Background: Today, despite the complex environment of businesses, the development of strategic thinking has become one of the important factors in gaining a sustainable competitive advantage in organizations; so that its application by managers leads to increased organizational performance and improved competitive conditions. Objectives: This investigation focused on determining the strategic cognition model used in Iran’s health industry. Methods: This study adopts a mixed-methods (qualitative-quantitative) approach with an applied research objective. The target population includes all health industry experts in Iran. The research process began with a comprehensive literature review, followed by in-depth interviews with 17 seasoned professionals to qualitatively identify and validate the key drivers of strategic thinking in Iran’s healthcare sector. Subsequently, a quantitative phase was implemented, during which expert surveys were used to construct the structural self- interaction matrix (SSIM). Following the interpretive structural modeling (ISM) methodology, the initial and final reachability matrices were derived, enabling the classification of research components and the development of the structural model. Additionally, MICMAC analysis was performed to evaluate variable dependence and penetration. Results: All the components and codes of this research are summarized within the framework of four main factors: Obstacles, national infrastructures, scientific insight, and foresight. After obtaining these results, and in order to quantitatively verify and achieve the structural- interpretive model, the main components of the research were tested using the structural-interpretive modeling method, and finally, the final model of the research was extracted. Conclusions: It is suggested that managers and all trustees of the health industry analyze the competitive and political-legal environment of their industry and organization as a first step. Using trend analysis and maintaining a forward-looking vision can help managers better understand the future environment.

Background: Efficient utilization of hospital beds is a key priority for healthcare systems today. Leveraging the potential of medical tourism can serve as a significant strategy in this regard. Objectives: The purpose of this study was to assess the readiness of hospitals in Ilam city to attract medical tourists. Methods: This descriptive cross-sectional study was conducted among educational and private hospitals in the center of Ilam province in 2023. Data were collected using a standard checklist designed to evaluate the International Patient Department (IPD), comprising 66 questions across five domains. The checklist was completed through observation, interviews, and a review of available documents. Data analysis was conducted using frequency and percentage distribution tables, means, and standard deviations in Excel software. Results: The highest readiness score for obtaining a license to establish an International Patient Department was achieved by Kowsar Private Hospital, with a score of 198. The lowest score was recorded at Razi Public Hospital, with a score of 119. Overall, none of the hospitals studied reached the cutoff score of 227 (65%). Conclusions: The results indicate that all the hospitals studied are currently in an unacceptable state of readiness to attract medical tourists. Establishing International Patient Departments should be a top priority for improving hospital efficiency and fostering the growth of medical tourism.

Background: Multiple sclerosis (MS) is a long-term autoimmune disorder affecting the central nervous system, leading to reduced quality of life and impaired physical and psychological functions. Objectives: This study aims to examine the relative efficacy of yoga and relaxation therapy in improving sleep disturbances, fatigue, and cognitive impairment among individuals diagnosed with MS. Methods: This study employed a semi-experimental research design, including a pre-test, post-test, and follow-up over three months. The target population comprised all MS patients referred to the Iranian MS Association in Tehran between July and November 2023. Sixty participants were selected using purposive sampling and randomly assigned to research groups: Two yoga therapy groups with 17 participants each, a relaxation therapy group with 16 participants, and a control group with 18 participants. The yoga therapy group participated in twelve 90-minute sessions twice a week, while the control group received no intervention and was placed on a waiting list. Various tools, including the Multidimensional Fatigue Inventory (MFI), Cohen-Mansfield Agitation Inventory (CMAI-O), and a concentration skills questionnaire, were used to collect data. The data were analyzed using ANOVA, Bonferroni post hoc test, MANCOVA, and Kruskal-Wallis H tests with a significance level of 0.05, utilizing SPSS 27 software. Results: The study found a significant difference (P < 0.001) in the restlessness factor in both the post-test and follow-up phases. Additionally, there was a significant difference (P < 0.001) in the levels of physical fatigue, mental fatigue, decreased activity, and decreased motivation in both the post-test and follow-up phases, indicating significant changes in the fatigue factor among the research groups. However, there was no significant difference in the general fatigue component between the research groups. A significant difference (P < 0.001) was also found in the concentration factor, particularly in the components of voluntary and involuntary concentration, during both the post-test and follow-up stages. Conclusions: The results of this study indicate that both yoga and relaxation therapy techniques significantly reduce restlessness, physical tiredness, mental fatigue, decreased activity, and decreased motivation. Furthermore, the findings validate that both yoga and relaxation therapy techniques effectively enhance voluntary and involuntary concentration.

Background: Hospital health service quality is a fundamental component of the health system. Hospital accreditation is a key approach to enhancing this quality, necessitating the correct implementation of processes. Objectives: This study aims to investigate the compliance of the executive processes of Iran’s hospital accreditation program with the requirements of the International Society for Quality in Health Care and to provide corrective solutions. Methods: This qualitative study uses an inductive content analysis technique. A checklist with seven axes was established by extracting and interpreting the requirements of the executive processes from the International Society for Quality in Health Care. By examining existing documents at the Ministry of Health’s Accreditation Office and conducting interviews with managers and experts in the field, challenges in the domain of the executive processes of Iran’s hospital accreditation program were identified using the relevant checklist. Corrective solutions were then gathered through semi-structured interviews with 19 experts, managers, and accreditation field specialists, categorized inductively, and presented using MAXQDA software. Results: Challenges in seven areas were identified, including governance; strategic, operational and financial management; risk management; human resources management; information management; survey and client management; and the granting of accreditation approval. Subsequently, solutions were categorized into five groups encompassing 26 concepts, focusing on reforming macro policies, addressing implementation challenges, fostering appropriate interactions, improving human resource management, and promoting evidence-based decision-making. Conclusions: The Iran hospital accreditation program’s adherence to International Society for Quality in Health Care standards is inadequate. Establishing a semi-autonomous, non-profit accreditation body that operates under government control and ensuring the independence of the accreditation office is essential for achieving higher compliance and receiving certification from International Society for Quality in Health Care.

The implementation of electronic health (e-Health) in healthcare organizations consistently encounters numerous challenges. These barriers hinder the widespread adoption of this promising technology within healthcare settings. This study addresses the challenges of implementing e-Health across various hospitals and also aims to evaluate the maturity of hospital information systems (HIS) in Iranian hospitals based on the electronic medical record adoption model (EMRAM). Through two rounds of literature review and case studies, a comprehensive understanding of these previously unexplored issues has been developed. The findings identify 13 social and technical challenges, including the lack of standard applications, high costs associated with e-Health and training, legal issues, security concerns, inconsistencies and diversities in perceived e-Health benefits and barriers, lack of proficiency, and difficulties healthcare professionals face in integrating e-Health into their daily tasks. There are also negative perceptions among physicians and patients regarding the use of e-Health software, the lengthy implementation times for HIS systems, technical difficulties due to platform diversity, resistance to change, and the limited use of pilot projects, particularly in Iran. Moreover, the maturity of hospital cases in Iran is at 3 stages, in contrast to the 7 stages of EMRAM. These results underscore the need to develop an effective strategy to address the challenges identified in this research. Additionally, a specific program should be implemented for developers to enhance the maturity of HISs and advance them to higher stages of EMRAM.

Background: Currently, health indicators are considered an important factor in the development of countries and can be effective in raising the level of developmental indicators Objectives: In this regard, the present study aimed to analyze the relationship between the effect of health indicators on the developmental indices of the provinces of Iran. Methods: The current study of an applied type was descriptive, cross-sectional, and retrospective. The data were prepared through forms designed based on experts’ opinions and classified information in statistical yearbooks for the provinces of the country during 2016 - 2020. Data analysis was carried out using Stata 17 software. Moreover, panel data was used to estimate the model, and the Xtpcse test was used to obtain the results of the hypotheses. Results: The results of the model estimation show the positive and meaningful impact of health indicators on educational indicators such as the ratio of students to teachers, the ratio of students to staff and management, the ratio of higher education students to the population of the provinces and the distribution of students in the province. Conclusions: The country’s authorities can improve and develop health by identifying and optimizing the use of effective indicators in the field of Health and education indicators such as increasing the number of medical and health students and developing educational programs in the field of Health and health and informing the community about these programs, as well as encouraging higher education in low-income areas.

The Article Abstract is not available.

Background: In line with the advancement of Artificial Intelligence (AI), innovative solutions have been designed to improve healthrelated Sustainable Development Goals (SDGs). Accordingly, there is an increasing trend in the realm of AI and SDG research areas. Objectives: This study aimed to analyze the trends and patterns of AI research in health-related SDGs using bibliometric analysis. Methods: The bibliometric approach facilitated the identification of key terms and countries from previous research. We used VOSviewer to map and analyze data obtained from three databases: Scopus, Web of Science, and PubMed. Results: Our findings illustrated that research on health has been a popular area of study in recent years. In particular, we observed a significant increase in research on AI in health-related SDGs during 2015 - 2022. Conclusions: This study provides insights into the trends and patterns of AI research in health-related SDGs using bibliometric analysis. The findings can guide future research by identifying key terms that require further investigation.

Context: The placenta performs a crucial function in nutrient exchange, but studying this tissue poses a number of challenges. Utilizing microfluidic and microfabrication technologies, a 3D placenta-on-a-chip model provides a biomimetic alternative for studying placental diseases and treatments.
 Objectives: Aim: To review and analyze the currently available placenta-on-chip data to study placental pathologies in patients.
 Methods: By systematically searching the PubMed, Scopus, and Science Direct databases, research papers that employed 3D printing techniques for the development of organoids and Organ-on-Chip (OoC) systems for in vitro experiments were gathered and scrutinized.
 Results: When exposed to glucose transfer, placenta-on-a-chip mimics the features of an in vivo human placenta. Microchips have the potential to become a platform for diagnostic purposes for placental diseases and a model for duplicating the important features of these diseases.
 Conclusions: The microfluidic placenta-on-a-chip platform holds promise as an affordable solution with versatile applications. However, research is essential to develop a comprehensive in vitro pregnancy model in the future to expand our understanding of feto-maternal communication.

Context: Online health consultation services are developing, both website-based and application-based, better known as telemedicine or telehealth. Over 50% of the population can access health information easily. Telemedicine can expand healthcare services, increase accessibility, provide clinical support, save time and costs, and be efficient because it overcomes geographic barriers, offers a wide variety of communication tools, and improves patient care. Telemedicine is used to bring specialist, anti-discriminatory and effective health services closer to the interests and safety of patients to expand the quality services in healthcare centers, especially in rural areas in Indonesia. Material and Methods: The study design used in this article is a narrative literature review or formal review by reading the references carefully, then making a summary, drawing conclusions, and finding gaps in the manuscript adapted to the topic to be discussed. Results: The significant number of problems and challenges in public health services in Indonesia can provide exciting opportunities to develop an e-health system that can help solve problems. To put a stop, the Indonesian government is advising the public and medical professionals to use telemedicine as an online public health service application between hospitals and patients. Conclusions: Telemedicine significantly correlates with government and start-up calls and can be employed as a health service option during the COVID-19 pandemic. In this pandemic, telemedicine can improve services in terms of monitoring, evaluating, and educating patients and medical staff.