Barriers to Implementing Performance-Based Budgeting at Iranian Universities of Medical Sciences: A Qualitative Study

Introduction: A performance-based budgeting system provides the link between performance indicators and resource allocation. This study aimed to identify the barriers to implementing performance-based budgeting at Iranian universities of medical sciences. Method: In this qualitative study with the framework analysis approach, semi-structured interviews were conducted with 14 university professors and directors of the Iranian Ministry of Health and Medical Education using purposive sampling and snowball model. MAXQDA-10 software was used to apply the codes and manage the data. The codes were extracted using deductive and inductive methods. Results: Barriers of performance-based budgeting were classified in three main areas including elements of environmental, human, and organizational management, and 14 themes. Conclusion: Having a deep understanding of the barriers to implementing evidence-based budgeting can help managers and policymakers to reach careful planning and successful implementation of budgeting. Paying attention to the environmental, human, and organizational infrastructure is essential for the successful deployment of performance-based budgeting at Iranian universities of medical sciences. Keywords: Budget, Budgeting, Universities, Ira

The relationship between succession and intellectual capital with entrepreneurship in hospitals

Abstract Background The hospital environment is very dynamic and faces many internal and external changes. Healthcare knowledge and technology are developing at a swift pace. This study investigated the relationship between succession and intellectual capital with entrepreneurship at the Qazvin University of Medical Sciences hospital, Iran. Methods The number of employees working in six hospitals was 2256, and according to Morgan’s table, the required number of samples was 331. We distributed three hundred sixty-five questionnaires considering 10% of sample loss. We used a multi-stage stratified sampling method. In the first stage, each hospital was considered a stratum. After that, occupational groups were considered the next stratum within each hospital, and based on the ratio, the required number of samples for each occupational group was randomly selected. We used the Sobel test to investigate the mediating role of intellectual capital and the structural equation model to fit the research model. Results Succession aspects, including culturalization, meritocracy, job promotion path, and the role of senior managers, have a positive and significant effect on intellectual capital. Succession is only effective on intellectual capital and does not affect the personnel’s entrepreneurship directly or through intellectual capital. Conclusion Conducting training classes and intervention programs and using localized succession models can create a suitable platform for increasing organizational creativity and entrepreneurship, motivating the hospitals’ personnel, and increasing intellectual capital

Effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients

Background: Many of the cognitive behavioral models and therapeutic protocols developed so far for psychological disorders and chronic diseases have proved effective through clinical research. Objective: This study aimed to determine the effectiveness of teaching cognitive-behavioral techniques on locus of control in hemodialysis patients. Methods: This controlled clinical trial study was conducted in 2015 with 76 patients selected by census and treated with a hemodialysis machine in the dialysis department of Vali-Asr Hospital in the city of Meshkinshahr. A total of four patients were excluded because of their critical conditions while the rest, who were recruited, were randomly divided into two equal groups of 36 patients as the intervention and control groups. First, the locus of control was measured in both groups through a pretest, and cognitive-behavioral techniques were then taught to the intervention group during eight 45 to 90-minute sessions. The locus of control in patients of both groups was finally re-measured through a posttest. Data were collected using Rotter's Locus of Control Inventory. The Wilcoxon test and Mann–Whitney U test were respectively used in SPSS18 for data analysis. Results: In the pretest and posttest stages respectively, 4.8% and 14.3% of samples in the control group as well as 14.3% and 33.3% of samples in the intervention group enjoyed internal locus of control. The difference between the pretest and posttest scores of internal locus of control in the intervention group was significant (p=0.004), which indicates the positive effect of cognitive-behavioral psychotherapeutic intervention on internalization of locus of control in this group. Conclusions: Given the external locus of control in most of the study patients and also the positive significant effect of cognitive-behavioral psychotherapy on internalization of locus of control in this group of patients, it appears necessary to have a psychology resident present in the hemodialysis department to teach the necessary cognitive-behavioral techniques to internalize the locus of control. Trial registration: The trial was registered at the Thai Clinical Trial Registry (http://www.clinicaltrials.in.th) with the TCTID: TCTR20170707003. Funding: The authors received no financial support for the research, authorship, and/or publication of this articl

Perceived stress, stress coping strategies, and post‐traumatic‐growth among healthcare professionals during COVID‐19 pandemic

Abstract Aim The purpose of this research was to identify the perceived stress, stress coping strategies, and Post‐Traumatic‐Growth (PTG) among Iranian healthcare professionals. Design A cross‐sectional study was applied. Methods This study was conducted among 402 healthcare professionals in northwestern Iran. Participants completed demographic, perceived stress, stress coping strategies, and PTG questionnaires. Multiple linear regression was employed to identify the predictors of perceived stress and PTG. Results The overall score of perceived stress was calculated 30.55 (6.18). The problem‐oriented strategy was the most common stress coping by healthcare professionals (52.66 (8.72)). Also, the total score of PTG was calculated at 45.72 (30.42). Perceived stress, stress coping strategies (except problem‐oriented), and PTG scores were significantly different between hospital and health centres participants (p‐value < 0.05). Previous experience in critical situations, crisis‐related course, degree, age, department, and stress coping strategies were related to the stress level. Moreover, workplace, department, work experiences, and employment status were the predictors of PTG

Explaining the role of organizational culture on succession-planning at the Ministry of Health and Medical Education: A qualitative study

Background: Developing and guiding new knowledge are futile unless the organizational culture can also be transformed. Future leaders cannot emerge out of an organizational environment that is not conducive to the accumulation of experiences. Objective: The aim of this study was to explore the role of organizational culture in creating a succession- planning system at the Ministry of Health and Medical Education in 2014. Methods: The present qualitative framework analysis held interviews with 23 director generals, administrative directors and deputies from the headquarters of the Iranian Ministry of Health and Medical Education in 2014 who were selected through snowball sampling. The data obtained were analyzed in MAXQDA-10. Codes were extracted using inductive techniques. Results: The cultural factors affecting succession-planning at the Ministry of Health and Medical Education were identified and classified under three main areas, including the cultural factors related to the directors with four themes (Directors’ job security, Constructive competition, Transparency and trust development, Creating opportunities), to the personnel with four themes (Organizational identity and loyalty, Trust in the organization, Talent and merit, Peer envy) and to the system with two themes (Values and beliefs, Politicization). Conclusion: Findings of the study show that establishment and institutionalization of the succession planning to the Ministry of Health and Medical Education is deeply affected by the components of organizational culture. Accordingly, unprofessional organization culture can deprive the organization of numerous advantages in multiple-succession planning

Risk Factors Associated with Head lice (Pediculosis) Infestation among Elementary School Students in Meshkinshahr County, North West of Iran

Background: Head louse (Pediculus humanus capitis) is one of the common health problems of the children in elementary schools. The aim of this study was to determine risk factors associated with head lice (Pediculosis) infestation among elementary school students in Meshkinshahr County,  Northwestern Iran. Materials and Methods: This descriptive-analytic study is done over 1,950 students (1,055 girls and 895 boys) in Meshkinshahr County,  North West of Iran that were selected two-stage cluster. Data collection was conducted using researcher-made questionnaire. In addition, the suspected cases were confirmed via physical examination for the presence of adult lice, and eggs. Head examinations were done by general physicians and medical entomologist experts. For data analysis, Chi-square and Regression Logistics tests were used. Results: In total, out of 1,950 students of primary schools, 200 students (10.25%) were infested with pediculosis. A total of 131 (12.42%) of girls, and 69 (7.71%) of boys were head lice infested. Most of head lice infested students 145 (72.5%) were in the classrooms with capacity of more than 20 students. Also, one hundred sixty-one (80.5%) of the cases were in the schools with capacity of more than 100 students. This study revealed significant differences among student’s family size, students and their parents' history of infestation, type of bathrooms, history of use shared hygiene items and head lice infestation (P < 0.05). Conclusion: The prevalence of head lice infestation in Meshkinshahr County was relatively high in comparison to other studied areas of Iran. It seems family size, students and their parents' history of infestation, type of bathrooms, and history of use shared hygiene items were probably risk factors associated with head lice infestation among students of primary schools

Genetic susceptibility of COVID-19: a systematic review of current evidence

International audienceAbstract Introduction While COVID-19 pandemic continues to spread worldwide, researchers have linked patterns of traits to poor disease outcomes. Risk factors for COVID-19 include asthma, elderly age, being pregnant, having any underlying diseases such as cardiovascular disease, diabetes, obesity, and experiencing lifelong systemic racism. Recently, connections to certain genes have also been found, although the susceptibility has not yet been established. We aimed to investigate the available evidence for the genetic susceptibility to COVID-19. Methods This study was a systematic review of current evidence to investigate the genetic susceptibility of COVID-19. By systematic search and utilizing the keywords in the online databases including Scopus, PubMed, Web of Science, and Science Direct, we retrieved all the related papers and reports published in English from December 2019 to September 2020. Results According to the findings, COVID-19 uses the angiotensin-converting enzyme 2 (ACE2) receptor for cell entry. Previous studies have shown that people with ACE2 polymorphism who have type 2 transmembrane serine proteases (TMPRSS2) are at high risk of SARS-CoV-2 infection. Also, two studies have shown that males are more likely to become infected with SARS-CoV-2 than females. Besides, research has also shown that patients possessing HLA-B*15:03 genotype may become immune to the infection. Conclusion Combing through the genome, several genes related to immune system’s response were related to the severity and susceptibility to the COVID-19. In conclusion, a correlation was found between the ACE2 levels and the susceptibility to SARS-CoV-2 infection

COVID-19 mortality and its predictors in the elderly: A systematic review

Background and Aims Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group. Methods We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies. Results Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin–angiotensin–aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality. Conclusion Overall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.publishedVersio