Objective: In this systematic review, we aimed at estimating the pooled prevalence of catastrophic health expenditures (CHE) in Iran and identifying and summarizing the determinants of CHE among Iranian households. Methods:We comprehensively searched the literature on November 2016 in PubMed, Scopus, Web of Science, the Cochrane Library, and 3 Persian databases. We also obtained the literature through colleague communications. Two review authors independently selected studies, extracted data, and evaluated them. We performed meta-analysis of prevalence of CHE and subgroup meta-analyses to assess the influence of data source and scope of research. Moreover, we categorized the determinants of CHE in Ian.Results: In this review, 16 studies met the inclusion criteria, and of them, 2 presented the results of multiple surveys. Results of 27 cross-sectional studies were used to estimate the pooled prevalence of CHE in Iran during 1995 and 2015, which was found to be 3.91% (95% confidence interval, CI: -3.26-11.07). Subgroup meta-analyses based on data source revealed that the highest prevalence estimate of facing CHE was associated with author-made questionnaires, and the lowest to the statistical Centre of Iran (SCI) questionnaire. Also, meta-regression showed that the difference in sample size and year of study did not have any significant effect on the prevalence of CHE. Some of the variables such as use of inpatient, outpatient, and dentistry services, education, place of residence, and household income, which were considered as determinants of CHE in Iran, increased the possibility of facing CHE. Conclusions:Decrease in CHE to less than 1%, which was the objective of the 2 of Iran's five-year development plans in 2007 and 2015, was not met. This percentage may need to be reconsidered according to the pooled estimate of CHE. Also, the factors revealed to be the determinants of an increase in the probability of facing CHE could indicate the need for health care services and socioeconomic variables that lower one's capacity to pay for health services.

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Abstract In the last decade, there has been an emergent interest, supported by various experimental and epidemiological studies, for health benefits of camel milk, in preventing various pathologic conditions, ranging cancer to diabetes. However, the precise mechanisms by which camel milk induce these health benefits remain to be investigated. Various reports have shown that consumption of camel milk by diabetes patients on a daily basis reduces blood sugar and glycosylated hemoglobin (HbA1C) levels and also reduces insulin requirements. Despite that these findings provide scientific evidences of anti-diabetic activities of camel milk, research is yet to be initiated with assurance for patients of diabetes and other metabolic disorders. This review summarizes the medicinal values of bioactive constituents of camel milk and reviews camel milk findings from the most significant preclinical studies in diabetes. Keywords: Camel milk, diabetes mellitus, blood glucose, HbA1C, insulin resistance

Background:In today's changing and uncertain environment, there is a need for transformational leaders. Besides, due to lack of effective leaders in organizations, identifying factors influencing managers to act as transformational managers is very important. Spirituality is one of the factors, which cause managers to act as transformational managers. Objectives: This study aimed to investigate the association between managers' spirituality at work and their leadership styles in Tehran University of Medical Sciences, Tehran, Iran in 2012. Materials and Methods:This was an applied, cross-sectional and descriptive-analytic study conducted on all managers at different levels (n = 44) and a sample of 74 employees of the Vice Chancellor of Management Development and Resource Planning of Tehran University of Medical Sciences, Tehran, Iran in 2012. Data was collected using two questionnaires evaluating managers' leadership styles and their spirituality at work. Collected data was analyzed using SPSS 16.0 by Pearson Correlation Coefficient and Multiple Linear Regression (Stepwise method). P < 0.05 was considered statistically significant. Results: There were positive and significant correlations between transformational leadership style and managers' spirituality at work (r = 0.364, P < 0.001) and between transformational leadership style and all dimensions of managers' spirituality at work (P < 0.05). Multiple Linear Regression showed that among the dimensions of managers' spirituality at work, only interpersonal communication had a significant effect on using transformational leadership style by managers (P = 0.001). Conclusions: If managers' spirituality at work, especially interpersonal communication skills improves, their use of transformational leadership would be increased. Therefore, it seems necessary to employ individuals with great interpersonal communication skills and good communication with other people and colleagues, teams, formal and informal organizations as managers. Furthermore, it is recommended to continuously improve managers' communication skills to enable them to act as transformational managers.

Background: With the outbreak of the COVID-19 pandemic, all the aspects of educational institutions such as universities have been affected. Trainings have changed from face-to-face and physical to online and digital. Therefor an educational reform has been recognized as a priority toward adaptation of universities with the current situation and transition to third-generation universities in order to synchronize with global trends. This study evaluated the preparedness of universities to manage the outbreak and moving toward a new generation, using the scenario planning approach. Methods: A mixed method design was used including three phases: 1) Identifying the variables affecting the future of medical education, 2) Prediction and building scenarios (future estimates), 3) Building the future (scenario-making).Results: The COVID-19 pandemic represents an enduring transformation in education with the advancement of smart universities, telehealth, adaptive research protocols, personalized and self-controlled learning and flexible approaches to achieve solutions. Conclusions: It is Inevitable that in this situation, the future of this path, must be clarified and a joint vision (scenarios) must be created. It is suggested that educational and environmental key factors should be constantly monitored to keep up with the process of managing the situation, globalization and the expansion of entrepreneurial universities.

introduction universities play a significantly important role in the development of societies. Furthermore, they have always been exposed to internal and external changes. Therefore, they are required to adapt themselves to the environment and its conditions in order to meet the needs and realize the values ​​of society. In this regard, Universities of Medical Sciences across the country have attempted to manage their paradigmatic transition to entrepreneurship in order to synchronize with global trends. so, this study aimed to evaluate the futures faced by the higher education system in Iran in the move toward third-generation universities and globalization, using the scenario planning approach. Methods In this research, a combination of quantitative and qualitative methods were used, in three phase: I: Identifying the variables affecting the future of medical education, II: Finalizing Key Factors for Prediction and Building Scenarios (Future Estimates), Phase III: Building the Future (Scenario-making) Results Five factors, which had high impact and possibility of occurrence, were selected as the final key factors in the movement of Shiraz University of Medical Sciences toward the third-generation university. A: The ability of the system to funding the university B: stabilization of long-term policy-making towards the realization of third-generation university C: the cultural and attitudinal infrastructures of university D: Status of hardware (equipment) and software (educational contents and processes) infrastructures in this regards. Conclusion Four compatible scenarios was extracted using the Scenario Wizard Software. 1. quick move toward the third-generation universities 2. opening the wing of e-learning and virtual schools 3. turtle movement 4. alert of moving backward to first-generation universities. It seems that a proper and principled policy-making for moving toward third-generation universities is an essential goal, hence the future of this path must be clarified and a joint vision must be created.

Introduction The physicians are responsible for prescribing medicine rationally. Physician's awareness of prescribing guidelines can lead to the selection of the most effective, appropriate and effective measures to the improved prescription. This study aim is to determine the factors influencing drug prescribing behaviour in family physicians. Methods This cross-sectional study was conducted in 2016 on a case study including 150 family physicians from Shiraz City who were selected by systematic random sampling method. A questionnaire related to the behaviour of prescribing physicians was used based on the theory of planned behaviour to collect data. The validity of the questionnaire was confirmed by the experts' opinion and its reliability was confirmed by calculating the Cronbach's alpha. The data were analyzed using structural equation modelling (SEM) by SPSS and Smart PLS software. Results It was specified that 39.3% of Shiraz family physicians have prescribed medicines for their most patients (61-70%) during the last month. Furthermore, 60% of physicians have prescribed for about 20% of their patients without any examination. In addition, 63% of doctors have repeated prescription for about 20% of patients with chronic disease. Based on the obtained results of the Research Structural Equation Model, none of the four considered variables explains changes in physicians' behaviour regarding prescribing. Although, “mental and perceived behavioural control” explain 30.2% of the changes in the intention of prescribing medication of family physicians in Shiraz. Conclusions The family physicians' behaviour in prescribing medicine shows the impact of factors such as the patient's request, as well as the role of the patients and colleagues pressure for prescribing medicine as a quality criterion for their practice. norms of mental and perceived behavioural control are effective in explaining the purpose of prescribing. Key messages Policymakers should implement policies to develop physicians’ behavior and logical prescription by education, financial incentives; consequently. Mental and perceived behavioral control are effective in explaining the purpose of prescribing.