مجله تصویر سلامت
سال چهاردهم شماره 1 (بهار 1402)

knowledge is a fluid mixed of experiences, existing information, values, and expert insight, which is acquired by education and experience. Knowledge is classified into two major types, namely explicit and tacit. Unlike explicit knowledge, the tacit knowledge is intuitive and exists in the human brain, and cannot be simply codified and transferred.1Epidemiology is the scientific and systematic study of the occurrence, dispersion, and determinants of health-related conditions in a specific population at a point or period of time in order to manage health issues. The most important goals of epidemiology are: 1. planning for health services, 2. reducing the rate of morbidity and mortality, 3. determining the natural history of diseases, 4. applying different types of prevention, and 5. evaluating health programs. 2 Knowledge is useful when its results are used for decisions-making. Knowledge transfer mediates between knowledge production and its utilization. Indeed, a successful transfer is an essential factor contributing to the conversion of knowledge into practice.3 Knowledge transfer is defined as the process of conveyance of knowledge to individuals, groups, and organizations to facilitate decision-making and activities. Effective knowledge transfer of epidemiology means changing the information, attitude, and behavior of health service providers, individuals, patients, and managers. 4 Knowledge transfer consists of two key components, including sender and receiver. Performing an efficient knowledge transfer requires producing standardized information based on the target group's demands. Knowledge translation is often confused with knowledge transfer. The field of knowledge translation was created to ensure the optimal communication between people using knowledge and those producing it. Advanced epidemiological methods such as structural equation modeling and social network analysis are used for effective knowledge transfer. Analysis of Social Networks Social networks refer to a group of organizations or people who are tied through social relationships such as friendship, cooperation, or information exchange. Social network analysis such as graph analysis methods is a powerful diagnostic method for investigating the pattern of relationship linking members of a group.5 In this method, transferring certain knowledge is possible by identifying influential people. Influential person is someone who is skilled to persuade other individuals in socio network. Social network analysis can be used in decision-making and policy-making, and it plays a significant role in knowledge transfer and improves the novelty of knowledge. For example, sharing knowledge between individual leads to the creation of a new knowledge that is greater than the total knowledge of each person. Relationship among individuals in the social network can be facilitate knowledge transference. Given that knowledge is embedded in the relationship, stronger relationships not only improve knowledge transference but also generate considerable knowledge. Structural Equation Modeling Structural equation modeling (SEM) is a comprehensive statistical model for exploring the correlation between latent and observed variables. SEM has several analytic techniques including analysis of variance, regression analysis, and factor analysis. Factor analysis is used to estimate latent variables based on the observed variables. The data extracted from observational, nonexperimental, and experimental studies can be analyzed by SEM. Although SEM is employed in many fields, it has not been extensively used in epidemiology yet.6Given the above discussion, effective knowledge transfer of epidemiology means changing the information, attitude, and behavior of health service providers, individuals, patients, and managers. Generating standardized information based on the target group's demands is essential to perform efficient knowledge transfer. Advanced epidemiological methods such as structural equation modeling and social network analysis are used for effective knowledge transfer.

The health of employees and the work environment is important for any organization, but some organizational phenomena challenge this issue. One of the emerging organizational phenomena is presenteeism, which causes an employee to decide to be at work despite being sick (physical or mental) and feeling unwell. The aim of the current research is to provide a model of employee presenteeism based on factors affecting this behavioral phenomenon.

In this study, by Meta-synthesis method, all the researches of reliable databases that were related to the research topic from 1991 to 2022 were systematically examined and finally, following the entry and exit criteria, 78 articles were identified and analyzed.

The results showed that the most important factors affecting employee attendance can be designed in the form of a three-dimensional model with 13 core categories and 60 components. In this model, three main dimensions include behavioral, structural and contextual dimensions. 13 core categories also include organizational characteristics and procedures, job characteristics, human resources management of the organization, organizational culture, health status of the individual, employee's attitude and perception towards the consequences of absenteeism or presenteeism, Organizational communications and interactions, Individual characteristics, Individual personality, Job and organizational attitude, Cultural and social factors, Economic factors of society and Legislation and infrastructure.

The results of the synthesis and analysis of 78 articles in this research showed that presenteeism is a complex and multidimensional phenomenon that is caused by various factors, and the correct management of this behavior in the organization depends on careful attention to the pattern identified in this research.

Training skilled doctors and the benefit the medical students receive from education, especially clinical education, depends on the realization of the goals of medical schools and teaching hospitals, which is achieved through communication and interaction between these two institutions in medical universities. These interactions are established through different policies, laws, regulations, and memorandums. This study aimed to determine the current status of professional interactions between the medical school and teaching hospitals in Iran University of Medical Sciences.

The present study was carried out in 2021 using a quantitative approach, in terms of practical purpose, descriptive method, and data collection method. Individuals from research areas, officials of the medical school, officials of the teaching hospitals, and the officials of the Iran University of Medical Sciences were selected for sampling. A total number of 105 individuals were questioned. A researcher-made questionnaire was used to collect data. Data analysis was performed using SPSS software.

According to the data analysis, the current status of professional interactions between the medical school and teaching hospitals in different areas of interaction were as follows (0 is the lowest and 10 is the highest): education and research: 5.68, governance: 4.79, financial budget: 3.83, human resources: 4.74, provision of health services: 4.55, physical resources and equipment: 4.76, and supply chain: 4.27.

Considering the current state of interactions between the Faculty of Medicine and teaching hospitals of Iran University of Medical Sciences, it was necessary to improve these interactions. Faculty members’ attention to education, adjustment of frequent treatment practices, referral of learners to teaching hospitals according to a specific program, definition of joint research projects, revision of organizational structure and powers, allocation of the required budget, holding joint workshops for employees of two institutions, fair payments, optimal application of space and educational equipment, as well as setting up dynamic monitoring systems played an important role in promoting the interactions of the two institutions.

Used oil is a problematic waste containing hazardous and toxic components. This study aimed to investigate the quantity of used oil produced by motor vehicles in Iran and offer management solutions based on health and environmental principles.

First, the conversion ratio of motor oil into used oil was determined. The mass balance method and the conversion ratio were used to estimate the used oil produced in the past 14 years. The amount of used oil produced over the following 15 years was also predicted using an artificial neural network. The current status of used oil management in Iran was assessed through checklists, observations, field visits, and interviews. Finally, an appropriate management solution was provided for it.

According to the results, 151.2 to 315.2 kilotons (kt) of used oil were produced annually in Iran between 2003 to 2017, and it would reach 250 kt by 2031 according to prediction. In Iran, approximately 77% of the used oil was collected and recycled, about 5% was used in construction, and the rest was disposed and managed without following the scientific principles.

The lack of principled management of used oil may have had a significant adverse impact on the environment. Taking into account the fact that about 55% of used oil was produced by vehicles, and assuming that the remaining 45% of used oil was produced by other sources, it was concluded that the overall percentage of used oil production in Iran was probably two-fold approximately. Therefore, it was recommended that the current situation and its principled management should be minitored.

Nurse prescription is a relatively new and developing subject, with many critics and advocates worldwide. However, it is expanding rapidly and is being implemented in many countries. In Iran, nurses are not allowed to prescribe. No significant action has been taken in this regard. In Iran, nurse prescribing requires preparing the ground and providing the necessary conditions. The current study aimed to examine nurse prescribing worldwide and its possible challenges in Iran.This study is a narrative review of the English and Persian articles published in 2022 on nurse prescription in Iran and worldwide. We collected data by searching the international databases of PubMed, Science Direct, and Scopus, and the local databases of SID, Magiran, and Iran Medex for the keywords “nurse prescribing”, “nurse prescription”, “prescribing factors”, “prescribing effect”, “prescribing facilitation”, “prescribing barriers”, “prescribing benefits”, “prescriptions”, “medication and nursing”, “independent nurse prescribing”, “supplementary nurse prescribing”, “independent prescribing”, “nurse prescriber”, “prescribing”, and the possible combinations. We retrieved all related articles published between 2010 and the end of 2022.A total of 32 case studies were reviewed in this study. The results showed that nurse prescribing occurs globally in one of three forms: independent, supplementary, and patient group protocols. In Iran, nurse prescribing is prohibited, necessitating social support and assistance in policy-making, planning, and nursing education.Due to the unprepared environment in Iran, it is vital to provide assistance for prescribing. Numerous factors play a role in implementing nurse prescribing in Iran, so it is necessary to use the successful experience of countries that have been pioneers in this domain. It is suggested that health officials and those engaged take steps to teach prescribing nurses at the postgraduate and doctoral levels, or create a new discipline of nurse prescription.

Autism Spectrum Disorders (ASD) is a neurodevelopmental disorder described by problems in behavioral and social interactions, stereotyped interests, and repetitive actions. Although the quality of ASD services is one of the most important predictors of the effectiveness of treatment and rehabilitation interventions, it has received no research attention in Iran. This study, therefore, aimed to explore the quality of ASD services in the Ardabil and East-Azerbaijan provinces of Iran.

The target population of this cross-sectional study included the parents of 2-14-years-old children with ASD. To collect the required data, a questionnaire consisting of four sections inquiring about demographic, diagnostic, and behavioral features as well as the quality of services was used. Service quality had four domains including participation in decisions, care coordination, continuity of care, and timeliness. Data were analyzed using SPSS-19.

According to the results, the participation in decisions with a mean score of 66.84 (41.21) had the highest score. Also, the total score of quality of services was 61.69 (30.32), suggesting that the quality of services delivered to children with ASD was moderate.

Although the service quality score was above the average, the gap between the current situation and the ideal situation was large; therefore, there was an urgent need for making interventions to improve the quality of services.

Outsourcing of the services, as one of the key interventions, has been always given a particular attention by policymakers seeking to improve the performance and reform the financial system of the health sector. This study aimed to identify the factors affecting the decision-making, challenges and obstacles, and evaluation criteria of the hospital services.In this study, a scoping review method based on the Arksey and O'Malley protocol was adopted. All articles published in four databases, namely SID, Magiran, Emerald, PubMed, and Google Scholar search engine were searched and collected using appropriate keywords. The inclusion criteria of this study were English and Persian original/review articles as well as case studies. Using qualitative analysis and coding approach, finally, the content of the entered studies was analyzed and summarized in the designed tables based on three main areas of criteria and factors affecting the decision-making, evaluation criteria, as well as outsourcing challenges and obstacles.A total of 44 studies were included in the present study. According to our study results, the criteria and factors effective in decision-making process of outsourcing hospital services included four components of the activity nature, internal and external stimuli, and supplier characteristics; and those effective in evaluation criteria included four financial components of beneficiaries, process internal and growth, learning, and innovation. Challenges and obstacles of outsourcing were also divided into four components including legal, structural, organizational, financial, and administrative components.To achieve a successful outsourcing in the organization, especially in the hospital, it was necessary that a scientific approach should be adopted in this field in order to formulate executive instructions and principles, implement strong laws, and strengthen the supervision.

This study aimed to design a model for developing health system partnerships by using electronic word-of-mouth communication. This issue has recently attracted the attention of researchers and managers of the country’s public and private sectors.

In this qualitative study, the meta-composite method and Delphi technique were employed. The data collection tools included library studies and review of articles related to the research background. First, relevant information and findings were extracted from reliable national and international scientific databases using the meta-combination method, and then the opinions of the expert panel were recorded using a questionnaire. After two stages of opinion polling, the initial findings of refinement and unnecessary items were merged or deleted. Finally, the components and indicators affecting the development of health system partnerships were identified and categorized through word-of-mouth communication.

Out of 66 primary codes extracted by metacombination method, 36 final indicators were identified by the experts using Delphi method. The identified indicators were then divided into three categories and nine components including Creation Factors with “structural and contextual, economic and financial, communication, and interactive” components, Diffusion Factors with “organizational and institutional, legal and contractual, awareness, and trust building” components, as well as Impact Factors with “legal and regulatory, technical and specialized, and acceptability and effectiveness” components.

A new model and perspective was presented for developing health system partnerships through electronic word-of-mouth communication, so that the enormous economic, social, and cultural potentials of the public, private, and charitable sectors may have been exploited for developing health and treatment through using new marketing tools and modern technologies.

The health system is responsible for the health of society, so it needs to develop its individual and organizational performance through mutual trust and professional ethics to improve health and treatment services. This research aimed to present a comprehensive model of organizational trust with a professional ethics approach in the health system.

This qualitative study used the Foundation Data method (Grounded theory). Data were collected by reviewing upstream documents and interviewing 22 informed experts. The validity of this study was reviewed and approved by the interviewees and professors. The continuous comparison method has been used for data analysis through three stages open, central, and selective coding. MAXQDA 2020 software was used for encoding.

Finally, five main dimensions and ten sub-categories were identified and classified based on data analysis: 1-Causative conditions with two sub-categories; (Structural and legal areas), 2-Contextual conditions with two sub-categories; (Organizational currents and individual competence), 3-Interventionist conditions with two sub-categories; (Environmental factors and administrative Factors), 4-Strategies and actions with two sub-categories; (Cultural and ethical standards and inter-organizational standards), 5-Consequences with two sub-categories; (Organizational and social consequences).

A high level of organizational trust with professional ethics increases job satisfaction and organizational commitment, fosters employee confidence, stimulates participation and data sharing, helps solve problems, facilitates empowerment and adaptability, and enhances learning and organizational innovation. On the other hand, building trust and promoting professional ethics in an organization reduces mental and psychological pressure, assists employees in overcoming hopelessness, facilitates conflict resolution, and ultimately establishes a framework for boosting productivity and organizational performance to provide higher-quality services and products, thereby enhancing social responsibility.

 The coronavirus disease 2019 (COVID-19) is still a global leading public health issue, especially in low- and middle-income countries (LMICs). Vaccine hesitancy can decelerate the effect of mass vaccination programs. This study aimed to assess the determinants of COVID-19 vaccination acceptance and its relationship with the perceived risk of COVID-19 among the Iranian population at the beginning of the vaccination program.

In this cross-sectional survey conducted in June 2021 in Tabriz, Iran, 500 subjects aged 18-64 years were investigated. The collected data included the demographic variables, participants' previous COVID-19 infection, history of the COVID-19 infection and mortality in the participant’s family members, perceived risk of COVID-19, and COVID-19 vaccine acceptance. The data were analyzed using the SPSS software version 16. Independent t-test and logistic regression were also performed.

The acceptance, doubt, and rejection of COVID-19 vaccine were reported by 232 (46.4%), 129 (25.8%), and 139 (27.8%) cases, respectively. Multivariate regression analysis showed that the age, education level, profession, and perceived risk of COVID-19 were significantly associated with the acceptance of the COVID-19 vaccine.

The acceptance rate of the COVID-19 vaccine was not optimal among the studied population at the beginning of vaccination program, and about half of the participants reported the vaccine acceptance. People with low education, low perceived risk level for COVID-19, and younger people may have been considered a high-risk group for doubt or rejection of the COVID-19 vaccine.

Knowledge management seeks to convert individual and organizational information and assets into scientific knowledge and teamwork skills. Success in knowledge management requires creating a new work environment where knowledge and experience can be easily shared. The current study aimed to investigate the pattern of knowledge management in the primary healthcare system of Tabriz, Iran in the field of suicide prevention.

This study was a descriptive and cross-sectional research conducted in 2022. The study’s statistical population included all healthcare providers involved in suicide prevention in the primary healthcare system of Tabriz city, Iran. To collect the data, a demographic questionnaire based on age, occupation, gender, education, work experience, and workplace was prepared and used along with the main scale of Lawson Knowledge Management Questionnaire. Measures of variability and mean were used to describe data. Independent T-test, chi-square and ANOVA were used to compare the groups. Data were analyzed using SPSS v.21.

From the perspective of suicide care providers, the utilization of knowledge management in the primary healthcare system of Tabriz was about 46.5%. A statistically significant differences was found between men and women in this regard. A significant relationship was also observed among all aspects of knowledge management.

The application of knowledge and inclusion of knowledge management in suicide prevention program was below the average. There were differences between healthcare providers and education levels. To apply knowledge management in the primary healthcare system in the field of suicide prevention, it was recommended that knowledge management should be integrated with the mission, vision, strategic plans, and work processes of this system as an important principle.