Vol 4, No 3 (2020)


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    Objective: this study aimed to localize the MIPQ questionnaire into Persian language through translation and validation in order to create a useful valid measure for assessing mindfulness in parenting in Iran.

    Methods and materials: the MIPQ- original version- was translated through forward-backward translation into Persian, and then was pilot-tested on mothers of children aged 7-12 after confirming the validity of the measure using CVR-CVI method. Confirmatory factor analysis was used to ensure the item-development validity of the measure. To evaluate the factor structure of data, AMOSE (version 24) software was used. In order to assess the reliability of translated version 15 mothers included in the first phase of the study. They filled out the MIPQ questionnaire, and also they filled out simultaneously “parenting scale” by Arnold and O’leary -1993 and MMAS by Brown and Ryan-2003. After having the measure confirmed regarding validity and reliability, it was distributed among 400 mothers of which 306 returned the questionnaire fully administered.

    Results: Confirmatory factor analysis assessed and it indicated that the two-factor model in the original measure was of a good fit. The total score of the questionnaire and the scores of the two domains (‘Mindfulness’ and ‘Being in the moment with the child’) were correlated significantly positive with the total score of the MAAS and PS. The CVR-CVI of the questionnaire was also confirmed.

    Conclusion: regarding psychometrics of the measure, according results of our study, it seems that the questionnaire benefits from a highly standard structure and content as well. As one could notice, this study is the second effort for translation and validation of MIPQ which in both the measure could meet the criteria’s requirements. Therefore, it seems that the measure could be a useful standard questionnaire for evaluating mindfulness in parenting. More research is needed to evaluate the effectiveness of the measure (P-MIPQ) in different kind of people.

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    Background and Aim: One of the most effective ways to cope with the financial constraints of health system, especially in developing countries, can be to engage the private sector in the form of a public-private partnership (PPP). Hence, the purpose of the present study is to introduce PPP as a general policy to increase the effective participation of the private sector in health system.

    Methods: Initially, existing literature was reviewed to identify methods, areas, and experiences in PPP. Then, an expert panel was organized with researchers, professors and experts in health services management and policy making. At the beginning of the panel, the content obtained in the previous step was presented, and then the requirements of PPP implementation in healthcare was discussed.

    Results: Considering the discussions, we can summarize the factors affecting PPP implementation in three topics: A) Private Sector Conditions: Sufficient number of eligible companies, significant financial gain for private companies; B) Public Sector Conditions: Principles, policies and indicators related to outsourcing of services, availability of transferable services, units or substations to private sector, lower cost of providing services in the private sector than the public sector; C) Background: Political, legal, economic and cultural conditions, successful experiences in other cities and provinces, support of the health system scientific body, common language and contract conditions.

    Conclusion: Given the private sector’s capabilities and potentials to improve the quality and quantity of services provided, transparent PPP policies should be developed as an appropriate strategy for effective private sector participation in the provision of health care, and required infrastructure must be provided.

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    Objective: It is essential to improve the educational curriculum over time. This study aims to evaluate the quality of the health technology assessment (HTA) curriculum in Iran.

    Method: This cross-sectional study was conducted in three groups of professors, students, and graduates of HTA by the census. The data needed for this purpose were collected using a specific questionnaire. Finally, descriptive and analytical statistics were used for data analysis.

    Results: Of 127 individuals, 114 ones responded to the study (response rate = 89%). The quality of the curriculum in terms of design elements in the core courses and the elements of the executive courses in the curriculum are in the range of medium to medium-to-optimal (1.66< mean> 2.32 to mean> 2.32, respectively). Also, the majority of the elements of the core courses and design elements are from compensatory courses in an unfavorable to moderate (1.66> mean to 1.66< mean> 2.32, respectively).

    Conclusion: The results of this study showed that there was no significant problem in most design elements of the curriculum sections. However, there are some challenges in some elements of the operation. Therefore, it is suggested madding some changes to correct inappropriate elements. To achieve this objective, it is necessary to investigate the interests of other stakeholders involved in this field and thus enhance the quality of the curriculum. Implementing the proposed proposals and reviewing the curriculum studied can be considered as an important step to improve the HTA curriculum in Iran.

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    Background: The health system is facing limited financial resources in all countries. Resource allocation is one of the tasks of the health system. Prioritizing interventions is one of the strategies that can help health policymakers in allocating financial resources. Rare diseases require more attention than other diseases due to their high cost and complex treatments. The countries use different policies to determine the effectiveness of interventions in the field of rare diseases. The purpose of this study is to refer to some policies in the field of allocating resources for rare diseases and to explain the importance of determining the threshold of cost-effectiveness for rare diseases in Iran.

    Methods: This research is a review study. First, a study was conducted on how to prioritize health interventions in the world and the thresholds of cost-effectiveness in different countries. Articles related to the research topic were then searched in accessible databases in Iran such as SID, Google Scholar and Medline. Finally, the obtained articles were screened and analyzed based on a thematic approach.

    Results: The World Health Organization (WHO) has set a threshold for determining the cost-effectiveness of health system interventions, that is determined and calculated based on the per capita GDP of each country. There are many differences between countries on policies related to the treatment of rare diseases, medicines, health care budgets and patient access.

    Conclusions: Due to the very high cost of treating rare diseases, it is impossible to use the threshold used for general disease interventions in rare diseases and it is necessary to use a higher threshold for rare diseases. In addition to cost-effectiveness, budget, justice, feasibility, and other criteria that are considered important at the national level should be considered.


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    Introduction: Safety has been neglected in primary health care (PHC). A review of the literature shows that a comprehensive and specific framework to assess the safety of the service recipients (SRs) in PHC has not yet been developed. Therefore, this study aimed to design and validate a framework for assessing the safety of SRs in PHC.

    Methods: This study is a qualitative study with a grounded theory approach that was designed and conducted in 2020 in the Vice-Chancellor for Health of Tabriz University of Medical Sciences. The present study was conducted in three stages: conducting a comprehensive literature review, consulting 15 experts and officials of the country and the province, and conducting two stages of the Delphi technique with the participation of 23 experts. Content analysis was used to analyze the data.

    Results: In the literature review phase, 114 criteria were identified from 16 references. Finally, 71 criteria, in 6 main areas and 20 sub-areas, were identified for assessing the safety of SRs in PHC. The main areas include management and leadership (26 criteria), process management (8 criteria), SRs' safety audit (15 criteria), human resources (5 criteria), SRs and community participation (5 criteria), and occupational safety (12 criteria).

    Conclusion: In this study, a comprehensive and systematic framework and criteria for measuring the safety of SRs in PHC were designed and validated, which can be used by policymakers and officials of PHC.


Review Article

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    Introduction: Empyema is a respiratory disease that has increased seriously in the past two decades. The usual treatments for the stage III patients includes thoracotomy and video assisted thoracoscopic surgery. Hence a systematic review was conducted to compare the effectiveness and safety of the two procedures.

    Materials and Methods: In this search systematic review the databases of PubMed, Cochrane Library, Scopus, NIHR HTA, Embace, Magiran and SID were searched from 1990 until the end of June 2018. We used CASP checklist to evaluate the quality. Data analysis was performed in STATA software. The pooled effectiveness results were demonstrated in Forest plat.

    Results: Among initially 2228 retrieved records, four studies entered in the final stage of review, among which three were included in the meta-analysis. The findings showed that there was no significant difference between the two methods of thoracoscopic surgery and thoracotomy in the treatment of organizational empyema in terms of duration of surgical operation (MD = 1.33, %95 CI: -0.66 _ 3.31, p = 0.18). Postoperative hospital stay was not statistically different between two surgical methods (MD = 1.68, %95 CI: -0.20 _ 3.56, p = 0.08). In terms of safety, there was no particular risk for patients across the surgeries.

    Conclusion: There is no statistically significant difference in the operation of video assisted thoracoscopic surgery with thoracotomy in terms of effectiveness and safety. Nevertheless, the results should be considered cautiously due to the little number of included studies.



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    COVID-19 has since been declared a global pandemic by the World Health Organization (WHO), infecting millions worldwide. In the absence of an approved antiviral treatment, several medications are currently being evaluated for their therapeutic effectiveness in the treatment of COVID-19. The use of Interferon (INF) subtypes previously examined in the treatment of SARS and MERS is also being initiated in some clinical trials. Although different clinical trials were evaluated IFNs in the treatment of COVID-19, its safety and efficacy remain unknown. Therefore, this study aims to systematically assess IFNs efficacy and safety in treating patients with COVID-19.


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    Health Technology Assessment (HTA) is a multidisciplinary activity that acts as a "bridge" between evidence and policymaking. HTA investigates the application of health technology (e.g. medicine, medical equipment, or clinical/surgical procedures) in terms of safety, clinical efficacy and effectiveness, cost, cost-effectiveness, organizational outcomes, social outcomes, legal and ethical considerations (1).

    Due to rising health expenditures, limitation of health budgets, and various effects that health technology can have on different costs, nowadays examining the costs of technologies is one of the most important topics of the HTA studies. In the health economics literature, it is known as 'economic evaluation' (2). Having an appropriate base to calculate the costs or choosing the appropriate type(s) of cost(s) or choosing a costing approach, is of crucial importance for accuracy of calculations (3).

    Given that during the recent years, HTA has become the main focus of decisions about the entrance of new technologies to the country and its role in policies related to the compensation of providers and insurance coverage for technologies, and since various types of cost-related phrases are using in the health systems (i.e. price, cost or tariff), these words should be carefully considered to provide an appropriate base for HTA studies.

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    The new coronavirus pneumonia, which first occurred in China in December 2019, has a wide spectrum of symptoms from asymptomatic to very severe involvement and even death. The main reason for the increase in the severity of this disease is the body's inflammatory response to the virus, and due to the lack of effective antiviral treatment for this disease, it is necessary to take therapeutic interventions to reduce the body's inflammatory response. It is noteworthy that diabetic patients are more severely exposed to this disease and this calls for appropriate treatment to control diabetes in patients with COVID19. In addition to its antioxidant and anti-inflammatory effects, alpha lipoic acid also has therapeutic effects in controlling diabetes and blood sugar. Therefore, it is suggested that clinical trials be performed to evaluate the effects of alpha-lipoic acid on diabetic patients with COVID19