Explaining the barriers faced by veterinarians against preventing antimicrobial resistance: an innovative interdisciplinary qualitative study.

BACKGROUND: Considering the significance of increased antimicrobial resistance (AMR) and its adverse effects on individual and social health and the important and effective role that veterinarians play in controlling this growing issue worldwide, it is essential to have effective preventive control programs. To this aim, the first step is to identify the factors behind the prevalence of AMR in Iran and the barriers veterinarians face to controlling this problem. Thus, the present study was conducted to explain the barriers veterinarians faced in the prevention of AMR from an Iranian veterinarian's perspective. METHODS: The present research was done in three cities in Iran in 2021. The data were collected through in-depth interviews with 18 veterinarians selected through purposive and snowball sampling and analyzed using conventional qualitative content analysis. RESULTS: The data analysis results were classified into 4 main categories and 44 subcategories. The former included: educational factors, administrative/legal factors, client-related factors, and veterinarian-related factors. CONCLUSIONS: The increased AMR can be approached from multiple aspects. Considering the different factors that affect the increased AMR, it is necessary to consider them all through effective planning and policy-making at multi-level and multidisciplinary dimensions. There is special attention needed to scientific and practical interventions at the individual, interpersonal, social, and even political levels. At the same time, measures should be taken to rehabilitate and maintain the health of society to strengthen supervision and attract the full participation of interested organizations.

An intervention to improve antibiotic prescription behavior in veterinary students: A protocol based on the multi-theory model to tackle antimicrobial resistance.

Background and Aims: Antimicrobial resistance (AMR) is a global health threat. Moreover, incorrect and inappropriate drug prescription behavior is considered a fundamental risk factor. Thus, the present study aims to develop, implement, and evaluate the effectiveness of an educational program based on the multi-theoretical model (MTM) in improving antibiotic prescription behavior in veterinary students of Iran. Methods: The present study will include four phases including a qualitative phase, an instrument design and psychometric test phase, and a cross-sectional, and an interventional phase. In the first phase, the sampling will be purposive with a maximum variety. The interviews will be conducted with a sample of veterinarians. Results: The data will be analyzed in MAXQDA 10. In the second phase, the face and content validity will be tested by a panel of experts as field specialists. A confirmatory factor analysis will be used to test construct validity, and Cronbach's alpha coefficient and intracluster correlation coefficient will be used to determine the internal consistency of the instrument. Then, at this stage, a number of veterinary students will be selected through a multi-stage sampling method. In the cross-sectional phase, another sample of veterinary students will complete a researcher-made questionnaire. Then, Spearman's correlation coefficient test will be used to test the relationship between the two stages of behavior initiation and behavior continuation. The data will be analyzed in SPSS 22. In the third phase, some veterinary students will be selected through a census and will be randomly divided into a control and an intervention group. To collect data in the final phase, the researcher-made questionnaire that was designed in the second phase of the study based on a multi-theory model will be used to extract data. To compare demographic characteristics, compare the correlation between the constructs of the multi-theory model with antibiotic prescribing behavior in the cross-sectional phase and compare the scores of the constructs of the MTM in two intervention and control groups paired-samples T test and independent-samples T test will be used. Conclusion: The present study will aim to improve antibiotic prescription behavior in veterinary students based on a MTM. The findings can be used as a model for training students in clinical fields such as veterinary medicine and general medicine at university at a national level. After verification and approval by experts and university professors, we can expect a change in the educational curriculum to include instructions on how to write out prescriptions for students. There are hopes that the present study if conducted accurately and widely to help prevent AMR in livestock, humans, and society.

Investigating the predictors of perceived social support to control COVID-19: A qualitative study.

Background: Considering the adverse effects of COVID-19 pandemic, the present study aimed to explore the barriers and facilitators of perceived social support to prevent the further spread of the disease. Methods: In the present qualitative study, a content analysis was done. To this aim, 37 Iranian subjects who had active accounts on Instagram were initially invited to participate in the study. The data were collected through face-to-face (n = 25) and telephone conversations (n = 12). A purposive sampling was used and the data collection continued until data saturation. Finally, 41 interviews were held which took 17-48 min. Results: The data analysis led to the extraction of two main categories, the barriers and facilitators of perceived social support, as well as 12 subcategories. Economic issues, familial factors, socio-cultural factors, personal and psychological factors, ineffective quarantine rules, and poor management were the main barriers to perceived social support. The facilitators were divided into six categories, including familial influences, personal factors, government support, and improved occupational, social, spiritual, and emotional condition. Conclusion: The findings showed that a combination of environmental and social variables might influence the COVID-19 disease, either decreasing or increasing its spread. A sound knowledge of these variables, influenced by the social context and real-life experiences during the pandemic, allows to take the right measures and enrich training programs. The prevalence of the disease can be controlled by increasing environmental and social facilitators and decreasing the influence of barriers.

Determinants of antimicrobial resistance occurrence in animal-based food, perceived by livestock farmers: A qualitative phenomenological study.

Background and Purpose of the Study: The determinants of antimicrobial resistance in human medicine have been copiously explored. On the other hand, the existing research in veterinary medicine and animal husbandry is in its infancy. The present qualitative study used the one-health approach to explore farmers' attitudes toward antimicrobial use and antimicrobial stewardship. Methodology: The present qualitative study was phenomenological in type. It was conducted in 2022 in the two cities of Kerman and Bandar Abbas in Iran. The data were collected through in-depth interviews by semistructured interviews with 17 livestock, poultry, and aquatic animal breeders selected through purposive sampling. The interviews lasted between 35 and 65 min in the Farsi language. The data were analyzed using conventional qualitative content analysis and Colaizzi's seven-step analysis technique. Results: The open coding was done in MAXQDA 10 and the results of data analysis were classified into five main themes and 17 subthemes subcategories. The main categories include personal determinants, contextual determinants, legal and regulatory determinants, social determinants, and economic determinants. Conclusion: Considering the increasing use of antibiotics among livestock farmers and breeders of animals used as human food, different measures such as educational, regulatory, social, and even cultural interventions may be able to control and prevent antimicrobial resistance.

Prediction of self-care behaviors among diabetic patients based on social cognitive theory.

Background: Diabetes is a global health issue and the most prevalent chronic metabolic disease, which requires lifelong self-care behaviors. Thus, the present study was conducted with the aim of predicting the factors of self-care behaviors based on social cognitive theory in diabetic patients referred to comprehensive health service centers in Fasa. Methods: This cross-sectional research comprised 106 type 2 diabetes patients who were referred to Fasa service providers to determine the optimal solution. Outcomes were assessed using an existing demographic questionnaire, the diabetic self-care questionnaire, and a unique questionnaire to assess social cognitive theory, the validity and reliability of which were estimated. SPSS21 software with a Chi license was used for data analysis, and Spearman correlations, independent t-tests, and one-way ANOVA were performed. Results: The age range of patients was between 33 and 67 years. There was a significant relationship between gender, education, and type of treatment with self-care. According to the findings, the variables of self-efficacy (r = 0.200), self-efficacy of overcoming obstacles (r = 0.285), environmental factors (r = 0.334), observational learning ability (r = 0.148), situational perception (r = 0.297), emotional adaptation (r = 0.051), outcome assessment (r = 0.114) and outcome expectation (r = 0.082) had a positive and significant correlation with self-care behaviors. Also, the self-efficacy variable (Beta coefficient = 0.340) had the highest predictive value. Conclusion: In designing and implementing educational interventions for self-care of diabetic patients, the theory of social cognition can be used as a framework to promote and maintain public health in patients.

Internet Addiction Status and Related Factors among Medical Students: A Cross-Sectional Study in Western Iran.

BACKGROUND: In recent years, Internet and social media technology use have emerged as an integral tool of human society, and the evolution of technological integration, cyberspace, and web-technology has become a common practice in educational institutions. Internet usage among students has played an indispensable role in learning behavior; however, the excessive usage of the internet and social media leads to internet addiction. This original study has performed a focalized scrutiny on revealing relationships between internet addiction and associated factors among the students of medicine, dentistry, and pharmaceutical departments. METHODS: This descriptive and analytical study recruited medical students from the Self-governing Education Incubator of Kermanshah. This survey distributed questionnaires among the respondents' three departments, and this statistical data reported on 420 valid responses of the respondents. They represent first and second-semester medical students of the academic year 2017-2018. The study selected medical students by applying Cochran's Sample Size Formula through Stratified Random Sampling and cross-sectional research design. The survey has utilized a demographic questionnaire of Young's Internet Addiction Test (IAT) for the data collection. The study analyzed received data by using SPSS version 23 and performed the descriptive statistics, and analytical statistics (t-test and ANOVA). RESULTS: The results of the present study established that the majority of subjects were female students (53.3%), and the average age was 23.84 ± 2.14, including the students of all departments. Besides, findings specified that the overall mean and standard deviation scores were 3.34 and ±0.88. Internet addiction revealed mean and the standard deviation score measured for all students 3.29 ± 0.73, 3.17 ± 0.92, and 3.57 ± 0.64 correspondingly. The survey results illustrated that medical students' internet addiction substantially correlated with demographic variables, such as age, marital status, the field of study, academic term, significant time of consuming the internet, the key reason of utilizing the internet, and daily usage of the internet (p < .05). CONCLUSION: The results of the study specified that 25% of medical students showed internet addiction. The students are increasingly using the internet, and it has penetrated among students. The design and implementation of adequate educational programs and the application of internet-based efficiency interventions are essential for both knowledge acquisition and medical students' healthy behavior.

Knowledge, attitude, and practice toward the COVID-19 infection among adults Iran: A cross-sectional study.

Background: Coronavirus illness (COVID-19) has spread globally and is affecting everyone severely. The evaluation of educational needs (knowledge, attitudes, and practices) is important in controlling COVID-19 situations. The goal of this study is to find out what adults in Ardabil City know, how they feel, and what they do about the COVID-19 infection. Methods: In November 2021, a cross-sectional descriptive-correlational survey of 384 people was conducted using stratified-cluster sampling in Ardabil. The researchers created a self-reported questionnaire with 23 items as the data collection technique. The quantitative data were evaluated using descriptive statistics, the chi-square test, the correlation coefficient, and regression analysis. Results: The correct answer rate for this research found that 73.17% of participants (n = 281) had appropriate knowledge, 61.19% (n = 235) had favorable attitudes, and 69.53% (n = 267) had enough practice behavior. However, knowledge was related to gender, employment, and location of residence. Age, marital status, education level, and location of residence were all connected with attitude. Age, gender, and marital status were all related to the behavior. The findings of linear regression analysis revealed that knowledge and attitude influence behavior. Conclusion: The study findings revealed a high degree of understanding of COVID-19, a positive attitude, and a strong commitment to good practices. Knowledge, attitudes, and behaviors were influenced to varying degrees by age, marital status, education level, employment, and location of residence. Furthermore, knowledge and attitudes influenced behaviors.

Exploring the Barriers in Maintaining the Health Guidelines Amid the COVID-19 Pandemic: A Qualitative Study Approach.

Due to the Irretrievable impacts of the COVID-19 pandemic on society, this study aimed to analyze the barriers and reasons for the Iranian people's implementation of public health measures during the COVID-19 pandemic in 2021. The study explores the barriers and reasons for non-compliance by Iranian people in following and maintaining the health guidelines to combat the spread of the coronavirus in 2021. This research is qualitative and recorded participants' feedback from the Ardabil province of Iran. The study used a purposeful sampling method and lasted from April to May 2021 to collect the data through semi-structured interviews with 45 participants based on their gender, education, employment status, and marital status. The researchers analyzed the qualitative content until the required data-target through interviews implementation. This study incorporated MAXQDA version 10 to analyze the data and followed Goba and Lincoln's criteria to ensure quality research results. After analyzing the data, two main categories (internal and external barriers) and seven subcategories were obtained. The internal barriers exhibited further classified subcategories, such as mental, belief, and awareness barriers. The results indicated that external barriers included social, political, managerial, and economic barriers. The study results designated that a set of internal and external factors might cause individuals' non-compliance with health guidelines and standard SOPs in the advent of the pandemic COVID-19. Recognition of such factors, identified following the social, cultural, and political context and individuals' characteristics during the COVID-19 outbreak, can be used effectively to plan educational and management programs. As a result, elimination and eradication of obstacles and the relevant dimensions may facilitate disease control. Moreover, the high prevalence and spread of the disease can be managed by reducing the influence of factors preventing proper health behaviors.

Explaining the Determinants of Pediculosis Control and Prevention: A Qualitative Study in Southern Iran.

In many regions of the world, human head lice infestations caused by Pediculus capitis are a major health concern among school-aged children. This study was carried out to explain variables influencing pediculosis prevention and control from the perspective of parents and teachers of female elementary school pupils, as well as healthcare practitioners in Bandar Abbas, Iran. Participants in this qualitative study included 23 participants, including parents and teachers of primary school girls, as well as healthcare practitioners. Purposive sampling was employed and sustained until data saturation was reached. Data was acquired through in-depth interviews and evaluated using content analysis in the form of constant comparison. To assess the quality of the outcomes, Lincoln and Guba's criteria were used. The data were extracted into 2 primary categories, including challenges and facilitators to controlling pediculosis, each with several subcategories as follows: 1) economic-political aspects; 2) family factors; 3) social-cultural elements; 4) personal and mental issues; 5) geographical position of the investigated region; 6) school and education factors; and 7) factors related to medications and therapy. There were 2 types of facilitators: 1) informative factors and 2) social-cultural variables. According to the findings, pediculosis prevention, control, and treatment necessitate multifaceted and multi-level intervention. Some solutions must be addressed at the personal-psychological, familial, political-economic, geographical, and informational levels, as well as school-related concerns, social stigma elimination, and evaluation of cultural components of the issue at the social level.

Evaluation of the educational services quality from the viewpoint of postgraduate students at Kermanshah University of medical sciences in 2019.

BACKGROUND: At present, the SERVQUAL model is one of the most significant tools for measuring customers' expectations and perceptions in organizations. Determination of expectations and perceptions of students who are the main university customers from educational services can provide valuable information to the programmers to improve the condition of educational services. Therefore, this study aims to measure the quality of education services from the viewpoint of postgraduate students at Kermanshah Medical Sciences University using the SERVQUAL model in 2019. MATERIALS AND METHODS: This was a descriptive cross-sectional study. The population under the study consisted of 162 students at the postgraduate education section (Master's degree and Ph.D.) studying in the second semester of the academic year of 2019 at Kermanshah Medical Sciences University. The standard SERVQUAL questionnaire was used for data collection, which included five dimensions of the quality of educational services, and the random-stratified sampling method was employed. The data were analyzed using the SPSS Statistics software (version 23.0, SPSS Inc., Chicago, IL, USA), and descriptive and other statistical tests, including the Pearson correlation coefficient, and paired and independent t-tests were performed. RESULTS: Based on the students' perspective in the provision of service there was quality gap existed in all services, and the largest gap was in the reliability dimension (-0.37), and after that, empathy (-0.37), guaranty (0.27), and responsiveness (-0.24) dimensions, respectively, and the lowest one was in the tangible dimension (0.15). There was a statistically significant observed difference between the quality gap in different educational dimensions (P > 0.001). CONCLUSION: Research findings showed that students were not meeting their expectations from the presented educational services. Hence, holding a training workshop is suggested in the field of how to serve and enhance communication skills for employees and teachers.

An overview of 2019 novel coronavirus COVID-19 pandemic: A review study.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, was first reported in December 2019 in Wuhan, Hubei province, China. It is now known as a pandemic and a global crisis due to rapid human-to-human transmission with the vast expansion that has affected almost all countries. The primary source of the disease is still unknown, but it is possible that the virus was transmitted through bat to an intermediate host and then to humans. The main and early symptoms of COVID-19 infection are fatigue, fever, dry cough, myalgia, and dyspnea. The incubation period of the disease is about 2-14 days, which is one of the important parameters for planning to prevent disease outbreak. PT-polymerase chain reaction test is used to diagnose the disease; chest computed tomography scan, chest X-ray, blood tests, and symptoms are also very helpful in diagnosing the disease. There is a strong emphasis on controlling infections and hand hygiene to prevent the transmission of the disease. There is not enough knowledge about this disease yet, and there are no specific vaccines or medications available to prevent and treat this disease. The current review study uses articles indexed on databases of Embase, Elsevier, PubMed, and World Health Organization and Centers for Disease Control and Prevention, and keywords of coronavirus, COVID-19, acute respiratory distress syndrome and China.

Backpack improper use causes musculoskeletal injuries in adolescents: A systematic review.

BACKGROUND: This research is one of the very few studies, which seeks a focalized examination to observe the effects of the backpack on the teenager students. Adolescents prefer rucksacks as one of their favorite school bags during their school studies. This study inspects how knapsacks gradually bring changes as injuries in the bodies of school-going adolescents. There are ample studies in the past literature, which evidence the injuries of backpack among adolescents, such as backache, neck pain, and shoulder pain. The principal objective of this study is to determine the effects of backpacks on musculoskeletal injuries among school-going adolescents based on previous studies support in this research field. MATERIALS AND METHODS: This review study selected observational studies from the past literature indexed in the databases of Scopus, PubMed, ScienceDirect, and CINAHL during 1999-2020. This review focused on the keywords of "Backpack," "Musculoskeletal Injuries," and "Adolescent" from MESH and selected 14 out of 210 articles based on the research objective. According to the Crombie Checklist, inclusion and exclusion criteria, and investigating the quality of the report, this review focused on literature evidence to the field under investigation. RESULTS: Based on the chosen 14 articles, the findings of the present review indicated two outcomes by considering the impact of the backpack on musculoskeletal injuries and pains among adolescents. The results of the review studies specified that there was a statistically significant positive relationship between the prevalence of musculoskeletal injuries and pain using a backpack among most of the male and female adolescents. The findings also stipulate that injuries and pain intensity among female adolescents were higher than the male students. CONCLUSION: The results of this review study specified that improper use of the backpack, which exceeded the standard weight, caused chorionic pain and injuries between both genders of adolescents. The generalizability of the results is suitable for this review study.

A comparative study on the quality of life and resilience of mothers with disabled and neurotypically developing children in Iran.

BACKGROUND: Mothers who take care of their disabled children usually suffer from several problems, such as physical, psychological, and social problems. The disability of children can also directly impress the quality of their mothers' lives. This study is going to check out how the disability of children affects the quality of life of the mothers. OBJECTIVE: This study was conducted to compare the quality of life and resilience of mothers with disabled and typically developed children in Fasa, Iran. METHODS: The subjects of this cross-sectional study were 240 mothers (120 mothers having disabled children and 120 mothers with typically developed children) referring to Fasa State Health Centers and Fasa State Welfare Office. They were randomly selected and included in the study. All samples were collected by the convenience sampling method. The data were collected by using the World Health Organization Quality-of-Life Scale (WHOQOL-BREF) and the Connor-Davidson Resilience Scale (CD-RISC). The collected data were then analyzed by the SPSS (v.22) software. The results of the descriptive statistics, Chi-square, independent t-test, and Pearson correlation coefficient were at a significant value of P < 0.05. RESULTS: The mean score of quality of life of mothers with disabled children on physical, psychological, social, and environmental domains was lower than that of mothers with neurotypically and statistically significant (p < 0.05); however, the mean scores on the resilience of mothers in both groups were not significantly different (p = 0.43).The results of the linear regression analysis showed that, having a disabled child (P < 0.001, t = 10.141), level of education (P < 0.001, t = 2.031), and resilience (P < 0.001, t = 8.205) affect the quality of life. The lower the education level is, the lower the quality of life. And higher resilience increases the quality of life. CONCLUSION: The quality of life of mothers with disabled children was lower compared to mothers with typically developed children, but there was no difference between mothers' resiliency in these two groups. These results suggest the necessity to provide supportive and therapeutic programs for improving the quality of life of mothers with disabled children.

The effect of peer group on self-care behaviors and glycemic index in elders with type II diabetes.

BACKGROUND: Diabetes is one of the most expensive and chronic diseases of elderly age. Knowledge and self-care behaviors play an important role in treating diabetes and preventing its side effects. This study aimed to investigate the effect of peer group on self-care behaviors and glycemic index in the elderly with type II diabetes mellitus in Fasa city, Fars province. MATERIALS AND METHODS: This quasi-experimental study was conducted on 100 elderly patients with type II diabetes (50 patients in the intervention group and 50 in control group) referred to the diabetes center. Among the elderly, the intervention group was selected as a trainer based on the checklist of the peer group and was trained by the researcher. In addition to the usual care of the diabetes clinic, the patients in the intervention group received training from their peers for 8 weeks during 8-45 min of training sessions. Data were collected using a valid self-reported questionnaire including demographic variables, awareness, and diabetes self-care behaviors (Summary of Diabetes Self-care Activities), as well as free practice (fasting blood sugar [FBS] and hemoglobin A1c [HbA1c]), which was completed by both groups before and 2 months after the intervention. Then, the data were entered into the SPSS statistical software, version 22 and were analyzed using Chi-square test, independent t-test, and descriptive statistical methods. P < 0.05 was considered statistically significant. RESULTS: The results showed that the two groups of intervention and test were identical in terms of demographic information. In the intervention group, before and after 2 months of educational intervention, there was a significant difference in increasing awareness and self-care behavior in diet, physical activity, blood sugar testing, foot care, and medication (P < 0.001). However, this difference was not significant in the control group (P < 0.05). In the intervention group, the mean FBS and quarterly (HbA1c) index decreased significantly (P < 0.05). CONCLUSION: This study showed that teaching self-care program, in the same way, has been effective in improving self-care behavior and blood sugar index in the elderly with diabetes and suggested that this educational method be used in other chronic diseases.

Teaching adults how to prevent COVID-19 infection by health workers: The application of intervention mapping approach.

INTRODUCTION: Education is one of the most important approaches to preventing infectious diseases at the time of the pandemic. The purpose of the study was to develop an intervention-training program using an intervention mapping approach (IMA) to prevent COVID-19 infection in adults at the time of the pandemic by health workers. MATERIALS AND METHODS: The present study was a study protocol where IMA was used as a planning framework for developing an intervention-training program to prevent COVID-19 infection in adults at the time of the pandemic by health workers in Ardabil city. Six intervention mapping (IM) steps have been described in this protocol. As the first step, needs assessment was performed by reviewing the studies, qualitative evaluation, and interviews. In the second step, the matrix of change objectives was designed from the intersection of performance goals and determinants. Later on, after designing the program and planning the program implementation, the program evaluation plan was developed. RESULTS: IMA guided us in designing and implementing a control-oriented training program with the participation of the participants along with the definition of outcomes, performance goals and determinants, theoretical methods and practical applications, intervention program, implementation, and step by step assessment. CONCLUSION: IM is a control-oriented, systematic, participation-based approach to design and implement targeted and on-going health promotion programs based on the needs of the target group at the time of the pandemic by health workers.

Nurses' Work-Related Quality of Life and Its Influencing Demographic Factors at a Public Hospital in Western Iran: A Cross-Sectional Study.

BACKGROUND: The quality of life as a concept beyond physical health stands one of the protuberant indexes, and various health-based studies required distinct measurements, which deemed necessary for their significant implications. The nurses fight at the front and play a leading role in providing services to patients at healthcare centers. They deserve a higher quality of life in catering to physical health services. This present study focuses on examining nurses' work-life quality standards and how demographic variables contribute to the hospital of Imam Reza in Kermanshah of Western Iran. METHODS: This descriptive-analytical study recruited a sample of 271 nurses affiliated with Imam Reza Hospital and Kermanshah University of Medical Sciences by incorporating the stratified random sampling in 2019. This study used a two-part questionnaire to collect data from the targeted respondents. The first part presented the participants' demographic profiles, and the second part showed the nurses' work-related quality of life (WRQoL) on the scale developed by Van Laar et al. The study screened the data and performed analyses through the SPSS version-23. The research study conducted a descriptive analysis to measure mean and standard deviation with inferential statistics, including independent samples t-test and one-way ANOVA (P < 0.05). RESULTS: The study findings specified that nurses' average quality of the work-life was at a moderate level 3.11 ± 0.47. Besides, results indicated that 57.50% of the nurses reported high standards of quality of work-life, 36.50% showed a modest and 5.20% revealed a lower level of work-life quality. The findings indicated that the quality of work-life significantly correlated with respondent'' age, marital status, education, work experience, position, department, shifts, and employment status (p < 0.05). CONCLUSION: The findings of this research demonstrated that the nurses' quality of work-life was higher than the average standard. The results provide useful insight for nurses and hospital managers. The policymakers and health managers need to pay more attention to providing a better quality of work-life to the nurses.

Hospital managers' skills required and onward challenges: A qualitative study.

INTRODUCTION: The qualification of managers in terms of management skills is one of the most important factors in the continuous success of each organization, and utilizing such skills can have a positive contribution in the effectiveness of the organization while improving the performance of the employees in line with the objectives and goals of the organization. The study's primary objective was to examine the necessary skills of the hospital managers and their capabilities to manage the challenges in providing health care facilities to their patients and employees. MATERIALS AND METHODS: This study is a qualitative that deep interviews were performed with 22 managers (senior and middle managers) of educational hospitals of Kermanshah city, and the sample size was 22 individuals. The interviews were analyzed by a MAXQDA software application after transcription. RESULTS: This study includes 8 themes and 23 subthemes. The strategic skill, the perceptive skill, the human relations skill, work experience, and personal characteristics were among the skills necessary for hospital managers. Some of the challenges facing the hospital managers included rapid changes in the policies, the limitations of financial resources, and lack of proportion between the educational and occupational spheres. CONCLUSION: Because of their existential philosophy and differences with other service sectors, managing hospitals poses a particular sensitivity. In this regard, the role of the hospital manager is very important. Therefore, in order to meet the satisfaction of those receiving services, decision-makers and policy-makers must think twice when selecting and appointing hospital managers and evaluate and appraise this group in terms of abilities and skills necessary for managing such an important service section.

A study of internet addiction and its effects on mental health: A study based on Iranian University Students.

INTRODUCTION: The Internet has drastically affected human behavior, and it has positive and negative effects; however, its excessive usage exposes users to internet addiction. The diagnosis of students' mental dysfunction is vital to monitor their academic progress and success by preventing this technology through proper handling of the usage addiction. MATERIALS AND METHODS: This descriptive-analytical study selected 447 students (232 females and 215 males) of the first and second semesters enrolled at Kermanshah University of Medical Sciences, Iran, in 2018 by using Cochrane's sample size formula and stratified random sampling. The study applied Young's Internet Addiction Test and Goldberg General Health Questionnaire 28 for data collection. The study screened the data received and analyzed valid data set through the t-test and Pearson's correlation coefficient by incorporating SPSS Statistics software version 23.0. RESULTS: The results of the current study specified that the total mean score of the students for internet addiction and mental health was 3.81 ± 0.88 and 2.56 ± 0.33, correspondingly. The results revealed that internet addiction positively correlated with depression and mental health, which indicated a negative relationship (P > 0.001). The multiple regression analysis results showed students' five significant vulnerability predictors toward internet addiction, such as the critical reason for using the Internet, faculty, depression, the central place for using the Internet, and somatic symptoms. CONCLUSIONS: The study findings specified that students' excessive internet usage leads to anxiety, depression, and adverse mental health, which affect their academic performance. Monitoring and controlling students' internet addiction through informative sessions on how to use the Internet adequately is useful.

A study of 0-14-year-old children's access to health centers in rural areas using a buffer model (a case study of villages based in Kermanshah province, Iran).

INTRODUCTION: Children are among the most vulnerable groups in society, whose health is of prominent significance. Moreover, as a group of clients with special needs in the health care system, they require special attention. Therefore, the present study aimed to investigate the 0-14-year-old children's access to health centers in rural areas of Kermanshah Province, Iran. MATERIALS AND METHODS: In the present cross-sectional study, both the latest published demographic statistics related to the Population and Housing Census, announced by the Statistical Center of Iran in 2011, and the information about the public and private hospitals in the province, collected by Kermanshah University of Medical Sciences, were used as the basis for the analyses. In addition, given the importance of the spatial nature of the research, geographic information system was used for data analysis, and a buffer model was also applied. RESULTS: The results revealed that out of the total population of 0-14-year-old children residing in rural areas within 15,000 and 30,000-km radii of Kermanshah Province, 87.94% and 75.11% of girls versus 88.15% and 75.38% of boys lacked access to health centers, respectively. CONCLUSION: It was found out that the 0-14-year-old children's access to health centers was in poor condition in rural areas of Kermanshah Province, which would endanger the health of this age group.

Investigating high blood pressure, type-2 diabetes, dislipidemia, and body mass index to determine the health status of people over 30 years.

INTRODUCTION: Over the past decades, the pattern of diseases in human societies had changed from infectious diseases to noncommunicable diseases (NCDs), and according to the report by the World Health Organization, the highest burden of disease is attributed to NCDs. The study was conducted to determine the status of hypertension, type-2 diabetes, lipid disorders, and body mass index (BMI) among the patients aged over 30 years admitted to health centers of Karaj, Iran. MATERIALS AND METHODS: In this cross-sectional study, the population included 2947 men and women aged 30 years and above admitted to six health-care centers in Karaj. The questionnaire includes demographic characteristics and had the questions on hypertension, diabetes and their risk factors, like lipid disorders and BMI was administered. The data were analyzed in SPSS, version 23, software using descriptive (frequency, percentage, mean, and standard deviation) and analytical (Chi-square and analysis of variance) tests (P < 0.01). RESULTS: About 10% of the participants had diabetes and 15% of the participants had hypertension. About 32% of the participants had dyslipidemia and 87% of the participants were overweight or obese and over 35% were obese. Furthermore, with the increase in BMI, the prevalence of lipid disorder, hypertension, and type-2 diabetes increased in the studied population (P < 0.01). CONCLUSION: According to the results, a high percentage of people had hypertension, type-2 diabetes, hyperlipidemia, and BMI in the population. Gender segregation showed that lipid disorders, overweight, and obesity in women were more than in men and percentage of people with hypertension among male were significantly higher than in females. In the case of type-2 diabetes, the results showed no statistically significant differences between men and women. The results may be helpful in developing educational strategies and prevention and control of these diseases.