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Isfahani P, Alirezaei S, Samani S, Bolagh F, Heydari A, Sarani M, Afshari M. Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis. Patient Saf Surg 2024; 18:4. [PMID: 38263177 PMCID: PMC10804626 DOI: 10.1186/s13037-023-00384-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/08/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. The hypothesis of this research was to investigate the prevalence of hospital-acquired pressure injuries in intensive care units (ICUs) of the Eastern Mediterranean Region. METHODS This study was designed as a systematic review and meta-analysis. All articles published on Pressure ulcer prevalence in the ICUs of hospitals in Eastern Mediterranean Region countries, identified by searching PubMed through MEDLINE, Web of Science, Scopus, and Google Scholar from January 1, 2011, until September 22, 2023. The reference lists of these articles were checked for additional relevant studies. Data were analyzed using the Comprehensive Meta-Analysis Software (v.2.2.064). RESULTS A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.6-29.6)). Both the highest and lowest prevalence was observed in Jordan in 2011 at 83.1% (95% CI (71.2- 90.7)) and in 2012 at 0.9% (95% CI (0.5- 1.5)), respectively. The results showed that publication year, average age, and sample size were the main causes of heterogeneity between the reviewed studies (p < 0.05). CONCLUSION This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs.
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Affiliation(s)
- Parvaneh Isfahani
- Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Samira Alirezaei
- Research Center for Social Determinants of Health, Saveh University of Medical Sciences, Saveh, Iran
| | - Somayeh Samani
- Department of Occupational Health, School of Public Health, Instructor of Occupational Health Engineering, Zabol University of Medical Sciences, Zabol, Iran
| | - Fateme Bolagh
- Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Azadeh Heydari
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Sarani
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Isfahani P, Alirezaei S, Samani S, Bolagh F, Heydari A, Sarani M, Afshari M. Prevalence of hospital-acquired pressure injuries in intensive care units of the Eastern Mediterranean region: a systematic review and meta-analysis. Patient Saf Surg 2024; 18:1. [PMID: 38167487 PMCID: PMC10763125 DOI: 10.1186/s13037-023-00383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Hospital-acquired pressure injuries are a major patient safety concern in intensive care units that are considered largely preventable adverse events by adherence to nursing standards of care. The hypothesis of this research was to investigate the prevalence of hospital-acquired pressure injuries in intensive care units (ICUs) of the Eastern Mediterranean Region. METHODS This study was designed as a systematic review and meta-analysis. All articles published on Pressure ulcer prevalence in the ICUs of hospitals in Eastern Mediterranean Region countries, identified by searching PubMed through MEDLINE, Web of Science, Scopus, and Google Scholar from January 1, 2011, until September 22, 2023. The reference lists of these articles were checked for additional relevant studies. Data were analyzed using the Comprehensive Meta-Analysis Software (v.2.2.064). RESULTS A total of 15 articles met the inclusion criteria. Based on the random-effects model, the overall Pressure ulcer prevalence rate was 16.6% (95% CI (8.6-29.6)). Both the highest and lowest prevalence was observed in Jordan in 2011 at 83.1% (95% CI (71.2- 90.7)) and in 2012 at 0.9% (95% CI (0.5- 1.5)), respectively. The results showed that publication year, average age, and sample size were the main causes of heterogeneity between the reviewed studies (p < 0.05). CONCLUSION This systematic review and meta-analysis of the pertinent peer-reviewed literature revealed a high prevalence of hospital-acquired pressure injuries of 16% in intensive care units of Eastern Mediterranean region. Therefore, it is necessary for health policymakers and managers in Eastern Mediterranean Region to take necessary measures to prevent the incidence of Pressure ulcers in hospitals, especially in ICUs.
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Affiliation(s)
- Parvaneh Isfahani
- Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Samira Alirezaei
- Assistant Professor, Research Center for Social Determinants of Health, Saveh University of Medical Sciences, Saveh, Iran
| | - Somayeh Samani
- Department of Occupational Health, Instructor of Occupational Health Engineering, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Fateme Bolagh
- Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Azadeh Heydari
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Sarani
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mahnaz Afshari
- Assistant Professor of Health Policy, School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Methodological rigor in climate-resilient health systems research: from criticism to contribution. Global Health 2023; 19:101. [PMID: 38098021 PMCID: PMC10722825 DOI: 10.1186/s12992-023-01002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Affiliation(s)
- Ali Mohammad Mosadeghrad
- Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Leila Eslambolchi
- Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Zahmatkesh
- School of Business and Management, Royal Holloway University of London, Egham, England
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Mosadeghrad AM, Isfahani P, Eslambolchi L, Zahmatkesh M, Afshari M. Strategies to strengthen a climate-resilient health system: a scoping review. Global Health 2023; 19:62. [PMID: 37641052 PMCID: PMC10463427 DOI: 10.1186/s12992-023-00965-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Climate change is a major global threat to human health and puts tremendous pressure on health systems. Therefore, a resilient health system is crucial to enhance, maintain, and restore the population's health. This study aimed to identify interventions and actions to strengthen a climate-resilient health system to deal with the adverse health effects of climate change. METHOD This study was a scoping review. Five databases and Google Scholar search engine were searched using relevant keywords. Initially, 4945 documents were identified, and 105 were included in the review. Content thematic analysis method was applied using MAXQDA 10 software. RESULTS Overall, 87 actions were identified for building a climate-resilient health system and were classified into six themes (i.e., governance and leadership; financing; health workforce; essential medical products and technologies; health information systems; and service delivery). The most commonly reported actions were formulating a national health and climate change adaptation plan, developing plans for essential services (electricity, heating, cooling, ventilation, and water supply), assessing the vulnerabilities and capacities of the health system, and enhancing surveillance systems targeting climate-sensitive diseases and their risk sources. CONCLUSIONS A holistic and systemic approach is needed to build a climate-resilient health system owing to its complex adaptive nature. Strong governance and leadership, raising public awareness, strategic resource allocation, climate change mitigation, emergency preparedness, robust health services delivery, and supporting research, are essential to building a climate-resilient health system.
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Affiliation(s)
- Ali Mohammad Mosadeghrad
- Professor of Health policy and management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Leila Eslambolchi
- PhD in Health management, Health Economics and Management Department, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Maryam Zahmatkesh
- School of Business and Management, Royal Holloway University of London, Egham, England
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
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Afshari M, Teymourlouy AA, Maleki M, Asadi-Lari M. Enhancing global health diplomacy for non-communicable diseases: application of the global health network framework. Global Health 2023; 19:41. [PMID: 37344896 DOI: 10.1186/s12992-023-00944-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 06/03/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND AND AIM Understanding the characteristics of global policy actors and the political context in which they address diplomatic issues in the field of NCDs can play an important role in advancing NCD-related goals. The purpose of this study was to identify and analyze the network of global health actors in the field of NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative methodology and framework analysis. In-depth semi-structured interviews were conducted with subject-matter experts from all levels of diplomacy, including global, regional, and national, who had managerial, administrative, and academic experience. FINDINGS A total of 21 interviews were conducted with individuals who met the inclusion criteria. Following the framework of the World Health Network, the findings were divided into three general areas: the features of the network and the actors; the policy environment; and the characteristics of the issue. CONCLUSION A successful and sustainable program to combat NCDs requires the participation of multiple actors from governments, the private sector, and civil society at international, national, and local levels. The Global Network for Prevention and Control of NCDs should enhance the effectiveness of NCDs policies by highlighting the need to simultaneously improve the internal factors of the network, including relationships among the actors; external factors, including the policy environment; and the complex nature of NCDs.
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Affiliation(s)
- Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Neyazi N, Mosadeghrad AM, Afshari M, Isfahani P, Safi N. Strategies to tackle non-communicable diseases in Afghanistan: A scoping review. Front Public Health 2023; 11:982416. [PMID: 36908476 PMCID: PMC9992526 DOI: 10.3389/fpubh.2023.982416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
Non-communicable diseases (NCDs) and their risk factors are the leading cause of death worldwide and contribute to 74.3% of deaths globally in 2019. The burden of NCDs is escalating in Afghanistan. Currently, every seconds, people in Afghanistan are dying of NCDs. Addressing this challenge in Afghanistan needs effective and practical interventions. This study aimed to identify the strategies developed and implemented in countries with low non-communicable premature death. To conduct a scoping review, we followed the six-step Arksey and O'Malley protocol and searched for eligible articles on eight international databases and the gray literature. The study followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were English documents and evidence produced up to 30 November 2021 for the control of NCDs. We excluded incomplete texts, duplicates, and dissertations due to lack of access. We used EndNote X9 and MaxQDA software for data management and analysis. We conducted content analysis for this study. A total of 122 documents developed between 1984 and 2021 met the inclusion criteria. We identified 35 strategies from which the most used strategies were related to unhealthy diets and smoking cessation programs. Canada (26.4%), Korea (19.8%), and the United Kingdom (19%) have the most publications on the control and prevention of NCDs among the countries included in the study. Most strategies were implemented over 2 years (41%). This study recommends specific interventions to control and prevent NCDs for the main risk factors of tobacco use, unhealthy diet, physical inactivity, and the main non-communicable diseases such as heart diseases, cancers, diabetes, and chronic obstructive pulmonary diseases. Afghanistan Ministry of Public Health, the WHO country office, and other involved stakeholders can use the findings of this review to design and implement strategies for controlling and preventing NCDs in Afghanistan. International organizations such as the World Health Organization, United Nations Agencies, the World Bank, and other involving communities should invest in strengthening good health governance in Afghanistan. The Afghan Government should focus on promoting and funding health literacy among the public and self-care to control and prevent NCDs.
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Affiliation(s)
- Narges Neyazi
- International Campus, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
| | - Ali Mohammad Mosadeghrad
- Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Najibullah Safi
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
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Ravaghi H, Afshari M, Isfahani P, Mahboub-Ahari A, Bélorgeot VD. Hospital efficiency in the eastern mediterranean region: A systematic review and meta-analysis. Front Public Health 2023; 11:1085459. [PMID: 36817899 PMCID: PMC9936516 DOI: 10.3389/fpubh.2023.1085459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Background Recent rising costs and shortages of healthcare resources make it necessary to address the issue of hospital efficiency. Increasing the efficiency of hospitals can result in the better and more sustainable achievement of their organizational goals. Objective The purpose of this research is to examine hospital efficiency in the Eastern Mediterranean Region (EMR) using data envelopment analysis (DEA). Methods This study is a systematic review and meta-analysis of all articles published on hospital efficiency in Eastern Mediterranean countries between January 1999 and September 2020, identified by searching PubMed through MEDLINE, Web of Science, Scopus, Science Direct, and Google Scholar. The reference lists of these articles were checked for additional relevant studies. Finally, 37 articles were selected, and data were analyzed through Comprehensive Meta-Analysis Software (v.2.2.064). Results Using the random-effects model, the mean hospital efficiency in Eastern Mediterranean hospitals was 0.882 ± 0.01 at 95% CI. Technical efficiency (TE) was higher in some countries such as Iraq (0.976 ± 0.035), Oman (0.926 ± 0.032), and Iran (0.921 ±0.012). A significant statistical correlation was observed between the hospital efficiency and the year of publication and sample size (p < 0.05). Conclusion Efficiency plays a significant role in hospital growth and development. Therefore, it is important for healthcare managers and policymakers in the EMR to identify the causes of inefficiency, improve TE, and develop cost-effective strategies.
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Affiliation(s)
- Hamid Ravaghi
- WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Mahnaz Afshari
- School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran,Student Research Committee, Saveh University of Medical Sciences, Saveh, Iran,*Correspondence: Mahnaz Afshari ✉
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Alireza Mahboub-Ahari
- Department of Health Economics, Iranian Evidence Based Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Afshari M, Morris S, Geulig LD, Chitgar ZM, Gibbon P, Thirolf PG, Schreiber J. The role of collisional ionization in heavy ion acceleration by high intensity laser pulses. Sci Rep 2022; 12:18260. [PMID: 36309599 PMCID: PMC9617862 DOI: 10.1038/s41598-022-23148-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/25/2022] [Indexed: 12/31/2022] Open
Abstract
We present here simulation results of the laser-driven acceleration of gold ions using the EPOCH code. Recently, an experiment reported the acceleration of gold ions up to 7 MeV/nucleon with a strong dependency of the charge-state distribution on target thickness and the detection of the highest charge states [Formula: see text]. Our simulations using a developmental branch of EPOCH (4.18-Ionization) show that collisional ionization is the most important cause of charge states beyond Z = 51 up to He-like Au.
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Affiliation(s)
- M. Afshari
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - S. Morris
- grid.7372.10000 0000 8809 1613Department of Physics, University of Warwick, Coventry, CV4 7AL UK
| | - L. D. Geulig
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - Z. M. Chitgar
- grid.8385.60000 0001 2297 375XInstitute for Advanced Simulation, Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany
| | - P. Gibbon
- grid.8385.60000 0001 2297 375XInstitute for Advanced Simulation, Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, 52425 Jülich, Germany ,grid.5596.f0000 0001 0668 7884Centre for Mathematical Plasma Astrophysics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium
| | - P. G. Thirolf
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
| | - J. Schreiber
- grid.5252.00000 0004 1936 973XFakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching bei München, Germany
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Eslambolchi L, Afshari M. Challenges and opportunities for Iranian global health diplomacy: lessons learned from action for prevention and control of noncommunicable diseases. Health Res Policy Syst 2021; 19:152. [PMID: 34952614 PMCID: PMC8703215 DOI: 10.1186/s12961-021-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis. RESULTS The identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system. CONCLUSIONS NCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Eslambolchi
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. .,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Afshari M. Opportunities and challenges of global health diplomacy for prevention and control of noncommunicable diseases: a systematic review. BMC Health Serv Res 2021; 21:1193. [PMID: 34736461 PMCID: PMC8567539 DOI: 10.1186/s12913-021-07240-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background and aim The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. Methods A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. Findings There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. Conclusion Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07240-3.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Dziadziuszko R, Ahn M, Kelly K, Popat S, Wakelee H, Baird A, Rooney I, Afshari M, Coleman S, Zhang Z, Kiruki H, Patil N, Wen X, Bradley J. SKYSCRAPER-03: A Phase III, Open-Label, Randomized Study of Atezolizumab Plus Tiragolumab Compared With Durvalumab in Patients With Locally Advanced, Unresectable, Stage III NSCLC Who Have Not Progressed After Platinum-Based Concurrent Chemoradiation. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Prasselsperger A, Coughlan M, Breslin N, Yeung M, Arthur C, Donnelly H, White S, Afshari M, Speicher M, Yang R, Villagomez-Bernabe B, Currell FJ, Schreiber J, Dromey B. Real-Time Electron Solvation Induced by Bursts of Laser-Accelerated Protons in Liquid Water. Phys Rev Lett 2021; 127:186001. [PMID: 34767414 DOI: 10.1103/physrevlett.127.186001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/24/2021] [Indexed: 06/13/2023]
Abstract
Understanding the mechanisms of proton energy deposition in matter and subsequent damage formation is fundamental to radiation science. Here we exploit the picosecond (10^{-12} s) resolution of laser-driven accelerators to track ultrafast solvation dynamics for electrons due to proton radiolysis in liquid water (H_{2}O). Comparing these results with modeling that assumes initial conditions similar to those found in photolysis reveals that solvation time due to protons is extended by >20 ps. Supported by magnetohydrodynamic theory this indicates a highly dynamic phase in the immediate aftermath of the proton interaction that is not accounted for in current models.
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Affiliation(s)
- A Prasselsperger
- Fakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching, Germany
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Coughlan
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - N Breslin
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Yeung
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - C Arthur
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - H Donnelly
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - S White
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Afshari
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
| | - M Speicher
- Fakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching, Germany
| | - R Yang
- Fakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching, Germany
| | - B Villagomez-Bernabe
- The Dalton Cumbria Facility and the School of Chemistry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - F J Currell
- The Dalton Cumbria Facility and the School of Chemistry, The University of Manchester, Oxford Rd, Manchester M13 9PL, United Kingdom
| | - J Schreiber
- Fakultät für Physik, Ludwig-Maximilians-Universität München, 85748 Garching, Germany
| | - B Dromey
- Centre for Plasma Physics, School of Mathematics and Physics, Queens University Belfast, Belfast BT7 1NN, United Kingdom
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Dziadziuszko R, Ahn MJ, Kelly K, Popat S, Wakelee H, Baird AM, Rooney I, Afshari M, Yao E, Zhang Z, Kuriki H, Patil N, Wen X, Bradley J. 1190TiP SKYSCRAPER-03: Phase III, open-label randomised study of atezolizumab + tiragolumab vs durvalumab in patients with locally advanced, unresectable, stage III non-small cell lung cancer (NSCLC) who have not progressed after platinum-based concurrent chemoradiation (cCRT). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Eslambolchi L, Mosadeghrad AM, Taheri S, Afshari M. Taxonomy of effective strategies to reduce unnecessary caesareans: a systematic review. East Mediterr Health J 2021; 27:826-849. [PMID: 34486719 DOI: 10.26719/emhj.21.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 11/16/2020] [Indexed: 11/09/2022]
Abstract
Background The increasing trend in unnecessary caesarean sections has caused maternal and neonatal health concerns worldwide. Various medical and non-medical interventions have been designed and implemented to reduce caesarian section overuse. However, their efficacy is questionable. Aims This study aimed to identify and classify effective interventions to reduce unnecessary caesarian sections. Methods We searched EMBASE, MEDLINE, Web of Knowledge and Scopus databases for articles, using appropriate search strategies, up to 2 June 2020. Overall, 7951 identified articles were screened and assessed using a valid quality assessment checklist. Finally, 109 eligible studies were included in this review. Thematic content analysis was used to identify and classify the effective interventions. Results Overall, 188 effective caesarian section reduction measures were identified. They were categorized into 45 actions, 16 intervention groups and 6 WHO building blocks, including "governance and leadership", "financing", "health workforce", "medical products and technologies", "information" and "service delivery". Using qualified and competent staff, intra-partum services, and oversight were the most commonly applied interventions to reduce unnecessary caesarian sections. Conclusions A taxonomy of effective strategies to reduce unnecessary caesarian sections was developed in this study. A holistic approach is crucial to addressing the new epidemic of unnecessary caesarian section. Multiple interventions based on the underlying causes of caesarian section overuse should be designed and implemented at local and global levels.
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Affiliation(s)
- Leila Eslambolchi
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ali Mohammad Mosadeghrad
- Health Economics and Management Department, Health Information Management Research Centre, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sara Taheri
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Islamic Republic of Iran
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15
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Seyedin H, Afshari M, Isfahani P, Hasanzadeh E, Radinmanesh M, Bahador RC. The main factors of supplier-induced demand in health care: A qualitative study. J Educ Health Promot 2021; 10:49. [PMID: 34084796 PMCID: PMC8057171 DOI: 10.4103/jehp.jehp_68_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/19/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Induced demand is a major challenge for financing health promotion, whereby providers exploit patients' information gap to manipulate their demand for health care. The purpose of this study was to identify the factors associated with induced demand for health-care services in hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018. MATERIALS AND METHODS In this qualitative study, semi-structured interviews were conducted with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze the data. RESULTS Overall, 24 subthemes or factors were identified and classified into the health system, the insurer, health-care provider, and health-care recipient themes. Poor monitoring and control, the fee-for-service payment system, limited role of insurance companies, insufficient monitoring of insurance companies, the educational nature of our health centers, health-care providers' interests, and patients' information gap were some important factors in induced demand for health-care services. CONCLUSION Our results showed that there are many factors that contribute to induced demand for health care. Given the four levels of factors identified in this study, health policymakers and managers must develop strategies at each level to reduce induced demand for health care.
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Affiliation(s)
- Hesam Seyedin
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Mahnaz Afshari, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Parvaneh Isfahani
- Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Ebrahim Hasanzadeh
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Radinmanesh
- Department of Health Economic, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Afshari M, Isfahani P, Shamsaie M, Peirovy S, Bahador R. Job Stress among Iranian Nurses: A Meta-Analysis. Nurs Midwifery Stud 2021. [DOI: 10.4103/nms.nms_28_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
PurposeThe operating theater (OT) is resource-intensive, costly and assuring its productivity is a high priority. This study aimed to examine a quality management model's effects on a hospital's OT productivity.Design/methodology/approachThe participatory action research approach was used for the intervention. A multidisciplinary quality improvement team was formed. The team improved OT operational processes using an eight-step quality management model. OT’s key performance indicators such as surgical cases, surgical cancellation, bill deductions, successful cardiopulmonary resuscitation, patients' complaints and employees' job satisfaction were collected before the intervention and compared with those of after intervention to determine the efficacy of the quality management model.FindingsApplying a quality management strategy increased surgical patients' number by 14.96%, reduced surgery operations cancellation by 14.6 %, and decreased bill deduction by 44.9%. Besides, successful cardiopulmonary resuscitation increased by 21.17%, patients' complaints reduced by 61.5% and, finally, staff satisfaction increased by 15.6 %. Improved OT productivity resulted in improved financial performance. As a result, the OT revenue has risen by 68.8%.Originality/valueThis study highlights that implementing the right quality management model properly enhances hospitals' productivity. It also offers suggestions on how to implement a quality management model successfully in a hospital setting.
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Aboutorabi A, Radinmanesh M, Rezapour A, Afshari M, Taheri G. A comparison of global surgery tariffs and the actual cost of bills at Hazrate Rasoole Akram educational and medical center. Cost Eff Resour Alloc 2020; 18:38. [PMID: 33005107 PMCID: PMC7525997 DOI: 10.1186/s12962-020-00232-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 09/11/2020] [Indexed: 11/10/2022] Open
Abstract
Background the health service tariff is an appropriate policymaking tool and the financial leverage of the health system control which affects quality, availability, cost, efficiency, equity and accountability of health services. Global surgeries include 91 common cases of general and specialized surgeries in hospitals; fixed tariffs are annually defined for these surgeries, and insurance companies must pay medical centers based on these tariffs. The aim of this study was to examine and compare hospital bills with global surgery tariffs at Hazrate Rasoole Akram Educational and Medical Center in 2017. Methods This descriptive-analytic study was conducted retrospectively and compared the global and actual costs of global surgeries performed in the third quarter of the year 2017 at Hazrate Rasoole Akram Educational and Medical Center. Required data on the actual costs of surgeries was collected through the Hospital Information System (HIS) and patients’ records. Information on the global costs was obtained from the Annual Circulars of Insurance Council for the studied period about the cost of global surgeries. Linear regression (STATA13 software) was used to investigate the effect of items on tariff and invoice differences; concerning other calculations, EXCEL software was used. Results The highest frequency of global surgeries was related to ophthalmic surgery which accounted for approximately half of total surgeries performed at Hazrate Rasoole Akram Hospital. The most significant difference between global tariff and invoice was also related to ophthalmic surgery (188709.3 Dollar a year).Overall, the actual hospital bills were much higher than the tariffs approved for global surgeries, and the total difference was 461805.5 Dollar. The results revealed that there was a significant relationship between some of the items such as the cost of operating rooms, anesthesia and other services. Conclusions Referral hospitals which are at the level three of referral networks usually treat more complex patients; this should be taken into account when defining surgery tariffs of these centers. On the other hand, hospitals need to control the costs and reduce the end cost of these surgeries by improving clinical management and cost management. In addition, prospective and case-based payment methods can control health costs.
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Affiliation(s)
- Ali Aboutorabi
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Radinmanesh
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.,Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ghasem Taheri
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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19
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Pourali F, Afshari M, Alizadeh-Navaei R, Javidnia J, Moosazadeh M, Hessami A. Relationship between blood group and risk of infection and death in COVID-19: a live meta-analysis. New Microbes New Infect 2020; 37:100743. [PMID: 32837730 PMCID: PMC7418722 DOI: 10.1016/j.nmni.2020.100743] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/14/2020] [Accepted: 08/07/2020] [Indexed: 02/08/2023] Open
Abstract
The relationship between ABO blood group and the incidence of coronavirus disease 2019 (COVID-19) infection and death has been investigated in several studies. The reported results were controversial, so the objective of the present study was to assess the relationship between different blood groups and the onset and mortality of COVID-19 infection using a meta-analysis method. We searched relevant databases using appropriate MeSH terms. We screened articles on the bases of titles, abstracts and full text, and articles that met the inclusion criteria were selected. Quality assessment was done with the Newcastle-Ottawa scale checklist. The estimated frequency of COVID-19 infection and death in terms of ABO blood group and the overall estimate of the odds ratio between blood group with COVID-19 infection and death was calculated with 95% confidence interval. The pooled frequency of blood groups A, B, O and AB among COVID-19-infected individuals was estimated as 36.22%, 24.99%, 29.67% and 9.29% respectively. The frequency of blood groups A, B, O and AB among patients who died of COVID-19 infection was estimated as 40%, 23%, 29% and 8% respectively. The odds ratio of COVID-19 infection for blood group A versus the other blood groups was estimated as 1.16 (95% confidence interval (CI), 1.02-1.33). The corresponding figures for blood groups O and AB versus other blood groups were estimated as 0.73 (95% CI, 0.60-0.88) and 1.25 (95% CI, 0.84-1.86) respectively. This meta-analysis showed that individuals with blood group A are at higher risk for COVID-19 infection while those with blood group O are at lower risk. Although the odds ratio of death for AB blood group was nonsignificant, it was considerable.
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Affiliation(s)
- F. Pourali
- Student Research Committee, School of Medicine, Iran
| | - M. Afshari
- Department of Community Medicine, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - R. Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - J. Javidnia
- Student Research Committee, School of Medicine, Iran
| | - M. Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - A. Hessami
- Student Research Committee, School of Medicine, Iran
- Systematic Review and Meta-Analysis Expert Group (SRMEG), Iran
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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20
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Karamikabir H, Afshari M, Lak F. Wavelet threshold based on Stein's unbiased risk estimators of restricted location parameter in multivariate normal. J Appl Stat 2020; 48:1712-1729. [DOI: 10.1080/02664763.2020.1772209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- H. Karamikabir
- Department of Statistics, Persian Gulf University, Bushehr, Iran
| | - M. Afshari
- Department of Statistics, Persian Gulf University, Bushehr, Iran
| | - F. Lak
- Department of Statistics, Persian Gulf University, Bushehr, Iran
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Afshari M, Ahmadi Teymourlouy A, Asadi-Lari M, Maleki M. Global Health diplomacy for noncommunicable diseases prevention and control: a systematic review. Global Health 2020; 16:41. [PMID: 32375804 PMCID: PMC7201808 DOI: 10.1186/s12992-020-00572-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/22/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The prevention and control of noncommunicable diseases (NCDs) are one of the main challenges of healthcare systems around the world. In addition to the technical level, it requires political negotiations and solutions, such as global health diplomacy (GHD), which involves the participation of a wide range of actors and stakeholders and innovative international health partnerships. This review aimed to draw lessons for strengthening linkages with a wide range of actors and stakeholders from the GHD literature for NCDs, and how policymakers and political leaders can effectively use international health partnerships to beat NCDs. METHODS This research was a systematic review of the literature on GHD for NCDs. All relevant articles published in English were identified by searching PubMed, Web of Science, Scopus, and Embase databases, Google and Google Scholar search engines, and the reference lists of identified articles as well as a number of special journals. 30 articles that met the inclusion criteria were analyzed using content analysis in MAXQDA 10. The Global Health Diplomacy Pyramid and Blouin and Dubé's (2010) analytical framework for examining negotiations were used to classify the data. FINDINGS 30 articles have been published on GHD for NCDs. Five key themes, i.e. the specific problem requiring global collective action, key actors, their interests in the problem, potential negotiation process, and potential scenarios for collective action and 46 sub-themes were identified. Moreover, given the importance of collaboration on NCDs in the international arena, actors were categorized into three groups based on the GHD Pyramid: (1) core diplomacy, (2) multi-stakeholder diplomacy, and (3) informal diplomacy. CONCLUSION Development and adoption of a global policy to tackle the rise in NCDs in developed and developing countries require policymakers and political leaders that participate in GHD. Successful developments in global health policy depend on the performance of and respectful relationships among the stakeholders, and global health diplomats need to understand the complexities of the institutional structures and functional relationships of the international institutions involved in health.
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Affiliation(s)
- Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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22
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Afshari M, Krumey P, Menn D, Nicoul M, Brinks F, Tarasevitch A, Sokolowski-Tinten K. Time-resolved diffraction with an optimized short pulse laser plasma X-ray source. Struct Dyn 2020; 7:014301. [PMID: 31934600 PMCID: PMC6941949 DOI: 10.1063/1.5126316] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 12/16/2019] [Indexed: 06/07/2023]
Abstract
We present a setup for time-resolved X-ray diffraction based on a short pulse, laser-driven plasma X-ray source. The employed modular design provides high flexibility to adapt the setup to the specific requirements (e.g., X-ray optics and sample environment) of particular applications. The configuration discussed here has been optimized toward high angular/momentum resolution and uses K α -radiation (4.51 keV) from a Ti wire-target in combination with a toroidally bent crystal for collection, monochromatization, and focusing of the emitted radiation. 2 × 10 5 Ti-K α1 photons per pulse with10 - 4 relative bandwidth are delivered to the sample at a repetition rate of 10 Hz. This allows for the high dynamic range (104) measurements of transient changes in the rocking curves of materials as for example induced by laser-triggered strain waves.
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Affiliation(s)
- M Afshari
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - P Krumey
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - D Menn
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - M Nicoul
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - F Brinks
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - A Tarasevitch
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
| | - K Sokolowski-Tinten
- Faculty of Physics and Center for Nanointegration Duisburg-Essen, University of Duisburg-Essen, Lotharstrasse 1, 47048 Duisburg, Germany
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Ravaghi H, Afshari M, Isfahani P, Bélorgeot VD. Correction to: A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions. BMC Health Serv Res 2019; 19:948. [PMID: 31822274 PMCID: PMC6902584 DOI: 10.1186/s12913-019-4766-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Hamid Ravaghi
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Victoria D Bélorgeot
- World Health Organization, Regional Office for the Eastern Mediterranean, Monazamet El Seha El Alamia Street, Extension of Abdel Razak El Sanhouri Street, Nasr City, Cairo, Egypt
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Ravaghi H, Afshari M, Isfahani P, Bélorgeot VD. A systematic review on hospital inefficiency in the Eastern Mediterranean Region: sources and solutions. BMC Health Serv Res 2019; 19:830. [PMID: 31718648 PMCID: PMC6852759 DOI: 10.1186/s12913-019-4701-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Evaluating hospital efficiency is a process to optimize resource utilization and allocation. This is vital due to hospitals being the largest financial cost in a health system. To limit avoidable uses of hospital resources, it is important to identify the sources of hospital inefficiencies and to put in place measures towards their reduction and elimination. Thus, the purpose of this research is to examine the sources of hospital inefficiency in the Eastern Mediterranean Region, and existing strategies tackling this issue. METHODS In this study, the electronic databases MEDLINE (via PubMed), Web of Science, Embase, Google, Google Scholar, and reference lists of selected articles, were explored. Studies on inefficiency, sources of inefficiency, and strategies for inefficiency reduction in the Eastern Mediterranean region hospitals, published between January 1999 and May 2018, were identified. A total of 1466 articles were selected using the initial criteria. After further reviews based on the inclusion and exclusion criteria, 56 studies were eligible for this study. The chosen studies were conducted in Iran (n = 35), Saudi Arabia (n = 5), Tunisia (n = 5), Jordan (n = 4), Pakistan (n = 2), the United Arab Emirates, Palestine, Iraq, Oman, and Afghanistan (n = 1 each). These studies were analyzed using content analysis in MAXQDA 10. RESULTS The analysis showed that approximately 41% of studies used data envelopment analysis (DEA) to measure hospital efficiency. Sources of hospital inefficiency were divided into four categories for analysis: Hospital products and services, hospital workforce, hospital services delivery, and hospital system leakages. CONCLUSION This study has revealed some sources of inefficiency in the Eastern Mediterranean Region hospitals. Inefficiencies are thought to originate from excess workforce, excess beds, inappropriate hospital sizes, inappropriate workforce composition, lack of workforce motivation, and inefficient use of health system inputs. It is suggested that health policymakers and managers use this evidence to develop appropriate strategies towards the reduction of hospital inefficiency.
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Affiliation(s)
- Hamid Ravaghi
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Victoria D Bélorgeot
- World Health Organization, Regional Office for the Eastern Mediterranean, Monazamet El Seha El Alamia Street, Extension of Abdel Razak El Sanhouri Street, Nasr City, Cairo, Egypt
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25
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Raeissi P, Taheri mirghaed M, Sepehrian R, Afshari M, Rajabi MR. Medical malpractice in Iran: A systematic review. Med J Islam Repub Iran 2019. [DOI: 10.47176/mjiri.33.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Raeissi P, Taheri mirghaed M, Sepehrian R, Afshari M, Rajabi MR. Medical malpractice in Iran: A systematic review. Med J Islam Repub Iran 2019; 33:110. [PMID: 31934570 PMCID: PMC6946923 DOI: 10.34171/mjiri.33.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Indexed: 01/06/2023] Open
Abstract
Background: Medical malpractice represents a serious problem in the health system and is one of the risk factors for patient safety which damages the patient and increases costs for the patient and the health care provider. The importance of these complaints against physicians is that litigation may continue for a long time and become problematic for patients and physicians. The objective of this study was to investigate the complaints of medical malpractices which were referred to Iran Medical Council to provide solutions to reduce the complaints and improve service delivery. Methods: Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases, such as MagIran, SID, and Irandoc, were searched from 01/01/1990 to 07/01/2018. Also, the grey literature (via Google Scholar) was searched. Studies written in English or in Persian were searched, and keywords used included malpractice, negligence, medical malpractice, physician impairment, Iran, and professional impairment. Results: Nearly 1455 complaints (36%) of the total number of 3977 complaints were proved to be medical malpractice, and physicians were acquitted in 2542 (64%) cases. Most complaints were from gynaecologists, accounting for 43% of all complaints, followed by orthopaedic specialists who ranked second with 21.4% of the total complaints. The most type of failure was due to lack of skill (30.4%), followed by negligence (29.2%). Imprudence or indiscretion (26.3%) and noncompliance with governmental requirements (14.1%) were also in the next ranks, respectively. Conclusion: Improving patient and physician relationships, observing medical ethics, increasing the scientific and technical skills of the medical staff, and following the guidelines and medical protocols will prevent medical malpractice. Therefore, health policymakers can reduce errors and failures by adopting continuing education on medical, ethical, and legal issues.
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Affiliation(s)
- Pouran Raeissi
- Department of Health Services Administration, School of Health Services Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masood Taheri mirghaed
- Department of Health Services Administration, School of Health Services Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Razieh Sepehrian
- Department of Health Services Administration, School of Health Services Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Services Administration, School of Health Services Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Rajabi
- Department of Nephrology and Cardiology, Faculty of Medicine, Shahed University, Tehran, Iran
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Hosseini S, Afshari M, Fazlali A, Koudzari Farahani S, Bandehali S, Van der Bruggen B, Bagheripour E. Mixed matrix PES-based nanofiltration membrane decorated by (Fe3O4–polyvinylpyrrolidone) composite nanoparticles with intensified antifouling and separation characteristics. Chem Eng Res Des 2019. [DOI: 10.1016/j.cherd.2019.05.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Babadi N, Tavakkoli H, Afshari M. Synthesis and characterization of nanocomposite NiFe2O4@SalenSi and its application in efficient removal of Ni(II) from aqueous solution. B CHEM SOC ETHIOPIA 2018. [DOI: 10.4314/bcse.v32i1.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Dehghani SM, Shahramian I, Afshari M, Bahmanyar M, Ataollahi M, Sargazi A. Acute Hepatic Allograft Rejection in Pediatric Recipients: Effective Factors. Int J Organ Transplant Med 2018; 9. [PMID: 29531646 PMCID: PMC5839629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Acute cellular rejection (ACR), a reversible process, can affect the graft survival. OBJECTIVE To evaluate the relation between ACR and clinical factors in recipients of allograft liver transplantation. METHODS 47 recipients of liver were consecutively enrolled in a retrospective study. Their information were retrieved from their medical records and analyzed. RESULTS Of the 47 recipients, 38 (81%) experienced acute rejection during 24 months of the transplantation. None of the studied factors for occurring transplant rejection, i.e., blood groups, sex, age, familial history of disease, receiving drugs and blood products, type of donor, Child score, and Child class, was not found to be significant. CONCLUSION During a limited follow-up period, we did not find any association between ACR and suspected risk factors.
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Affiliation(s)
- S. M. Dehghani
- Professor of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - I. Shahramian
- Associate Professor of Pediatric Gastroenterology, Zabol University of Medical Sciences, Zabol, Iran,Correspondence: I. Shahramian, MD, Associate Professor of Pediatric Gastroenterology, Zabol University of Medical Sciences, Zabol, Iran E-mail:
| | - M. Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - M. Bahmanyar
- Assistant Professor of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. Ataollahi
- Assistant Professor of Pediatric Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A. Sargazi
- Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran
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Gorjizadeh M, Afshari M. 4-Bis(triphenylphosphonium)-2-butene peroxodisulfate as an efficient oxidizing agent for one-pot synthesis of ethyl pyrimidin-2(1H)-one-5-carboxylates. RUSS J GEN CHEM+ 2017. [DOI: 10.1134/s1070363217040284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Pourasghari H, Jafari M, Bakhtiari M, Keliddar I, Irani A, Afshari M. Analysis of equality in Iranian household healthcare payments during Iran's fourth development program. Electron Physician 2016; 8:2645-9. [PMID: 27648192 PMCID: PMC5014504 DOI: 10.19082/2645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 05/03/2016] [Indexed: 11/21/2022] Open
Abstract
Introduction Today, the provision of healthcare should be efficient and equitable to achieve the health system’s goals. The aim of this study was to survey equality in healthcare expenditures and its effects on income redistribution. Methods This study was a descriptive-analysis, cross-sectional study that was conducted with data obtained from the Statistical Center of Iran (SCI) during 2006 and 2011. The source population and study population were the urban and rural residents of Iran and their households’ income and expenditures on health. The analysis was based on annually aggregated data from all provinces relative to their share of the total population. The data were collected using a pre-tested checklist consisting of two sections. The first section was used to retrieve data about total gross non-food expenditures of households. The second section retrieved out-of-pocket payments for healthcare. The data that were collected were analyzed using a Microsoft Excel spreadsheet. The Kakwani index was used to measure the extent of the deviation from equity. The redistributive effect of healthcare costs was considered as the impact of healthcare payments on households’ income distribution. Results The overall Kakwani index during the fourth development program for urban households was progressive (OKI = 0.013), but it was regressive for rural households (OKI = −0.012). Healthcare payments had a negative effect on income redistribution in urban areas during the entire period of the study, and they had a positive effect in rural areas, except for the years 2010 and 2011, for which the effects were negative and non-existent, respectively. Conclusion By regarding the regressive Kakwani index and the negative effect of healthcare expenditures on income redistribution in some years, the government can use health grants, such as increasing health facilities and supplementary insurance, to increase the ability of households to deal with the cost of developing a remedy and reducing health inequalities.
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Affiliation(s)
- Hamid Pourasghari
- Department of health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehdi Jafari
- Department of health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran; Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bakhtiari
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman Keliddar
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Afifeh Irani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Health Services Management, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahnaz Afshari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Health Services Management, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Gorjizadeh M, Afshari M, Naseh M. Mild regioselective iodination of pyrazoles using n-butyltriphenylphosphonium peroxodisulfate. RUSS J GEN CHEM+ 2016. [DOI: 10.1134/s1070363216080259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- M. Afshari
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
| | - F. Lak
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
| | - B. Gholizadeh
- Department of Statistics, College of Science, Persian Gulf University, Bushehr, Iran
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Moghaddasifar I, Lankarani KB, Moosazadeh M, Afshari M, Ghaemi A, Aliramezany M, Afsar Gharebagh R, Malary M. Prevalence of Non-alcoholic Fatty Liver Disease and Its Related Factors in Iran. Int J Organ Transplant Med 2016; 7:149-160. [PMID: 27721961 PMCID: PMC5054138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in developing and developed countries. Estimating the total prevalence of NAFLD by means of appropriate statistical methods can provide reliable evidence for health policy makers. OBJECTIVE To determine the prevalence of NAFLD in Iran using a systematic review and meta-analysis. METHODS We identified relevant studies by searching national and international databases. Standard error of the prevalence reported in each study was calculated assuming a binomial distribution. The heterogeneity between the results of the studies was determined using Cochran's Q and I square indices. We used a random effect model to combine the prevalence rates reported in the studies. RESULTS We entered 23 eligible studies in this systematic review investigated NAFLD among 25,865 Iranian people. The total prevalence of NAFLD, prevalence of mild, moderate and severe fatty liver disease were estimated at 33.9% (95% CI 26.4%-41.5%), 26.7% (95% CI 21.7%-31.7%), 7.6% (95% CI 5.7%-9.4%), and 0.5% (95% CI 0.1%-0.9%), respectively. The majority of studies reported that NAFLD was more common among men (seven of eight studies), obese person (15 of 15 studies), older people (10 of 10 studies), patients with systolic hypertension (5 of 8 studies), patients with diastolic hypertension (7 of 9 studies), patients with hypertriglyceridemia (14 of 16 studies), patients with high HOMA level (4 of 4 studies), patients with metabolic syndrome (4 of 4 studies), and those with elevated serum ALT (8 of 12 studies). CONCLUSION Our study showed that the prevalence of NAFLD in Iran was relatively high and male gender, old age, diabetes, metabolic syndrome, systolic/diastolic hypertension, high serum ALT, and hypertriglyceridemia may be determinants of NAFLD.
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Affiliation(s)
- I. Moghaddasifar
- Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - K. B. Lankarani
- Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran,Correspondence: Mahmood Moosazadeh, MPH, PhD, Assistant Professor, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran, E-mail:
| | - M. Afshari
- Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran
| | - A. Ghaemi
- Department of Basic Science and Nutrition, Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - M. Aliramezany
- Research Center for Health Services Management, Institute of Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - M. Malary
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Moosazadeh M, Nezammahalleh A, Movahednia M, Movahednia N, Khanjani N, Afshari M. Predictive factors of death in patients with tuberculosis: a nested case–control study. Easter Mediterr Health J 2015; 21:287-92. [DOI: 10.26719/2015.21.4.287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 02/23/2015] [Indexed: 11/09/2022]
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Afshari M. A Fast Wavelet Algorithm for Analyzing One-Dimensional Signal Processing and Asymptotic Distribution of Wavelet Coefficients With Numerical Example and Simulation. COMMUN STAT-THEOR M 2013. [DOI: 10.1080/03610926.2011.642917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Haghdoost AA, Ghazi M, Rafiee Z, Afshari M. The trend of governmental support from post-graduated Iranian students in medical fields to study abroad. Iran J Public Health 2013; 42:141-6. [PMID: 23865032 PMCID: PMC3712597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 11/15/2012] [Indexed: 11/06/2022]
Abstract
BACKGROUND To explore the trend and composition of post-graduate Iranian students who received governmental scholarship during the last two decades. METHOD Detailed information about the awarded scholarships and also about the number of post graduate students in clinical and basic sciences in domestic universities were collected from the related offices within the ministry of health and medical education and their trends were triangulated. RESULTS A sharp drop was observed in the number of awarded scholarships, from 263 in 1992 to 46 in 2009. In the beginning, almost all of scholarships fully supported students for a whole academic course; while in recent years most of scholarships supported students for a short fellowship or complementary course (more than 80%). Students studied in a wide range of colleges within 30 countries; more than 50% in Europe. Although one third of students studied in UK in the first years, only 4% of students selected this country in recent years. conversely, the number of scholarships to Germany and sweden have increased more than 10 and 3 times during this period. In parallel, the capacity of domestic universities for training of post-graduate students has been expanded dramatically. CONCLUSION Although expanding post-graduate education has been one of the main strategic objectives of the ministry of health and medical education in last two decades, it was obtained using different approaches. By time, more attention was to expanding the capacities of Iranian universities, and choosing less but more targeted students to continue their studies abroad.
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Affiliation(s)
- AA Haghdoost
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - M Ghazi
- The Center for Management of Students’ Affairs, the Ministry of Health and Medical Education, Tehran, Iran
| | - Z Rafiee
- The Center for Management of Students’ Affairs, the Ministry of Health and Medical Education, Tehran, Iran
| | - M Afshari
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran,Corresponding Author:
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Najafipour H, Mirzazadeh A, Haghdoost AA, Shadkam M, Afshari M, Moazenzadeh M, Nasri HR, Masoomi M, Mirzaiepour F, Azimzadeh BS, Forood A, Bahreini F, Mahmoudi MR, Sanjari M, Mohamadi TM, Banivaheb GH, Naderi MA, Kashanian GHM, Afshar RM, Ghazanfari Z, Navadeh S, Esmaeili AS. Coronary Artery Disease Risk Factors in an Urban and Peri-urban Setting, Kerman, Southeastern Iran (KERCADR Study): Methodology and Preliminary Report. Iran J Public Health 2012. [PMID: 23193513 PMCID: PMC3494222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study (first round) in an urban and peri-urban setting, Kerman, southeastern Iran 2009-11. METHOD 5900 (3238 female) people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package. RESULTS The participation rate was more than 95% in all subgroups. Cigarette smoking (18.4% vs. 1.2%), opium use (17.8% vs. 3.0%) and triglyceridemia (16.1% vs. 12.0%) were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety (29.1% vs. 16.7%), obesity (16.8% vs. 9.2%), low-physical activity (45.1% vs. 39.2%) and uncontrolled diabetes (60.2% vs. 31.0%). More than 68% of all subjects have presented with moderate to severe gingival index scores. CONCLUSION The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort.
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Affiliation(s)
- H Najafipour
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - A Mirzazadeh
- Dept. of Epidemiology and Biostatistics, School of Public Health, Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran,Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Tel: +98-(0)-341-2263725, E-mail address:
| | - AA Haghdoost
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran,Dept. of Epidemiology and Biostatistics, School of Public Health, Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - M Shadkam
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - M Afshari
- Dept. of Epidemiology and Biostatistics, School of Public Health, Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - M Moazenzadeh
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - HR Nasri
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - M Masoomi
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - F Mirzaiepour
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - B Sarvar Azimzadeh
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - A Forood
- Dept. of Cardiology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - F Bahreini
- Dept. of Nutrition, School of Public Health, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - MR Mahmoudi
- Dept. of Nutrition, School of Public Health, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - M Sanjari
- Dept. of Endocrinology, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - T Malek Mohamadi
- Dept. of Dental Public Health, Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - GH Banivaheb
- Dept. of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - MA Naderi
- Dept. of Psychiatry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - GH Moshtaghi Kashanian
- Dept. of Biochemistry, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - R Malekpour Afshar
- Dept. of Pathology, School of Medicine, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Z Ghazanfari
- Dept. of Nursing, School of Nursing and Midwifery, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - S Navadeh
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran,Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shah Esmaeili
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran,Dept. of Epidemiology and Biostatistics, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Afshari M, Dehghany M, McKellar ARW, Moazzen-Ahmadi N. New infrared bands of nonpolar OCS dimer and experimental frequencies for two intermolecular modes. J Chem Phys 2012; 137:054304. [DOI: 10.1063/1.4739465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Kooti M, Afshari M. Molybdenum Schiff Base Complex Covalently Anchored to Silica-Coated Cobalt Ferrite Nanoparticles as a Novel Heterogeneous Catalyst for the Oxidation of Alkenes. Catal Letters 2012. [DOI: 10.1007/s10562-012-0770-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Afshari M, Gupta A, Jung D, Kotek R, Tonelli A, Vasanthan N. Properties of films and fibers obtained from Lewis acid–base complexed nylon 6,6. POLYMER 2008. [DOI: 10.1016/j.polymer.2008.01.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Monti H, Piras P, Afshari M, Faure R. Structural elucidation of the cyclic products obtained from TiCl4-catalysed reaction of methyl cyclopropyl ketones with allyltrimethylsilane using 1H, 13C and two-dimensional homonuclear correlation shift spectroscopy. J Mol Struct 1991. [DOI: 10.1016/0022-2860(91)87024-c] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kay HR, Afshari M, Barash P, Webler W, Iskandrian A, Bemis C, Hakki AH, Mundth ED. Measurement of ejection fraction by thermal dilution techniques. J Surg Res 1983; 34:337-46. [PMID: 6834817 DOI: 10.1016/0022-4804(83)90081-1] [Citation(s) in RCA: 168] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The reproducibility, accuracy, and clinical applicability of ventricular ejection fraction derived by a thermal dilution technique were assessed in 22 dogs and 18 patients. Results obtained by the thermal technique were compared to simultaneous results obtained by radionuclide angiography. Right ventricular ejection fraction, measured in 9 dogs (1014 determinations) and 8 patients (744 determinations) was reproducible +/- 5%. Left ventricular ejection fraction, measured in 10 patients, was reproducible +/- 5%. Correlation between thermal and radionuclear measurements varied from 0.86 to 0.93 (all P less than 0.02). We conclude that, because of its low cost, ease of use, and accuracy, thermally derived ejection fraction determinations can be helpful in hemodynamic monitoring of critically ill patients.
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Jafari N, Kumar M, Donnelly JC, Afshari M. Removal of a foreign body from the esophagus. Del Med J 1981; 53:443-5. [PMID: 7338286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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