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Background & Aims: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. MS is the result of damage to myelin. There is the exact relationship between stress and the onset or progression of MS so stress management is important in MS patients. Materials & Methods: This study intended to investigate the effect of stress management educational program based on Basnef model to improve behavior in MS patients. This was a quasi-experimental study that was performed on 100 MS patients between the ages of 15-50 years from Sina and Shariati hospitals, Tehran. Participants in the study randomly divided into two groups: experimental and control groups. The instruments for data collecting were a questionnaire which was developed by the researcher and established based on the Basnef model. The both groups completed the questionnaires before and one month after intervention, while only the patients in the experimental group participated in 3 educational intervention sessions. Eventually, the data were analyzed by using independent-t, chi-square and mann-whitney statistical tests. Result: Our findings indicated that both groups didn't have any significant difference based on Basnef model variables (attitudes, subjective norm, enabling factors, and intention) before intervention. But the mean scores of Basnef model variables were significantly increased in the experimental group compared to the controls after intervention. Also behavioral methods of stress management improved significantly among the experimental group, compared to control group. Conclusion: Since stress management is highly recommended for MS patients, applying the Basnef model is very effective for developing an educational program for MS patients in order to control their stress. [ABSTRACT FROM AUTHOR]

Introduction: Due to the population explosion and its detrimental effects on different parts of society and the fact that men do not play a significant role in family planning, this study was conducted aiming at investigating the effects of education through health Belief Model on the knowledge and attitude of male teachers in Marvedasht about family planning. Material and Methods: This is a quasi-experimental research. It was a kind of before and after intervention research. 90 male teachers were evaluated by a questionnaire including personal, attitudinal, and knowledge- estimating questions. The educational program was performed using pamphlets and question and answer meetings according to health belief model. The results were analyzed using t-tests, χ2, and Pearson and Spearman correlation. Results: The results of the t-tests between the scores of awareness and attitude before and after training the teachers under the study show that there was a statistically significant difference before and after the training program (P<0.001). Moreover, there was a correlation between awareness and attitude scores of the individuals as well as the variables of the individuals' age, their spouses' age, the number of children, job, and their spouses' level of education. Conclusion: Education can increase the knowledge and change in the attitudes of the individuals about family planning. Finally, it is suggested that the educational programs related to family planning which are specially designed for men be designed by the health authorities in our country. [ABSTRACT FROM AUTHOR]

Background: Optimal, need-based, and equitable allocation of financial resources is one of the most important concerns of health systems worldwide. Fulfilling this goal requires considering various criteria when allocating resources. The present study was conducted to identify the need indicators used to allocate health resources in different countries worldwide., Methods: A systematic review conducted on all published articles and reports on the need-based allocation of health financial resources in the English language from 1990 to 2020 in databases, including PubMed, Cochrane, and Scopus as well as those in Persian language databases, including magiran, SID, and Google and Google scholar search engines. After performing different stages of screening, appropriate studies were identified and their information were extracted independently by two people, which were then controlled by a third person. The extracted data were finally analyzed by content analysis method using MAXQDA 10 software., Result: This search yielded 823 studies, of which 29 were included for the final review. The findings indicated that many need-based resource allocation formulas attempt to deal with health care needs using some weighting methods for individuals. In this regard, the most commonly used indicators were found as follows: age, gender, socio-economic status or deprivation, ethnicity, standardized mortality ratio (SMR), the modified health indicators (disease consequences, self-assessed health, and disability), geographical area / place of residence (geographical) (rural versus urban), cross-boundary flows, cost of services, and donations., Conclusion: The indicators used in allocating the health systems' financial resources in each country should be designed in order to be simple and transparent and in accordance with the moral norms of that society. Moreover, these should be a good representative of the health needs of people in different geographical areas of that country. In addition, their related data should be available to an acceptable extent., (© 2021. The Author(s).)

Background: Evidence- Based Medicine (EBM) refers to the ability and skill in the use and integration of the best evidence obtained from repeatable bias-free clinical trials with the patients' preferences and conditions. Considering this fact that few large-scale studies have been done in this field in Iran, the present study aimed at comprehensively reviewing the status of EBM performance among health care providers in Iranian hospitals. Methods: This cross-sectional study was conducted during 2014 and 2015. Study participants consisted of 2800 health care providers (physicians, nurses, midwives, and paramedical personnel) in active hospitals in Iran. Data collection tool was a self-made questionnaire. Content validity of the questionnaire was improved by comments of 10 experts. The reliability of the questionnaire was assessed using test-retest method (α= 0.85). Results: The results revealed that only 12.7% and 15.8% of the participants were highly familiar with EBM databases and terminologies, respectively. Most participants believed that EBM-related workshops and practical involvement in EBM-related programs and activities can have a more effect on the improvement of EBM performance. Most participants had a positive view of the EBM. About 47% of the participants reported that their EBM knowledge and skills is high. Among the demographic variables, there were only significant relationships between work experience and attitude, gender and attitudes, and between knowledge and skills (p<0.05). Conclusion: According to the results of the present study, it seems that holding EBM-related workshops and practical participation in EBP-related programs and activities as well as improving facilities such as manpower, equipment, and access can have a significant effect on improving EBM- related activities.

Background: Social networking has a dramatically increasing trend among adolescents. By creating novel models of content production, distribution, and reception, this space has introduced opportunities and threats for adolescents, which must be understood in relation with their health status. This study was conducted with the aim of describing the psychosocial experiences of Iranian adolescents in the Internet's virtual space. Methods: The present qualitative formal content analysis was conducted in Mashhad a city Iran. The participants included 32 adolescents of 13-18 years of age. Data were collected through 32 semi-structured individual and group interviews with maximum variation. The data were recorded, transcribed, and then analyzed via MAXQ 10 software. Results: In this study, 2 main themes of "moving towards constructiveness" and "perceiving social and psychological tensions" were formed. Accordingly, 9 subcategories were formulated including: increasing the social capital, a good feeling in life, escaping loneliness, being seen in the social network, intelligent selection of content, perceived threats, temptation, decline of behavioral values and principles, and emotional and social helplessness. Conclusion: Adolescents' positive and negative experiences in the Internet form based on personal and environmental factors. These experiences affect the mental and social dimensions of their health. These factors call for the attention of scholars and policymakers for developing enabling strategies for adolescents, and their families and for experts for promoting adolescents' health.

Background: Effective leadership that rises from managerial training courses is highly constructive in managing hospitals more effectively. This study aims at investigating the relationship between leadership effectiveness with providing management training courses for hospital managers. Methods: This was a cross-sectional study carried out on top and middle managers of 16 hospitals of Iran University of Medical Sciences. As a sample, 96 participants were selected through census method. Data were collected using leadership effectiveness and style questionnaire, whose validity and reliability were certified in previous studies. Pearson correlation coefficient and linear regressions were used for data analysis. Results: Leadership effectiveness score was estimated to be 4.36, showing a suitable status for managers' leadership effectiveness compared to the set criteria. No significant difference was found between leadership effectiveness and styles among managers who had passed the training courses with those who had not (p>0.05). Conclusion: Passing managerial training courses may have no significant effect on managers' leadership effectiveness, but there may be some other variables which should be meticulously studied.

Background: Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran., Methods: This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software., Results: According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389., Conclusion: This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved.

Background: Nowadays, for quality improvement, measuring patient safety culture (PSC) in healthcare organizations is being increasingly used. The aim of this study was to clarify PSC status in Iranian hospitals using a meta-analysis method., Methods: Six databases were searched: PubMed, Scopus, Google Scholar, Cochrane Library, Magiran, SID and IranMedex using the search terms including patient safety, patient safety culture, patient safety climate and combined with hospital (such as "hospital survey on patient safety culture"), measurement, assessment, survey and Iran. A total of 11 articles which conducted using Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire initially were reviewed. To estimate overall PSC status and perform the meta-analyses, Comprehensive Meta-Analysis (CMA) software v. 2 was employed., Results: The overall PSC score based on the random model was 50.1%. "Teamwork within hospital units" dimension received the highest score of PSC (67.4%) and "Non-punitive response to error" the lowest score (32.4%). About 41% of participants in reviewed articles evaluate their hospitals' performance in PSC as 'excellent/very good'. Approximately %52.7 of participants did not report any adverse event in the past 12 months., Conclusion: The results of this study show that Iranian hospitals' performances in PSC were poor. Among the 12 dimensions of HSOPSC questionnaire, the "Non-punitive response to error" achieved the lowest score and could be a priority for future interventions. In this regard, hospitals staff should be encouraged to report adverse event without fear of punitive action.

Background: Households' financial protection against health payments and expenditures and equity in utilization of health care services are of the most important tasks of governments. This study aims to measuring equity in household's health care payments according to fairness in financial contribution (FFC) and Kakwani indices in Tehran-Iran, 2013., Methods: This cross-sectional study was conducted in 2014.The study sample size was estimated to be 2200 households. Households were selected using stratified-cluster sampling including typical families who reside in the city of Tehran. The data were analyzed through Excel and Stata v.11software. Recall period for the inpatient care was 1 year and for outpatient1 month., Results: The indicator of FFC for households in health financing was estimated to be 0.68 and the trend of the indicator was ascending by the rise in the ranking of households' financial level. The Kakwani index was estimated to be a negative number (-0.00125) which indicated the descending trend of health financing system. By redistribution of incomes or the exempt of the poorest quintiles from health payments, Kakwani index was estimated to be a positive number (0.090555) which indicated the ascending trend of health financing system., Conclusion: According to this study, the equity indices in health care financing denote injustice and a descending trend in the health care financing system. This finding clearly shows that deliberate policy making in health financing by national health authorities and protecting low-income households against health expenditures are required to improve the equity in health.

Background: Dental traumas are common among children and adolescents in many societies posing health and social problems. The aim of this study was to conduct a systematic review and meta-analysis on prevalence, etiology, types, and other epidemiologic aspects of dental trauma in children and adolescents (0-18 years old)., Methods: In this systematic meta-analytical review, data were collected searching for key words including traumatic dental injuries, dental trauma, dental injury, dental trauma, tooth injuries, tooth trauma, traumatized teeth, dentoalveolar trauma, oral trauma, epidemiology, etiology, prevalence, incidence, occurrence, child*, and adolescence in the following databases: Scopus, CINAHL, Science Direct, PubMed and Google scholar., Results: From the total of 3197 articles, 44 completely relevant papers were included in the study. The prevalence of dental trauma was variable based on geographical area and was estimated 17.5% in the population, with higher prevalence in boys. Falling was the major cause for dental trauma, and the most frequent location was home. The most frequent type of trauma was enamel fracture., Conclusion: A relatively high prevalence was detected for dental trauma, which calls for effective planning and intervention to prevent the occurrence in children and adolescents. These may include special care for children, eliminating fall-prone areas, installing safety measures at homes, using protective appliances in sports, education, and raising the knowledge and availability of services to address enamel fracture. Region-specific criteria should be taken into account in programs and interventions.

Background: Drug costs in Iran accounts for about 30% of the total health care expenditure. Moreover, pharmaceutical business lies among the world's greatest businesses. The aim of this study was to analyze Iran's comparative advantage and intra-industry trade in pharmaceuticals so that suitable policies can be developed and implemented in order to boost Iran's trade in this field., Methods: To identify Iran's comparative advantage in pharmaceuticals, trade specialization, export propensity, import penetration and Balassa and Vollrath indexes were calculated and the results were compared with other pharmaceutical exporting countries. The extent and growth of Iran's intra-industry trade in pharmaceuticals were measured and evaluated using the Grubel-Lloyd and Menon-Dixon indexes. The required data was obtained from Iran's Customs Administration, Iran's pharmaceutical Statistics, World Bank and International Trade Center., Results: The results showed that among pharmaceutical exporting countries, Iran has a high level of comparative disadvantage in pharmaceutical products because it holds a small share in world's total pharmaceutical exports. Also, the low extent of bilateral intra-industry trade between Iran and its trading partners in pharmaceuticals shows the trading model of Iran's pharmaceutical industry is mostly inter-industry trade rather than intra-industry trade. In addition, the growth of Iran's intra-industry trade in pharmaceuticals is due to its shares of imports from pharmaceutical exporting countries to Iran and exports from Iran to its neighboring countries., Conclusions: The results of the analysis can play a valuable role in helping pharmaceutical companies and policy makers to boost pharmaceutical trade.

Background: Effective leadership is essential to passing through obstacles facing the health field.The current health care system in Iran has major problems and gaps in the field of effective leadership. The aim of this study was to evaluate hospital managers' leadership style through selfassessment and to determine the correlation between leadership styles with healthcare executives' leadership readiness and leadership effectiveness., Methods: In this cross-sectional study a self-administered questionnaire completed by all internal healthcare executives of all teaching and non-teaching hospitals affiliated to Iran University of Medical Sciences. Questionnaire was composed to determine demographic information, leadership style questions, leadership effectiveness and leadership readiness. Descriptive statistics and Pearson correlation coefficient were used for data analysis., Results: According to the findings, the dominant style of healthcare executives was transformational leadership style (with a score of 4.34). The leadership effectiveness was estimated at about 4.36 that shows the appropriate level of leadership effectiveness. There was a significant correlation (correlation coefficient of 0.244) between leadership readiness and transformational leadership style (p<0.05). Also, there was a significant correlation between leadership effectiveness with transformational (0.051) and transactional (0.216) styles., Conclusion: There was a correlation between leadership readiness and leadership effectiveness with leadership styles. Application of this research will be crucial to universities and healthcare executives. This study suggests that strengthening the scientific basis is essential for leadership readiness and leadership effectiveness in healthcare system.