Designing a model of drug quality assurance for Iran

Objective: To take up the project for designing a Drug Quality Assurance Model (GMP) for Iran. Methodology: It is a descriptive and comparative study. GMP models from USA, EU, Australia and Iran, and WHO, ICH and PIC/S were selected for the comparative study. Internet sites and scientific journals were used for data collection. The comparative study determined the primary proposed model. Then, based on Delphi technique, the primary model was evaluated by experts and eventually the final model was designed, for application in Iran. Results: The comparative study and feedbacks of experts determined the final proposed model for pharmaceutical quality assurance (GMP) for Iran, which consisted of two parts. The first part included thirteen chapters consisting sixty-two major titles. The second part consisted of sixteen annexes. Conclusion: Establishment of standards of the final model of GMP in the drug industry could lead to the improvement of quality of national manufactured drugs, hence, promoting the population health levels

Comparative study of branding in Iranian public hospitals and some other public hospitals in selected countries

Applying branding models by health sectors of other countries, leads to delivering quality products and services tailored to customer needs. The objective was a comparative study of branding in Iranian public hospitals and some other public hospitals in selected countries. In this descriptive-comparative study, hospitals that have implemented successful branding were selected from Britain, Canada, Australia, New Zealand, China, Ireland, South Korea and South Africa. A similar public hospital in Iran was also entered in this study. To collect data of hospitals under study, papers, and dissertations of electronic databases i.e. NHS, WHO and reports of selected hospitals were utilized. Collected data were summarized and classified based on the variables of the study and compared and analyzed in comparative tables. Each of the hospitals under study has taken some measures such as organization's competitive position, branding strategies, established brand and relationship with customers and has utilized the results to attract more patients and reduce the health expenditures; While Iran has limited experience in using this model in public hospitals. With regard to actions taken in selected hospitals to extend the branding, using their experiences in Iran, drafting, and adoption of policies and guidelines in this regard due to Iran's local conditions are highly recommended

Phenomenological study of determining the basic skills of work and technology curriculum

Background and Objectives: Today, vocational education is a part of the school curriculum that is more about preparing students for life and employment in the society. This training can be the main part of the curriculum with a part of as the requirements for graduation or the fulfilment of other courses. This type of training should be an integral part of all phases of education and should be provided through an organized and graded program. In this regard, the main categories of work that are specifically emphasized are: work related to individual needs, work at home, work in the classroom, school and extracurricular activities, and integrated school loss, work as a learning experience, work in society by focusing on altruistic and selfless services, and work related to professional growth, production, social utility, and the discovery of opportunities and ways of caring. In addition to business skills, in today's modern world, access to information and knowledge and gain insight and attitude in this field, is considered important, so the skill of acquiring credible knowledge and information can be a factor in the growth and development of societies. And any plan, initiative, tool and device that focus on the interaction between the instructor and the learner in order to gain competencies is an example of educational technology. The purpose of the present study was to identify the basic skills of work and technology curriculum designed for junior high school students. Methods: This research has been carried out qualitatively using phenomenological method. The research community consisted of sample Iranian instructors of work and technology curriculum. Sampling was carried out by utilizing target method and standard type sampling.  Professional interviews with 13 participants to the extent of saturation were used. For data analysis, the three-step coding method (open, axial and selective) was used. Findings: The findings showed that the basic skills included in work and technology curriculum at the junior high school consists of a series of categories as follows: perceptual (11 subcategories), communication (5 subcategories), ethics (5 subcategories), technical (6 subcategories) and technological (3 subcategories). Conclusion: Today, it is clear that the teaching and learning of students in the field of work and technology is not limited to school and high school, but it is necessary that students throughout life, from formal to informal education, have a desire for lifelong learning. In the meantime, one of the important tools of lifelong learning that leads to the growth and development of students is the acquisition of information and technology literacy skills, so that information literacy for students increases their ability to recognize information needs, recognize incomplete information, ability to access and discover information, the ability to evaluate information and select information. Technological literacy also increases students' innovation in practice, as well as their ability to use, manage, evaluate, and understand technology, followed by lifelong learning. In general, whether a student is successfully completing high school or not, learning basic skills can prepare him or her for the future. Learning the basics of work and technology should be such that the student is equipped with the abilities, skills, experiences, ambitions that lead to success in life after high school. The results show that it is necessary to revise work and technology curriculum at the junior high school education, and take into account the basic skills mentioned in this study.   ===================================================================================== COPYRIGHTS  ©2020 The author(s). This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, as long as the original authors and source are cited. No permission is required from the authors or the publishers.  ====================================================================================

Future Research in Health Information Technology: A Review

INTRODUCTION: Currently, information technology is considered an important tool to improve healthcare services. To adopt the right technologies, policy makers should have adequate information about present and future advances. This study aimed to review and compare studies with a focus on the future of health information technology. METHOD: This review study was completed in 2015. The databases used were Scopus, Web of Science, ProQuest, Ovid Medline, and PubMed. Keyword searches were used to identify papers and materials published between 2000 and 2015. Initially, 407 papers were obtained, and they were reduced to 11 papers at the final stage. The selected papers were described and compared in terms of the country of origin, objective, methodology, and time horizon. RESULTS: The papers were divided into two groups: those forecasting the future of health information technology (seven papers) and those providing health information technology foresight (four papers). The results showed that papers related to forecasting the future of health information technology were mostly a literature review, and the time horizon was up to 10 years in most of these studies. In the health information technology foresight group, most of the studies used a combination of techniques, such as scenario building and Delphi methods, and had long-term objectives. CONCLUSION: To make the most of an investment and to improve planning and successful implementation of health information technology, a strategic plan for the future needs to be set. To achieve this aim, methods such as forecasting the future of health information technology and offering health information technology foresight can be applied. The forecasting method is used when the objectives are not very large, and the foresight approach is recommended when large-scale objectives are set to be achieved. In the field of health information technology, the results of foresight studies can help to establish realistic long-term expectations of the future of health information technology

Future Research in Health Information Technology: A Review

INTRODUCTION: Currently, information technology is considered an important tool to improve healthcare services. To adopt the right technologies, policy makers should have adequate information about present and future advances. This study aimed to review and compare studies with a focus on the future of health information technology. METHOD: This review study was completed in 2015. The databases used were Scopus, Web of Science, ProQuest, Ovid Medline, and PubMed. Keyword searches were used to identify papers and materials published between 2000 and 2015. Initially, 407 papers were obtained, and they were reduced to 11 papers at the final stage. The selected papers were described and compared in terms of the country of origin, objective, methodology, and time horizon. RESULTS: The papers were divided into two groups: those forecasting the future of health information technology (seven papers) and those providing health information technology foresight (four papers). The results showed that papers related to forecasting the future of health information technology were mostly a literature review, and the time horizon was up to 10 years in most of these studies. In the health information technology foresight group, most of the studies used a combination of techniques, such as scenario building and Delphi methods, and had long-term objectives. CONCLUSION: To make the most of an investment and to improve planning and successful implementation of health information technology, a strategic plan for the future needs to be set. To achieve this aim, methods such as forecasting the future of health information technology and offering health information technology foresight can be applied. The forecasting method is used when the objectives are not very large, and the foresight approach is recommended when large-scale objectives are set to be achieved. In the field of health information technology, the results of foresight studies can help to establish realistic long-term expectations of the future of health information technology

Organization's quality maturity as a vehicle for EHR success

In health care industry, EHR has been advocated to improve care quality. The journey toward the development and adaptation of EHR should be holistic and integrate all the EHR's building blocks-health record management, business process improvement (BPI), collaboration and innovation, change management, user governance, etc.-that are intertwined together as like the links of a chain to improve quality of health care services. These cornerstones that shares common features with quality principles will pave the way for implementing EHR. To go along with quality features and take advantage of quality principles namely "quality maturity" builds a solid foundation for adaptation of EHR. Therefore, the recent theories of EHR success go far beyond technical rationales and focus on organizational and managerial factors in quality improvement. The milestone of quality concept in information system success is revealed in Delone and Mclean's model which launches system quality, information quality, service quality, as distinct elements of the IS success. EHR is a means to an end -to improve quality within enterprises- based on quality approaches. In this regards, more research should be conducted to investigate the relationship between of organization's quality maturity and EHR development success. © Springer Science+Business Media, LLC 2010

Cost-effectiveness of a population-based AAA screening program for men over 65 years old in Iran

Background: Screening program tend to recognized patients in their early stage and consequently improve health outcomes. Cost-effectiveness of the abdominal aortic aneurysm (AAA) screening program has been scarcely studied in developing countries. We sought to evaluate the cost-effectiveness of a screening program for the abdominal aortic aneurysm (AAA) in men aged over 65 years in Iran. Methods: A Markov cohort model with 11 mutually exclusive health statuses was used to evaluate the cost-effectiveness of a population-based AAA screening program compared with a no-screening strategy. Transitions between the health statuses were simulated by using 3-month cycles. Data for disease transition probabilities and quality of life outcomes were obtained from published literature, and costs were calculated based on the price of medical services in Iran and the examination of the patients� medical records. The outcomes were life-years gained, the quality-adjusted life-year (QALY), costs, and the incremental cost-effectiveness ratio (ICER). The analysis was conducted for a lifetime horizon from the payer�s perspective. Costs and effects were discounted at an annual rate of 3. Uncertainty surrounding the model inputs was tested with deterministic and probabilistic sensitivity analyses. Results: The mean incremental cost of the AAA screening strategy compared with the no-screening strategy was 140 and the mean incremental QALY gain was 0.025 QALY, resulting in an ICER of 5566 (14,656 PPP) per QALY gained. At a willingness-to-pay of 1 gross domestic product (GDP) per capita (5628) per QALY gained, the probability of the cost-effectiveness of AAA screening was about 50. However, at a willingness-to-pay of twice the GDP per capita per QALY gained, there was about a 95 probability for the AAA screening program to be cost-effective in Iran. Conclusions: The results of this study showed that at a willingness-to-pay of 1 GDP per capita per QALY gained, a 1-time AAA screening program for men aged over 65 years could not be cost-effective. Nevertheless, at a willingness-to-pay of twice the GDP per capita per QALY gained, the AAA screening program could be cost-effective in Iran. Further, AAA screening in high-risk groups could be cost-effective at a willingness-to-pay of 1 GDP per capita per QALY gained. © 2021, The Author(s)

Insulin and insulin receptor gene polymorphisms and susceptibility to nonalcoholic fatty liver disease Insulina e polimorfismos do gene do receptor de insulina e a suscetibilidade à doença hepática gordurosa não alcoólica

Background � Nonalcoholic fatty liver disease (NAFLD) is an increasing global health concern defined by excessive hepatic fat content in the absence of excessive alcohol consumption. Objective � Given the pivotal role of insulin resistance in NAFLD, we hypothesized that insulin (INS) and insulin receptor (INSR) gene polymorphisms may be associated with NAFLD risk. Methods � A total of 312 subjects, including 153 cases with biopsy-proven NAFLD and 159 controls were enrolled in this case-control study. Four polymorphisms in INS (rs3842752, rs689) and INSR (rs1052371, rs1799817) genes were genotyped using PCR-RFLP method. Results � The cases with NAFLD were older and had higher BMI, systolic blood pressure, diastolic blood pressure, as well as higher serum levels of aspartate aminotransferase, alanine aminotransferase, and gamma glutamyl transferase than the controls (P<0.001). The �TT� genotype of INSR rs1799817 compared with �CC� genotype occurred more frequently in the controls than the cases with NAFLD and the difference remained significant after adjustment for confounding factors (P=0.018; OR=0.10, 95CI=0.02�0.76). However, no significant difference was found for INS rs3842752, INS rs689, and INSR rs1052371 gene polymorphisms between the cases with NAFLD and the controls either before or after adjustment for the confounders. Conclusion � These findings corroborate the hypothesis that genetic polymorphisms related to insulin resistance play a role in NAFLD susceptibility. Specifically, the INSR rs1799817 �TT� genotype had a protective effect for NAFLD. However, our results remain to be validated in other studies. © 2020, IBEPEGE - Inst. Bras. Estudos Pesquisas Gastroent. All rights reserved

Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Anemia prevalence in women of reproductive age in low- and middle-income countries between 2000 and 2018

Anemia is a globally widespread condition in women and is associated with reduced economic productivity and increased mortality worldwide. Here we map annual 2000–2018 geospatial estimates of anemia prevalence in women of reproductive age (15–49 years) across 82 low- and middle-income countries (LMICs), stratify anemia by severity and aggregate results to policy-relevant administrative and national levels. Additionally, we provide subnational disparity analyses to provide a comprehensive overview of anemia prevalence inequalities within these countries and predict progress toward the World Health Organization’s Global Nutrition Target (WHO GNT) to reduce anemia by half by 2030. Our results demonstrate widespread moderate improvements in overall anemia prevalence but identify only three LMICs with a high probability of achieving the WHO GNT by 2030 at a national scale, and no LMIC is expected to achieve the target in all their subnational administrative units. Our maps show where large within-country disparities occur, as well as areas likely to fall short of the WHO GNT, offering precision public health tools so that adequate resource allocation and subsequent interventions can be targeted to the most vulnerable populations.Peer reviewe