مریم معینی

Graduate studies in medical universities face the challenge of lengthening the duration of studies, which negatively affects both students and the educational system. This increases costs, reduces productivity, and demotivates students. Qualitative research has identified key factors associated with this process by identifying the experiences of successful students in completing their studies on time. The study findings showed that the quality of faculty guidance, student personal motivation, and academic support are the three main pillars in accelerating the educational process. Students who had a more effective relationship with their supervisor, chose a research topic that suited their interests, and benefited from educational support were more likely to complete their studies on time. Accordingly, several operational solutions were proposed as policy options: Establishing a monitoring system to improve the quality of faculty guidance can help reduce conflicts and increase the effectiveness of this relationship. Providing expert advice on choosing a thesis topic is also another effective measure that helps students start their research faster. Developing skill-building workshops in areas such as research methods and time management can enhance students' capabilities. Also, designing preparatory courses for new students can help them adapt more quickly to the academic environment. Finally, targeted financial support for students in need can reduce some of their concerns. Implementing these solutions requires the support of all stakeholders, including students, faculty, and educational administrators.

A qualitative study has studied the preferences of parents referring to pediatric dental centers in Isfahan to identify factors related to the selection of these centers. The findings showed that parents pay special attention to factors such as ease of access, history and reputation of the center, physical environment suitable for children, efficient scheduling system, treatment costs, quality of services, and staff behavior. To improve these indicators, several solutions have been proposed, including facilitating the scheduling system mainly development of online scheduling systems, specialized training of staff in dealing with children, expansion of insurance coverage of dental services, design of child-friendly treatment environments, and increase in service centers in deprived areas. The implementation of these solutions is accompanied by challenges, the most important of which include financial constraints, resistance to changing traditional methods, infrastructure problems in underprivileged areas, and inadequacies of insurance systems. To overcome these obstacles, it was suggested that low-cost and quickly implementable projects such as the establishment of an electronic scheduling system be prioritized. At the same time, communication skills of employees can be improved by holding training courses. For more costly sectors such as physical development of centers or expansion of insurance coverage, attracting private sector participation and long-term planning seem essential. The important point in the successful implementation of these plans is to include all stakeholders, including medical centers, employees, insurance companies and especially families.

Postgraduate students are under increasing pressure to complete their studies within set time frames. This research aims to identify the components related to graduating in-time in the postgraduate courses of the School of Management and Medical Information Sciences of Isfahan University of Medical Sciences from the student's point of view.

This qualitative study was conducted in the first half of 2023. Participants were master's degree students entering the year 2013 and later, as well as doctoral students entering the year 2014 and later of the School of Management and Medical Information Sciences of Isfahan University of Medical Sciences, who in the approved period had successfully completed their courses. The sampling method was convenient and included five students. Semi-structured interviews were used to collect research data, either face-to-face or by phone.

The result of the research was 12 issues or subthemes, seven themes, and three main themes. Identified concepts were classified into the following three main themes: "pre-existing factors," "educational domain," and "personal characteristics."

Graduating in-time postgraduate levels depends on various factors at the individual and university level. The research results can provide more understanding and knowledge of the mentioned factors and help educational planners plan more effectively, considering the different conditions of students and the heterogeneity of postgraduate courses.

The coverage of dental services by the health system is not only related to reducing the financial burden of oral and dental diseases of households but also helps to improve the oral and dental health of children. The purpose of this study is to investigate the prioritization of parents to cover dental services for children in the form of basic medical insurance.

The present study is a cross-sectional survey that was conducted in Isfahan City in the winter of 2018 and spring of 2019. The statistical population included households with children aged 6-12 who, at the time of sampling, had visited public and private dental clinics with pediatric dental specialists in Isfahan City to receive dental services for children. Data collection was done through a researcher-made questionnaire. Out of the 464 questionnaires, 51 questionnaires were completed online and 413 questionnaires were completed through face-to-face interviews. STATA 14 software was used for data analysis.

The findings of the study show that the expansion of pediatric dental care in social health insurance is a priority for parents.

The findings of the study show that the expansion of children's dental services in social health insurance is an unmet demand. This finding can be of interest to oral and dental health policymakers as well as medical insurance policymakers.

Statistical facts show that despite the declining trend of death rates for populations across the developed countries as well as for non-white Americans, the death rate among middle-aged white Americans without a college degree has increased since the beginning of the 21st century causing a decrease in life expectancy in USA. The increase in deaths among middle-aged whites has been attributed to suicide, drug overdose, and alcohol-related liver disease. This phenomenon has been labeled deaths of despair. The original causes of deaths of despair in American society are a long economic stagnation and the way they as a nation have dealt with it. The original causes have raised competition in the market of low-skilled jobs. Subsequent rise in unemployment rate among lower-skilled whites has accelerated deaths of despair. In the past few decades, Iran has faced the problem of economic stagnation or very low rates of economic growth, thus experiencing a high unemployment rate. Therefore, deaths of despair are a potential threat for Iranian society. In order to prevent and mitigate such deaths in Iranian society, a national consensus seems to be vital to put sustainable and long-term economic growth as a top priority in public policy.

Israʼiliyyat (Israelisms) are superstitious beliefs and stories that have taken root in the teachings of some previous nations, especially the Children of Israel, and have been introduced into the religious texts of Muslims by Jews pretending to be Muslims, and have caused deviations in the religious texts and hadiths of the Islamic Ummah. The introduction of these forgeries into Islamic sources has caused suspicions and the spread of many superstitions among Muslims, which have nothing to do with the Quran or the Prophetic Sunnah. Various aspects of our cultural life, especially from the perspective of religious beliefs and perceptions with beliefs arising from Israel, need a serious revision. In this article, which has been conducted through a descriptive-analytical method, an attempt has been made to reveal the contradictions between this chain of narrations with the Quran and the Sunnah. The most important result of this research is that the negative beliefs about women and superstitions in the story of the creation of Eve in some interpretations, have roots in Israʼiliyyat (Israelisms) and fake traditions, and what has caused the wrong perception and understanding in this area is this penetration.

Knowledge about health care utilization and its determinants are important for health care planning. Andersen’s behavioral model of health services use is one of the most widely acknowledged models identifying predictors of health care utilization is the. According to Andersen’s model, factors associated with utilization of health services include predisposing factors, enabling factors, and need factors (health status). The purpose of this study is to identify the factors related to the utilization of inpatients health services in Iran, according to the Andersen’s behavioral model.

The present study is a secondary analysis of two waves of the Utilization of Health Services Survey conducting in the years of 2007 and 2015. The samples were 8326 and 5684 in 2007 and 2015, respectively. The Logistic regression model was used to analyze utilization of inpatient health services.

It was found that women (OR=1/48, P-value≤0/01), older patients (OR=1/01, P-value≤0/05), referral patients (OR=1/98, P-value≤0/01), those living in a household with a head educated more than diploma(OR=1/65, P-value≤0/01), and patients living in deprived areas of the country (OR=1/42, P value≤0/01) were more likely to use inpatient services. Furthermore, the odd of using inpatient health services were higher in the year of 2015 (OR=2/15, P-value≤0/01).

Andersen’s Behavioral Model of Health Services can be a good theoretical framework to explain the determinants of inpatient health services utilization in Iran. These factors should be considered for making policies related to inpatient health services in Iran.

Oral health is an important factor affecting quality of life. This research examined the correlates of demand for basic dental services among the Iranian households.

This research was a secondary data analysis of cross-sectional data in which the data extracted from National Survey of Iran’s Household Income and Expenditure Survey-2018 were analyzed. The study sample included 17548 eligible households from whole country. The logistic regression model was used to analyze demand for basic dental services. Three regression models were estimated.

The probability of demand for basic dental services was reduced as households’ heads were more educated, non-married or unemployed (p value < 0.05). The probabilities of demand for basic dental services were higher among households of higher income quintiles comparing to the first income quintile (p value < 0.05). Furthermore, the probability of demand for basic dental services was higher among those households with elderlies aged more than 70 years old or those households with children aged between 6-12 years old (p value < 0.05).

The possibility of demand forbasic dental services was correlated to demographic and economic factors as well as age component of household’s members. As a result, dental health policymakersshould pay attention to demographic and economic status and age status of population.

Dental insurance package provided with health system is related to promotion of dental health, and reduction of burden of dental diseases. The purpose of this study is to investigate the willingness to pay of households for children's dental insurance coverage with using the open-ended question technique.

The present study is a cross-sectional survey. Sample size included 496 head of household or their spouses who had at least one 6-12 years old child and visited to selected dental clinics in Isfahan city in the year of 2020. An online /paper & pencil self-completion questionnaire was filled in by each respondent.The open-ended question technique was used to estimate the willingness to pay of respondents. Stata11 software was used to process the data.

The mean of monthly WTP per each child in the scenarios with ceiling reimbursement was 285782.2 Rial. The highest and lowest WTP for those scenarios averaged 44365.8 Rial and 195819.7 Rial, respectively. The mean of monthly WTP per each child in the scenarios without ceiling reimbursement was 246926.2 Rial. The highest and lowest WTP for these scenarios averaged 345319.2 Rial and 165629 Rial, respectively.

The findings indicated that households value pediatric dental insurance packages differently considering the attributes of each dental package. Thus, policy-makers and health insurers need to pay special attention to households’ valuation for pediatric dental insurance coverage.

 The patients ‘satisfaction with health service is one of the five indicators of quality evaluation in health care programs. This study aimed to identify the attributes related to the non-satisfaction of insurance coverage among patients visited to dental clinics.

In the framework of a qualitative study conducted in Tehran city, six private and public dental clinics were selected in regions with variant socio-economic status. Face-to-face interviews with the head of household or their spouses who visited to selected dental clinics were carried out and sampling continued until saturation. Data collection lasted from October until February 2018. Thematic analysis was used for content analysis and MAXQDA12 software was applied for data analys

54 interviews were conducted and overall 14 codes were extracted. Peculiarity and non-peculiarity attributes were identified as two main attributes related to dissatisfaction of the basic and complementary health insurance. To more detail, both basic and complementary insured interviewees expressed dissatisfaction with high premiums, inadequate service packages, as well as rarity of contract centers. Moreover, the interviewees with basic insurance were highly dissatisfied with quality of health services, and those of complementary coverage were dissatisfied with reimbursement system of insurance.

The findings suggest that in order to improve the level of satisfaction with insurance coverage, it is necessary for policy makers to consider the affordability of insurance coverage, insurance packages, and also the quality of health services provided by insurers.

The present article intends to discover the motives of the youth to enter Islamic Science Hawzah and reasons of some students to abandon their studies in Islamic Science Hawzah.

This research was based on the qualitative method and based on grounded theory. The semi-structured interview was conducted with 10 of these students. These people were selected based on the Snowball sampling, and the interviews continued to a theoretical saturation.

Spiritual, scientific, social, and instrumental motivations motivated individuals to study in Islamic Science Hawzah. On the other hand, the quality of the education system had led to the loss of knowledge amongst the learners, which, in turn, had implications for the individual, the organization (Islamic Science Hawzah), and society.

 The change in attitude towards Islamic science Hawzah is necessary. If the Islamic science Hawzah is considered to be a cultural center, then it can be planned with the right definition of its mission to reach this mission.

Equal distribution of human resources in health sectors was one of the main aspects of Alma-Ata Declaration (2000). Since physicians are among the skillful human resources in health sector, optimal allocation of medical specialties has been always a challenge for policy makers. Distribution of general medicine physicians and specialties is related to medical students’ preferences for speciality choice. This study aimed to identify the factors affecting preferences in choosing medical specialty.

This was a qualitative study based on the grounded theory. Through apllying snowball sampling, participants were selected from senior medical students of Isfahan University of Medical Sciences in the academic year 2016/2017and 28 interviews were conducted. Data analysis was done based on thematic analysis and applying MAXQDA18 software.

We extracted 4 main themes and 10 subthemes. Main themes included students’ perception of the medical specialties, students’ characteristics, medical specialties’ characteristics, and social conditions. 

In order to attract medical students to more needed medical specialities and optimal distribution of specialities, policy makers should consider both individual and social determinants of medical specialty choice.

Informal payments are out-of-pocket payments that are paid to health care providers for services that must be provided to patients with no cost. These services can be in various forms including cash or non-cash contributions and presents. Since the informal payments have a significant effect on the health care system in terms of equity, access, and efficiency, the aim of this study was to estimate the amount and frequency of informal payments in patients referring to the Isfahan hospitals.
This study was a cross-sectional study which was carried out during the last six months of 2015 in 10 hospitals of Isfahan. 250 patients were randomly selected and their demographic profile consisted of gender, age, type of insurance, payment amount, type of treatment, hospital, etc. To collect the data regarding the amount of informal payment obtained by health care providers, questionnaires and telephone interviews were adopted and data analysis was carried out using SPSS 19 software.
Results of the study showed that 27.2 % of patients had informal payments. The average informal payment made to doctors was 590,000 Tomans, to nurses was 23,500 Tomans and to other staff was 14,500 Tomans per patient. With informal payments compared to non- informal payments, the results revealed there was significant statistical differences (P This study revealed the amount, frequency and variables that contributed to patients’ informal payments. Considering the negative consequences of informal payments, it is recommended that by controlling and studying the influential variables as well as paying enough attention to the amount of these payments in different groups, these payments can be detected and prevented.

Any personal decision to invest in higher education requires evaluation of its economic return. This paper aimed to analyze the expected economic return of general medicine and medical specialty programs from the viewpoints of general medicine students.

This study was a descriptive, cross-sectional, applied study. Using Gorjesy & Morgan table, a total of 208 general medicine students were selected from Isfahan University of Medical Sciences in 2016. The internal rate of return (IRR) method was applied to evaluate the investment in general medicine and medical specialty programs. Data collection tool was a questionnaire designed according to Hackman & Oldham’s standard job motivation questionnaire with the items adjusted for general medicine and medical specialty programs. The content validity and repeatable reliability were confirmed by experts’ opinion and inter-cluster correlation coefficient (r=0.82) respectively. Data were analyzed in Stata 12.

The students believed that the general medicine and medical specialty programs had higher expected return in comparison to competing fields with medical specialties having the greatest expected return among all of the assessed fields of study. The expected return of general medicine and medical specialty programs was higher for the male students.

Medical students showed an economically oriented behavior in choosing their field of study. They considered their expected economic evaluations in deciding to continue their studies in general medicine and medical specialty programs. Thus, economic components of the future job were one of the factors of studying in medical fields.

Non-alcoholic steatohepatitis is a part of broad spectrum of chronic non-alcoholic fatty liver disease. The aim of present study was to evaluate the effect of 12 weeks vitamin E supplementation and aerobic training on liver enzymes level of non-alcoholic steatohepatitis Patients (NASH).
In the present quasi-experimental study, 30 NASH patients, ages 25-50 years participated in the study , and were divided into three groups of vitamin E (n=10), aerobic training (n=10) and combination (aerobic training plus vitamin E, n=10) randomly. Vitamin E Supplementation and aerobic trainingcombination groups, consumed 400 IU per day of Vitamin E Supplementation. aerobic training and combination groups performed progressive aerobic exercise 3 times a week for 12 weeks. Data were evaluated usingindepended t-test and One-way ANOVA (pretest-posttest design) and post hoc test of Sheffee at a significance level of p≤0.05.
there was a significant within group difference in ALT in supplementation(P=0.0001), aerobic training(P=0001) and combination (P=0.001) groups. There was a significant pre – post training difference in AST in supplementation(P=0.001), aerobic training(P=0.001) and combination (P=0.002) groups but there was no significant within group difference in ALP(P>0.05). between group comparison indicated significant difference regarding ALP between supplementation and aerobic traing groups and also combination and supplementation groups(P=0.001). But thee was no significant between group difference regarding ALT and AST(P>0.05).
The results of this study showed that vitamin E supplementation and aerobic training can improve non-alcoholic steatohepatitis Patients (NASH).

Access to dental insurance is related to the utilization of more dental services and better oral and dental health. The current study aimed at addressing the 2 following questions: how much are the premium households willing to pay for dental insurance, and which factors are associated with their willingness to pay for this insurance coverage.
In the current survey study, data were collected through a self-reporting questionnaire based on the contingent valuation method. The open-ended question method was applied to elicit willingness to pay in a sample of 385 respondents attending Isfahan dental clinics, Iran, in 2015. The linear regression approach was used to address factors related to willingness to pay for dental insurance. Data analysis was performed using Stata version 11.
The median and 5% trimmed mean of willingness to pay for dental insurance per person per month was $US 2.74 and 51.10, respectively. The result of regression analysis indicted that the subjects older than 40 revealed significantly less willingness to pay for dental insurance. No significant association was found between willingness to pay for dental insurance and variables of households’ health status, households’ economic status, as well as households’ demographic characteristics.
From a policy point of view, willingness to pay can be used as a guide to set a premium for dental insurance. Almost all potential factors made no contribution to willingness to pay. Thus, in order to expand this insurance coverage, government policies should be adopted to improve people awareness about oral and dental health.

Hospitals as the most expensive health care system is an operational unit, considering the cost efficiency of this unit is very important. The aim of this study was to evaluate the performance of the intensive care units of hospitals affiliated with Yazd University of Medical Sciences.
This is a descriptive - analytic study performed in 2014. Intensive care units of 8 hospitals affiliated with Yazd University of Medical Sciences were included in this study. Data envelopment analysis (DEA) was used to evaluate the economic efficiency of intensive care units. Input variables included the number of physicians, nurses, and active beds, as well as the number of equipment (ventilator), and output variables included bed occupancy rate and the number of patients discharged healthy. Input prices contained the doctors and nurses income, bed price, and depreciation cost of equipment (ventilator).
The findings show that among 8 studied hospitals, the efficiency of 5 hospitals were 1 and the efficiencies of the other hospitals were 0.174, 0.645, and 0.855. The mean economic efficiency of intensive care units of all hospitals was 834.0 in 2014.
By ameliorating the allocation of resources allocated for hospitals including human resources and equipment, the efficiency level of hospitals can be improved.

Organic amendments are an excellent source of phosphorus (P) for plant production in sustainable agriculture. This paper describes the short term (100 days) effects of sewage sludge (SS), cow manure (CM) and poultry manure (PM) on the soil organic P (OP) fractions and their availability to wheat in a calcareous soil of Kerman Province . The experiment was arranged on a completely random design consisting of control (with no P fertilizer) and two levels (2 and 4%) of SS, CM and PM in four replications. Organic amendments markedly (pCM>PM. A significant correlation were observed between labile organic P with soil available P (r=0.92**), P uptake by wheat (r=0.92**) as well as between MLOP and shoot dry weight (r=0.96**), showing that labile and moderately labile organic P fractions have more contributors to available P than the others. These results suggest that adding of organic amendments can increase P availability and plant growth due to increase in soil OP fractions especially labile and moderately labile organic P fractions.

Informal payments are paid to individuals and organizations offering health services، either in cash or non-cash via informal channels. The aim of this study was to estimate the amount of informal payments in Urmia hospitals and to assess the related factors. This cross-sectional study was conducted in February 2013. Data were collected using a questionnaire that was completed via telephone calling to the patients. Data were analyzed using the OLS model in the SPSS-21 and EVIEWS7. The mean formal and informal payments to the hospitals were 3270000 and 600000 Rials، respectively. The mean (SD) informal payment to the doctors was 5030000 (5520000). The mean (SD) informal payments to the nurses and other staff were 200000 (130000) and 160000 (160000) Rials، respectively. Type of hospital، place of settlement، treatment procedure and income were recognized as the related factors with the amount of informal payments. Given the results of this study that indicated high amounts of informal payments، and considering the serious negative effects of informal payments on appropriate governance، policymakers should pay attention on the issue in order to restrict the informal payments.

Nowadays Social health insurance does not cover all health expenditures because of increasing cost of diagnosis and treatment services which results in private insurer entry to health market. This study is aimed to determine key indicators which have important effect on the demand for private health. This identification of indicators leads to better planning for prospering private health insurance. This is a a descriptive and analytical study. The data were collected by questionnaires which has been filled by a sample of 950 households. The samples had been chosen by three-stage cluster sampling. The model had been estimated by econometric methods based on models of Probit and extreme value distribution. The result indicated that having basic health insurance, doing exercise each day routinely, having regular medical checks, being landlord and being retired raised the probability of demand for private health insurance. On the other hand, demanding private health insurance is less common among older adults and people who use to wear seat belts. Identification of important factors which influence the demand for private health insurance would assist policy makers to provide essential structures for expanding private health insurance coverage.

The objective of this study was to determine factors associated with time to relapse and، thus، retention time، of a cohort of opioid-dependents under methadone maintenance treatment، using survival models، in the Iranian National Center for Addiction Studies (INCAS). A total of 198 opioid-dependent clients participating in the Methadone Maintenance Treatment Program، implemented by INCAS between April 2007 and March 2011، were included in the study. A Cox proportional hazard (PH) model was applied to determine predictors of relapse time among the patients. The data showed that 86 clients relapsed into drug use during the treatment program. The proportional hazard assumption was satisfied according to the goodness of fit test showing that Cox proportional hazard model was appropriate. Estimates of the PH model indicated that an increase of 1mg in the methadone dosage could lead to a decrease of 0. 15 in hazard ratio and an increase in the length of treatment (p<0. 001). Predictors for raising the probability of drug relapse included suffering from mental disorders (compared to mentally healthy: hazard ratio = 2. 29، p<0. 001)، being a poly-substance user (compared to mono-substance users: hazard ratio = 4. 80، p<0. 001)، and having retention experience in the past (compared to those with no previous therapy: hazard ratio = 1. 90، p<0. 001). Other variables entered in the model، including social and demographic variables، had no statistically significant effect on hazard ratio. Although higher methadone dosages are associated with a longer time to relapse، we recommend highly to pay special attention to providing more therapeutic and consultive services to mental health patients، poly-substance users، and individuals with a past therapy record.

Deductions are a part of hospital revenues. However, they mostly remain unpaid due to incorrect documentation. This study focused on the rate and causes of deductions made by hospitals affiliated to Kashan University of medical Sciences, Kashan, Iran, according to available documents.

This was a descriptive cross-sectional study conducted in the first half of 2009 in hospitals of Kashan University of Medical Sciences. The research population included 7907 medical records covered by the Social Security Insurance. The data was collected by a standard checklist. It was then analyzed through descriptive statistics.

Based on available documents, the most important causes of deductions were lack of a physician's order in drug forms (427), lack of laboratory report in laboratory forms (2195), lack of radiology report in radiology forms (226), incorrect operation report in surgery forms (429), lack of an anesthesiologist's signature in anesthesia forms (322), and lack of consultation order in consultation forms (226). The study also showed that in general, among all evaluated forms, drug forms had the maximum of deductibles.

The most frequent cause of deductions is incorrect documentation. On the other hand, insurance organizations only pay costs according to registered data. Therefore, it is really essential and helpful to pay enough attention to documentation principles. In addition, it is important to use diagnosis related group (DRG) and healthcare information systems.