A Systematic Literature Review: Workplace Violence Against Emergency Medical Services Personnel - Archives of Trauma Research - - Kowsar

Introduction: The variety of frameworks and models to describe resilience in the health system has led researchers and policymakers to confusion and the inability to its operationalization. Therefore, the purpose of this study was to create a meta-framework using the Critical Interpretive Synthesis method. Method: For this purpose, studies that provide theories, models, or frameworks for organizational or health system resilience in humanitarian or organizational crises were systematically reviewed. The search strategy was conducted in PubMed, Web of Science, Embase, and Scopus databases. MMAT quality appraisal tool was applied. Data were analysed using MAXQDA 10 and the Meta-ethnography method. Results: After screening based on eligibility criteria, 43 studies were reviewed. Data analysis led to the identification of five main themes which constitute different framework dimensions. Health system resilience phases, attributes, tools, and strategies besides health system building blocks and goals are various dimensions that provide a systematic framework for health system resilience analysis. Discussion: This study provides a systemic, comprehensive framework for health system resilience analysis. This meta-framework makes it possible to detect the completeness of resilience phases. It examines the system’s resilience by its achievements in intermediate objectives (resilience system attributes) and health system goals. Finally, it provides policy solutions to achieve health system resilience using tools in the form of absorptive, adaptive, and transformative strategies.

Health-related quality of life (HRQoL) measurement in elderly people can provide appropriate information for an optimal management of physical/mental conditions. The main objective of the present study was to quantitatively assess the HRQoL among healthy elder Iranian individuals as measured by the Short-Form 36 (SF-36) questionnaire, both overall and at the level of each its single component/domain. This study was designed as a systematic review and meta-analysis, following the "Preferred Reporting Results of Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases such as MagIran, SID and Irandoc were mined from inception up to 1st September 2017. Also the grey literature (via Google Scholar) was mined. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality using the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) checklist. Twenty five studies were included. Mean overall HRQoL was 54.92 [95%CI 51.50–58.33], lower than the value found by studies done in other countries, especially in those economically developed. The sensitivity analysis indicated stability and reliability of results. Pooled scores of each HRQoL domain/sub-scale of the SF-36 questionnaire ranged from 49.77 (physical role functioning) to 63.02 (social role functioning). HRQoL among healthy elder Iranian individuals is generally low. Health policy-makers should put HRQoL among the elderly as a priority of their agenda, implementing ad hoc programs and providing social, economic and psychological support, as well as increasing the participation of old people in the community life and use their experiences.

Background: Developing and strengthening the competencies and skills of health care managers is a key objective in many health systems. Selecting adequate training methods, content, and using appropriate criteria for assessing their impact is fundamental for improving their usefulness and effectiveness. Filling an important gap in knowledge, this review assesses the evidence on the effectiveness of different types of training and educational programmes delivered to hospital managers. Methods: In this narrative systematic review, the following electronic databases were searched for literature published between January 1st, 1990 and January 31st, 2019. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the included studies. Results: In total, 9 articles were included. Results showed that the main topics covered by training programs for hospital managers were: planning, organization and coordination, control and supervision of hospital staff, teamwork, communication, motivation and leadership, monitoring and evaluation, and quality improvement skills. Training in these skills was found to improve managers’ strategic and operational planning abilities, change management and behavioural management methods, and leadership. Conclusions: The examined training programs had a relatively positive effect on the managerial skills, knowledge and competencies of hospital managers. In general, these capacity-building programs focused on developing three types of skills: technical, interpersonal and conceptual. Training programs focused on developing technical skills among managers were more effective than those focused on developing other types of skills. Increased investment and large-scale planning are needed to develop better the knowledge and competencies of hospital managers.

Malnutrition is one of the main causes of death in children under 5 years of age and one of the most common factors threatening children’s life and health. Nutrition policy analysis and solving existing problems in children can reduce the effects of malnutrition. This study aimed to analyze the current policies of malnutrition prevention in children under five years of age in Iran. This study was conducted in 2017 to analyze policies using the "policy triangle framework". In order to examine the policy-making process, the Kingdon’s multiple streams model was used. A combination of two sampling methods, including purposeful and snowball sampling, was applied to select the interviewees. In relation to the implemented documents and policies, the country’s most important policies were selected based on the suggestions of policy makers as well as searching scientific databases and electronic portals. A data collection form was used to identify the current policies and documents and a semi-structured interview guide form was used for the interviews. The framework analysis and MaxQDA software were applied to analyze the data obtained from the interviews. The key factors affecting policies in Iran included the status of indicators as well as economic, social, structural-legal, policy and international factors. Among the most important policies and implemented programs, the following can be mentioned: growth monitoring, oral rehydration, breastfeeding, immunization, female education, family spacing, food supplementation, nutrition for children under five years of age, and control of nutritional deficiencies. Currently there is a need for a nationwide program and comprehensive document in the field of the nutrition in children under 5 years of age, which requires strengthening of the political process. Participants and stakeholders in nutrition-related policies for children under the age of five were divided into four categories of governmental, semi-governmental, non-governmental, and international organizations. More attention should be paid to the shortage of some micronutrients, accurate implementation of breastfeeding programs, supplementary nutrition, fortification and supplementation programs for children and mothers, utilization of the advantages of each region and its resources, and better coordination between organizations and their policies, and finally strong incentives are needed to promote macro nutritional goals for children under five years of age.