Policy analysis of Iranian pharmaceutical sector; A qualitative study

Introduction: Improving public health through providing affordable and accessible pharmaceuticals is among the concerns of governments worldwide. This study aimed to analyze Iran�s pharmaceutical sector policies in order to identify the challenges and suggest some strategic solutions to overcome such challenges. Methods: Top managers (15), middle managers (10), and operational managers (5) working in the Food and Drug Administration of Iranian Ministry of Health along with community pharmacists (5) participated in a qualitative study using semi-structured in-depth interviews. Data were recorded, transcribed, and then analyzed via MAXQDA 10 software. Results: Policies for national pharmaceutical sector were divided into four groups of �research & development�, �import & export�, �pharmaceutical procurement�, and �pharmaceutical supply and distribution�. Then, the challenges faced by each sector were extracted. Considering the challenges, some policy options were recommended for growth and development of national pharmaceutical sector. Conclusion: Iran�s pharmaceutical sector has managerial and administrative differences compared with overseas pharmaceutical sectors. These differences are the main reasons for the current status of Iran�s pharmaceutical sector and have put Iran behind foreign pharmaceutical sectors. Iran�s pharmaceutical sector has endured many critical periods during recent decades and has gained great experience during these stages. Therefore, it is believed that Iran�s pharmaceutical sector, with its experience and potential, is capable of producing world-level medicines. © 2019 Ebadi Fardazar et al

Experiences of rural women with damages resulting from an earthquake in Iran: A qualitative study

Background: Women, with more vulnerabilities and less access to resources, are often seen as victims of natural disasters. Therefore, the present study aimed to investigate the experiences of rural women with damages resulting from an earthquake in Iran. Methods: In this research, a qualitative approach, as well as the conventional content analysis was employed. The study population consisted of rural women residing in the earthquake-stricken areas of Sarpol-e Zahab and Salas-e Babajani counties in Kermanshah Province, Iran. Semi-structured interviews were used for data collection. Moreover, sampling was purposeful, theoretical saturation was achieved by conducting 22 interviews, and the data analysis process was performed according to the steps proposed by Graneheim and Lundman. For the strength and transferability of the research, Lincoln and Guba's Evaluative Criteria were used. Results: There were seven categories regarding the experiences of rural women after the earthquakes including neglecting the health needs; tension in the family and marital relations; gender inequality in the provision of assistance; feeling insecure; ignoring the ruling culture of the region; concealing needs for fear of stigmatization, and incoherent mourning as well as two categories regarding their reactions to and interaction with the earthquake consequences including positive and negative interactions. Conclusions: Paying more attention to the needs of rural women, taking the culture governing the village into account at the time of service delivery, and helping them with positive adaptations are some indispensable measures that should be taken. © 2020 The Author(s)

On Effectiveness and Legitimacy of ‘Shaming’ as a Strategy for Combatting Climate Change

While states have agreed to substantial reduction of emissions in the Paris Agreement, the success of the Agreement strongly depends on the cooperation of large Multinational Corporations. Short of legal obligations, we discuss the effectiveness and moral legitimacy of voluntary approaches based on naming and shaming. We argue that effectiveness and legitimacy are closely tied together; as voluntary approaches are the only alternative to legally imposed duties, they are most morally defensible particularly if they would be the most effective in reducing the harmful greenhouse gases. Shaming could be made effective if states could prompt more corporations to accept voluntary cuts with high gains—such as public acknowledgements—and high losses, such as reporting on noncompliance and public exposure (naming), along with some kind of condemnation (shaming). An important challenge of such voluntary approaches is how to ensure compliance with the agreed upon commitments, while avoiding greenwashing or selective disclosure. Certain institutional arrangements are inevitable, including an independent measurement, monitoring and verification mechanism. In this paper, we discuss the potentials and ethical pitfalls of shaming as a strategy when corporations have a direct relationship with consumers, but also when they are in a relationship with governments and other corporations.Ethics & Philosophy of Technolog

The Impact of Educational Intervention Based on Theory of Planned Behavior for Promoting Physical Activity Among Middle-Aged Women Referring to Karaj (Iran) Health Centers

Background: Physical activity is the most critical determinant of physical health which reduces the health risks during life. This designed study aims to evaluate the effect of educational intervention based on the theory of planned behavior on promoting physical activity among middle-aged women attending the health centers in Karaj city during 2017�2018. Methods: This research was a quasi-experimental controlled trial, and the study incorporated 140 Middle-Aged Women Referring to Karaj Health Centers assigned randomly to a control and intervention group (70 each group). Participants enrolling in the survey were asked to complete the International Physical Activity Questionnaire and also the theory of planned behavior measures at the baseline and the end of the study. The SPSS software were used, to analyze the data. The study applied Nonparametric Wilcoxon and Mann-Whitney tests and ANCOVA to interpret the results. Results: The results revealed participants' age range between 30 to 50 years with the mean and standard deviation scores 40.07 (8.750) in training and 45.81 (8.513) at the control group. The intervention improved the theory of planned behavior measures and the physical activities of participants. The results showed a significant difference in the attitude score, the perceived behavioral control score, and the level of subjective norms between two training and non-training groups (P < 0.001). The followed-up physical activity score also showed an improvement in the IPAQ score of participants in the training group (p < 0.001). Conclusions: The results of this specific study support the effectiveness of the theory of planned behavior for promoting the physical activity of women. © The Author(s) 2020

The effect of selenium and zinc on CD4(+) count and opportunistic infections in HIV/AIDS patients : a randomized double blind trial

Objectives: We assessed the effect of selenium and zinc supplementation on CD4 cell count and the risk of developing opportunistic infections. Methods: In a double blind clinical trial, 146 HIV(+) patients receiving combination antiretroviral therapy with CD4(+) >200/cubic millimeter were screened for comorbidities and opportunistic infections, and randomized to receive daily selenium (200 mu g), zinc (50 mg) or placebo for 6 months, before a 3-month follow-up period. CD4 cell counts were measured in the 3(th), 6(th) and 9(th) months. The serum selenium and zinc were measured in the 6(th) month. The incidence of opportunistic infection was assessed monthly for 6 months and at the end of the 9(th) month. Results: The final incidence of supplement deficiency for placebo, zinc and selenium were 46.7%, 44.7% and 50.0%, respectively. Overall compliance with supplementation was 99.42%. Although the changes from baseline were not statistically significant, zinc supplementation was significantly associated with reduced risk of opportunistic infections. Conclusion: Development of the opportunistic infections after zinc supplementation significantly decreased; however, significant improvement in CD4 count was not observed in this group