مجله تعالی بالینی
سال یازدهم شماره 1 (پیاپی 30، تابستان 1400)

Type 1diabetes (T1D) is one of the most common chronic diseases of childhood which, apart from physical health issues, can lead to decrements in cognition as well. This article aimed to provide a thorough review of cognitive deficits in children and adolescents with T1D. To this end, a systematic literature search was performed in the scientific databases including: Google Scholar, APA PSycNET, Web of Science, and Science Direct. Articles published in English up until 2020 were retrieved with the following keywords:cognitive problems/deficits, type 1 diabetes, adolescents, children, neuropsychological profile and pediatric. Results from studies suggested that children and adolescents with T1D showed deficits in attention, memory, spatial cognition, executive functions, and speed of information processing. Considering that cognitive difficulties could lead to reduced quality of life and less adherence to self-care activities, it seems necessary for therapists to pay careful attention to cognitive problems in T1D.

One of the challenges of health care system in Iran is the disproportionate level of the health houses compared to the people’s need. As health houses are considered the first line of defense in the realm of health, their excellence is crucially important to achieve acceptable performance. Thus, this study aimed to analyze the excellence strategies of health houses located in Iran rural areas. In this systematic review study, twelve electronic databases and search engines were searched by related keywords to find articles in both Persian and English from 2000 to 2020. CASP checklist was employed to evaluate the quality of these articles which were about primary health care. Out of 558 articles, 28 were selected with related titles, abstracts, and content. The findings of this study revealed that the main strategies of rural health houses’ excellence included improving the quality of care services, information technology, work conditions, the behavior of service providers, community participation, support and motivation, as well as improving governance and leadership strategies with several sub-strategies. Rural health houses’ excellence strategies revitalize and recreate the passivized role and mission of health houses in achieving the goals of primary health care in Iran health care system. Therefore, rational, balanced, scientific, and systematic investment is required not only in one strategy but in all mentioned strategies.

Substance abuse disorder like other human behaviors is caused by multiple reasons, so culture as one of the most important etiological factor  plays a crucial role in emergence, manifestation and different features of symptoms. Various culture and subculture in Iran as a risk factor or protective factor through a series of facilitating norms such as medical and pharmacological recommendations, folk beliefs and specific customs  impress substance abuse disorder in a distinctive  ways. as a result it has led to a different pattern of signs and symptoms, variable prevalence of this disorder and the variable kind of substances used in different regions of Iran. Method the method in this study is qualitative meta-synthesis which includes a combination of qualitative articles published in the field of substance abuse disorders in Iran. Seven qualitative studies and two combined studies (qualitative-quantitative) which is related to substance abuse in Iran were included in this article and reviewed. all selective qualitive studies’ content were reviewed with the aim of accessing to a more general imagination, possible causation, prevention and management of substance abuse disorder in Iran. Only qualitative studies which is evaluated the cultural context of substance abuse disorder from 2001 were included. In qualitative research which is related to the cultural context of substance abuse in Iran, different levels of environment and culture such as microsystem, mesosystem, exosystem  and macrosystem affecting the formation of this disorder in a different ways. It seems that considering the intervention related to the cultural context of substance abuse disorder in Iran is a kind of primary intervention and it would better researchers; in their prioritization of their topics, therapists, in all stages of their treatment from initial diagnosis to application of therapeutic intervention; institution and finally individual, who are responsible for policies related to the prevention and treatment of this disorder; consider culture as a vital risk factor or protective factor from the innermost level to the outermost level of the environment.

Leadership of large organizations such as medical universities require general, specialized knowledge for optimal organizational management. Knowledge-based organizational leadership is a necessity for organizational leadership and the importance of knowledge-based leadership in organizational development and Brexit scientific authority is not hidden. Therefore, the present study aimed to investigate the impact of knowledge-based leadership and scientific authority in medical universities. The present study is a review that has been done by searching the databases of Google Scholar, ProQuest, Elsevier, Pubmed, Iran Medex, Scopus in the range of 2003 to 2020. Searching for articles based on review keywords, Leadership, knowledge-based, authority. The results show that knowledge-based leadership is a leadership style in the organization that is the connecting point of the organization. Knowledge-based leadership (with general and specialized capabilities and optimal organizational management) is a valuable organizational asset that can implement the goals of leadership in a desirable way and the highest efficiency in the organization. Therefore, with proper leadership, organizational resources can be used with a scientific authority approach. The results of this study suggest to the officials of medical universities to use knowledge-based and effective leaders in the organization in order to promote scientific authority and organizational orientation.

Chronic diseases reduce life expectancy and disability. The elderly are one of the most important groups who are more exposed to social, physical and environmental harms than other members of society. They often have various problems. Chronic illness is a multidimensional experience in which the patient has to adapt to different situations and people. Due to the existence of various chronic diseases in the elderly, the present study was conducted to review the psychological components associated with chronic diseases in the elderly. Given the existence of chronic diseases in the elderly, it is important to consider long-term planning and treatment to cure the diseases in them. The present review study was conducted by searching the information sources of Magiran, Sid, ScinceDirect, Web of science, pubmed. Articles related to chronic illness, the elderly, mental health, quality of life and life expectancy were extracted from 2009-2019 and after reviewing and summarizing and full text of the articles, finally 45 articles were used for writing. The results showed that components such as mental health, quality of life and life expectancy play an important role in chronic disease in the elderly. Given that chronic disease in the elderly is a multifaceted complication that is affected by several factors, so it seems In order to prevent and reduce chronic diseases in the elderly and improve their health, a multiple approach with the participation of individuals, families and social institutions is necessary.