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Introduction: Professional burnout is a state of mental exhaustion and it is a passive reaction caused by chronic occupational stress that is not properly managed. Physician burnout is more prevalent than in the general population, particularly among residents. The aim of this study is to investigate burnout among the residents of Shahid Sadoughi University of Medical Sciences in Yazd. Methods: This analytical cross-sectional study was conducted on 214 residents of Shahid Sadoughi University of Medical Sciences, Yazd, in 2022-2023 based on the Maslach Burnout Questionnaire. Residents were categorized into no, moderate and severe burnout groups using rates of 33% and 66%. Residents’ career choices, including their decision to enter the medical field and choose a specialty, as well as their priorities were also surveyed. Results: A total of 151 residents participated in this study (70.5%) with the mean age of 31.91±5.02 years. The mean burnout score was 51.25±26.97. Professional burnout did not differ significantly by gender, marital status, having children, type of specialty (surgical or non-surgical), or residency level. Burnout was highest in pediatrics, orthopedics and cardiology, and lowest in emergency medicine, infectious diseases and ophthalmology. This difference was significant between the disciplines (P-value=0.003). The most important unmet needs cited by residents were a suitable fellowship (77.5%) and fewer working hours (76.8%). 63 residents regretted their choice of medicine (41.7%) and 38 (25.2%) regretted their choice of specialty. There was no significant association between age and professional burnout (P-value=0.057). Conclusion: More than half of the residents suffer from moderate professional burnout. It is recommended to improve the conditions for residents, to conduct more studies with details and to evaluate this topic regularly.

Introduction and purpose:According to statistics, the share of the global medical tourism market in 2017 was USD 53 billion and is predicted to reach USD 143 billion by 2025 and record an annual growth of 12.9% from 2018 to 2025. Attracting international patients is the core of the medical tourism market, and major representatives will be distinguished by their ability to attract foreign medical travelers as the industry becomes more competitive. Marketing is the key to success in the health tourism industry, and leading hospitals and countries with large numbers of medical travelers have strong marketing strategies that fulfill the needs of patients. Methods: The present applied descriptive study was performed in public and private hospitals in Yazd. A valid checklist with 8 dimensions and 79 items was used to collect data. Mean, standard deviation, and percentage were analyzed using SPSS software (version 26). Results: Public and private hospitals were acceptable in terms of location, people, process, and physicians; however, elements of promotion, prices, and physical attractiveness were moderate. In addition, the product element was acceptable in public hospitals and moderate in private hospitals. Overall, the condition of the public and private hospitals was acceptable. Conclusion: Now that the needs of the patients have changed in the new health environment, hospitals need to use more effective and efficient methods to meet these needs. The marketing system in the new concept can be effective in attracting customers by fulfilling customer needs and paying attention to elements of the marketing mix. Therefore, hospitals need to focus on elements of the marketing mix to satisfy patients and maintain their values. It seems that the studied hospitals are relatively ready to attract medical tourists. Hospitals can cover their weaknesses by investing in their existing strengths and upgrading them, and bringing the factors to an acceptable level.

In this paper, selecting of an appropriate mooring system for spar platform of a wind turbine consisting of chain–cable–chain is investigated based on a meta-heuristic method. The purpose is to investigate the hydrodynamic behavior of the structure and the mooring system in a normal and damaged conditions. ANSYS-AQWA software is applied to hydrodynamics analysis and the numerical results were first verified by experimental results. According to the characteristics of the experimental mooring system and designed stiffness in the desired depth of the sea, an appropriate chain is selected for the prototype model and then by investigating the changes applied to it and replacing a chain mooring system with a mooring system including chain–cable–chain, the survival behavior of the structure and mooring system evaluated for the 100-years return period, considering one of the mooring line disconnection. According to the controlling role of the initial chain connected to the structure, it was also observed that the decreasing the length of the initial chain and increasing the anchor chain length, the tension as well as the amplitude of the structural movements in the degrees of surge, heave and pitch increases.

A‌n a‌c‌c‌u‌r‌a‌t‌e m‌a‌t‌e‌r‌i‌a‌l q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f a‌n‌d e‌s‌t‌i‌m‌a‌t‌i‌o‌n a‌r‌e v‌i‌t‌a‌l i‌s‌s‌u‌e‌s i‌n v‌a‌r‌i‌o‌u‌s c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n p‌r‌o‌j‌e‌c‌t‌s. S‌u‌c‌h a‌n a‌c‌c‌u‌r‌a‌t‌e e‌s‌t‌i‌m‌a‌t‌i‌n‌g a‌n‌d m‌a‌t‌e‌r‌i‌a‌l q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f i‌s r‌e‌q‌u‌i‌r‌e‌d p‌r‌i‌o‌r t‌o i‌n‌i‌t‌i‌a‌t‌i‌n‌g a p‌r‌o‌j‌e‌c‌t f‌o‌r t‌e‌n‌d‌e‌r‌i‌n‌g a‌n‌d b‌i‌d‌d‌i‌n‌g p‌u‌r‌p‌o‌s‌e‌s, a‌n‌d d‌u‌r‌i‌n‌g t‌h‌e c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n p‌h‌a‌s‌e f‌o‌r p‌r‌o‌c‌u‌r‌e‌m‌e‌n‌t a‌n‌d p‌r‌o‌j‌e‌c‌t c‌o‌n‌t‌r‌o‌l p‌u‌r‌p‌o‌s‌e‌s. T‌h‌u‌s, a n‌u‌m‌b‌e‌r o‌f B‌u‌i‌l‌d‌i‌n‌g I‌n‌f‌o‌r‌m‌a‌t‌i‌o‌n M‌o‌d‌e‌l‌i‌n‌g (B‌I‌M) a‌p‌p‌l‌i‌c‌a‌t‌i‌o‌n‌s h‌a‌v‌e b‌e‌e‌n u‌t‌i‌l‌i‌z‌e‌d r‌e‌c‌e‌n‌t‌l‌y n‌o‌t o‌n‌l‌y f‌o‌r e‌f‌f‌i‌c‌i‌e‌n‌t m‌a‌t‌e‌r‌i‌a‌l q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f a‌n‌d e‌s‌t‌i‌m‌a‌t‌i‌n‌g p‌u‌r‌p‌o‌s‌e‌s, b‌u‌t a‌l‌s‌o f‌o‌r o‌t‌h‌e‌r c‌o‌n‌s‌t‌r‌u‌c‌t‌i‌o‌n e‌n‌g‌i‌n‌e‌e‌r‌i‌n‌g a‌n‌d m‌a‌n‌a‌g‌e‌m‌e‌n‌t c‌o‌m‌m‌i‌t‌m‌e‌n‌t‌s (e.g., v‌i‌s‌u‌a‌l‌i‌z‌a‌t‌i‌o‌n, c‌l‌a‌s‌h d‌e‌t‌e‌c‌t‌i‌o‌n, 4D 5D p‌l‌a‌n‌n‌i‌n‌g, a‌n‌d v‌i‌r‌t‌u‌a‌l r‌e‌a‌l‌i‌t‌y). T‌h‌e m‌o‌s‌t c‌o‌m‌m‌o‌n B‌I‌M a‌p‌p‌l‌i‌c‌a‌t‌i‌o‌n‌s c‌a‌n b‌e n‌a‌m‌e‌d a‌s ``A‌u‌t‌o‌d‌e‌s‌k R‌e‌v‌i‌t'' a‌n‌d ``T‌e‌k‌l‌a S‌t‌r‌u‌c‌t‌u‌r‌e‌s'' f‌o‌r i‌n‌t‌e‌g‌r‌a‌t‌e‌d m‌o‌d‌e‌l‌i‌n‌g (e.g., s‌t‌r‌u‌c‌t‌u‌r‌e, a‌r‌c‌h‌i‌t‌e‌c‌t‌u‌r‌a‌l, a‌n‌d M‌E‌P m‌o‌d‌e‌l‌i‌n‌g) a‌n‌d ``A‌u‌t‌o‌d‌e‌s‌k N‌a‌v‌i‌s‌w‌o‌r‌k‌s M‌a‌n‌a‌g‌e'' f‌o‌r s‌i‌t‌e m‌a‌n‌a‌g‌e‌m‌e‌n‌t a‌n‌d 4D P‌l‌a‌n‌n‌i‌n‌g p‌u‌r‌p‌o‌s‌e‌s. I‌n t‌h‌i‌s r‌e‌s‌e‌a‌r‌c‌h, t‌h‌e a‌c‌c‌u‌r‌a‌c‌y o‌f a‌u‌t‌o‌m‌a‌t‌i‌c q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f, u‌s‌i‌n‌g a‌f‌o‌r‌e‌m‌e‌n‌t‌i‌o‌n‌e‌d B‌I‌M a‌p‌p‌l‌i‌c‌a‌t‌i‌o‌n‌s, h‌a‌s b‌e‌e‌n i‌n‌v‌e‌s‌t‌i‌g‌a‌t‌e‌d. F‌i‌r‌s‌t, s‌u‌c‌h a‌n e‌x‌e‌r‌c‌i‌s‌e i‌s p‌e‌r‌f‌o‌r‌m‌e‌d o‌n s‌i‌m‌p‌l‌e s‌t‌e‌e‌l a‌n‌d r‌e‌i‌n‌f‌o‌r‌c‌e‌d c‌o‌n‌c‌r‌e‌t‌e e‌l‌e‌m‌e‌n‌t‌s m‌o‌d‌e‌l‌e‌d u‌s‌i‌n‌g R‌e‌v‌i‌t s‌t‌r‌u‌c‌t‌u‌r‌a‌l e‌x‌t‌e‌n‌s‌i‌o‌n. F‌u‌r‌t‌h‌e‌r‌m‌o‌r‌e, t‌h‌i‌s e‌x‌e‌r‌c‌i‌s‌e i‌s e‌x‌t‌e‌n‌d‌e‌d t‌o s‌t‌e‌e‌l a‌n‌d r‌e‌i‌n‌f‌o‌r‌c‌e‌d c‌o‌n‌c‌r‌e‌t‌e 3D s‌t‌r‌u‌c‌t‌u‌r‌e‌s, m‌o‌d‌e‌l‌e‌d i‌n b‌o‌t‌h T‌E‌K‌L‌A a‌n‌d R‌e‌v‌i‌t s‌t‌r‌u‌c‌t‌u‌r‌e‌s. B‌y r‌e‌c‌o‌g‌n‌i‌z‌i‌n‌g t‌h‌e p‌o‌i‌n‌t‌s o‌f w‌e‌a‌k‌n‌e‌s‌s o‌f s‌u‌c‌h B‌I‌M a‌p‌p‌l‌i‌c‌a‌t‌i‌o‌n‌s, s‌o‌m‌e p‌r‌a‌c‌t‌i‌c‌a‌l r‌e‌c‌o‌m‌m‌e‌n‌d‌a‌t‌i‌o‌n‌s a‌r‌e p‌r‌o‌v‌i‌d‌e‌d t‌o e‌n‌h‌a‌n‌c‌e t‌h‌e a‌c‌c‌u‌r‌a‌c‌y o‌f a‌u‌t‌o‌m‌a‌t‌i‌c q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f a‌n‌d e‌s‌t‌i‌m‌a‌t‌i‌o‌n. A‌n‌o‌t‌h‌e‌r s‌i‌d‌e p‌r‌o‌d‌u‌c‌t o‌f k‌n‌o‌w‌i‌n‌g t‌h‌e a‌c‌c‌u‌r‌a‌c‌y o‌f a‌u‌t‌o‌m‌a‌t‌e‌d m‌a‌t‌e‌r‌i‌a‌l q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f i‌s p‌r‌o‌v‌i‌d‌i‌n‌g a r‌e‌a‌l‌i‌s‌t‌i‌c e‌s‌t‌i‌m‌a‌t‌e b‌a‌s‌e‌d o‌n t‌h‌e u‌t‌i‌l‌i‌z‌e‌d e‌s‌t‌i‌m‌a‌t‌i‌n‌g a‌p‌p‌r‌o‌a‌c‌h a‌n‌d e‌m‌p‌l‌o‌y‌i‌n‌g B‌I‌M s‌o‌f‌t‌w‌a‌r‌e t‌o a‌v‌o‌i‌d u‌n‌p‌l‌a‌n‌n‌e‌d m‌i‌s‌t‌a‌k‌e‌s i‌n e‌s‌t‌i‌m‌a‌t‌i‌n‌g a‌n‌d q‌u‌a‌n‌t‌i‌t‌y t‌a‌k‌e-o‌f‌f.

The marine and ocean energies are part of renewable energy that Wave energy converters (WECs) are used to extract them. Experimental modeling will be useful in evaluating their performance. In this research, the experimental model of an attenuator WEC is built in the Sea-Based Energy Research Group of the Babol Noshirvani University of Technology, and its performance is studied and evaluated in the wave tank of the university by applying the sea waves conditions. In this evaluation, the effects of wave amplitude and wave period on the average and maximum net power of the Wavestar system are investigated. According to the results, it was observed that in larger wave amplitudes (13 to 15), at 35 and 25 rpm, the maximum net power was close to each other and was 36.7 (Watts) and 31(Watts), respectively. Due to the irregular wave and possible damage to the system at 35 rpm, the wave amplitude of 15 and the speed of 25 rpm are chosen as the optimal mode for better performance of the system.

Background: Medical tourism industry with global revenue of around 20 billion dollars in 2005 is one of the largest industries in the world. Absorbing a percentage of this amount can have a significant impact on medical tourism economy of Asian countries, including Iran. The aim of this study was to provide solutions for attracting medical tourists in Shiraz. Methods: This qualitative study was carried out on health care management specialists, hospital administrators, statistics and medical records' specialists, as well as medical tourism officials in Shiraz University of medical sciences. The participants were selected using targeted sampling method. Focused-group discussion and personal interview techniques were used to obtain the participants' viewpoints. Results: Interviews with experts about the strategies for improving medical tourists’ attraction led to determination of 44 different solutions represented as varied marketing strategies. Conclusion: Applying the offered solutions in different marketing strategies by the relevant managers and authorities of medical tourism can lead to increase of medical tourists' attraction on public and private hospitals in Shiraz city.

Background and Aim: The number of patients who leave hospital against medical advice could reflect patient dissatisfaction and it is a notable important problem. The present study aimed to identify the causes of discharge against medical advice at a hospital of Shiraz University of medical sciences. Materials and Methods: This was a qualitative study using grounded theory. Data were collected through telephone interviews with patients or their concomitants. All interviews were recorded by researcher and thematic method used to analyze the data. Based on it, causes of discharge against medical advice were determined and solutions were provided. Results: Causes of discharge against medical advice were categorized into 3 general themes: "causes related to the status of the hospital", "causes related to hospital staff", and "causes related to patients" that each of them include some sub-themes. Between the sub-themes, the issues relating to the hospital staff and economic status of patient had the most and the least frequency respectively. Conclusion: The research findings make it possible for the hospital managers to find solutions to prevent creation of DAMAs and side effects for early discharged patients, patientschr('39') readmission and imposing additional costs on them. These solutions can be mentioned as attention and understanding of authorities, preparing some amenities for patients, holding justification meetings for medical personnel and students and reengineering some hospital processes.

Background and Aim: The main purpose of all organizations is improving efficiency and effectiveness. One of the barriers of reaching effectiveness is burnout which can be seen as the final outcome of job stress in many professions including nursing. This study aimed to evaluate the correlation between effectiveness of nurses and burnout in Shiraz Nemazee hospital. Materials and Methods: This descriptive-analytic and cross-sectional study was done among all of the nurses in the Shiraz Nemazee hospital. Two hundred and forty five nurses were selected using random classified sampling method. The data gathering form was standardized questionnaire. Data were entered into SPSS 15 software and the Pearson correlation test was used for data analysis. Results: The study nurses were at moderate level according to burnout and effectiveness variables. There were positive correlation between “effectiveness” and “target acquisition” and “preservation of the cultural model” dimensions with “lack of individual success” dimension (P

Introduction: Given the high income that can be earned from health tourism, many people in private sectors are willing to enter this field. Nevertheless, Iran's share of this source of income is small since no active and successful bodies in health tourism market have been developed in private sector. The purpose of this paper is to identify the driving as well as the constraining factors of private sector development in health tourism. Method: This paper is cross-sectional and retrospective. The data were gathered via structured Likert scale questionnaire and face to face interview. The participants of this study were 60 managers working in different tourism agencies in Tehran. In order to analyze the data and evaluate the results, t-test and chi-square test were run using SPSS software version 16. Results: The results of the study indicate that the averages of technology, policy, coordination and security as constraining factors are 3.25, 3.92, 3.90, and 4.02 while they are 4.14, 3.47, 4.04 and 2.53 as driving factors. The results show that except the safety as a driving factor, the averages are higher than (3) for other factors. Conclusion: The multiplicity of decision making and policy making centers, lack of coordination between private and public sectors, technological restrictions and tourists' attitudes concerning unsafety are directly related to the unwillingness of the private sector in investing in health tourism.

Job satisfaction as one of the important variables being studied in organization treatment, is a subject to which the managers of the organizations pay special attention in a way that it is considered as the final goal for the managers in organization behavior issues. Considering the organization culture variant as a crucial and effective factor on job satisfaction, the general purpose of the current research is to study the relation between organization culture and job satisfaction of the employees in Iran's National Company of Distribution of Petroleum Products in the district of Mazandaran Province. A statistical society of 420 of this company was considered in order to respond to the problem of existence and intensity of the relation between the two variants being studied. Accordingly, along with a comprehensive review of the subjective literature relating to the organization culture and job satisfaction, 235 cases as statistical samples were selected among the above mentioned statistical society. Then, in the form of field and library research, necessary data and information were collected by using the questionnaire and SPSS software and Lisrel software were also used in order to perform the related statistical tests to study the affectivity between the organization culture and job satisfaction of the employees in the National Company of Distribution of Petroleum Products. The result of the research shows that the totality of the affectivity of organization culture factors on the job satisfaction of the personnel of National Company of Distribution of Petroleum Products in Mazandaran Province is admitted based on the structural equations, and the variables of Organization Identity and Relation Model have been the most effective factors on the personnel satisfaction. On the other hand compromise or conflict and manager support (or protections were the least effective factors.

Introduction: Selection and employment of clerks and managers is a crucial factor in modern organization and, recruiters try to select the best candidates in all organizational levels. One challenge which has been harmful for management stability is Similar-to-me (STM) effect. This effect explains that people usually tend to select a person with whom they have common demographic and attitudinal characteristics. Determination of all factors and challenges related to STM was the main objective of the present study. Method: This is a descriptive, cross-sectional study performed on all managers of Shiraz University of Medical Sciences (SUMS). A four-dimension questionnaire was applied with more than 0.7 α Chronbach coefficient for all dimensions. Moreover, its content validity was approved by experts' perspectives. SPSS 18 and Person correlation were used in to analyze the data. Results: According to the results obtained with the participation of 60 mangers of Shiraz University of Medical Sciences, narcissism had a significant correlation with STM effect (0.805). Also a positive correlation was observed between STM and groupthinking (0.875). Another result of the current research was the negative impact of functional conflict on STM (-0.685) Conclusion: Findings of the study revealed that the destructive consequences of similar-to-me effect through narcissism, groupthinking and functional conflict avoidance can affect the performance of SUMS managers negatively. These behaviors should be studied and prevented in order to achieve the goals of this system in the future. [ABSTRACT FROM AUTHOR]