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Aging causes the reduction in physical and physiological strength and an increase in the odds of affliction with chronic physical and mental diseases ultimately affecting the quality of life (QoL). So far, several primary studies have been conducted on the impact of religious-spiritual education and care on the QoL of the elderly. However, to the best of our knowledge, a study that compiles and represents these findings in a published paper is lacking. Therefore, the current study conducted a systematic review and meta-analysis to investigate the effect of religious-spiritual education and care on the QoL of the elderly population. To access studies related to the aim of the study, SID, MagIran, IranMedex, IranDoc, Embase, PubMed, Scopus, Web of Science, and Google Scholar databases were searched. The search was done using relevant and validated keywords with MeSH/Emtree without time limitations until December 2021. The qualitative appraisal of the papers was done using the JBI checklist. To estimate the heterogeneity of studies, I2 index was used, and to combine the data and carry out a meta-analysis, Random Effects model was used. In the primary research, 1065 studies were found. The omission of the redundant cases led to a total number of 12 papers with a sample size of 317 in the intervention group and 321 in the control to be included in the meta-analysis. After the intervention, the mean score of QoL showed a significant increase by 1.42 ± 0.31 with a Confidence Interval of 95% (P<0.001). Meta-regression results showed that the increase in the year of conducting the study, and the number of intervention sessions, that the standardized mean difference had a decreasing trend, and that with the increase in the average age of the elderly, there was a rising trend (P<0.001). Therefore, it seems that the application of religious-spiritual education and care could be part of a program to improve the QoL of the elderly. [ABSTRACT FROM AUTHOR]

This paper aimed to identify and evaluate the environmental factors that influence human health in Hashtpar. The town locates in the coastal plain of northern Iran and has an area of 1378 ha and a population of about 53,000 people. Fourteen indicators were included in the dataset and the data was collected in 34 data collection points through the evaluation of at least 5 experienced people or by calculations using Geographical Information System (GIS) and related shape files. First, it is used a descriptive and qualitative method and statistical parameters to analyze each determinant of health, regardless of its spatial differences, then the data entered into GIS to produce zoning maps using the Kriging interpolation tool. Findings show that generally, healthy environment indicators are higher than average level and the indicators are in better condition in central parts of the town than in its outskirts. [ABSTRACT FROM AUTHOR]

Objective: Ambiguity arises when more than one meaning and concept can be understood from a word, phrase or sentence. Since it seems necessary to understand this by the information retrieval system in order to increase the accuracy of the information retrieval system and increase the retrieval of related resources, the present research aims to identify the ambiguous and disambiguating factors through a systematic review of studies. It has been done in Iran. Methodology: The research method is applied in terms of purpose, in terms of approach, qualitative and in terms of information gathering method, systematic review using PRISMA standard. The statistical population includes journal articles, conferences, and dissertations indexed in Iranian databases, including: Magiran, Noormags, Shiraz Regional Center for Science and Technology, Civilica, and Academic Jihad Center (SID) and Scientific Information of Iran (treasure). 175 scientific sources and 138 scientific sources were excluded based on the output criteria and 37 scientific sources were selected based on the input criteria. Input criteria: focusing on the studies conducted on the subject of ambiguity and disambiguation, in the fields of linguistics, information technology, artificial intelligence, computer and information science, and epistemology, scientific sources published in Persian language, without publication time limits, review articles, Scientific research, master's and doctorate theses and national and international conference papers held inside Iran. Output criteria: studies carried out except for ambiguity and disambiguation, non-Persian language scientific sources, books, reports, editorials, abstract writings and short articles (less than 5 pages). Findings: The results show that the main topic of interest in this research was "ambiguity of the meaning of words" (53%) and "disambiguation of words" (44%) and the least topics of ambiguity in machine translation (21%) and disambiguation through ontology (5 percent). The most research methods with the "neural network" approach (22 percent) and the least research methods used were content analysis, methodology and machine learning (5 percent), the largest number of sources related to the articles of conferences and national conferences and was international (48 percent) and the least were master theses and doctoral dissertations (5 percent). Computer and linguistics fields (27 percent) have had the most scientific productions in this regard, and information science and epistemology fields (9 percent) have had the lowest productions. Conclusion: The present research is considered innovative in the sense that it deals with the issue of ambiguity and disambiguation in information retrieval with a systematic review approach. Its findings indicate that most Iranian researches were focused on disambiguation, which were mostly presented in national and international conferences and meetings. The topic of ambiguity and disambiguation is more important in the fields of computer science and linguistics, and the fields of information science and epistemology have not dealt with it. The semantic ambiguity of words and, by nature, the disambiguation of words has been the concern of format in Iranian researches. Ontology as a new approach to disambiguation has received less attention. [ABSTRACT FROM AUTHOR]

Widespread public vaccination is one of the effective mechanisms to ensure the health and prevent deaths in societies. The coronavirus disease 2019 (COVID-19) vaccine is a stark instance in this regard. Vaccine development is a complex process requiring firm-level capabilities, various infrastructures, long-term planning, and stable and efficient policies. Due to the global demand for vaccines during the pandemic, the national capability to produce vaccines is critical. To this end, the current paper investigates influential factors, at the firm- and policylevel, in the COVID-19 vaccine development process in Iran. By adopting a qualitative research method and conducting 17 semi-structured interviews and analyzing policy documents, news, and reports, we extracted internal and external factors affecting the success and failure of a vaccine development project. We also discuss the characteristics of the vaccine ecosystem and the gradual maturity of policies. This paper draws lessons for vaccine development in developing countries at both firm and policy levels. [ABSTRACT FROM AUTHOR]

Background & Aims: Education is the main factor of economic growth in a country, and the curriculum is the heart of any education system. As civilization makes the transition from the industrial era to one of sustainability, educational leaders around the globe ought to implement a learning system that prepares young people for life in a unified society. Every country that has experienced high growth for a long time makes great efforts to educate its nation and reinforce its human capital. In contrast, there is considerable evidence that many developing countries are not doing enough. Education has a legal claim on public funds for at least two obvious reasons. First, the social returns are likely to be greater than the private returns. Second, some families with low incomes and credit constraints may not be able to invest as much in education as they would like, even if a higher income is guaranteed for a diploma or university degree in the case of a successful job search. Therefore, public spending on education is established based on impartial opportunity and efficiency. This paper provides a starting point to explore what skills and concepts students should be studying to lead the future. The curriculum model provides an explicit outline of some of the competencies that will likely be required for whatever world scenario emerges. This study focuses on the key roles of education and its relation to economic development as well as the curriculum as a core part of the entire educational drive of nations. In particular, the aim of the present study was to study the goals and contents of the high school curriculum of Group 7 countries and Iran with a focus on the differences and similarities of cognitive and metacognitive skills, which were compared with Iran in order to reach an appropriate model. Methods: The method used in this study is qualitative, seeking to understand a research phenomenon in its usual environment that leads to a deep understanding of the studied phenomenon. In particular, this research is a documentary analytical research with a comparative approach. The statistical population of the research in the first study, which had a comparative approach, includes all documents, printed and electronic texts regarding the curriculum elements of the selected countries. It includes all articles, websites, studies, and research related to the research topic. In the Delphi method, the presence of experts and experts in the subject is emphasized. Statistical sample: In this research, in the first part, after searching the official portals of the countries and databases, all the documents that contain the content of the curriculum elements of these countries have been found. Data analysis in qualitative research is the process of classifying, describing, and combining data. In this section, after collecting the information and data, the contents were separated into 4 components: goal, content, method, and evaluation for each country. Then it was analyzed based on John Stuart Mill's agreement and difference model. The analysis in the quantitative part includes Kendall's coefficient and confirmatory factor analysis with the help of SPSS22 and Amos Graphics version 23 software. Meanwhile, Maxqda18 software was used in the qualitative part and model extraction. All documents were translated by translators from IACTI (Iranian Certified Translators and Interpreters). It must be acknowledged that the process of translating the documents was complicated and difficult due to the different languages and finding the appropriate equivalent in Persian. 212 participants, including secondary school teachers, university professors, and Ph.D. students in the fields of curriculum and education management helped to confirm and categorize the collected information. In the next step, the Delphi method was used to obtain the opinions of experts and reach a consensus about the studied components. With a 5-point Likert style scale 80% agreement was obtained, which was regarded as attaining a minimum acceptable interrater agreement. Results: This study was motivated by doubts that have been raised about the role of education and human capital in economic development. These doubts come from a variety of vantage points ranging from whether the research has correctly identified the impact of education to whether other institutional aspects of countries might be more important. They also encompass concerns about whether or not we really know how to change educational outcomes, particularly in developing countries. The eight studied countries were divided into two groups for comparison: (a) Group of Seven, and (b) Iran. The objectives and content included in the curricula of these countries were identified, and then similarities and differences between these two groups were analyzed. The results show the importance of both minimal and high-level skills, the complementarity of skills and the quality of economic institutions, and the robustness of the relationship between skills and growth. International comparisons incorporating expanded data on cognitive skills reveal much larger skill deficits in developing countries than generally derived from just school enrollment and attainment. The magnitude of change needed makes clear that closing the economic gap with developed countries will require major structural changes in schooling institutions. Moreover, the results of this research showed that the goals and content of the curriculum of these countries often emphasize the areas of work and employment and are somehow economy-oriented. In Iran, there is not much emphasis on these areas in Iran. Although the principles and teachings of Islam pay attention to work, there is a lack of attention to this issue in the goals and content of the curriculum. It is suggested that there is an emergency need to review the national curriculum in Iran. Taking help from religious foundations in this field, such as paying attention to work and effort in Islam, avoiding laziness, and contentment, paying attention to halal earning and sustenance, etc., is very beneficial and enlightening. Using the fundamentals of Islam only in prohibitions and outward criticisms and only paying attention to prayer and fasting not only makes students evasive but also limits the main mission of religion which enlightens the path of people's lives and can open a way in their social and economic life. Pointing to the fact that the longest verse of the Holy Quran is in the field of economic transactions is one of the examples of the importance of the field of economics in Islam and proof of this matter. The lack of economic attention and cultivating students’ cognitive as well as metacognitive is felt in terms of preparing people for the future, after graduating from secondary education. It seems that it is better for the planners to update and modify the secondary school curriculum in line with economic development and changes in psychological knowledge. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to explore Iranian women's life stories living with compulsive sexual behaviour. Data were collected between 2014 and 2016 in two cities. Forty‐four semi‐structured interviews were conducted by using theoretical sampling and constant comparative analysis. Four thematic categories were constructed from the data, including "scars left on the spirit and mind,"; "bizarre beliefs regarding sexuality and gender,"; "compensation for emptiness and the loss,"; and "difficulty in emotional regulation." This paper shows how abusive patterns of relationships in childhood could lead to sexual compulsivity. The paper results can direct our attention to the importance of health and social care and training to recognise abusive situations and support these children. [ABSTRACT FROM AUTHOR]

Background & Aims: The underlying factors of human behavior have been the subject of research for centuries, and the concept of happiness has generally been proposed as an answer to this question. The search for happiness is like every person. In recent years, intense work speed, working conditions, stress, anxiety, and technological advances have brought the concept of happiness to the fore. Therefore, the phenomenon of being happy, which is needed due to negative reasons arising today, has brought many questions about the definition and nature of happiness, its determinants, and whether it exists. Positive psychology, which focuses on the positive aspects of people, states that a person should actualize himself at the highest level. Today, football has become a global sport played by people in almost every corner of the world. This game attracts millions of people through its activities as players, coaches, referees, fans, volunteers, and supporters. Also recently, football has been identified as a driver with economic, social, and political influence for many stakeholders. So multinational companies invest billions of dollars in the field of financial support. Also, from childhood, players and teenagers in football schools choose their favorite football models and play on the football fields by imitating them. Football in developed countries has become a revenue-generating industry, and sports managers are looking for solutions that can make the best use of the potential around them and achieve their sports and economic goals in the shadow of that. In such a situation, managers are successful in creating better conditions for themselves by diversifying their work environment. Nowadays, most countries have realized that diversifying services and taking advantage of their direct and indirect benefits are not possible without proper planning and policies, and other organizations and companies need to formulate goals, strategies, and operational planning. It is so that, while being aware of the direction of movement, he can avoid any reworking, going astray, and wasting his physical financial, and informational resources. Currently, football schools are in trouble with their mushroom-like growth in terms of facilities, or they have drawn a goal other than the training and development of football talents, which if it were otherwise, even now, despite the many years of activity of these schools, the team We had strong players in the club and national level. Although some steps have been taken in this direction in recent years, it is not enough, and more attention should be paid to this matter. Perhaps a suitable solution is to identify ways to develop happiness and joy in football schools. By researching this and compiling it, football schools can play their crucial role in the sport and football of the country in the best way and without a doubt take their rightful place in developing talents. And its durability is getting closer every day; therefore, in this research, an attempt is made to investigate the effect of the factors affecting the vitality and vitality by relying on the diversification of football school services. Methods: The approach of the current research is a combination (of quantitative and qualitative). The statistical population of the qualitative part includes 17 sports management experts and physical training managers and coaches of the country's football leagues, and the statistical population of the quantitative part includes all the visitors to football schools in Mashhad, whose number was about 3000 people. The number of statistical samples in the qualitative section was 17 experts and in the quantitative section, the number was 306. The methods of collecting information are different in different stages. a) Collecting information and identifying the factors in the phase of identifying and studying related articles and books and interviewing experts, then according to the above question, there is a need to choose a specific criterion for including or not including the articles and works are done. To ensure that the research is well-formed. These criteria are necessary because as filters, they eliminate incorrect and irrelevant information. For this purpose, for a study to be considered in the systematic review of this research, it must first be a scientific article published in a university journal that has a scientific review, in addition to the fact that it must have been published between 2010 and 2020. In addition, it should be taken into consideration, whether it is in an operational method or in a conceptual way, it affects the goals of the research (study) since concepts and ideas in management progress and develop very quickly. This is the reason why articles older than fourteen years are not recognized as suitable because they can cause problems and distort the results. Of course, it should be noted that in addition to the articles selected based on the above criteria, some articles in lower-ranked journals and even articles presented at conferences have been considered to have more comprehensive access. To the literature related to this field. Papers were searched in Google Scholar, Springer, and ScienceDirect databases. To analyze the data, Lisrel software was used. Results: The results showed that the number of 34 open codes and 5 core codes (the existence of basic standards, safe physical facilities, service quality, having a written program and experienced trainers, and having a talent search program) are among the factors affecting vitality and vitality based on diversity. It is part of the services of football schools. Conclusion: In general, it can be said that by diversifying the services of football schools, it is possible to create a higher level of freshness and vitality in those who refer to football schools, which can improve the reputation of a football school and earn and increase Help the health level of people in the society. Undoubtedly, creating a happy and cheerful environment through the services of football schools in a good way and creating trust and understanding among families and every football school is of particular importance. On the other hand, this leads to branding and creating a brand image with the customer as a tool to create loyalty in customers and gain profitability as well as the sustainability of the organization. If we can design a good brand name and adhere to the commitments that we claim in the brand name, we can guarantee their loyalty to our future services. Because the football school has a set of organizational facilities it is profitable to enter into other businesses using those resources, and the branding of the football school means searching and entering into businesses that are well with The company's facilities are matched and the long-term effect within the football school is positive in terms of profitability. [ABSTRACT FROM AUTHOR]

Authenticity is a fundamental concept in the conservation of architectural and urban heritage. It has a very close relationship with cultural heritage values as well as being a conveyor of such values. This paper identifies the factors of recognition in relation to this concept by qualitative research methods and content analysis of international documents and theories. It also sets out the main research questions to be considered in relation to the concept of authenticity in the conservation and development of the Jameh Mosque complex in the city of Urmia, West Azerbaijan province, north-western Iran. Based on this premise, the paper evaluates the conservation and development of the Mosque at different periods, where the evaluation indicate that the measures of 1988 failed to consider the notion of authenticity. Then, establishing the correlation between the explanatory factors of authenticity and the actions taken in 1988 the impact of development is assessed by quantitative research methods. The result is that from the point of view of the specialists and the local people, socio-cultural factor has been neglected to a greater degree than other factors; so much so that the 'socio-cultural', 'historical-evidential' and 'aesthetic' values have been neglected in a downward trend. The findings are confirmed for both groups of local people and specialists. [ABSTRACT FROM AUTHOR]

Background: Neurofibromatosis type I (NF1) is a rare genetic disorder, associated with some physical symptoms including spots and tiny bumps on the skin, and internal organ involvement. People suffering from neurofibromatosis face various challenges in their daily lives. However, there is little understanding on how patients deal with neurofibromatosis. This study aimed to investigate the life challenges of patients with NF1. Methods: This qualitative study was performed by implementing a grounded theory with the cooperation of the Society for Neurofibromatosis Patients over the course of 15 months in 2019 across 4 provinces in Iran. Twenty‐four patients with NF1 were interviewed. An analysis was performed using the constant comparative method. Findings: The results of the analyses indicated that the major concern of the NF1 patients was feelings of failure and falling behind in life. In the face of failure in life in such a context, patients used the main strategy of "unsuccessful struggle to escape" the disease and its complications, which was represented itself in the forms of 'hopelessness and impatience', 'suicidal thoughts and unsuccessful suicide attempts', 'isolation and seclusion', 'expressing complaints and grievances to God', 'hiding the disease' and 'hopelessness and refusing to receive care'. The implementation of such strategies helped patients reduce tension and achieve a temporary, though vulnerable and fragile, sense of relief and peace. Conclusion: Given an unfavourable life condition, NF1 patients turned to a harmful passive strategy in the face of the challenges posed by the disease. Patient or Public Contribution: Public contributors were active partners throughout, and co‐authored the paper. [ABSTRACT FROM AUTHOR]

Background: Clinical trials play an important role in expanding the knowledge of diabetes prevention, diagnosis, and treatment, and data management is one of the main issues in clinical trials. Lack of appropriate planning for data management in clinical trials may negatively influence achieving the desired results. The aim of this study was to explore data management processes in diabetes clinical trials in three research institutes in Iran. Method: This was a qualitative study conducted in 2019. In this study, data were collected through in-depth semi-structured interviews with 16 researchers in three endocrinology and metabolism research institutes. To analyze data, the method of thematic analysis was used. Results: The five themes that emerged from data analysis included (1) clinical trial data collection, (2) technologies used in data management, (3) data security and confidentiality management, (4) data quality management, and (5) data management standards. In general, the findings indicated that no clear and standard process was used for data management in diabetes clinical trials, and each research center executed its own methods and processes. Conclusion: According to the results, the common methods of data management in diabetes clinical trials included a set of paper-based processes. It seems that using information technology can help facilitate data management processes in a variety of clinical trials, including diabetes clinical trials. [ABSTRACT FROM AUTHOR]

Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses' experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses' experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman's techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: "threat to patient safety" and "Care breakdown". Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care. [ABSTRACT FROM AUTHOR]

With an increasing number of different materials, choosing the best one has become an arduous task. The vast domain of alternatives and decision criteria has led to the complexity of decision making in the conceptual phase for designers. On the other hand, due to the importance of environmental and energy concerns, considering the sustainability principles through the decision process is significantly important. Although sustainable material selection as a strategy leads to some general and main assessment criteria, identification of sub-criteria not only depends on general criteria but also pertains to the specific type of elements in buildings. Interior walls are one of those elements in construction with a complex decision making process due to their great variety of types and features. This paper aims to provide a sustainable multi-criteria decision making framework for choosing the proper interior walls in buildings. A qualitative research method using literature review, unstructured interviews and questionnaires was adopted to achieve the aims of this research. The initial data, including the criteria and sub-criteria, were collected through literature review. A framework consisting of four main components related to environmental, financial, social and technical aspects was finally developed and validated through unstructured interviews held with 23 experts in the construction industry in Iran. By dividing the main criteria into sub-criteria, in total, 23 sub-criteria were identified; to calculate their weight, questionnaires were distributed among 143 experts in the construction industry in Tehran and the analytic hierarchy process method was applied. High-rise residential buildings in Tehran were selected as a case to apply the framework, and finally the results are discussed. [ABSTRACT FROM AUTHOR]

When a preterm neonate is born and needs to be taken care of in the neonatal intensive care unit (NICU), the mother experiences a different process of mothering. A grounded theory study was conducted to explore the maternal role attainment in mothers of preterm infants. The authors of this paper report the most prominent experience of Iranian mothers with preterm neonates during their stay in the NICU that emerged as part of the process of maternal role attainment. Data were collected through in-depth semi-structured interviews with mothers in the NICU. We found four categories as emerged from experiences that formed the concept of "emotional disorganization". We argue that these findings can help caregivers and nurses to provide sensitive and supportive care to mothers of preterm neonates. [ABSTRACT FROM AUTHOR]

Subjective well-being (SWB) has been widely found to have a profound impact on the individual, yet the process of its occurrence in public organizations remains unexplored. So the primary purpose of this paper is to explore the determining factors affecting the process of employee's subjective well-being in public organizations using mixed methods research. Qualitative analysis using the grounded theory methodology reveals the effective factors that affect the process of employee's subjective well-being in public organizations. Quantitative hypotheses are then developed based on a qualitative investigation. Survey data were collected from employees of public organizations in one of the provinces of Iran. Analysis of Moment Structure is used for data analysis. The results of the research revealed that both individual and organizational factors (as causal factors) influence the employees' subjective well-being process (life satisfaction and positive affect). This phenomenon leads to the use of strategies which are affected by intervening and contextual factors. The consequences of this process are to change the attitude and behavior of individuals and improve the efficiency and effectiveness of the organization. This paper is among the first known to examine subjective well-being in public organizations using mixed methods research. The mixed methods approach offers a better insight to understanding effective factors affecting subjective well-being compared to the use of either a qualitative or quantitative method alone. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: A search of common databases indicates the absence of any research focused on the needs of Iranian women diagnosed with severe mental illness post‐discharge from an inpatient setting.Moreover, there is a lacuna of information about the unique experiences and needs of persons diagnosed with severe mental illness living in non‐Western communities (esp. Middle Eastern communities). What this paper adds to existing knowledge: This study examined interviews of women diagnosed with severe mental illness receiving treatment at an Iranian inpatient hospital. Three categories of post‐discharge needs emerged: support, skill acquisition and information.Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. What are the implications for practice?: Findings highlight the need for systemic changes to current care models. Broadly, families should be incorporated into care to improve outcomes and decrease stigma. Regarding mental health nursing, results highlighted the need for additional nursing and occupational therapy interventions to empower families and patients. Nursing practitioners can aid in preparing these patients for employment and public health initiatives to decrease stigma and improve access to care. Introduction: Understanding the post‐discharge needs of patients diagnosed with severe mental illness is critical for improving treatment outcomes. Aim: The aim of the present study was to determine the unique post‐discharge needs of Iranian women diagnosed with severe mental illness. Method: Conventional content analysis was utilized to analyse data gathered via focus group interviews conducted within the psychiatric inpatient unit at Farabi hospital located in Kermanshah, Iran. Participants (N = 42; M age = 40; SD = 6.3 years) had been diagnosed with a severe mental illness, had a history of at least two psychiatric hospitalizations and were awaiting discharge following significant symptom improvement. Results: Content analysis extracted three categories of post‐discharge needs: support, skill acquisition and information. Support consisted of family, social and health system subcategories. Skill acquisition was comprised of social skills, work skills and self‐management skills. Lastly, information distinguished between illness‐related information and women's health information. Discussion/Implications for practice: Analysis of interview data highlighted the general need for adopting a family‐system approach to reduce stigma, increase knowledge and foster skill acquisition. Regarding mental health nursing, results highlighted the unique role of nurses and their capacity to pre‐emptively address needs such as aiding in employment. Lastly, findings are contrasted against Western care models. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traditional medicine is a complete system, including diagnostic methods, etiology and treatment based on interpersonal differences. Owing to a lack of investigations in the field of Iranian traditional medicine as well as its many present challenges, certain studies in this area can prove quite practical in identifying and solving ongoing challenges. This study investigates the challenges of the health system in Iranian traditional medicine in the context of control levers. METHODS: The study was qualitative content analysis. A framework analysis, "Control Knob Approach", was considered appropriate to promote apprehension of challenges of health systems in Iranian traditional medicine. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 35 experts of Iranian traditional medicine. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis. RESULTS: Upon analysis of data by Iranian medicine experts, five main categories including financing, payment system, regulations, behavior and organization were defined alongside 13 subcategories. CONCLUSION: According to current challenges and the tendency of society to receive traditional medicine services, as well as the long history of traditional medicine in Iran, fair access to traditional medicine services should be provided. This access must be through the production of indigenous knowledge and the formulation of regulatory and educational policies and guidelines and the empowerment of relevant, healthy, effective, evidencebased and cost-effective forces. [ABSTRACT FROM AUTHOR]

Purpose: High quality health-care delivery is not only the governments' responsibility but also every prisoner's right. Health care in prison and, particularly, of Iranian prisoners is increasingly important topic because of the rising number of the prison population. This paper aims to explore health-care managers' perspectives and experiences of prisons and the barriers to health-care delivery in Iranian prisons.Design/methodology/approach: A qualitative research design was conducted in Iran from October 2018 to August 2019. The participants consisted of 51 health-care managers (50 men and one woman) from Iranian prisons. A combination of face-to-face (N = 42) and telephonic (N = 9) semi-structured interviews were used because of the geographical distribution of the respondents. The first part of the interview guide consisted of demographic characteristics, and the second part consisted of three main open ended-questions. Interviews were recorded and transcribed, and thematic descriptive analysis was used to interpret the data.Findings: The barriers to health-care delivery in Iranian prisons were categorized into four main topics: human resources, financing, facilities and barriers related to the health-care delivery process. Data synthesis identified the following themes for barriers to human resources: barriers to human resources planning (with eight sub-themes); barriers to education (with three sub-themes); and motivational barriers (with seven sub-themes). Moreover, barriers to financing consisted of five sub-themes. The barriers to facilities consisted of barriers related to physical infrastructures (with two sub-themes) and barriers related to equipment (with six sub-themes). Finally, barriers to the health-care delivery process included the following themes: communication barriers (with six sub-themes); legal barriers (with five sub-themes); and environmental-demographic factors (with seven sub-themes).Originality/value: Identifying the barriers to health-care delivery in Iranian prisons plays a critical role in the improvement of planning, decision-making and the health-care delivery process. [ABSTRACT FROM AUTHOR]

This paper has attempted to explore factors which should be considered in designing a sexuality education package for severe mental illness. Method: Twenty-one in-depth semi-structured interviews were conducted in one of the psychiatric hospitals in Tehran. All participants were selected by purposive sampling. Interviews continued until data were saturated. Using conventional qualitative content analysis, data reduction was done by MAXQDA 10 software. Findings: Qualitative interview analysis revealed 222 codes which are summarized in 15 subcategories and 3 categories including "key competences must be created", "Educational package features" and "Educational Organization". Conclusion: Sexual package should provide necessary information, improve risk perception and motivate learning of sexual issues in these patients. Also, providing an appropriate educational package should be concise, ordered and comprehensive. [ABSTRACT FROM AUTHOR]

Background: An estimated 96% of registered refugees in Iran are Afghan. Almost half of them are young women at the reproductive age. The adequate maternity care is crucial for healthy pregnancy. There is limited knowledge regarding the access and adequacy of maternity care among Afghan women in Iran. The reports from ministry of health (MOH) implicate higher prevalence of perinatal complications in Afghan population. This mainly attributed to the inadequate prenatal care during pregnancy. Therefore, this paper explores the potential barriers to prenatal care among Afghan women in Iran.Methods: Using convenience sampling, thirty pregnant Afghan women were recruited at three community health centers with the highest number of Afghan visitors in Tehran, the capital city of Iran. Data were collected through face-to-face interviews in Persian language using an interview guide. The interviewers were two bilingual Afghan graduate midwifery students. Each interview lasted for an hour. The questions regarding the concerns and experienced obstacles in seeking prenatal care were asked. The interviews were transcribed into original language (Persian) and analyzed using content analysis and further translated back into English. The main themes were extracted grouping the similar codes and categories after careful consideration and consensus between the researchers.Results: The financial constraints and lack of affordable health insurance with adequate coverage of prenatal care services, particularly the diagnostic and screening tests, were the most frequent reported obstacles by Afghan women. In addition, personnel behavior, transportation issues, stigma and discrimination, cultural concerns, legal and immigration issues were also mentioned as the source of disappointment and inadequate utilization of such services.Conclusions: The findings of present study emphasize the necessity of available and most importantly, affordable prenatal care for Afghan women in Iran. Providing an affordable health insurance with adequate coverage of prenatal and delivery services, could reduce the financial burden, facilitate the access, and ensure the maternal and child health in this vulnerable population. The issues of fear and concern of deportation must be removed for at least illegal Afghan mothers to ensure their access to maternity care and improve the health of both mother and offspring. [ABSTRACT FROM AUTHOR]

Aim: This paper outlines the protocol for a study aimed at exploring perspectives about the role of patients' in the delivery of safe care in hospital. Design: Qualitative exploratory study. Methods: Research Ethics Committee approval for this study was obtained in October 2018. The study will be conducted between February–April 2019 with data collected through focus group discussions and semi‐structured interviews and will involve patients and healthcare professionals from hospitals in Tabriz. A descriptive qualitative approach will be adopted, and the data will be managed and analysed using MAXQDA 10 software. Discussion: The role of patients in furthering their own safety whilst in hospital cannot be underestimated and the results from this study can be used to support the development of practical strategies that address the delivery of safe hospital care and which involve patients and their caregivers. [ABSTRACT FROM AUTHOR]

Background: Cultural sensitivity is a core concept to establish awareness and knowledge about various ethnicities, cultures, genders and additional diversity characteristics to understand individual's requests and respond appropriately to them. A need for further development of the concept is warranted, especially in the context of paediatric nursing. Aims: The purpose of this paper was to determine the main elements of cultural sensitivity in the context of paediatric nursing in Iran. Methods: The Hybrid method was implemented consisting of three phases: theoretical, fieldwork and final analysis. In the theoretical phase, articles from 2007 to 2017 were reviewed for relevance. In the phase of fieldwork, 25 nurses and nine parents were interviewed to explore the aspects of cultural sensitivity in paediatric nursing. The interviews were transcribed, and content analysis was conducted. In the final phase, an overall analysis of the two previous phases was performed. Results: In the theoretical phase, the following attributes were determined: cultural encounter and awareness, acceptance of cultural diversity and designing programmes in accordance with family culture. The fieldwork phase explored three themes of intercultural encounters, intercultural communication and adapting the care plan with family culture. The final synthesis yielded that sensitivity to family requests and beliefs, effective intercultural communication and integration of family culture with the care plan are the main elements of cultural sensitivity in Iranian paediatric nursing. Conclusion: With a deeper understanding of the term cultural sensitivity, nurses will have a foundation to improve paediatric nursing care and align the care plan with the patient's culture to provide trust, child/parent participation, secure care, effective communication and satisfaction. Since the concepts are the building blocks that underpin theory, the present concepts identified can help to serve as the foundation for the development of a theoretical model. [ABSTRACT FROM AUTHOR]

The Health in All Policies (HiAP) approach requires formal and sustained governance structures and mechanisms to ensure that the policies of various non-health sectors maximize positive and minimize negative impacts on population health. In this paper, we demonstrate the usefulness of a network perspective in understanding and contributing to the effectiveness of HiAP. We undertook an exploratory, qualitative case study of a HiAP structure in Iran, the Kerman province Council of Health and Food Security (CHFS) with diverse members from health and non-health sectors. We analyzed relevant policy texts and interviewed 32 policy actors involved in the CHFS. Data were analyzed using within-case analysis and constant comparative methodology. Our findings suggest that CHFS governance from a network perspective drew in practice on elements of two competing network governance modes: the network administrative organization (NAO) and the lead organization mode. Our results also show that a shift from a hierarchical and market-based mode of interaction to a network logic within CHFS has not yet taken place. In addition, CHFS suffers from large membership and an inability to address complex 'wicked problems', as well as low trust, legitimacy and goal consensus among its members. Drawing on other HiAP studies and commentaries, insights from organization network theory, and in-depth findings from our case study, we conclude that a NAO may be the most effective mode of governance for tackling complex social problems in HiAP structures. Since similar studies are limited, and our single case study may not be transferable across all contexts, we suggest that further research be undertaken to explore HiAP structures from a network perspective in different institutional and cultural settings. With increasing emphasis given to HiAP approaches in national and international health policy discourse, it is important that comparative knowledge about the effectiveness of HiAP governance arrangements be developed. [ABSTRACT FROM AUTHOR]

Background: The competence of faculty in conducting e-learning is one of the preconditions for e-learning implementation in a university. This study aimed at investigating the readiness of the faculty members of Ardabil University of Medical Sciences (ARUMS) to have e-learning. Methods: To fulfil this purpose, a triangulation method has been used. In the quantitative section, based on the Technological Pedagogical Content Knowledge (TPACK) model, the faculty competence in conducting e-learning has been measured in four areas: pedagogical knowledge, technological knowledge, content knowledge, and finally the skill of combining pedagogical knowledge, technological knowledge, and content knowledge. Subsequently, with the qualitative data of the semi-structured interview, the findings of the research have been explained. Finally, the strategies for improving the readiness of ARUMS faculty have been identified in e-learning. Results: One-sample t test with a significant level (P = 0.5) showed that the faculty e-learning of ARUMS had the highest mean of pedagogical knowledge, content knowledge and contentpedagogical knowledge respectively. In other words, the faculty had a high level of pedagogical, content and content-pedagogical knowledge, but they need to improve their technological, technological-content, technological-pedagogical and ultimately, technological-pedagogicalcontent knowledge. Conclusion: That is why, in order to have effective e-learning at ARUMS, the faculty has to improve their technological, technological-content, technological-pedagogical and technological-pedagogical-content knowledge. In this regard, several solutions have been proposed in this paper. [ABSTRACT FROM AUTHOR]

The aim of this paper is discover the causal relationship of IPPM performance. This paper shows that performance of IPPM consist of an integrated elements of strategic alignment, portfolio balance, resource fit and value maximization. Qualitative research design was chosen for this study and through using semi-structured and in-depth interviews with 24 experts in five Iranian organizations producing equipment of the power industry. According to the findings from these qualitative data, effective IPPM is the result of three areas of capabilities: IPPM Process, IPPM structure, IPPM people. These causal relationships are moderated by project context. Finally, we develop a set of propositions regarding the key performance drivers of IPPM. [ABSTRACT FROM AUTHOR]

Background and Objective: Children's rights to good health care are enshrined in various publications and policy documents. The maintenance of human dignity is recognized as a core value in foundational to human rights. Although it has been studied extensively from adult patients perspective, there are few studies of dignity in relation to school age children, generally or in relation to health care. This paper explores school age childeren,s and parents perceptions of children's, dignity. Materials and Methods: A conventional qualitative content analysis method was used to explore the meaning of hospitalized childrens' dignity. Hospitalized children and parents in general medical and surgical pediatric units were eligible to participate. Data were obtained through unstructured interviews. Purposive sampling was used and school age children and parent were recruited until data saturation was reached (n =20, 12 children and 8 parent). Results: Hospitalized children and parents in general medical and surgical pediatric units were eligible to participate. Data were obtained through unstructured interviews. Purposive sampling was used and school age children and parent were recruited until data saturation was reached (n =20, 12 children and 8 parent). Ethical approval for the study was granted by the Ethics Committee of Shiraz University of Medical Sciences. Participants were provided with information about the purpose, reasons for recording interviews, voluntary participation, and confidentiality of data and interviewees. Dignity was reflected in three themes (1) Respect for the child (2) protection of personal privacy (3) family center communication. Conclusion: Hospitalized childrens and parents stated that healthcare services should Respect for the child and protect their personal privacy. Also, they should communicating with the child and their parents to provide dignity. School age is a discrete developmental stage, with specific healthcare needs which must be addressed effectively by healthcare providers. [ABSTRACT FROM AUTHOR]

Enhancing therapeutic relationships between patients and staff is of central importance to improve the quality and safety of care in psychiatric inpatient units. However, there is limited evidence as to how therapeutic relationships may be enabled in this specific context. This paper presents findings of a study that explored the link between therapeutic relationships and safety in Iranian psychiatric inpatient units. In this exploratory, descriptive study, seven patients at the point of discharge and 19 staff in psychiatric inpatient units in Iran were interviewed regarding their experiences of care. The quality of staff-patient relationship in providing a safe environment was categorized into two groups of "facilitators" and "inhibitors". Facilitators of a safe environment included "supportive relationship with patients" and "improving patient capacity for self-efficacy/self-control". Inhibitors, on the other hand, included "detachment from patients" and "domination over patients", which ultimately limited safety on the ward. Findings indicate interrelated environmental, patient and staff factors mediating the potential for therapeutic relationships and quality and safety of care. Findings suggest the need for more effective preparation and support for staff working within psychiatric inpatient settings. In addition, environments more conducive to collaborative recovery-oriented practice are required to enhance therapeutic relationships and improve quality and safety of care. Both individual staff responsibility and effective leadership are required to realize change. [ABSTRACT FROM AUTHOR]

This paper explored the support needs of family caregivers of people living with a mental illness in Iran. This descriptive study focused on the experiences of 20 family caregivers as well as the views of 29 professional support workers through individual face-to-face interviews. From these interviews three key themes emerged in regards to the care needs of family caregivers: (i) social support; (ii) emotional support; and (iii) safety and security. These themes highlighted the complex role of caring for a family member with a mental illness and the emotional, social and economic challenges that these caregivers experienced as a result. Iranian caregivers garnered support not only from other family members but also from neighbors and religious leaders but lacked the much needed respite care found in western countries. This research study highlighted the importance of ensuring that the caregivers themselves receive appropriate and adequate support to fulfill their caregiving role. [ABSTRACT FROM AUTHOR]

Background: This paper has attempted to explore views of patients with severe mental illness and their care providers about sharing sexual problems with care providers in these patients within the context of Iran. Method: A total of 17 in‐depth semi‐structured interviews were conducted in one of the psychiatric hospital in Tehran: 4 with patients, 2 with patient's family, and 11 with health providers who had been employed for 5 years in psychiatric wards at least. All participants were selected by purposive sampling. Using conventional qualitative content analysis data reduction was done. Findings: A total of 89 codes about the reasons for lack of communication between clinician and patients, about sexuality were extracted. These are classified in two categories. The first is "Clinicians avoidance from addressing sexual issues" and second is "Patients avoidance from expressing their sexual problems." Conclusion: Despite having sexual needs, severe mental illnesses patients do not disclose it due to poor communication between clinician and patients, about sexuality. So, physician had to be pioneer in communicating with them. Therefore, to enhance clinicians' sexual knowledge and effective communication skills with patients, especially those with severe mental illnesses, training is completely necessary. [ABSTRACT FROM AUTHOR]

Background: Health systems have a set of limited resources for meeting the needs of communities. Health priority setting based on criteria and values is inevitable in such situation. This paper aims to identify the social values that are considered in Iranian health system. Methods: This qualitative study was conducted in 3 steps including collecting national documents and literature review, interviewing key informants, and a 2 round Delphi. Interviews and documents were analyzed through thematic framework analysis. Statistical guidance was applied for determining consensus cut-off in Delphi technique. Results: Five social values including freedom of choice, equity, solidarity, severity of disease(s), and burden of disease(s) were considered more important than other values in the health priority setting decisions. Moreover, 2 non-value based factors including conflict of interest and lobbying had a high effect on decision making. Conclusion: Most health policy makers decide based on Egalitarian school, but restriction of resources in the country decreases the outcome. Moreover, personal judgments and preferences sometimes affect their decisions. It seems that developing a valuebased framework and making it as a national guidance could have affirmative effect on health administers decisions. [ABSTRACT FROM AUTHOR]

Abstract: Background: Healthy spousal communication of marital and sexual expectations is one of the most important factors to improve the quality of sexual relations in marriage. Objectives: This paper has attempted to explore women's expectations of men for having pleasurable sex in a monogamous and steady sexual relationship within the context of Iran. Methods: In this qualitative study, 20 interviews were conducted in Tehran from December 2013 to May 2014. Participants were recruited using purposive sampling, face‐to‐face, in‐depth, and semistructured interviews. The collected data were analyzed using qualitative conventional content analysis. The research was designed with regard to Lincoln and Guba's four major rigor criteria in qualitative investigation. Results: Women's expectations for having enjoyable sex were classified in two areas: (1) marital components and (2) sexual components. Marital components included romantic relationships, attention, respect and admiration, appreciation, man's loyalty, and having compatibility. Sexual components included enough sexual skills, good sexual function, and commitment to equity in sex. Conclusions: This research helps to identify women's expectations for having a gratifying sexual relationship and thus contributes to enhanced sexual satisfaction, as well as marital stability and continuity. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to identify barriers to seeking help among abused Iranian women.Design/methodology/approach This qualitative research was carried out using content analysis approach. The participants were 24 married women who were selected from health care centers, recreational centers, and two universities in Tehran, Iran. Semi-structured interviews were used to collect the data.Findings During data analysis, four themes emerged that explained barriers to seeking help in the participants: “fear of negative consequences of help-seeking,” “lack of resources,” “beliefs and attitudes,” and “indirect experiences of not being supported.”Originality/value This study has practice and policy implications for promoting help-seeking among abused women. Based on the results, to promote help-seeking, intervention plans must focus on empowering women to improve their education and employment, eliminating attitudes and beliefs hindering help-seeking, and fortifying formal and informal support systems for abused women. [ABSTRACT FROM AUTHOR]

This paper explores the role of perturbance and attractor, two key nonlinear features described by the Neuro-occupation model in shaping human behavior. A convenience sample of eleven Iranian participants who had both strokes and demonstrated high resilience were recruited for this study. To explore the process of how participants fell under the influence of the perturbance and attractor, the content analysis with pre-determined categories using deductive reasoning was used. The findings suggest that perturbance and attractor exerted considerable influences on adaptation to stroke and assist in the understanding of the Neuro-occupation model. [ABSTRACT FROM AUTHOR]

Abstract: The paper is based on a large qualitative study of ethics, policy and regulation of human embryonic stem cell (hESC) science in Iran. This case study in five academic research centres used semi-structured interviews to examine in depth the views of stem cell scientists, embryologists and ethics committee members on hESC research policy in this Shia Muslim country. Although Iran's policy approach has been considered ‘intermediate’, what is described here seems to be a ‘more flexible’ policy on hESC science. This article describes three arguments to explain why Iran has shaped such a policy. These are: (1) a flexibility of the Shia tradition has allowed for hESC science; (2) permissive policy related to other fields of biomedicine, such as new assisted reproductive technologies, facilitated approval of hESC research; and (3) a lack of public debate of bioscience in Iran influences how its hESC research policy is perceived. Based on the empirical data, this paper then expands and refines the conceptual bioethical basis for the co-production of science, policy, and society in Iran. The notion of co-production implies that scientists, policy-makers, and sometimes other societal actors cooperate in the exchange, production, and application of knowledge to make science policy. [Copyright &y& Elsevier]

Background. For years, researchers have sought to provide a clear definition of spirituality and its features and consequences, but the definitions provided of this concept still lack transparency. The present qualitative research was conducted to clarify this concept within the religious-cultural context of Iran. Materials and Methods. The present conventional qualitative content analysis was conducted with an inductive approach. Data were collected through semistructured interviews with 17 spiritual health experts and activists selected through purposive sampling. Results. Three themes emerged from the analysis of the data, including (1) the structure of spirituality, (2) defects in the conceptualization of spirituality, and (3) spirituality in practice, which are explained in this paper with their relevant subthemes and codes. The definition which this study proposes for this concept is that “spirituality is the sublime aspect of human existence bestowed on all humans in order for them to traverse the path of transcendence that is closeness to God (Allah).” Conclusion. The definition provided by this study is similar to the previous definitions of this concept in its main part (transcendence) and in incorporating a God-centered view of spirituality within the context of an Islamic society. This definition has implications for health services’ education, research, and practice in similar societies. [ABSTRACT FROM AUTHOR]

Interprofessional collaboration (IPC) has long been identified as a way of providing optimal mental health services (MHS). It is important, therefore, to identify and facilitate factors driving IPC. This paper presents health professionals' experiences and perceptions regarding the clients' role as a driving factor for IPC in MHS in an Iranian context. Health professionals included nurses, physicians (general physicians and medical specialists), psychologists and consultants. Qualitative methods were employed in the form of in-depth individual interviews and focus groups to collect data from 24 professionals and 4 clients. Data analysis generated four key themes: 'Clients as axis of IPC', 'Seamless services as a common incentive for IPC', 'Clients as a common interprofessional linkage' and 'Clients as a driving force to achieve IPC'. From the professionals' perspective, it was found that clients had a mediating role in their collaborative relationships and practices. These findings are discussed in relation to the interprofessional literature. This paper goes on to argue that professionals need to be aware of and be trained about how to manage, as well as benefit from, the clients' fundamental role in IPC. [ABSTRACT FROM AUTHOR]

Controversy surrounding disclosure among the recipients of assisted reproductive donation procedures is escalating worldwide, but little research has been conducted in this topic. The purpose of this qualitative study was to explore the experiences of infertile couples undergoing assisted reproductive donation procedures. In this exploratory qualitative study, 32 patients (nine couples and 14 women) who were candidates to use donor eggs, donor embryos or surrogacy, and 5 members of infertility treatment team including gynaecologists, midwives and psychologist (total 37) were purposively selected from the Montaserieh Infertility Research Centre at Mashhad, Iran in 2012 and interviewed using a semi-structured in-depth method. Data were analysed using conventional qualitative content analysis with MAXqda software. One overarching theme, entitled ‘experiencing uncertainty surrounding the disclosure to others’ was identified from the data. This theme contained two subthemes including ‘Couples’ decisions to not disclose to others’ and ‘Couples’ decisions to disclose to others’. Five categories formed the first subtheme, and the second subtheme emerged from four categories which are discussed in this paper. The main reason for secrecy was concern over societal negative views about assisted reproductive donation procedures. This worry deprived the couples from support from family and friends and as a result requires them to tolerate psychological pressure when using such procedures. [ABSTRACT FROM PUBLISHER]

Introduction: Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. Aim of paper: To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. Methods: A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo‐Australian, and Indigenous peoples. Results: Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups – Anglo‐Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. Conclusion: The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. [ABSTRACT FROM AUTHOR]

This paper aims at exploring women's meaningful perception, semantic understanding, and their experiences of breast cancer in a religion context. Accordingly, eight women who had one of their breasts completely removed by surgery (mastectomy) were studied by narrative interviews. In this narrative interview, participants told their life stories since the beginning of disease. Findings showed that religious concepts have a heightened role in the interpretation and understanding of disease, coping strategies, and gaining new concepts for life and death. Two main themes discovered in this research were fatalism on the one hand, and the hope and empowerment on the other. Despite the intrinsic conflict between these two concepts, religion, as a specific cultural and epistemological context, reconciles them; in a way, these polar concepts form a unitary structure of meaning and activity. In this structure, semantic coherence and concrete experience leads women with breast cancer to a new meaningful system, which shapes a new path for living well. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this paper is to explore themes for enhancing socially accountability in medical education. Background: Medical education in Iran experience new challenges due to the enormous influence of changes in technology, development of new methods of teaching and learning, student requirements, patient management, financial credit constraints, and social and economic developments. For responding to these, use of strategic thinking in order to make appropriate decisions is the only solution. Strategic plans need to formulate practical guides which can help accountable to people's reasonable expectations. Patients and methods: For this qualitative study, along with the 14thnational conference on Medical Education in Iran, the opinions of experts were obtained during seven expert panels' group discussions, each lasting four hours and including 10 participants. Data were collected by audiotapes, which were then transcribed. Data analyzed using a thematic content analysis approach. Peer and member checking during analysis and data triangulation from other recent studies were used to increase the findings' trustworthiness. Results: Among more than hundred meaning units groups identified the following eight main themes as affecting the social accountable medical education in Iran: organization of responsive education councils; development of community based courses; development in field training; organization of educational processes; homogeneity in educational rules and regulations; budget management, educational outcomes; educational programs in departments and groups. Conclusion: This study have found the main themes that might affecting social accountable medical education in Iran, where Iranian policymakers should consider those when plan to make changes in medical education and could potentially adopt the proven useful policies and strategies of other countries. [ABSTRACT FROM AUTHOR]

Background: This study explored the strategies to overcome diabetes-related social stigma in Iran. Materials and Methods: This paper is part of an action research study which was designed in Iran in 2012 to plan and implement a program for overcoming diabetes-related stigma. Participants were people with type 1 diabetes, their family members, people without diabetes, and care providers in a diabetes center. Data collection was done through unstructured in-depth interviews, focus groups, e-mail, Short Message Service (SMS), and telephone interview. Data were analyzed using inductive content analysis approach. Results: Participants believed that it is impossible to overcome the stigma without community-based strategies. Community-based strategies include education, advocacy, contact, and protest. Conclusions: The anti-stigma strategies obtained in the study are based on the cultural context in Iran. They are extracted from statements of a wide range of people (with and without diabetes). However, during planning for stigma reduction, it is necessary to note that the effectiveness of social strategies varies in different studies and in different stigmatizing conditions and many factors are involved. These strategies should be implemented simultaneously at different levels to produce structural and social changes. It should be accepted that research on reducing health-related stigma has shown that it is very difficult to change beliefs and behavior. Evidence suggests that individuals and their families should be involved in all aspects of the program, and plans should be made according to the local conditions. [ABSTRACT FROM AUTHOR]

Abstract: Hospital solid waste assessment is regularly characterized by a large number of known criteria that are both qualitative and quantitative in nature. The qualitative criteria can only be assessed by human judgments, which predictably engage a variety of uncertainties such as fuzziness and ignorance. Therefore, hospital solid waste assessments need to be analyzed and modeled using approaches that can handle uncertainties. The evidential reasoning (ER) approach can be utilized for such an analysis. In this paper, perhaps for the first time, the ER approach is applied to regional hospital solid waste assessment. The assessment criteria are characterized by a set of assessment grades assumed to be commonly exclusive and communally exhaustive. All assessment information, incomplete or complete, qualitative or quantitative, and imprecise or precise, are modeled using a cohesive belief structure. The ER approach will be used to aggregate multiple hospital solid waste assessment criteria, resulting in distributed assessment for each alternative. The proposed methodology is applied for regional hospital solid waste assessment in the province of Khuzestan, Iran. [Copyright &y& Elsevier]

Background: The vaccine industry is one of the most important health-related industries. It can be affected by accession to the World Trade Organization (WTO) because of probable dramatic changes in the business environment. Iran has already initiated accession negotiations. Purpose of the study: In this paper, we investigate the position of, challenges to, and opportunities for vaccine manufacturing in Iran with regard to accession to the WTO. Methods: This is a qualitative and cross sectional study. To collect information, we designed a questionnaire and interviewed some of the vaccine industry's key opinion leaders in Iran. Before the interviews were conducted, the questionnaires were sent to these individuals by email. Results: According to the interviewees, the country's main challenges with regard to accession to the WTO are the lack of firm internal intellectual property (IP) rules, not being recognized as pre-qualified by the World Health Organization (WHO), the use of old equipment, and a lack of cooperation with global vaccine companies. Major conclusions: Iran's local vaccine industry, with a long history and international reputation that could be used as an advantage, is faced with several challenges, such as problems with keeping up with Current Good Manufacturing Practice (cGMP), a lack of adequate and meaningful investment in research and development (R&D), and limitations on private sector participation in the production of vaccines. Gradual privatization of the industry, improved international relations, utilization of the R&D power of small hi-tech companies, consistent education of human resources, and modernization of infrastructures and equipment are among the suggested solutions. [ABSTRACT FROM AUTHOR]

shahbazi s. (2012) The consequences of unsafe abortion : a qualitative study. Journal of Advanced Nursing 68(6), 1247-1255. Abstract Aim. This paper is a report of a study of the consequences of illegal abortions experienced by Iranian women. Background. Despite the increase in effective and safe methods of contraception and the distribution of information about these methods, unwanted pregnancy is still a problem in some societies. Induced abortion is a common procedure throughout the world and at least half of more than 45 million induced abortions which happen in a year are performed under unsafe circumstances. Unsafe abortions carry a high risk of maternal mortality and morbidity, accounting for more than 80,000 maternal deaths per year. Method. In this qualitative study, 27 participants were interviewed in 2006. Some participants were women who had illegal abortions and others were people who had contact with those women. Content analysis was used to identify and categorize participants' responses to the interview questions. Findings. Four consequences of women's experiences of illegal abortion were identified: physical, psychological, socio-political and judicial. Conclusion. In Iran, as in some other developing countries intentional abortion, except for some special cases, is illegal because of social and religious beliefs. In these countries, offering services and support to women with unwanted pregnancies seems to be the best solution for reducing or preventing illegal abortion. [ABSTRACT FROM AUTHOR]

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

Aim. This paper is a report of a qualitative descriptive study of nurses' experiences of uncertainty in clinical practice. Background. Uncertainty as a complex phenomenon is inherent in many nursing and medical encounters and can vary along different dimensions. Despite the existence of studies on the theoretical definitions of uncertainty, few studies have been conducted to explore nurses' experiences in this regard and strategies employed by them to encounter situations of uncertainty in nursing practice. Methods. Semi-structured interviews were conducted in 2009 with 18 female bachelor's degree nurses working in a teaching hospital in an urban area of Iran. Content analysis was used to identify themes. Findings. The data analysis resulted in three main themes: 'unclear domain of practice', 'compatibility with uncertainty', 'psychological reactions to uncertainty'. The second theme consisted of two categories: 'losing sensitivity' and 'avoiding trouble'. The themes were not mutually exclusive or independent, but rather overlapping and intertwined. The themes and their related categories summarized the nurses' experiences of uncertain situations and the way they used to present efficacious care and meet patients' needs in spite of being immersed in uncertainty. Conclusion. Enhanced awareness and increased understanding about uncertainty can be important factors in improving nursing work environment and the quality of care presented to patients. The findings will be helpful for nurse managers to educate and prepare nurses in order to encounter uncertain situations in practice. [ABSTRACT FROM AUTHOR]

Abstract: Taking account of uncertainty in multicriteria decision making problems is crucial due to the fact that depending on how it is done, ranking of alternatives can be completely different. This paper utilizes linguistic values to evaluate the performance of qualitative criteria and proposes using appropriate shapes of fuzzy numbers to evaluate the performance of quantitative criteria for each problem with respect to its particular conditions. In addition, a process to determine the weights of criteria using fuzzy numbers, which considers their competition to gain greater weights and their influence on each other is described. A new fuzzy methodology is proposed to solve such a problem that utilizes parametric form of fuzzy numbers. The case study of diversion of water into Lake Urmia watershed, which is defined using triangular, trapezoidal, and bell-shape fuzzy numbers demonstrates the utility of the proposed method. [ABSTRACT FROM AUTHOR]

Since nursing education was transferred to universities in Iran, the public and health administrators have criticized Iranian nurses because of poor-quality patient care. It seems that nurses are not able to transfer the taught theoretical knowledge in academia into practice. This paper attempts to provide an insider view of why the taught theoretical knowledge in academia might be difficult to enact in the clinical setting. Using the grounded theory approach, individual in-depth interviews and participant observation were undertaken with a purposive and theoretical sample of 26 participants in Tehran University of Medical Sciences. The data were analyzed using the constant comparative method. The findings showed that, in spite of increased academic input into nursing education, clinical behaviors in both the education and practice settings were perceived as “traditional routine-based”. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study exploring how Iranian women coped with newly diagnosed breast cancer and provides a foundation for cultural-based care. Background. Although research has indicated that coping strategies are associated with adaptation to breast cancer, and despite the number of women with newly diagnosed breast cancer increasing each year, there is no information on how Iranian women cope with breast cancer when compared with women of other cultures. Method. In this qualitative study, 19 women with newly diagnosed breast cancer were interviewed during the period May–September 2004 about coping with their disease. Interviews were analysed using a content analysis method. Findings. The main themes emerging from this qualitative study included coping using a religious approach (acceptance of disease as God's will; spiritual fighting), thinking about the disease (positive thinking: positive suggestion, hope, intentional forgetfulness; negative thinking: hopelessness, fear, impaired body image), accepting the fact of the disease (active acceptance; passive acceptance), social and cultural factors and finally finding support from significant others. Conclusion. Understanding how Iranian women cope with diagnosis of breast cancer is important to nurses involved in the process of healing. The majority of strategies used by Iranian women were positive, and religious faith played a major role in this. The findings of the study can be used to design a nursing approach to improve successful coping in Iranian women suffering from breast cancer, and can provide nurses and other healthcare professionals with deeper understanding of these women as they face this diagnosis. [ABSTRACT FROM AUTHOR]