurses Performance 1. Mwita. Performance management model. International Journal of Public Sector Management. 2000 ;13(1):19-37.##Tine health 2017. How to Develop Effective Hospital Training and Development Programs. Available at :http://tinehealth.com/2017/05/02/how-to-develop-effective-hospital-training-and-development-programs/##Goldstein and Ford . Training in Organizations. Belmont, CA: Wadsworth. 4th Edition, 2002.##Importance of ongoing learning in a healthcare setting. CHAS Feb 2017. Available at : https://chas.org/blog/?p=827##Barbazette. Training Needs Assessment: Methods, Tools, and Techniques, Brand: Pfeiffer Publishers. 2006##Brown . Training needs assessment: A must for developing an effective training programme. Public Personnel Management. 2002; 31 (4);569-578##Dierdoff and Surface. Assessing training needs: Do work experience and capability matter? Human Performance. 2008;21:28-48.##Barratt and Fulop. Building capacity to use and undertake research in health organizations: a survey of training needs and priorities among staff. BMJ Open. 2016;6:e012557.doi:10.1136/bmjopen-2016-012557##MahmudKT, Wahid IS, Arif I . Impact of training needs assessment on the performance of employees: Evidence from Bangladesh.Cogent Social Sciences.2019;5:1, DOI: 10.1080/23311886.2019.1705627##Markaki A, Malhotra S, Billings R et al. Training needs assessment: tool utilization and global impact. BMC Med Educ. 2021; 21: 310.##Hennessy-Hicks Training Needs Analysis Questionnaire and Manual. Available at: https://www.who.int/ workforcealliance/knowledge/HennessyHicks_trainingneedstool.pdf##Gaspard and Yang. Training need assessment of health care professionals in a developing country: the example of Saint Lucia. BMC Medical Education. 2016;16:112.##Singh S, Shweta K, Arya S et. al. Training need assessment of nursing personnel at super specialty tertiary care hospital in northern India. Int J Health Sci Res. 2015; 5(3): 262-270..##Kristensen N, Nymann C, Konradsen H. Implementing research results in clinical practice- the experiences of health care professionals. BMC Health Services Research. 2016;16:48##Dehghani K, Nasiriani K, Sahimi T . Requirements for nurse supervisor training: A qualitative content analysis. Iran J Nurs Midwifery Res. 2016;21(1):63-70##Yousif AK, Ahmed OY, Osman WN. Training needs assessment of academic teaching staff in Faculty of Dentistry, University of Gezira, Sudan 2018. Education in Medicine Journal. 2019;11(1):31-41.##Byamugisha J, Munabi IG, Mubuuke AG et al. A health care professionals training needs assessment for oncology in Uganda. Human Resources for Health.2020;18:62##Wu X, Wu Xinjuan, Gao Y et al. Research-training needs of clinical nurses: A nationwide study among tertiary hospitals in China. Int J Nurs Sci. 2019; 6(3): 300-308.## ##

Social Acceptance for Patients with Pulmonary Tuberculosis from Their Own Perspective in Rafsanjan, Iran: A Cross Sectional Study پذیرش اجتماعی بیماران مبتلا به سل ریوی از دیدگاه خود در شهر رفسنجان، ایران: مطالعه مقطعی 2 1 مقدمه: پذیرش اجتماعی به عنوان حمایت بیماران توسط شبکه اجتماعی که شامل خانواده، دوستان و همکاران می باشد تعریف می گردد که اغلب باعث مدیریت و پیش آگهی بهتر می شود. چنانچه  پذیرش اجتماعی در بیماران مبتلا به بیماری های مزمن مانند سل به طور قابل توجهی پایین باشد، برنامه ریزی مناسب می تواند سطح دانش و فرهنگ جامعه را برای ارتقای سطح پذیرش بیمار و جامعه ارتقا بخشد. هدف نویسندگان، بررسی پذیرش اجتماعی و عوامل مرتبط با آن در این بیماران در شهر رفسنجان است. روش کار: این مطالعه از نوع توصیفی و مقطعی بود که بر روی 29 بیمار سل ریوی (سل) مراجعه کننده به مرکز بهداشت شهرستان رفسنجان در سال 1393 انجام شد که به روش سرشماری انتخاب شدند. پرسشنامه مارلو کراون توسط بیماران تکمیل و نمرات براساس کلید پرسشنامه با استفاده از نرم افزار SPSS 16 محاسبه گردید. آزمون T-test، فیشر و کای اسکویر جهت ارزیابی استفاده و سطح معنی داری کمتر از 0.05 درنظر گرفته شد. یافته‌ها: نتایج نشان داد که فراوانی پذیرش اجتماعی در بین بیماران متوسط تا زیاد (62%) و متوسط تا کم (38%) بود. پانزده نفر (52%) مرد و 14 نفر (48%) زن بودند که محدوده سنی آنها بین 8 تا 90 سال بود. ملیت، سابقه خانوادگی مثبت سل و پذیرش اجتماعی معنی دار بود (P-value <0.05). نتیجه‌گیری: بر اساس این مطالعه  بیماران مسن‌تر، افراد با سابقه خانوادگی سل و بیماران مهاجر، پذیرش اجتماعی بالاتری دارند (P-value <0.05).   2 Introduction: Social acceptance is defined as the support by social network for patients via family, friends and colleagues that often reason the better management and prognosis. If the social acceptance is significantly low in patients with chronic diseases like tuberculosis, an appropriate plan can raise the level of knowledge and the culture of the community to enhance the level of patient and community's acceptance. The authors aim to evaluate social acceptance and related factors in these patients in Rafsanjan. Methods: This was a descriptive and cross-sectional study. It was conducted on 29 pulmonary TB (tuberculosis) patients who had referred to Rafsanjan city health center in Iran in 2014. They were selected by census method. The Marlou-Crown questionnaire was completed by patients, and the scores were calculated based on the questionnaire key using SPSS 16. T-test, Fisher and chi-square tests were used for evaluation, and the significance level was P-value <0.05. Results: Results showed that the frequency social acceptance among patients was moderate to high (62%) and moderate to low (38%). Fifteen (52%) patients were male and 14 (48%) were female whose age range was 8 to 90.  Among the variables of age, sex, education, place of residence, nationality and family history of patients, the relationship between age، nationality, positive family history of TB and social acceptance was significant (P-value <0.05). Conclusion: This study concludes that older patients, those with a family history of TB, and migrant patients have higher social acceptance (P-value <0.05). 183 190 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/242021/07/1 1400/4/10 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/192022/09/19 1401/6/28 رضا بیدکی Rzea Bidaki Professor of Psychiatry, Research Center of Addiction and Behavioral Sciences, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran reza_bidaki@yahoo.com مرضیه باقری ماهونکی Marzie Bagheri Mahonaki Doctor of Medicine (MD), Psychiatry Department, Rafsanjan University of Medical Sciences, Rafsanjan. Iran Iran marzieh.bagheri1991@yahoo.com زیبا شعبانی شربابکی Ziba Shabani Shahrbabaki Associate Professor of Internal Medicine and Infectious Disease Immunology Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran Iran shabaniz20@yahoo.com حمید بخشی علی آباد Hamid Bakhshi Aliabad Assistant Professor of Biomedicine Sciences, Rafsanjan University of Medical Sciences, Rafsanjan. Iran Iran bakhshi_hamid@yahoo.com مریم ساده Maryam Sadeh Assistant Professor of Bacteriology, Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Iran sadeh_m20@yahoo.com Behavior Disease Social Stigma Tuberculosis رفتار بیماری انگ اجتماعی سل 1. Khosravi AD, Shahraki AH, Dezfuli SK, al. e. Genetic Diversity of Multidrug-Resistant Mycobacterium Tuberculosis Strains Isolated From Tuberculosis Patients in Iran Using MIRU-VNTR Technique. Kaohsiung J Med Sci. 2017;33(11):550-7.##2. Rodriguez-Takeuchi SY, Renjifo ME, Medina FJ. Extrapulmonary Tuberculosis: Pathophysiology and Imaging Findings. Radiographics. 2019;39(7):2023-37.##3. Floyd K, Glaziou P, Zumla A, al. e. The global tuberculosis epidemic and progress in care, prevention, and research: an overview in year 3 of the End TB era. Lancet Respir Med. 2018;6(4):299-314.##4. Gilpin C, Korobitsyn A, Migliori GB, Raviglione MC, Weyer K. The World Health Organization standards for tuberculosis care and management. Eur Respir J. 2018;51(3).##5. Organization WH. Meeting report of the WHO expert consultation on the definition of extensively drug-resistant tuberculosis, 27-29 October 2020 2021 [Available from: https://www.who.int/publications/i/item/meeting-report-of-the-who-expert-consultation-on-the-definition-of-extensively-drug-resistant-tuberculosis.##6. Torkaman MRA, Nasiri MJ, Farnia P, Shahhosseiny MH, Mozafari M, Velayati AA. Estimation of Recent Transmission of Mycobacterium Tuberculosis Strains Among Iranian and Afghan Immigrants: A Cluster-Based Study. Journal of clinical diagnostic research: JCDR. 2014;8(9):DC05-DC8.##7. Tavakoli A. Incidence and prevalence of tuberculosis in Iran and neighboring countries. Zahedan Journal of Research in Medical Sciences. 2017;19(7):e9238.##8. Nikonajad A, Azimi SA, Allami A, Qasemi Bargi R, Tabarraei A. Epidemiology of extrapulmonary tuberculosis in Northeast of Iran %J Medical Laboratory Journal. 2021;15(1):1-7.##9. Bidaki R, Rajabi Z, Rezaeian M, Sabouri Ghannad M, Salehi Shahrbabaki MH. Social Acceptance for Patients Infected with Human Immunodeficiency Virus in Kerman and Rafsanjan, Iran. International Journal of High Risk Behaviors and Addiction. 2016;6(1):e30564.##10. Pozsik CJ. Compliance with tuberculosis therapy. Med Clin North Am. 1993;77(6):1289-301.##11. Madadizadeh F, Vali L, Khalilabad Th, Asar Me. Work-related musculoskeletal disorders among administrative employees of Kerman university of medical sciences. International Journal of Occupational Hygiene. 2016;8(2):78-84.##12. Nichter M. Illness semantics and international health: the weak lungs/TB complex in the Philippines. Soc Sci Med. 1994;38(5):649-63.##13. Moya EM, Biswas A, Chavez Baray SM, al. e. Assessment of stigma associated with tuberculosis in Mexico. Public Health Action. 2014;4(4):226-32.##14. Ghanbari-Firoozabadi M, Mirzaei M, Nasab MV, Grace SL, Okati-Aliabad H, Madadizadeh F, Dadras H, Amrolahi N, Entezari M, Sadrbafghi SM. Cross-cultural adaptation and psychometric validation of the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P). BMJ open. 2020 Jun 1;10(6):e034552. doi:10.1136##15. Tan HC, Ho JA, Kumarusamy R, Sambasivan M. Measuring social desirability bias: Do the full and short versions of the Marlowe-Crowne Social Desirability scale matter? Journal of empirical research on human research ethics : JERHRE. 2021:15562646211046091.##16. Taherzadeh Chenani K, Madadizadeh F. Popular Statistical Tests for Investigating the Relationship between Two Variables in Medical Research. JCHR 2020; 9 (1) :1-3##17. Marvi A, Asadi-Aliabadi M, Darabi M, Rostami-Maskopaee F, Siamian H, Abedi G. Silent changes of tuberculosis in Iran (2005–2015): A joinpoint regression analysis. Journal of family medicine primary care. 2017;6(4):760.##18. Eyanoer PC, editor Social acceptance among tuberculosis patients at Puskesmas Amplas Medan, Indonesia. IOP Conference Series: Earth and Environmental Science; 2018: IOP Publishing.##19. Lacerda SNB, de Abreu Temoteo RC, de Figueiredo TMRM, de Luna FDT, de Sousa MAN, de Abreu LC, et al. Individual and Social Vulnerabilities Upon Acquiring Tuberculosis: A Literature Systematic Review. 2014;7:35.##20. Sanchez AI, Bertolozzi MR. Beyond DOTS (Directly Observed Treatment Short-Course) in tuberculosis' control: interfacing and sharing needs. Rev Lat Am Enfermagem. 2009;17(5):689-94.##21. Kibrisli E, Bez Y, Yilmaz A, Aslanhan H, Taylan M, Kaya H, et al. High social anxiety and poor quality of life in patients with pulmonary tuberculosis. Medicine (Baltimore). 2015;94(3):e413.##22. Liu D, Hinton L, Tran C, Hinton D, Barker JC. Reexamining the Relationships Among Dementia, Stigma, and Aging in Immigrant Chinese and Vietnamese Family Caregivers. Journal of cross-cultural gerontology. 2008;23(3):283-99.##23. Bekelman DB, Parry C, Curlin FA, Yamashita TE, Fairclough DL, Wamboldt FSJJop, et al. A Comparison of Two Spirituality Instruments and Their Relationship to Depression and Quality of Life in Chronic Heart Failure. 2010;39(3):515.##24. Fouladi N, Shahidi E. The Role of Personality Traits and Life Expectancy in Predicting Psychological Hardiness in Students Regarding Sexuality. J Clinical Psychology Personality 2020;15(1):93-101.##25. Quinn F, Zvonareva O, Witte S, Kabanets N, Filinyuk O. Adolescents in a tuberculosis hospital: Qualitative study of how relationships with doctors, caregivers, and peers mediate their mental wellbeing. Plos One. 2021;16(10):e0257379-e.##26. Snow KJ, Cruz AT, Seddon JA, Ferrand RA, Chiang SS, Hughes JA, et al. Adolescent tuberculosis. The Lancet Child & Adolescent Health. 2020;4(1):68-79.##27. World Health O. Roadmap towards ending TB in children and adolescents. Geneva: World Health Organization; 2018 2018.## ##

investigating the effect of Infodemic on the Perception and Willingness to Take the COVID – 19 Vaccine in Delta State, Nigeria 2 2 Introduction: The rollout of COVID-19 vaccine in response to the COVID-19 pandemic has been accompanied by infodemic. This study ascertained the influence of infodemic on individuals’ willingness to be vaccinated for increased vaccine coverage in Delta State. Methods: In this cross-sectional study, 2500 respondents across the twenty five Local Government Areas in Delta State, with age of at least 15 years were selected using stratified random sampling to provide an appropriate demographic representation. A researcher – made questionnaire including demographic characteristics and questions related to participants' knowledge and attitude regarding COVID-19 vaccine was used. Descriptive Statistics of Frequency (Percentage) was used for data analysis using Microsoft Excel software version 2016. Results: Demography of respondents showed that secondary education was highest (43%), while 50% of the respondents were urban dwellers.  80.44% of the respondents admitted to the existence of the virus, while 45.84% admitted to its existence in Delta State. 27.68% of the respondents were willing to take the COVID-19 vaccine; while 58.08% declined. 63% of respondents had access to social media; and majority of them (52%) admitted to not verifying health information seen on social media with medical experts. Majority of the respondents willing to take the vaccine were aged 45 to 60 years (42.37%); reside in urban areas, have tertiary education, access to social media; and often verified health information with medical experts. Infodemic about the COVID-19 vaccine and lack of trust in the government were identified as the major debilitating factors to the public acceptance of the vaccine. Conclusion: Improving  COVID-19 vaccine coverage in Delta State requires a holistic approach of combating misinformation about the vaccine,, regulation of health information shared on the social media space, and criminalizing the act of infodemic.  Infodemic, COVID-19 vaccine, health information, social media, public health, Delta State. 191 201 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/242021/07/12021/10/2 1400/7/10 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/192022/09/192022/09/19 1401/6/28 Nkonyeasua Kingsley Egun Nkonyeasua Kingsley Egun Department of Animal and Environmental Biology, University of Benin, Edo State, Nigeria Nigeria kenegun@yahoo.com Jude C. Igborgbor Jude C. Igborgbor Department of Biology, University of Delta, Agbor, Delta State, Nigeria Nigeria judeigborgbor@gmail.com  Infodemic COVID-19 vaccine health information social media public health Delta State. اینفودمیک واکسن COVID-19 اطلاعات بهداشتی رسانه های اجتماعی بهداشت عمومی ایالت دلتا. World Health Organization. Infodemic, 2022. https://www.who.int/health-topics/infodemic#tab=tab_1. Assessed 15 January, 2022.##Rothkopf DJ. SARS also spurs an 'information epidemic'. Newsday. 14 May 2003. ProQuest 279705520. https://www.proquest.com/newspapers/sars-also-spurs-information-epidemic/docview/279705520/se-2. Assessed 12 December 2020.##World Health Organization. WHO Coronavirus (COVID-19) Dashboard, 2021. https://covid19.who.int/. Assessed August 28, 2021.##Thomas J, Peterson GM, Walker E, Christenson JK, Cowley M, Kosari S, Baby KE, Naunton M. Fake news: medicines misinformation by the media. Clin Pharmacol Ther., 2018; 104 (6): 1059 - 1061.##Mheidly N, Fares J. Leveraging media and health communication strategies to overcome the COVID‑19 infodemic. Journal of Public Health Policy, 2020; 41:410 - 420.##Madadizadeh F, Sefidkar R. Ranking and Clustering Iranian Provinces Based on COVID-19 Spread: K-Means Cluster Analysis. Journal of Environmental Health and Sustainable Development. 2021 Mar 10;6(1):1184-95.##Del Vicario M, Bessi A, Zollo F, Petroni F, Scala A, Caldarelli G, Stanley HE, Quattrociocchi W. The spreading of misinformation online. Proc Natl Acad Sci USA, 2016; 113 (3): 554 - 559.##Lazer DM, Baum MA, Benkler Y, Berinsky AJ, Greenhill KM, Menczer F, Metzger MJ, Nyhan B, Pennycook G, Rothschild D, Schudson M. The science of fake news. Science, 2018; 359 (6380): 1094 - 1096.##Hua J, Shaw R. Coronavirus (Covid-19) "infodemic" and emerging issues through a data lens: the case of China. Int J Environ Res Public Health, 2020; 17 (7): 2309.##Pulido CM, Villarejo-Carballido B, Redondo-Sama G, Gómez A. COVID-19 infodemic: More retweets for science-based information on coronavirus than for false information. Int Sociol., 2020: 0268580920914755.##Larson HJ. The biggest pandemic risk? Viral misinformation. Nature, 2018; 562 (7726): 309 - 10.##Nigeria Centre for Disease Control. First Case of Corona Virus Disease Confirmed in Nigeria. 28 February 2020. Assessed August 28, 2021.##Bahariniya S, Madadizadeh F. Alcohol: A Double-Edged Sword in the Fight Against COVID-19. Health Scope. 2021 May 31;10(2).##Sefidkar R, Madadizadeh F. A summary of the main actions of the Iranian government during the Covid-19: From March 5 until December 20 in 2020. Journal of Community Health Research. 2021 Mar 10;10(1):1-3.##Geldsetzer P. Knowledge and perceptions of COVID-19 among the general public in the United States and the United Kingdom: a cross-sectional online survey. Ann. Intern. Med. 2020; 173: 157-160.##Islam M. S. et al. COVID-19-related infodemic and its impact on public health: a global social media analysis. Am. J. Trop. Med. Hyg. 2020; 103, 1621-1629##Kim HK, Ahn J, Atkinson L, Kahlor LA. Effects of COVID-19 misinformation on information seeking, avoidance, and processing: a multicountry comparative study. Sci Commun 2020; 42, ##https://doi.org/10.1177/1075547020959670##Roozenbeek, J. et al. Susceptibility to misinformation about COVID-19 around the world. R. Soc. Open Sci. 2020; 7, 201199##Bahariniya S, Ezatiasar M, Madadizadeh F. Recommendation for How to Improve Taking Care of the Elderly with Covid-19. Journal of Community Health Research. 2021.##CDC Africa. COVID-19 Vaccine Perceptions: A 15-country study. African Centre for Disease Control and Prevention, February 2021.##Omirhobo A, Egun NK. Concept Paper on Best Contemporary Waste Management Practices in Delta State, Nigeria, 2015.##Jung S.H. Stratified Fisher's exact test and its sample size calculation. Biom. J., 2014; 56: 129 -140. https://doi.org/ 10.1002/bimj.201300048##Bahariniya S, Asar ME, Madadizadeh F. Caring of Health Care Team in COVID-19 Crisis. Psychology. 2020;25(7):883-7.##Basti M, Madadizadeh F. A beginner's guide to sampling methods in medical research. Critical Comments in Biomedicine. 2021 Sep 30;2(2).##Lukrecija Djeri, Tanja Armenski, Dragan Tesanovic, Milan Bradić & Svetlana Vukosav (2014) Consumer behaviour: influence of place of residence on the decision-making process when choosing a tourist destination, Economic Research-Ekonomska Istraživanja, 27:1, 267-279, DOI: 10.1080/1331677X.2014.952108##Taheri Soodejani M, Hosseini S, Sefidkar R, Madadizadeh F, Fallahzadeh H, Dehghan A, Dehghani Tafti N, Lotfi MH. Comorbidity and its Impact on mortality of COVID-19 in Yazd province, a central part of Iran: a hospital-based study. Journal of Community Health Research. 2022 Jun 10;11(2):137-41.##Larson HJ, Hartigan-Go K, Figueiredo A. 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Stratified Fisher's exact test and its sample size calculation. Biom. J., 2014; 56: 129 -140. https://doi.org/ 10.1002/bimj.201300048##Bahariniya S, Asar ME, Madadizadeh F. Caring of Health Care Team in COVID-19 Crisis. Psychology. 2020;25(7):883-7.##Basti M, Madadizadeh F. A beginner's guide to sampling methods in medical research. Critical Comments in Biomedicine. 2021 Sep 30;2(2).##Lukrecija Djeri, Tanja Armenski, Dragan Tesanovic, Milan Bradić & Svetlana Vukosav (2014) Consumer behaviour: influence of place of residence on the decision-making process when choosing a tourist destination, Economic Research-Ekonomska Istraživanja, 27:1, 267-279, DOI: 10.1080/1331677X.2014.952108##Taheri Soodejani M, Hosseini S, Sefidkar R, Madadizadeh F, Fallahzadeh H, Dehghan A, Dehghani Tafti N, Lotfi MH. Comorbidity and its Impact on mortality of COVID-19 in Yazd province, a central part of Iran: a hospital-based study. 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Tutorial on Applied Study Designs in Medical Research آموزش طرح های مطالعات کاربردی در تحقیقات پزشکی 2 1 مقدمه: یکی از ارکان اصلی مطالعه، انتخاب صحیح طرح مطالعه است. این مطالعه با هدف ارائه مروری بر انواع مطالعات کاربردی در تحقیقات پزشکی انجام شده است. روش پژوهش: در این مطالعه آموزشی، تمامی مطالعات کاربردی از نظر کمی و کیفی بررسی شد. بر این اساس، عبارات مرتبط با «مطالعات پژوهشی» در پایگاه‌ های اطلاعاتی آنلاین مانند Google Scholar، PubMed، Web of Science و Scopus جستجو شدند. یافته ها: بر اساس یافته های پژوهش حاضر، انواع مطالعات به طور کلی به دو گروه مطالعات کمی و مطالعات کیفی تقسیم می شوند. مطالعات کمی به دو دسته مطالعات اولیه و ثانویه تقسیم می شوند. مطالعات اولیه شامل مطالعات مشاهده ای و غیر مشاهده ای است. مطالعات مشاهده ای به دو دسته مطالعات توصیفی و تحلیلی تقسیم می شوند. مطالعات توصیفی شامل گزارش های موردی، مطالعات مقطعی، مطالعات همبستگی مقطعی و مطالعات بوم شناختی و مطالعات تحلیلی شامل مطالعات گذشته نگر و گروهی می باشد. مطالعات غیرمشاهده ای نیز شامل مطالعات آزمایشگاهی، کارآزمایی های بالینی، کارآزمایی های صحرایی و آزمایش های اجتماعی است. نتیجه گیری: با درک خوب انواع مطالعات، به راحتی می توان تصمیم گرفت که کدام نوع مطالعه برای تحقیق مناسب است. انتخاب طرح مطالعه مناسب می تواند هزینه های فرآیند اجرایی را کاهش دهد، دقت و کیفیت تحقیق را افزایش دهد و نتایج قابل اطمینان تری به دست دهد.   2 Introduction: One of the main pillars of the study is the correct choice of study design. This study aimed to give an overview of different type of study designs in medical research. Methods: In this tutorial study, all applied research designs in terms of quantitative and qualitative study were reviewed. Accordingly, terms related to "Research Designs" were searched in the online databases such as Google Scholar, PubMed, Web of Science and Scopus. Results: Based on the findings of the present study, the types of studies are generally divided into two groups: quantitative studies and qualitative studies. Quantitative studies are divided into two categories: primary and secondary studies. Preliminary studies include observational and non-observational studies. Observational studies are divided into two categories: descriptive and analytical studies. Descriptive studies include case reports, cross-sectional studies, cross-sectional correlational studies and ecological studies, and analytical studies include retrospective and group studies. Non-observational studies also include laboratory studies, clinical trials, field trials, and community trials. Conclusion: With a good understanding of the types of studies, it is easy to decide which type of study is appropriate for the research. Choosing proper study design can reduce the costs of the executive process, increase the accuracy, quality of research and give more reliable results. Corrigendum at https://jhr.ssu.ac.ir/article-1-962-en.html   202 209 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/242021/07/12021/10/22022/04/19 1401/1/30 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/192022/09/192022/09/192022/09/28 1401/7/6 سجاد بهاری نیا Bahariniya MSc student of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran فرزان مددی زاده Farzan Madadizadeh Center for healthcare Data modeling, Departments of biostatistics and Epidemiology, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran الهام خالدی Elham Khaledi MSc student of biostatistics, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran فرنوش قمی Mehrnoosh Qomi MSc student of biostatistics, School of public health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran Study designs Research methodology Research Designs Experimental Designs طرح های مطالعه روش تحقیق طرح های تحقیق طرح های آزمایشی King WR, He J. 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Frequency of Cutaneous Leishmaniasis and Complete Ulcer Healing in Patients Referred to Skin Diseases and Leishmaniasis Research Center, Isfahan, Iran from 2018 to 2019 فراوانی نسبی بیماری سالک پوستی و میزان بهبودی زخم کامل در بیماران مراجعه کننده به مرکز تحقیقات بیماری های پوستی و سالک ، اصفهان ، ایران از سال 2018 تا 2019 2 1 مقدمه: ایران یکی از مهم ترین مناطق اندمیک سالک در جهان است. تا به امروز، هیچ مطالعه ای در مورد هر دو جنبه اپیدمیولوژیک و طول دوره درمان سالک انجام نشده است. مطالعه حاضر با هدف تعیین فراوانی نسبی سالک در بیماران مشکوک به ضایعات پوستی و مدت زمان بهبودی پس از درمان با رژیم های مختلف انجام گردید. روش کار: این مطالعه مقطعی بر روی بیماران مبتلا به سالک مراجعه کننده به مرکز تحقیقات بیماری‌های پوستی و سالک اصفهان طی سال‌های 1397 تا 1398 انجام گردید. اطلاعاتی مانند سن، جنس، تحصیلات، محل، اندازه ضایعه، مدت زمان درمان و میزان بهبودی ثبت شد. برای تجزیه و تحلیل داده ها از نرم افزار SPSS نسخه 20 و آزمون های chi-square, Fisher´s Exact, one Way ANOVA  با سطح معنی داری 05/ 0 <  P استفاده گردید. یافته ها: از بین 350 بیمار مشکوک ، 150 مورد مبتلابه سالک بودند ( 42/85 %) . میزان بهبودی کامل در بیماران با میانگین سنی 18/9 ± 33/88 سال بیشتر بود، اما این تفاوت ها از نظر آماری معنی دار نبود (0/077 = P). در این محدوده سنی، 34 مورد بیشتر از سایر گروه ها بود. (میزان بهبودی کامل در بیماران با سابقه مهاجرت به مناطق آندمیک بیشتر از بیماران بدون سابقه مهاجرت بود (0.81 P=) ). میزان بهبودی کامل در بیمارانی که میانگین مدت زمان درمان آنها 41/43 ± 59/03 روز بود بیشتر از سایر دوره‌های بهبودی بود (0/23 = P). نتیجه‌گیری: میزان بهبودی کامل در بزرگسالان بیشتر از سایر گروه‌ها بود. در مطالعه حاضر ثابت شد میزان بهبودی بیماران، با میانگین مدت درمان رابطه معناداری دارد.   2 Introduction: Iran is one of the most important hot spots for cutaneous leishmaniasis (CL) in the world. To date, no studies have been done on both epidemiological aspects along with the length of the treatment course of CL. This study aimed to determine the relative frequency of CL in patients with suspected skin lesions and the duration of healing after treatment with different regimens. Methods: This cross-sectional study was conducted on patients with CL referred to the skin diseases and leishmaniasis research center (SDLRC) in Isfahan during the years 2018 to 2019. Among 389 patients with suspected skin lesions, 150 cases were included with proven CL. Information such as age, sex, education, location, size of the lesion, duration of treatment, and the rate of recovery were recorded. SPSS software version 20 was used for data analysis, the chi-square, Fisher´s Exact, and one Way ANOVA tests were used with a significant level of p < 0.05. Results: Among 350 admitted cases, 150 cases were CL. positive (42.85%). The rate of complete recovery was higher in cases with an average age of 33.55 ±18.9 years, but these differences were not statistically significant (P =0.077). There was 34 cases more than the other groups in this range of age. ( The rate of complete recovery in patients with a history of migration to endemic areas was higher than in patients without a history of migration (P = 0.81)). The rate of complete recovery in patients whose means treatment duration was 59.03 ± 41.43 days was higher than other recovery periods (P = 0.23). Conclusion: The rate of complete recovery was higher in adult cases than the other groups. In this study, it was proved that the rate of recovery of patients had the significant relationship with the average duration of treatment. 210 218 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/242021/07/12021/10/22022/04/192021/01/2 1399/10/13 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/192022/09/192022/09/192022/09/282022/09/19 1401/6/28 لطیفه عبداللهی latifeh Abdellahi Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran. Iran latifeabdellahi@yahoo.com سید حسین حجازی Seyed Hossein Hejazi Skin Diseases and Leishmaniasis Research Center, Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Iran hejazih12@gmail.com نور امیرمظفری Nour Amirmozafari Iran University of Medical Sciences, School of Medicine, Microbiology Department, Tehran, Iran. Iran amirmozafari@iums.ac.ir فتاح ستوده نژاد نعمت الهی Fattah Sotoodehnejadnematalahi Department of Biology, School of Basic Science, Science and Research Branch, Islamic Azad University, Tehran, Iran. Iran sotoudehnejad@srbiau.ac.ir cutaneous leishmaniasis frequency Ulcers healing. لیشمانیوز جلدی فراوانی نسبی بهبود زخم. 1. Jaffary F, Abdellahi L, Nilforoushzaheh MA. Review of the prevalence and causes of antimony compound resistance in different societies review article. Tehran University Medical Journal TUMS Publications. 2017;75(6):399-407.##Aghaei Afshar A, Hojjat F, Yaghoobi‐Ershadi MR, Rassi Y, Akhavan AA, Gorouhi MA, Yousefi S, Hanafi‐Bojd AA. Modeling and evaluating the risk of zoonotic CL in selected areas of Kerman Province, south of Iran. Transboundary and emerging diseases. 2020 May;67(3):1271-83.##Ahmadi NA, Modiri M, Mamdohi S. First survey of cutaneous leishmaniasis in Borujerd county, western Islamic Republic of Iran. East Mediterr Health J. 2013;19:847-53. doi: 10.26719/2013.19.10.847. PubMed PMID: 24313148.##Nassif PW, DE MELLO TFP, NAVASCONI TR, Mota CA, Demarchi IG, ARISTIDES SMA, et al. Safety and efficacy of current alternatives in the topical treatment of cutaneous leishmaniasis: a systematic review. Parasitology. 2017;144(8):995.##Alten B, Maia C, Afonso MO, Campino L, Jiménez M, González E, et al. Seasonal dynamics of phlebotomine sand fly species proven vectors of Mediterranean leishmaniasis caused by Leishmania infantum. PLoS Negl Trop Dis. 2016;10:e0004458.##McGwire BS, Satoskar AR. Leishmaniasis: clinical syndrome and treatment. QJM. 2014;107(1):7-14. ##https://doi.org/10.1093/qjmed/hct116##World Health Organization. Leishmaniasis. 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/ leishmaniasis [Accessed 14 August 2019].##World Health Organization (WHO). Control of the leishmaniasis: report of a meeting of the WHO Expert Committee on the Control of Leishmaniases, Geneva, 22-26 March 2010. Geneva: World Health Organization; 2010.##Ershadi M-RY, Zahraei-Ramazani A-R, Akhavan A-A, Jalali-Zand A-R, Abdoli H, Nadim A. Rodent control operations against zoonotic cutaneous leishmaniasis in rural Iran. Annals of Saudi medicine. 2005;25(4):309-12.##Nilforoushzadeh M, Shirani-Bidabadi L, Hosseini S, Fadaei-Nobari R, Jaffary F. The epidemiology of cutaneous leishmaniasis in Isfahan province, Iran, during 2001-2011. Journal of Isfahan Medical School. 2015;32(315):2241-51.##Razavi TSV. Cutaneous leishmaniasis susceptibility mapping using multi-criteria decision-making techniques analytic hierarchy process (AHP) and analytic network process (ANP). 2018. Journal of Research in Environmental Health. 2018;3(4):276-286.##Khademvatan S, Salmanzadeh S, Foroutan-Rad M, Bigdeli S, Hedayati-Rad F, Saki J, et al. Spatial distribution and epidemiological features of cutaneous leishmaniasis in southwest of Iran. Alexandria Journal of Medicine. 2017;53(1):93-8.##Valero NN, Uriarte M. Environmental and socioeconomic risk factors associated with visceral and CL: a systematic review. Parasitology research. 2020 Feb;119(2):365-84.##Mohammadi J, Faramarzi H, Ameri A, Bakhtiari H. Epidemiological Study of CL in Marvdasht, Iran, 2017. Armaghane Danesh. 2018;23(4):488-98.##de Souza RAF, Andreoli RV, Kayano MT, Carvalho AL (2015) American CL cases in the Metropolitan region of Manaus, Brazil: association with climate variables over time. Geospatial Health 10:40-47.##Barati H, Barati M, Lotfi MH. Epidemiological study of cutaneous leishmaniasis in Khatam, Yazd province, 2004-2013. Paramedical Sciences and Military Health. 2015;10(2):1-5.##Jaffary F, Nilforoushzadeh MA, Siadat A, Haftbaradaran E, Ansari N, Ahmadi E. A comparison between the effects of glucantime, topical trichloroacetic acid 50% plus glucantime, and fractional carbon dioxide laser plus glucantime on cutaneous leishmaniasis lesions. Dermatology research and practice. 2016;2016.##Nejati J, Mojadam M, Hanafi Bojd AA, Keyhani A, Habibi Nodeh F. An epidemiological study of cutaneous leishmaniasis in Andimeshk (2005-2010). scientific journal of ilam university of medical sciences. 2014;21(7):94-101.##Piroozi B, Moradi G, Alinia C, Mohamadi P, Gouya MM, Nabavi M, Gharachorloo F, ERFAN MB, Shirzadi MR. Incidence, burden, and trend of CL over four decades in Iran. Iranian Journal of Public Health. 2019 Mar 4;48(Supple 1):28-35.##Ayaz MM, Nazir MM, Ullah N, Zaman A, Akbar A, Zeeshan M, Hussain Z, Naz S, Zheng Y, Javed A, Lindsay DS. CL in the Metropolitan City of Multan, Pakistan, a neglected tropical disease. Journal of medical entomology. 2018 Jun 28;55(4):1040-2.##Jafarnejad A, Jamshidi F, Deghan A. Evaluation of CL in the city of Lamerd in2004-2014. Medical Journal of Mashhad University of Medical Sciences. 2017;60(1):376-82.##Roghani AR, Yasemi MR, Jalilian M, Abdi J, Rezai Tavirani K. Epidemiology of CL in Ilam province. Research in Medicine. 2013;36(5):50-3.##Ghohe HP, Pagheh AS, Fakhar M, Tavakoli G, Nazar E, Kiani M. Molecular identification of Leishmania species isolated from patients with cutaneous leishmaniasis in Pakdasht district, Iran, 2009-2014. J Mazandaran Univ Med Sci. 2016;26(143):216-21.##Alkhawajah A, Larbi E, Al-Gindan Y, Abahussein A, Jain S. Treatment of cutaneous leishmaniasis with antimony: intramuscular versus intralesional administration. Annals of Tropical Medicine & Parasitology. 1997;91(8):899-905.##Sadeghian G, Shirani BL, Ziaei H, Hejazi S, Zolfaghari BA. Evaluation of Glucantime activity in cutaneous leishmaniasis lesion contaminated with secondary bacterial infection compared with non-infected lesions. Annals of Millitary and Health Science Research. 2010;8( 1):6-10.##Nilforoushzadeh MA, Jaffary F, Derakhshan R, Haftbaradaran E. Comparison between intralesional meglumine antimoniate and combination of trichloroacetic acid 50% and intralesional meglumine antimoniate in the treatment of acute cutaneous leishmaniasis: a randomized clinical trial. Journal of Skin and Stem Cell. 2014;1(1).##H M, M G. Evaluation of epidemiologic causes in cutaneous leishmaniasis patients referred to the health care center of Mashhad Moghadam province from 2008 to 2013. . Journal of Medical science. 2017;22(7):1-3.##Lotfi M.H., Noori S., Taj Firouze A.A., Fallahzadeh H., Ayatollahi J. Epidemiological Study of an Outbreak of CL in Five Endemic Foci, Yazd Province, Iran March 2015-March 2016. Journal of Community Health Research 2017; 6(2): 77-84.##1. Jaffary F, Abdellahi L, Nilforoushzaheh MA. Review of the prevalence and causes of antimony compound resistance in different societies review article. Tehran University Medical Journal TUMS Publications. 2017;75(6):399-407.##Aghaei Afshar A, Hojjat F, Yaghoobi‐Ershadi MR, Rassi Y, Akhavan AA, Gorouhi MA, Yousefi S, Hanafi‐Bojd AA. Modeling and evaluating the risk of zoonotic CL in selected areas of Kerman Province, south of Iran. Transboundary and emerging diseases. 2020 May;67(3):1271-83.##Ahmadi NA, Modiri M, Mamdohi S. First survey of cutaneous leishmaniasis in Borujerd county, western Islamic Republic of Iran. East Mediterr Health J. 2013;19:847-53. doi: 10.26719/2013.19.10.847. PubMed PMID: 24313148.##Nassif PW, DE MELLO TFP, NAVASCONI TR, Mota CA, Demarchi IG, ARISTIDES SMA, et al. Safety and efficacy of current alternatives in the topical treatment of cutaneous leishmaniasis: a systematic review. Parasitology. 2017;144(8):995.##Alten B, Maia C, Afonso MO, Campino L, Jiménez M, González E, et al. Seasonal dynamics of phlebotomine sand fly species proven vectors of Mediterranean leishmaniasis caused by Leishmania infantum. PLoS Negl Trop Dis. 2016;10:e0004458.##McGwire BS, Satoskar AR. Leishmaniasis: clinical syndrome and treatment. QJM. 2014;107(1):7-14. ##https://doi.org/10.1093/qjmed/hct116##World Health Organization. Leishmaniasis. 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/ leishmaniasis [Accessed 14 August 2019].##World Health Organization (WHO). Control of the leishmaniasis: report of a meeting of the WHO Expert Committee on the Control of Leishmaniases, Geneva, 22-26 March 2010. Geneva: World Health Organization; 2010.##Ershadi M-RY, Zahraei-Ramazani A-R, Akhavan A-A, Jalali-Zand A-R, Abdoli H, Nadim A. Rodent control operations against zoonotic cutaneous leishmaniasis in rural Iran. Annals of Saudi medicine. 2005;25(4):309-12.##Nilforoushzadeh M, Shirani-Bidabadi L, Hosseini S, Fadaei-Nobari R, Jaffary F. The epidemiology of cutaneous leishmaniasis in Isfahan province, Iran, during 2001-2011. Journal of Isfahan Medical School. 2015;32(315):2241-51.##Razavi TSV. Cutaneous leishmaniasis susceptibility mapping using multi-criteria decision-making techniques analytic hierarchy process (AHP) and analytic network process (ANP). 2018. Journal of Research in Environmental Health. 2018;3(4):276-286.##Khademvatan S, Salmanzadeh S, Foroutan-Rad M, Bigdeli S, Hedayati-Rad F, Saki J, et al. Spatial distribution and epidemiological features of cutaneous leishmaniasis in southwest of Iran. Alexandria Journal of Medicine. 2017;53(1):93-8.##Valero NN, Uriarte M. Environmental and socioeconomic risk factors associated with visceral and CL: a systematic review. Parasitology research. 2020 Feb;119(2):365-84.##Mohammadi J, Faramarzi H, Ameri A, Bakhtiari H. Epidemiological Study of CL in Marvdasht, Iran, 2017. Armaghane Danesh. 2018;23(4):488-98.##de Souza RAF, Andreoli RV, Kayano MT, Carvalho AL (2015) American CL cases in the Metropolitan region of Manaus, Brazil: association with climate variables over time. Geospatial Health 10:40-47.##Barati H, Barati M, Lotfi MH. Epidemiological study of cutaneous leishmaniasis in Khatam, Yazd province, 2004-2013. Paramedical Sciences and Military Health. 2015;10(2):1-5.##Jaffary F, Nilforoushzadeh MA, Siadat A, Haftbaradaran E, Ansari N, Ahmadi E. A comparison between the effects of glucantime, topical trichloroacetic acid 50% plus glucantime, and fractional carbon dioxide laser plus glucantime on cutaneous leishmaniasis lesions. Dermatology research and practice. 2016;2016.##Nejati J, Mojadam M, Hanafi Bojd AA, Keyhani A, Habibi Nodeh F. An epidemiological study of cutaneous leishmaniasis in Andimeshk (2005-2010). scientific journal of ilam university of medical sciences. 2014;21(7):94-101.##Piroozi B, Moradi G, Alinia C, Mohamadi P, Gouya MM, Nabavi M, Gharachorloo F, ERFAN MB, Shirzadi MR. Incidence, burden, and trend of CL over four decades in Iran. Iranian Journal of Public Health. 2019 Mar 4;48(Supple 1):28-35.##Ayaz MM, Nazir MM, Ullah N, Zaman A, Akbar A, Zeeshan M, Hussain Z, Naz S, Zheng Y, Javed A, Lindsay DS. CL in the Metropolitan City of Multan, Pakistan, a neglected tropical disease. Journal of medical entomology. 2018 Jun 28;55(4):1040-2.##Jafarnejad A, Jamshidi F, Deghan A. Evaluation of CL in the city of Lamerd in2004-2014. Medical Journal of Mashhad University of Medical Sciences. 2017;60(1):376-82.##Roghani AR, Yasemi MR, Jalilian M, Abdi J, Rezai Tavirani K. Epidemiology of CL in Ilam province. Research in Medicine. 2013;36(5):50-3.##Ghohe HP, Pagheh AS, Fakhar M, Tavakoli G, Nazar E, Kiani M. Molecular identification of Leishmania species isolated from patients with cutaneous leishmaniasis in Pakdasht district, Iran, 2009-2014. J Mazandaran Univ Med Sci. 2016;26(143):216-21.##Alkhawajah A, Larbi E, Al-Gindan Y, Abahussein A, Jain S. Treatment of cutaneous leishmaniasis with antimony: intramuscular versus intralesional administration. Annals of Tropical Medicine & Parasitology. 1997;91(8):899-905.##Sadeghian G, Shirani BL, Ziaei H, Hejazi S, Zolfaghari BA. Evaluation of Glucantime activity in cutaneous leishmaniasis lesion contaminated with secondary bacterial infection compared with non-infected lesions. Annals of Millitary and Health Science Research. 2010;8( 1):6-10.##Nilforoushzadeh MA, Jaffary F, Derakhshan R, Haftbaradaran E. Comparison between intralesional meglumine antimoniate and combination of trichloroacetic acid 50% and intralesional meglumine antimoniate in the treatment of acute cutaneous leishmaniasis: a randomized clinical trial. Journal of Skin and Stem Cell. 2014;1(1).##H M, M G. Evaluation of epidemiologic causes in cutaneous leishmaniasis patients referred to the health care center of Mashhad Moghadam province from 2008 to 2013. . Journal of Medical science. 2017;22(7):1-3.##Lotfi M.H., Noori S., Taj Firouze A.A., Fallahzadeh H., Ayatollahi J. Epidemiological Study of an Outbreak of CL in Five Endemic Foci, Yazd Province, Iran March 2015-March 2016. Journal of Community Health Research 2017; 6(2): 77-84.## ##

The Survey of Presenting New Health Services to Middle-aged Population in Health Transformation Plan: a Qualitative Study بررسی ارائه خدمات نوین سلامت به جمعیت میانسال درطرح تحول سلامت : یک مطالعه کیفی 2 1 مقدمه: ارائه خدمات سلامت به افراد میانسال با توجه به فراوانی ونقش آن در بهره وری و تأثیر رفتارهای بهداشتی این گروه سنی بر ابعاد مختلف سلامت خانواده از اهمیت ویژه ای برخورداراست. هدف از این مطالعه ارزیابی ارائه خدمات سلامت میانسالان می باشد. روش کار: این مطالعه کیفی در سال 1396 در دانشگاه علوم پزشکی شهید صدوقی انجام شد. 62 نفر (متخصص، پزشک عمومی و کارشناس) ارائه دهنده خدمات سلامت در مراکز جامع سلامت شهرهای بالای 20000 نفر به روش نمونه گیری هدفمند بر اساس موارد انتخاب شدند. مصاحبه‌ها با روش فردی نیمه ساختاریافته انجام شد. سوالاتی در حوزه های زیر مطرح شد: نقاط ضعف و قوت و توصیه هایی در مورد نحوه ارائه خدمات و محتوای آن. یافته‌ها: بر اساس نتایج، 15 نقطه ضعف و 5 نقطه قوت در روش ارائه خدمات، 8 نقطه قوت و 7 نقطه ضعف در مورد محتوای بسته‌های خدمات سلامت و 17 مکانیسم پیشنهادی در مورد بهبود ارائه خدمات و 11 مورد توصیه شده است. مکانیزم هایی در خصوص بهبود محتوای بسته ها استخراج شد. مهمترین نقاط ضعف در ارائه خدمات به شرح زیر بود: عدم رعایت سیستم ارجاع، عدم پوشش بیمه ای برخی خدمات، مشکلات سیستم یکپارچه پرونده سلامت. نقاط ضعف بسته های خدمات سلامت برای افراد میانسال عبارت بود از: عدم پیش بینی بسته های خدماتی سطوح 2 و 3، تکرار سوالات در ارزشیابی و کم توجهی به سلامت اجتماعی و طب سنتی. نتیجه گیری: تمرکز بر بهبود ارائه خدمات و محتویات بسته های خدمات نوین سلامت با بهره گیری از توصیه های ارائه شده بر اساس دیدگاه تخصصی ارائه دهندگان خدمات سلامت به ارتقای سطح سلامت در این گروه سنی و افزایش کارایی در افراد میانسال کمک می کند . 2 Introduction: Providing health services to middle-aged people is of special importance due to the large population, productivity, and the impact of health behaviors of this age group on various aspects of family health. The purpose of this study is to evaluate the provision of middle-aged health services. Methods: This was a qualitative   study performed in 2017 in   comprehensive health centers of Yazd city. Central part of Iran. Sixty two individuals (specialists, general practitioners and experts) providing health services in comprehensive health centers were selected through targeted sampling . Interviews were done with a semi-structured individualized method. Questions were asked in the following domains: weaknesses and strengths and recommendations about the method of providing services and its content. Results: According to the results, 15 weak points and 5 strong points in the method of providing services, and 8 strong points and 7 weak points about the content of health service packages and 17 recommended mechanisms about the improvement of the providing services and 11 recommended mechanisms about improvement of the content of packages were extracted. The main weak points in providing services were such as not observing referring system, lack of insurance coverage for some services, problems in Integrated Health Record System. The weak points of the packages of health services for middle-aged people were as lack of predicting the service packages for levels 2 and 3, repetition of the questions in evaluation, and low attention to social health and traditional medicine. Conclusion: Concentrating on the improvement of the service providing and the contents of the packages of new health services by utilizing presented recommendations according to professional viewpoints of health service providers helps improve health level in this age group and increase the efficiency in the middle-aged people. 219 231 2022/01/192022/07/102021/02/192022/06/212020/10/92021/05/242021/07/12021/10/22022/04/192021/01/22020/05/2 1399/2/13 2022/09/192022/09/202022/09/192022/09/192022/09/192022/09/192022/09/192022/09/192022/09/282022/09/192022/09/19 1401/6/28 محمد رضا اعلایی اردکانی Mohammad Reza Aalaei Ardakani Department of Health Services Management, Islamic Azad University, Shiraz, Branch, Shiraz, Iran. Iran سمیه حسام Somayeh Hessam Department of Health Services Management, South Tehran Branch, Islamic Azad University, Tehran, Iran Iran somayehh59@yahoo.com محمود وکیلی Mahmoud Vakili Social Medicine Specialist, Associate Professor, Department of Social Medicine, Health Monitoring Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Iran New health services program middle age urban comprehensive health centers اصلاح مراقبت‌های بهداشتی مراقبت‌های بهداشتی اولیه میانسالی سیستم یکپارچه پرونده سلامت 1. H AS. Changes in Global Patterns of Health and Disease: Demographic Transition and Transition Epidemiological. Journal of Medical History. 2012;4(11):11-43.##2. Madadizadeh F, Vali L, Khalilabad Th, Asar Me. Work-related musculoskeletal disorders among administrative employees of Kerman university of medical sciences. International Journal of Occupational Hygiene. 2016;8(2):78-84.##3. Office MAH. Executive Guide for Men and Women Health Services. 2012. p. 1-136.##4. Abedi G, Kontai S, Amir S, Marvi A, Mazidi S, Abedini E, et al. SWOT Analysis of Health Reform Plan on Healthcare Sector from the Stakeholder Perspective. Journal of Mazandaran University of Medical Sciences. 2018;28(166):199-212.##5. Menachemi N, Collum TH. Benefits and drawbacks of electronic health record systems. Risk management and healthcare policy. 2011;4:47.##6. Heidari F, Mohammadkhan KS, Vanaki Z, KAZEM NA. A Survey the effect of planned program of health promotion on stress management in middle-aged women. 2011##7. Davies P, Carrin G. Risk-pooling-necessary but not sufficient? Bulletin-World Health Organization. 2001;79(7):587-587.##8. Babashahy S, Akbari SA, Rashidian A, OLYAEE MA. Payments of physicians employed in public and private hospitals after modification of surgical and invasive services tariffs. 2012.##9. Organization WH. 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