مجله تعالی بالینی
سال نهم شماره 1 (پیاپی 22، تابستان 1398)

Today, human beings inevitably face stress and its negative outcomes. Recently, application of religious-cultural traditions have been introduced as effective strategies to cope with stress. Clinical trials and studies by researchers in the fields of psychology of religion and health have demonstrated that holy name repetition reduces stress and enhances peace in individuals and patients. However, almost no comprehensive investigation has theoretically interpreted the possible mechanisms involved in this effectiveness. The main objective of the current study was to describe and analyze the approaches explaining mechanisms by which Zikrs reduce stress. In so doing, a review study was conducted. In addition to religious books, the data were also collected through databases, including Sciencedirect, Pubmed, Magiran, SID, Proquest, Eric, Psychinfo, Springer, Ebsco, and Noormags, from 2000 to 2019. Altogether, 36 studies were found and ultimately, 19 studies entered into investigation. Different approaches in explaining the process of the effectiveness of Zikrs on reducing stress were collected and then reflected in the article after describing and interpreting. Findings demonstrated that each of the following approaches may take a part in explaining this complex process, extending our knowledge regarding this mechanisms involved in this effectiveness: physiological perspective, cognitive approach, emotional-affective view, mindfulness-based perspective, attachment-oriented approach, generalized expectancies perspective, self-fulfilling prophecy, and imaginal world paradigm. Application of merely one perspective in explaining the process of the effectiveness of Zikrs on reducing stress may limit the general view of researchers in the field. On the other hand, an integrated, mixed and comprehensive approach may pave the way for a better understanding and analysis of this process. Ultimately, theoretical implications and practical applications of the findings have been discussed.

The significant progress made by the health sciences and healthcare system has made it possible to adapt to flexible changes and to make efficient developments to advance the goals, Resistance to change will be considered a form of organizational disease that requires organizational inertial treatment. Based on this, the present study aims to investigate organizational inertia as a barrier to effective development in the health system. The present study was conducted in Persian and English in the databases of Google Scholar, Elsevier, Pubmed, ISI (Web of Science), Iran Medex, Scopus over the period 2000-2018. Searching for articles using organizational inertia keywords, organizational change, organizational innovation, health system and their equivalent in English, Organizational Inertia, Organizational Evolution, Organizational Innovation, and Health System. The result of the search was 128 articles. After screening the title and abstract, 24 papers were recognized as criteria for entry into the study. The findings indicate that organizational inertia will occur due to organizational resistance, and sometimes the lack of removal of this resistance and the creation of stagnation in the organization, especially the health system that requires diligence, will lead to serious organizational problems, and the health system to maintain customer satisfaction, organizational survival , The advancement of high health and medical goals requires efficient development and this should be done with the help of all stakeholders in the organization and in order to strengthen the relations within and outside the organization. Therefore, by removing inertia and creating flexibility in the health system, it can take effective steps in the provision of health services and improve the competitive advantage, so the need for effective transformation in the health system is increasingly evident.

Pertussis is a severe life-threatening respiratory infectious disease caused by the gram-negative Bordetella pertussis bacteria and is categorized into two typical and atypical types. Despite the relatively high coverage of the pertussis vaccine, the disease has reappeared periodically in recent years. In typical form, the patient has prolonged bronchiolitis along with lymphocytosis or whoop (long rasping indrawn breath). The atypical form usually occurs in younger infants and has no whoop and in these patients vomiting occurs following coughing. The severity of the disease ranges from mild to severe. Diagnosis in these patients is due to exposure to parents or adults with pertussis or chronic cough. The incubation period of the disease is 7-10 days ranging from 3 to 21 days, divided into three catarrhal, paroxysmal, and convalescent stages. Pertussis should be suspected in any person with prominent symptom or chief complaint of cough, especially in absence of fever, lethargy or muscle aches, exanthem or enanthem, sore throat, hoarseness, tachypnea, wheezing and rales. Infants under 3 months of age who are suspected of having pertussis are usually referred to hospital. Also, infants 3 to 6 months of age with severe paroxysms and other children with significant complications should be hospitalized. For the treatment, macrolides can be prescribed and Azithromycin is an optional in neonates. Until 5 days of treatment and 21 days if the patient is not treated, respiratory droplet isolation is necessary. Pertussis complications are common in younger infants, especially apnea. Although 3 first doses vaccination until 6 months of age is common in many countries, but booster doses varies in different countries based on the types of acellular vaccines.

Given the rapid growth of science and technology in the field of higher education and the growing spread of knowledge and promoting the quality of science, universities and higher education centers require the development of a culture of moral values among the stakeholders is higher education, especially the health sector. Therefore, this review study was conducted to investigate the place of research ethics in the higher education system. Efforts in the identification and development of ethics in the field of health is the responsibility of higher education institutions. Thus, in the way of research, honesty, integrity and secrecy when reviewing the research results, the accuracy of the good use of funds and instruments, should be considered by researchers. Obtained data were collected based on the articles published in the Google Scholar, Scopus, Sciences Direct, Magiran, SID, PubMed, Irandoc, Iranmedex databases using keywords: ethics, research, research ethics, ethics, higher education, and health. Of 2728 articles, 45 articles related to the subject of research were considered between years 2003-2019. The findings showed that in all scientific researches, observing the principles and scientific process of research is indispensable and indisputable that should be considered by all researchers. Individual features include commitment and secrecy, honesty, perseverance and patience, the spirit of cooperation in teamwork and professional characteristics including community responsibility and supporters, colleagues, subjects as well as data analysis and its release is of interest to researchers. Based on the results of this research Ethics in scholarly research help the researcher to thoroughly review his research process at all stages of his research. In general, it can be said that observing ethics in education and research in health science community requires attention to the necessary infrastructures and quality in research. Therefore, in order to enhance the research culture and adhere to ethical principles, it is recommended to include research ethics as a teaching unit in all higher education institutions and universities. It is also suggested to conduct ethics workshops and seminars on a regular basis in order to institutionalize the culture of research ethics.

Methadone and Buprenorphine are synthetic opioids that have been used for many decades as a substitution treatment in people with opioid dependence. Sexual dysfunction is one of the most common problems in patients receiving maintenance therapy with opioid agonists. Methadone & Buprenorphine appear to have same efficacy and side effects in opioid maintenance treatment, though this is not the case for effects on sex hormones. The aim of the present narrative study is, review on articles related to effects of methadone or buprenorphine substitution on reproductive hormone profile and seminal fluid analysis in human & animal models receiving opioid maintenance treatment, and also possibility of alternating these medicines with each other. The writing of this abstract was performed using the keywords opioid, fertility, buprenorphine, seminal fluid, methadone, infertility, reproductive (sexual) hormones by searching in specific databases such as Medline, SID, Magiran, PubMed, Scopus, Science Direct. After reading the abstracts of the articles, those were not directly related to the topic in question, as well as articles with duplicate findings were excluded. Finally, data from 22 articles were used to write the findings of this summary. A review of studies showed that long-term methadone causes sexual dysfunction and infertility. Few studies on seminal fluid parameters, have shown reduced sperm motility in methadone-consuming men, may be a potential cause of infertility. Replacement of methadone with Buprenorphine in the treatment of opioid dependency, provides more options for clients and clinicians. Also, considering lower side effects, it is recommended that substitution begins with buprenorphine as the first line of treatment, and directed to methadone as the second medication if there is not satisfied respond to buprenorphine.