IntroductionMaking appropriate plans for the provision of hospice care is considered a perceived need in the Iranian health system. The current study aimed to develop a model for establishing hospice care delivery system for the adult patients with cancer.Materials and MethodsThis study is part of a larger study that has been done in four phases. This Health System Policy Research utilized a mixed qualitative-quantitative approach. At the first phase, a qualitative study was conducted which explained the care needs and the (...) requirements for establishing this system from the stakeholders’ perspective. The second phase aimed to examine the current situation of hospice care delivery in Iran and identify and determine the similarities and differences among them in the selected countries. At the third phase, the main areas of the model and the related indicators were extracted and prioritized by consulting with experts. Then the model was formulated. At the fourth phase, the proposed model was validated and finalized in terms of importance, scientific acceptability, and feasibility.ResultsBased on the developed model the first and the most important step in establishing the hospice care delivery system is laying the groundwork in the health system which requires focusing on policymaking. It is necessary to establish hospice centers and implement public awareness raising programs, train, and supply expert manpower, strengthen family physician and referral process, formulate clinical guidelines, encourage the private sector and NGOs.) to invest, develop end-of-life and hospice care service packages, and create quality care indicators. The proposed model had moderate feasibility.ConclusionThis model was developed based on the current Iranian healthcare structure and the needs of terminally ill cancer patients. It can be used as a model tailored to the current state of the health system and community in Iran. It is suggested to use this model as a pilot at the regional level. (shrink)

IntroductionUrinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence.MethodsThis qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously (...) and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman.ResultsThe results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: “problem incompatibility with the disease,” “mental impasse,” “facing social restrictions,” and “concealment and social escapism.”ConclusionThe findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life. (shrink)

The paper delves into the evolution of language in French and English, focusing on the feminization and neutralization of job titles in legal and professional settings. It explores how these linguistic changes are intertwined with the broader implications of language in shaping moral and ethical standards, advocating for gender equality, and challenging gender biases. The study highlights the slow but impactful progress in linguistic reform within legal contexts, suggesting strategies to align legal language with contemporary principles of gender equality.

The attempt is made in this article to analyze and compare the religious policies of the two Safavid and Qajar dynasties’ governments with respect to Sunnite sect. In these eras the related policies differed although the official religion of both regimes was Shiism: The Safavid central government’s confronting policies against Sunnite, the Sunnite elites’ long-term appointments to high state ranks by Qajar Kings and these policies were more consistent in Qajar than Safavid era. Here the approaches of both the dynasties (...) are categorized in four parameters: confronting, excommunication, discrimination and moderation. In Safavid era the first three parameters were more apparent while the fourth parameter is more evident in Qajar era. (shrink)

Anxiety is a common unpleasant reaction among patients undergoing surgery. Many non-pharmacological methods such as spiritual strength are effective in preoperative anxiety management. This study aimed to assess the effects of listening to Quran recitation on reducing preoperative anxiety. A systematic review was performed in Medline, EMBASE, Cochrane Library, PsycINFO, Arab World Research Source, and other relevant databases to collect the data. Randomized controlled trials about the effects of listening to Quran recitation on preoperative anxiety reduction in elective surgery were (...) selected without any language and date restriction. Interventions with self-reading/self-recitation were excluded. The Cochran’s Q statistic and the I2 index with 50% threshold were used for calculating the heterogeneity and inconsistency index. Subgroup analysis was conducted based on the surgery type. The funnel plot was used to evaluate the possibility of publication bias. Twelve studies were included in the qualitative synthesis and nine studies in the quantitative synthesis. The meta-analysis showed a significant anxiety reduction with listening to Quran recitation. The heterogeneity between the included studies was statistically significant. The pooled effect size of anxiety was d = −8.893 = −10.763 to −7.022). The subgroup analysis showed that listening to Quran recitation reduces anxiety in major and minor surgeries. There was no publication bias in the studies. The findings indicated that listening to Quran recitation can be considered a non-invasive and peaceful intervention to reduce preoperative anxiety in elective surgery. (shrink)

BackgroundMedical education is currently more considerate about the human dimension. The present qualitative study aimed to explain the experiences of clinical professors with regard to humanism in clinical education in Iran.MethodsThis mixed methods study had two phases, a quanitative phase of scientometrics and a qualitative phase of a content analysis. In the scientometrics phase, Ravar PreMap and VOSviewer software programs were utilized for plotting the conceptual networks. The networks were analyzed at the micro-level based on centrality indices. The conceptual network (...) was plotted and the prominent topics in clinical education were identified using co-word analysis. In the second qualitative phase on the topic, based on the scientometrics phase, semi-structured interviews were conducted with clinical professors. The interviews were transcribed verbatim and analyzed.ResultsOn the basis of the analysis of titles, abstracts, and keywords of the retrieved articles on clinical education from ISI Web of Science, Scopus, and PubMed, 1412 keywords were extracted. After the refining process, 356 keywords with 6741 relations remained. Upon plotting the conceptual network, 19 conceptual clusters related to clinical education were obtained. Then, micro-level network analysis indicated that the keyword humanism with the frequency of 137 had the highest rate, closeness, and betweenness. Moreover, from the interview data analysis, two themes of “intertwined nature of the human spirit in clinical education” and “humanistic behavior of professors in clinical education” were extracted.ConclusionAs a part of the educational culture, humanistic values must be intertwined with the medical education curriculum. In this regard, humanism and clinical reasoning are the two major clusters of clinical teaching; moreover, altruism and adherence to humanistic values, and scientific qualification are other main pillars that should be considered as the criteria for the selection of clinical professors and medical students. (shrink)

Making proper decisions in today’s complex world is a challenging task for decision makers. A promising approach that can support decision makers to have a better understanding of complex systems is agent-based modeling. ABM has been developing during the last few decades as a methodology with many different applications and has enabled a better description of the dynamics of complex systems. However, the prescriptive facet of these applications is rarely portrayed. Adding a prescriptive decision-making aspect to ABM can support the (...) decision makers in making better or, in some cases, optimized decisions for the complex problems as well as explaining the investigated phenomena. In this paper, first, the literature of DM with ABM is inquired and classified based on the methods of integration. Performing a scientometric analysis on the relevant literature lets us conclude that the number of publications attempting to integrate DM and ABM has not grown during the last two decades, while analysis of the current methodologies for integrating DM and ABM indicates that they have serious drawbacks. In this regard, a novel nature-inspired model articulation called optimal agent framework has been proposed to ameliorate the disadvantages and enhance the realization of proper decisions in ABM at a relatively low computational cost. The framework is examined with the Bass diffusion model. The results of the simulation for the customized model developed by OAF have verified the feasibility of the framework. Moreover, sensitivity analyses on different agent populations, network structures, and marketing strategies have depicted the great potential of OAF to find the optimal strategies in various stochastic and unconventional conditions which have not been addressed prior to the implementation of the framework. (shrink)