253 research outputs found
Political analysis of health technology assessment implementation in Iran
No full textBACKGROUND: Health technology assessment (HTA) is a critical tool for evidence-based decision-making in healthcare systems, yet its implementation in low- and middle-income countries such as Iran remains understudied. This study examines the political dynamics of HTA implementation in Iran, focussing on the roles, interests and interactions of key stakeholders. By addressing the gap in understanding the political challenges and opportunities associated with HTA implementation, this study aims to provide actionable insights for policymakers and practitioners. METHODS: A qualitative study design was employed, using in-depth semi-structured interviews with 19 stakeholders from 6 categories: interest groups, political leaders, donors, financial decision-makers, beneficiaries and bureaucracies. Participants were selected through purposive sampling to ensure representation across sectors. Data were analysed using thematic analysis, guided by the political analysis framework of Campos and Reich. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist to ensure methodological rigour. RESULTS: The findings reveal significant barriers to HTA implementation in Iran, including limited political will, competing priorities, inter-agency coordination challenges and concerns about equity and access. Interest groups, such as physicians and pharmacists, expressed concerns about restricted clinical autonomy and limited access to innovative treatments. Political leaders emphasized the difficulty of prioritizing HTA amidst competing healthcare and economic issues, whilst donors highlighted the need for alignment with national priorities and long-term sustainability. Financial decision-makers acknowledged the potential of HTA to improve resource allocation but raised concerns about budgetary constraints. Beneficiaries stressed the importance of transparency and inclusion, and bureaucrats underscored the need for stronger leadership and capacity building. CONCLUSIONS: The study underscores the importance of strong political leadership, stakeholder engagement and institutional capacity building for successful HTA implementation in Iran. Practical steps include strengthening inter-agency coordination mechanisms, ensuring transparent and inclusive decision-making processes, aligning donor support with national health priorities and investing in training programs to build technical capacity within government agencies. By addressing these challenges, policymakers can enhance the integration of HTA into the health system, ensuring efficient and equitable resource allocation
Challenges of using artificial intelligence in Iran's health system: a qualitative study
No full textBackground: Artificial intelligence (AI) is transforming healthcare globally, enhancing diagnostics, treatment, and efficiency. However, low- and middle-income countries (LMICs) like Iran face significant barriers to AI integration. Iran's health system, challenged by an aging population, increasing non-communicable diseases, and limited resources, could benefit from AI-driven, patient-centered care. Yet, its adoption remains limited. Understanding the barriers to AI implementation is critical for informed policymaking. Methods: This qualitative study involved semi-structured interviews with 15 stakeholders from healthcare management, policymaking, and AI sectors in Iran, conducted between January and April 2025. Participants were selected purposively to represent government, academia, healthcare, and technology. Data were analyzed thematically using Braun and Clarke's framework. Rigor was ensured through member checking, triangulation, and adherence to qualitative research standards. Results: Five major barriers to AI adoption emerged: (1) organizational and structural limitations, including poor infrastructure and fragmented governance; (2) legal and policy challenges, marked by regulatory gaps and ethical concerns; (3) data-related issues such as low data quality, lack of standardization, and security risks; (4) shortage of skilled professionals and limited training opportunities; and (5) challenges in integrating AI into policymaking, including concerns about losing human oversight in decision-making. Conclusion: AI implementation in Iran's health system faces complex and interrelated challenges. Addressing these requires a coordinated strategy focused on legal reform, infrastructure investment, capacity building, and cultural adaptation. Balancing technological innovation with ethical and human-centered care is essential for successful and sustainable integration
Mapping the social networks of key actors in the development of health technology assessment in Iran
No full textBackground: Health Technology Assessment (HTA) is vital for evidence-based policymaking and resource allocation. In Iran, HTA development involves diverse actors with varying levels of power, influence, and support. Understanding their interactions is key to strengthening HTA processes. Methods: We applied Social Network Analysis (SNA) to map relationships among 27 stakeholders identified through document review and expert interviews. Data were collected via an online questionnaire completed by 83 experts (response rate: 72.2%), assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree, closeness, betweenness, and eigenvector centrality, were analyzed using R Version 4.4.1. Results: The Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and Parliament were perceived as the most influential actors. The Plan and Budget Organization (degree centrality 0.34) and National Institute of Health Research (0.26) emerged as key connectors with high bridging roles. Overall, the network exhibited low density (0.13) and limited clustering (0.11), indicating sparse connectivity. Peripheral actors, such as the Chamber of Commerce, were largely disconnected from the network. Conclusion: HTA development in Iran is shaped by a few central institutions, but weak connectivity and limited engagement of peripheral actors hinder collaboration. Strengthening stakeholder communication, enhancing inclusiveness, and securing sustainable funding are critical for more effective HTA implementation and evidence-informed health policy
Iran's Health System Transformation Plan: A SWOT analysis
No full textBackground: Societies are characterized by evolving health needs, which become more challenging throughout time, to which health system should respond. As such, a constant monitoring and a periodic review and reformation of healthcare systems are of fundamental importance to increase the efficiency and effectiveness of healthcare services delivery, equity, and sustainable funding. The establishment of President Rouhani's government in Iran, on May 5, 2014, the settlement of the new Ministry of Health and Medical Education administration (MoHME) and the need for change in the provision of healthcare services has led to the "Health System Transformation Plan" (HSTP). The aim of the current investigation was to critically evaluate the health transformation plan in Iran. Methods: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis enables to identify and assess the strengths and weaknesses within an organization or program, as well as the threats and opportunities outside the given organization or program. To identify SWOT of the HSTP in Iran, all articles concerning this program published in scholarly databases as well as in the gray literature were systematically searched. Subsequently, all factors identified at the first round were thematically classified into four categories and for reaching consensus on this classification, the list of points and factors was sent to 40 experts - policy- and decisionmakers, professors and academicians, health department workers, health activists, journalists. Results: Thirty-four subjects expressed comments on classification. Incorporating their suggestions, the SWOT analysis of Iran's HSTP was revised, finalized and then performed. Conclusion: HSTP in Iran, like many of the initiatives that have been recently introduced and not fully implemented, have various challenges, difficulties and pitfalls that health policymakers need to pay attention to. Interacting with criticisms, taking into account public opinion and strengthening the plan can make the project more effective, and it can be anticipated that in the future, better conditions in the health sector will be achieved. © Iran University of Medical Sciences
A Hypothesis about the Author of Aja’ib al-Dunya
No full textAja’ib al-Dunya is one of the most famous Books of Wonders in Persian which has had a great impact on later works. Some scholars reject the attribution of this book to Abol-moayyed Balkhi, but identifying the author is a question that has so far remained unanswered. In the book Aja’ib Va Ghara’ib, Azari Esfarayeni referred to this book 14 times. In one of them, he attributed the book to Naser Khosrow. In this research, the author seeks to verify the accuracy of this attribution. The study demonstrates that the quotations made by Azari are available in the mentioned sources, and we can trust his honesty. Comparing those 14 stories shows that Azari used the same Aja’ib al-Dunya which is now available. Additionally, the examination of biographies and Naser Khosrow's works shows that he was probably interested in this branch of knowledge in an episode of his life. Therefore, it can be concluded that Azari Esfrayeni's statement is probably true and the book Aja’ib al-Dunya may have been composed by Naser Khosrow before converting to the Isma’ili thought and being entitled “Hojjat of Khorasan Island”
The economic burden of breast cancer in western Iran: a cross-sectional cost-of-illness study
No full textAbstract Background Breast cancer is a significant global health challenge, affecting millions annually and imposing a considerable burden on healthcare systems and economies worldwide. This cross-sectional study aims to determine the economic impact of breast cancer in Lorestan Province, western Iran. Methods A retrospective cost-of-illness analysis utilizing a cross-sectional design was performed from November 2023 to July 2024. Data were collected using patient medical records and telephonic interviews. Costs were categorized into direct medical costs, direct non-medical costs, and indirect costs. A bottom-up approach was employed for cost calculation from a societal viewpoint, with a prevalence-based analysis. Results The study analyzed 525 patients with an average age of 42.74 ± 11.75 years. The total economic burden of breast cancer was estimated at 10,275.07 per patient. Direct medical costs comprised 70.2% of the total expenses, primarily attributed to hospitalization, chemotherapy, and laboratory tests. Direct non-medical costs, including accommodation and transportation for patients and their companions, accounted for 12.5%. Indirect costs, largely stemming from productivity losses due to morbidity and mortality, represented 17.3% of the total burden. Conclusion Breast cancer imposes a substantial economic burden on patients and their families in Lorestan Province. Enhancing health insurance coverage, providing government subsidies for treatment, and improving healthcare infrastructure to offer advanced diagnostic and treatment options locally are critical steps to alleviate this burden. Early detection and prevention programs can facilitate earlier diagnosis and reduce treatment costs. Comprehensive policies addressing both medical and non-medical expenses are necessary to improve patients’ quality of life and lessen the financial challenges associated with breast cancer in Iran
Deprivation to destruction? : a look at Reich, Azari and the Iranian Revolution
No full textIn 1933 Wilhelm Reich wrote The Mass Psychology of fascism to psychologically explain the attraction of Hitler to the people of Germany, claiming that the combination of sexual suppression, religiosity and authoritarian parenting prevalent in Germany was the cause. In 1983 Farah Azari, in Women in Iran, endorsed his opinion, by suggesting that these factors accounted for the success of the Islamic regime in the Iranian Revolution.
Wilhelm Reich has not been endorsed by the mainstream psychological fraternity and acquired a bad reputation for his use of a particular "sexual therapy". This thesis examines the contentions Reich makes in Mass Psychology considering modern psychological and affiliated findings, attempting to sort the gold from the dross in his theories.
The thesis further examines Farah Azari's reasons for agreeing with Reich by looking at the Shia Karbala paradigm and its attendant beliefs and rituals, plus formal religious prescription, and social attitudes prevailing in Iran to see if she is correct in her assumptions.
Broadly, the thesis finds that both Reich and Azari are more right than wrong, but sometimes err in their emphases. The author looks too for other areas of influence, and suggests that gendered socialisation plays a much larger part than sexual suppression itself in the formation of Iranian character tendencies.
The thesis concentrates on negative character types, and therefore is not a balanced look at either Iranian society or Islamic religion. Reich correctly noted that "authoritarianism" is a pervasive worldwide character trait and therefore elucidation of the psychological mechanisms which "cause" or enhance it are of value to our own society, as well as helping us to understand that of others
Spaces of contestation: the everyday experiences of ten African migrants in Cape Town
No full textIncludes bibliographical references.Xenophobia in South Africa is so overt that it has take a covert form. The 'xenocide' events that took place in 2008 were called xenophobic acts. It is the recurrent denialism of xenophobia on an everyday basis that this project has explored through the narrative accounts of ten African migrants in Cape Town. The lived everyday experiences of ten African migrants have brought forward the central argument of this thesis. From the data, it is evident that as a reponse to everyday pressures of prejudices and xenophobia in social and physical spaces, African migrants have developed mutable, unsettled and vagrant identities in order to cope with everyday low level violence. This argument emerged as four key stressors have been identified as the components of a more substantial explanation of xenophobia in South Africa. The four key components are: the enforcement of identity (national and group), the demarcation of spaces of belonging, the experiences of economic insecurity, and lastly a 'culture of violence' in South Africa. This thesis argues that these four stressors are the result of an on-going active process of xenophobic attitudes
The hepatitis C virus in the EMRO Region: health policy, historical, ethical aspects and future challenges
No full textBackground: Hepatitis C infection (HCV) can have a harmful effect on the health of people and can impose relevant health care costs. The World Health Organization has eliminated Hepatitis C by 2030 as an important goal for all countries. This study aimed to identify the HCV-related policies in Iran.
Methods: A qualitative approach was used for this study. Data was collected through a comprehensive search of documents and interviews with different stakeholders related to the HCV program. Data was analyzed and validated using content analysis based on the policy triangle framework.
Results: Our findings highlighted that certain social and cultural issues related to stigma can impact on awareness-raising processes. It is also necessary to consider HCV directly in the context of government policies. All stakeholders must act in their own right. Continued talks need to be made between them for the participation of all stakeholders.
Conclusion: The findings of this study can provide useful information for improving, supporting and developing policy processes. Healthcare providers must address all aspects of the disease by 2030 in order to achieve the goal of HCV elimination. Evidence-based planning, support for up-to-date policies and resource mobilization are needed to achieve this ambitious goal
Periodontal condition in rats with experimental diabetes mellitus after orthodontic surgery
No full textAzari Mehrdad Mohammad Ali. Periodontal condition in rats with experimental diabetes mellitus after orthodontic surgery. Journal of Education, Health and Sport. 2019;9(10):246-252. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3522313
http://ojs.ukw.edu.pl/index.php/johs/article/view/7610
The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26/01/2017).
1223 Journal of Education, Health and Sport eISSN 2391-8306 7
© The Authors 2019;
This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland
Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike.
(http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.
The authors declare that there is no conflict of interests regarding the publication of this paper.
Received: 03.10.2019. Revised: 08.10.2019. Accepted: 29.10.2019.
UDK 616.31:615.37:616.179:379:008
PERIODONTAL CONDITION IN RATS WITH EXPERIMENTAL DIABETES MELLITUS AFTER ORTHODONTIC SURGERY
Azari Mehrdad Mohammad Ali
Odessa National Medical University
[email protected]
Abstract
Background. Determine periodontal condition in rats with experimental diabetes mellitus after orthodontic surgery.
Methods. In rats, type 1 diabetes mellitus (DM1) was reproduced with aloxane (100 mg / kg, intraperitoneally) once. Orthodontic surgery was performed by fixing the spring, starting from the 12th day. Animal euthanasia was performed on the 35th day of the experiment. The activity of urease, lysozyme, catalase, elastase, as well as the content of malondialdehyde (MDA) and hyaluronic acid were determined in the gum homogenate. In the alveolar bone homogenate, the activity of alkaline phosphatase (AlP) and acid phosphatase (AcP) and elastase was determined, as well as the content of calcium and protein. The antioxidant-prooxidant index (API) was calculated by the ratio of catalase activity and MDA content, and the degree of dysbiosis according to A. P. Levitsky was calculated by the ratio of the relative activities of urease and lysozyme. The mineralizing activity (MA) was calculated by the ratio of the activity of alkaline phosphatase (AlP) and AcP in the bone tissue and the mineralization (MD) degree was calculated by the ratio of the concentration of calcium, and protein.
Results. In rats with DM1, the level of elastase, urease, MDA and the degree of dysbiosis increase in the gum, however, the level of lysozyme, hyaluronic acid, and the API index decrease. In the bone tissue of the periodontium of rats with type 1 diabetes, the level of alkaline phosphatase and MA decreases, but the level of AC increases. Orthodontic surgery significantly reduces the degree of dysbiosis in the gums and shows a tendency to increase API and decrease elastase activity. After orthodontic surgery, rats significantly increase the level of alkaline phosphatase and MA.
Conclusion. With type 1 diabetes, periodontitis, dysbiosis develops and the mineralizing activity of periodontal bone tissue decreases. Orthodontic surgery tends to improve periodontal conditions.
Keywords: periodontium; diabetes mellitus; orthodontics; dysbiosis; inflammation; mineralizing activity
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