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Student life stress, characterized by mental pressure arising from the university life demands, is a significant concern. We aimed to investigate stressors faced by students and their coping mechanisms within an Iranian university. Using a crosssectional design in 2021, we selected 165 international students through simple random sampling. Data were collected using a standardized student life stress questionnaire. The mean score of students' stresses was (63 ± 17), with selfimposed stress being the most prevalent stressor (64%), while conflict was the least prevalent (44%). When examining students' reactions to stressors, the mean score was (64 ± 21), with cognitive reactions being the most common response (68%) whereas behavioral reactions were the least common (38%). There was no significant relationship between students' stress levels and their demographic characteristics. Overall, our study highlights the need for culturally sensitive and tailored support programs for international students, as most participants experienced moderate stress. [ABSTRACT FROM AUTHOR]

Background: Accreditation and ISO 9001 programs in hospitals are widely adopted for quality control and quality improvement in healthcare. Objectives: The objective of this study is to identify stakeholders' perspectives and experiences regarding the implementation of accreditation and ISO 9001 programs in hospitals affiliated with the Social Security Organization in Alborz Province, Iran. Methods: In this qualitative study, participants were selected based on purposive sampling. For data collection, semi-structured one-to-one interviews were conducted with hospital staff in different positions (n = 30). All interviews were digitally recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Based on the analysis, 10 primary themes and 88 subthemes were identified. The 10 primary themes were categorized as experiences, strengths, weaknesses, effective factors, and recommendations for the implementation of accreditation and ISO 9001 programs in hospitals. Proper planning, benchmarking, physician involvement, increased resources, and more training are suggested for the successful implementation of accreditation in hospitals. Additionally, fostering a positive culture, focusing on the executive dimension, changing managerial attitudes, training, and supporting and motivating staff are the most important recommendations for the implementation of the ISO 9001 program. Conclusions: The results provide important insights into the dimensions of implementing accreditation and ISO programs in hospitals, which can be used by health policymakers and managers to improve the implementation of these programs in Iranian hospitals. [ABSTRACT FROM AUTHOR]

Objectives Falling can have significant negative consequences on the health and quality of life of older adults. This study aims to assess the effect of online self-care education on the knowledge, attitude and practice of older adults in preventing falls at home. Methods & Materials This is a quasi-experimental study with a pre-test/post-test/follow-up design that was conducted on 120 people aged ≥65 years referring to comprehensive health centers in the south of Tehran, Iran, in 2021. A researcher-made questionnaire was completed by the participants before, immediately after, and three months after the intervention. The intervention was a virtual self-care educational program for fall prevention at home. Data analysis was done in SPSS software, version 26 using descriptive statistics (such as Mean±SD) and analytical tests including independent t-test, Mann- Whitney U test, and chi-square test. Results About 22% of the elderly had a history of falling in the past year. Immediately after the intervention, the mean scores of knowledge, attitude, and practice were 18.39±2.86, 14.99±2.51, and 13.76±3.1, respectively, which were significantly higher than the pre-test scores (P<0.001). Three months after the intervention, the mean scores of knowledge, attitude, and practice were 18.18±1.14, 14.91±1.57, and 9.06±2.78, respectively, which were significantly higher than the pre-test scores (P<0.001). Conclusion Online self-care education for fall prevention at home can significantly increase the knowledge, attitude, and practice of the elderly and reduce the risk of falling. [ABSTRACT FROM AUTHOR]

The article emphasizes the importance of integrating equity into the healthcare accreditation process in Iran. Topics include the historical evolution of healthcare accreditation and its implementation in Iran, the limited focus on equity within existing accreditation standards, and the role of equity in achieving sustainable development goals and universal health coverage.

Background: Philanthropic activities play an important role in health systems. Donors contribute to financing, generating resources, and providing healthcare services in Iranian health system. However, they face many challenges. This study aimed to identify barriers to donors' participation in the Iranian health system and to provide solutions. Methods: This qualitative study was performed using semi-structured interviews with 38 donors and 26 policy-makers and managers in the social affairs department of health ministry and medical universities in 2018. In addition, document analysis was performed and the relevant data were extracted. Thematic analysis was used for data analysis. All ethical considerations were followed in this research. Results: Insufficient structures, poor communications, low trust, ineffective working processes, bureaucracy, insufficient senior managers' support, weak legal support and poor monitoring were the most important challenges for donors' participation in the Iranian health system. Effective donor participation in the health system requires the creation of an appropriate system including the right structures, processes, culture, and management. The necessary changes must be planned, led and monitored to promote donors' participation in healthcare. A conceptual model was developed to strengthen donors' participation in the health system. Conclusion: Iranian donors face structural, procedural, cultural, and managerial challenges when financing the health system, generating resources, and providing health services. Policy-makers and managers should tackle these challenges and adopt strategies to reinforce donors' participation in the health system. Planning, organizing, leading, monitoring, evaluation, transparency, accountability, and a commitment to meet donors' needs are necessary for successful philanthropy initiatives in the health sector. [ABSTRACT FROM AUTHOR]

Keywords: waste; waste management; hospital waste; Tehran University of Medical Sciences (TUMS); Iran; Tehran; wmr 1396--1 304 Report: The assessment of hospital waste management: a case study in Tehran SAGE [...]

Objectives: Improving the organizational structure of medical universities and the continuous adaptation to the mission and new functions is an irrefutable necessity. The current article aimed to explain how this improvement was happened in 2019 in Iran medical universities. Methods: It takes qualitative method with managers and experts from the Ministry of Health and 17 medical universities. Via the Snowball sampling method 57 people were interviewed by using semi-structured in-depth method. MAXQDA 2020 software was used for the content analysis. Results: The opportunity window was opened for medical universities to reform their organizational structure according the agenda of the Ministry of Health in 11th government. High-level documents and laws related to this subject, in addition to the cooperation of medical universities process owners and the Ministry of Health stakeholders and the formation of specialized working groups lead to formulate organizational structure (policy stream). Conclusion: Regarding to having a dynamic and flexible structure for meeting environmental needs, Iranian medical universities were modified in 2013 by Ministry of Health policymakers and managers. The Kingdon Multi-Stream Model helps to better understand the content of this policy. [ABSTRACT FROM AUTHOR]

Abstract Background As Iran started to experience population ageing, it is important to consider and address the elderly people's needs and concerns, which might have direct impacts on their well-being and quality of life. There have been only a few researches into different aspects of life of the elderly population in Iran including their health-related quality of life. The purpose of this study was to measure health-related quality of life (HRQoL) of elderly Iranians and to identify its some determinant factors. Methods This was a cross-sectional survey of a random sample of community residents of Tehran aged 65 years old and over. HRQoL was measured using the Short From Health Survey (SF-36). The study participants were interviewed at their homes. Uni-variate analysis was performed for group comparison and logistic regression analysis conducted to predict quality of life determinants. Results In all, 400 elderly Iranian were interviewed. The majority of the participants were men (56.5%) and almost half of the participants were illiterate (n = 199, 49.8%). Eighty-five percent of the elderly were living with their family or relatives and about 70% were married. Only 12% of participants evaluated their economic status as being good and most of people had moderate or poor economic status. The mean scores for the SF-36 subscales ranged from 70.0 (SD = 25.9) for physical functioning to 53.5 (SD = 29.1) for bodily pain and in general, the respondents significantly showed better condition on mental component of the SF-36 than its physical component (mean scores 63.8 versus 55.0). Performing uni-variate analysis we found that women reported significantly poorer HRQoL. Multiple logistic regression analysis showed that for the physical component summary score of the SF-36, age, gender, education and economic status were significant determinants of poorer physical health-related quality of life; while for the mental component summary score only gender and economic status were significant determinants of poorer mental health-related quality of life. The analysis suggested that the elderly people's economic status was the most significant predictor of their HRQoL. Conclusion The study findings, although with a small number of participants, indicate that elderly people living in Tehran, Iran suffer from relatively poor HRQoL; particularly elderly women and those with lower education. Indeed to improve quality of life among elderly Iranians much more attention should be paid to all aspects of their life including their health, and economic status.

Objectives: To investigate direct and stress-buffering associations between social support from family and the mental health of older people in Iran, a country which has recently undergone an exceptionally fast fertility transition and is consequently experiencing rapid population ageing. Method: A cross-sectional stratified random survey of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. The Social Provisions Scale and the General Health Questionnaire were used to measure perceived social support and mental health, respectively. Multilevel mixed-effects models were used to examine the hypotheses. Results: The findings supported the hypothesis of a direct association between perceived and received social support and mental health. However, we did not find strong evidence to suggest that social support buffered the effects of stress arising from limitations of physical functioning. Lack of help doing paperwork was associated with worse mental health for women but not men. Source of support did not seem to be important. Conclusion: Our results indicated that in Tehran, as in Western settings, social support is important for the mental well-being of older people. Recommendations for policy and further research priorities based on the study findings were provided. [ABSTRACT FROM AUTHOR]