Palliative care is a fundamental component of comprehensive care for patients at the end of their lives, and plays a crucial role in alleviating the pain and suffering caused by illness for both patients and their families. The purpose of this letter to editor is to promote the development of palliative care for terminally ill patients in Iran. The findings indicate that increased attention to palliative care contributes to improved quality of life and facilitates a peaceful and dignified death. Integrating palliative care into healthcare programs can lead to the provision of more humane, patient-centered, and dignity-based care.
Background: In recent years, due to unforeseen global crises, particularly the COVID-19 pandemic, the demand for utilizing Home Health Care centers as an effective alternative to hospital care has increased. Maintaining the functionality of these centers in the face of unpredictable events requires an understanding of the dimensions and components of resilience. This study was conducted with the aim of presenting a model to explain the dimensions and components of resilience in these centers. Methods: The present study was conducted using a multi-grounded theory approach and included systemic integration of theoretical (meta-synthesis of related studies over the past 20 years) and empirical data (interview with specialists) via purposive sampling. Data analysis and coding were performed using the constant comparative approach with MaxQDA 2020 software, and the integration of theoretical and empirical data led to the formulation of the theory. Results:The research findings led to the design of a comprehensive model with four main dimensions: Responsiveness (to ensure service continuity), Prediction (for early threat detection and preventive planning), Growth and Learning (through continuous training and documentation of events), and Monitoring and Value Creation (focusing on data-driven monitoring, feedback, and continuous performance improvement). Conclusion: This study provides a strategic and practical model that transforms resilience from a theoretical concept into an executable operational framework. The final model helps health sector managers and policymakers to understand the key components of resilience better, design more robust infrastructure, and build the necessary capacity to effectively deal with future crises in home health care centers. Applying this model can lead to enhanced service sustainability and guaranteed care quality even under abnormal conditions.
Objective: Value-Based Health Care (VBHC) is an innovative approach to improving the delivery of health services, designed to maximize value for patients. Despite its development in several countries, a shared and comprehensive understanding of the concept has yet to emerge. Accordingly, this study was conducted to identify the key elements of Value-based healthcare and to examine how these elements are implemented in hospitals and health systems across different countries. Information sources and selected methods for study: The study was conducted following Arksey and O’Malley’s six-stage framework for scoping reviews and in accordance with the PRISMA-ScR guidelines. A systematic search of ten databases and two websites was performed in English and Persian for the period 2006 to 2024 and was supplemented by a manual search. Reference management and study screening were carried out using Endnote 2020, resulting in the selection of 70 studies. These studies were subsequently coded in MaxQDA 2020, and the relevant elements were identified and categorized using Braun and Clarke’s six-phase thematic analysis approach. Results: During the thematic analysis phase, 117 codes were identified and organized into 15 elements within eight groups, including defining value in the healthcare delivery system; delivering patient-centered, integrated, comprehensive, and coordinated care; measuring outcomes and costs; integrating care delivery systems; expanding the geographic scope of care; reforming service reimbursement systems; establishing an active health information technology platform; and conducting comprehensive evaluations to improve value. In most countries, greater emphasis had been placed on measuring outcomes and costs and on organizing integrated practice units compared with the other identified elements. Conclusion: Not all of the six elements proposed by Porter and Tizberg have been implemented uniformly in different countries, and attention to other key elements is needed for a more comprehensive conceptualization of Value-Based Health Care. Also, the elements recommended based on the findings of this study in the following three groups can be helpful in developing a theoretical framework for value-based healthcar: defining the concept and determining how to measure value; providing patient-centered, integrated, comprehensive, and coordinated care; and comprehensive evaluation and improvement of value.
Background: With the rapid growth of health data and advances in artificial intelligence and computational modeling, digital twin technology has emerged as a novel approach for simulating and analyzing complex systems. In medicine, the Medical Digital Twin (MDT) enables the creation of dynamic virtual representations of patients or clinical processes, allowing prediction of disease progression, monitoring of patient conditions, and support for clinical decision-making. This study aimed to systematically review the applications, opportunities, and challenges of MDT in healthcare using a systems-oriented perspective. Methods: This study was conducted as a systematic review following the PRISMA guidelines. A comprehensive search was performed in PubMed, Web of Science, Scopus, and Google Scholar using the keywords “Digital Twin” and “Digital Medicine & Health.” A total of 465 records were initially identified. After removing duplicates and screening titles and abstracts, full texts were assessed according to inclusion criteria, including relevance to the research topic, publication in English or Persian, and a focus on the application of digital twin technology in healthcare. Ultimately, 25 studies were included in the final analysis. Results: The findings indicate that MDT serves as a platform for integrating multimodal clinical, genetic, and physiological data and can be applied across a wide range of medical domains. These include hospital management and optimization of clinical processes, design and evaluation of medical devices and surgical procedures, drug discovery and development, personalized medicine, simulation of human physiology, and the design of clinical trials. The analysis also revealed that most studies primarily focus on technological and clinical applications, while comparatively limited attention has been given to systemic dimensions such as the role of digital twins in the health workforce and health system governance. Furthermore, several challenges hinder the broader implementation of MDT, including the integration of heterogeneous data sources, interpretability and generalizability of artificial intelligence models, data security and privacy concerns, and the need for scalable computational infrastructures. Conclusion: The effective development and implementation of medical digital twins require a systems-based approach that extends beyond technological advancement to include integrated data infrastructures, interoperability standards, and robust data governance frameworks. Strengthening interdisciplinary collaboration among clinicians, data scientists, engineers, and policymakers is essential for ensuring the safe and effective use of this technology. Addressing existing technical and infrastructural challenges could enable MDT to become a strategic tool for advancing predictive and personalized medicine and improving managerial decision-making within health systems.
Infection prevention and control programs are critical components of healthcare quality and patient safety. While traditional infection prevention and control approaches have focused primarily on healthcare workers and system-level interventions, there is growing recognition of the vital role that patients and families can play as partners in infection control efforts. However, operationalizing meaningful community participation remains challenging in practice. This letter proposes concrete strategies to effectively engage patients and families in infection prevention and control programs, addressing a significant gap in current implementation frameworks. Community participation in infection prevention and control extends beyond basic education to include active involvement in care processes, decision-making, and quality improvement initiatives. The World Health Organization emphasizes patient engagement as a key strategy for reducing healthcare-associated infections, yet practical guidance remains limited. Drawing from successful models in chronic disease management and patient safety, we propose the following operational strategies: Structured Education and Empowerment Programs: Develop targeted educational materials using clear, accessible language and multiple formats (videos, pictograms, brochures). Implement "Infection Prevention Ambassador" programs where trained patient volunteers educate peers about hand hygiene, respiratory etiquette, and environmental cleanliness. Family-Integrated Care Models: Integrate family members into care teams through structured programs that teach basic infection prevention and control principles. Designate "Family Safety Champions" who partner with healthcare staff to monitor and promote compliance with infection control measures in clinical areas. 3-Digital Engagement Platforms: Utilize mobile applications and patient portals to provide real-time infection prevention and control education, send reminders about hand hygiene and preventive behaviors, and enable patients to report concerns about infection control practices anonymously. 4-Participatory Quality Improvement: Establish patient and family advisory councils specifically focused on infection prevention and control. Include community representatives in infection control committees to provide input on policy development, environmental design, and educational materials. Feedback and Recognition Systems: Implement structured mechanisms for patients and families to provide feedback on infection prevention and control practices. Create recognition programs that acknowledge exemplary patient and family participation in infection prevention activities. Implementation challenges include literacy barriers, cultural resistance to patient involvement in safety matters, and resource constraints. These can be addressed through culturally tailored approaches, staff training on partnership models, and phased implementation starting with pilot units. Operationalizing patient and family community participation in infection prevention and control programs requires moving beyond token involvement to genuine partnership. The strategies outlined above provide a framework for healthcare organizations to systematically engage communities in infection control efforts. Future research should focus on evaluating the impact of these approaches on infection rates, patient satisfaction, and healthcare culture. Policy makers and healthcare leaders should prioritize the development of infrastructure and training programs to support meaningful community participation in infection prevention.
Background: Administrative Process Leadership constitutes a fundamental pillar of efficiency and effectiveness in any organization. It extends beyond routine management, focusing on leading transformation in work procedures. Accordingly, the present study investigated the effect of management stability on administrative process leadership, with the mediating role of professional ethics of staff at North Khorasan University of Medical Sciences within a causal model framework. Methods: The present study, based on its purpose, is an applied research, and in terms of its implementation method, is a descriptive-survey study of the correlational type. The statistical population consisted of 147 staff employees of the headquarters of North Khorasan University of Medical Sciences. From this population, 108 individuals responded to the questionnaires via convenience sampling method. The research tools included researcher-made managemen stability questionnaire, the Standard Genuine Leadership Questionnaire by Avolio et al. (2004), and the Professional ethics Questionnaire by Ghasemzadeh et al. (2014) whose validity was confirmed by the field management's professors and their reliability was estimated by Cronbach's alpha (0.85), (0.87) and (0.87). To analyze the data in descriptive and presumption statistics, two SPSS 24 and AMOS 16 software were used. Results: The findings revealed that the variable of professional ethics mediates the relationship between management stability and administrative process leadership. The indirect path was significant with a p-value of < 0.001. It is also confirmed that management stability has an indirect effect on self-awareness, ethical conduct, and relational transparency. Conclusion: Considering the key role of management stability and its impact on administrative process leadership alongside professional ethics, it seems essential that managers and officials in the Organization of Medical Sciences pay special attention to these variables and, by eliminating obstacles, provide the necessary grounds for institutionalizing ethics and enhancing the professional ethics of employees.
Background: Considering the growing role of medical sciences universities in producing and transferring knowledge, identifying mechanisms to develop performance and innovation is of great importance. This study aimed to examine the impact of knowledge management on strategic human resource functions, job performance, and innovative behavior of employees at Shahid Sadoughi University of Medical Sciences, Yazd. Methods: The research was applied in purpose and descriptive–survey in method. The statistical population consisted of all employees of Shahid Sadoughi University of Medical Sciences in 2024. Using a stratified random sampling method, 290 individuals were selected. Data were collected through standardized questionnaires on knowledge management, strategic human resource functions, job performance, and innovative behavior. The data were analyzed using SPSS 26 and Lisrel10.2 software through Structural Equation Modeling (SEM). Results: The results indicated that knowledge management had a positive and significant relationship with strategic human resource functions. In addition, knowledge management directly influenced both job performance and innovative behavior. Moreover, strategic human resource functions also had significant positive effects on job performance and innovative behavior. Conclusion: The effective integration of knowledge management and strategic human resource functions can simultaneously enhance productivity and innovative behaviors in academic environments. Accordingly, medical universities should invest in knowledge management infrastructures and design knowledge-based human resource policies to improve performance and support innovation.
Background: Effective communication between nurses and patients from diverse cultural backgrounds is vital for quality care. This study investigates the relationship between cultural competence and communication skills among nursing students at Shahid Sadoughi University of Medical Sciences in Yazd. Methods: This was a cross-sectional, analytical study conducted on all clinical-stage nursing students at Shahid Sadoughi University of Medical Sciences in Yazd using a census sampling method during the Solar Hijri year 2024. Data collection tools; data were collected using the communication skills questionnaire developed by Javaher et al. and the cultural competence questionnaire developed by Naghizadeh et al. Data analysis was performed using SPSS 27, employing descriptive statistics (median, mean, standard deviation) and inferential statistics, including independent-samples t-tests, Spearman’s correlation coefficient, Analysis of Variance (ANOVA), and Liner regression analysis. Results: The analysis showed that the majority of students (63.3 %) demonstrated good communication skills. The highest mean score within communication skills belonged to the component of ‘Respect for the Patient/Client’, while the lowest was for the component of ‘Unconditional Acceptance of the Patient/Client’. Most of the dimensions of cultural competence had the median of 4, and the only dimension with a relatively lower function belonged to habits, behavior, and speaking. Moreover, 94.2 % of the students had a higher than average score in cultural competence. A positive and statistically significant correlation was found between students’ communication skills scores and their cultural competence scores (r = 0.221 , p < 0.001 ). Furthermore, for every one-unit increase in the cultural competence score, the communication skills score was found to increase by an average of 0.147 units. Conclusion: Based on the study findings, developing educational programs aimed at increasing nursing students’ knowledge of health behaviors, beliefs, and physiological differences, alongside strengthening their skills in the unconditional acceptance of patients, could lead to improved quality of nurse-patient communication and a more effective delivery of patient care.
Background: Neglecting the optimal consumption of energy carriers not only increases hospital costs but also leads to the waste of energy resources. This study was conducted to investigate the consumption trends of energy carriers in a super-specialized hospital and to provide optimization strategies. Methods: This mixed-methods (quantitative-qualitative) study was conducted in three phases. In the first phase, time-series data of water, gas, and electricity consumption over a ten-year period (2011–2021) were collected from the studied hospital. In the second phase, the relationship between hospital performance indicators and energy carriers consumption was examined using the SARIMAX regression model. In the third phase, strategies for improving energy efficiency were identified through a review of previous studies and a survey of experts. Results: The ten-year average consumption of water, electricity, and gas per active bed was 33.76 ± 1.63 cubic meters, 1919.66 ± 243.39 kilowatts, and 341.46 ± 38.96 cubic meters, respectively. Indicators such as occupied bed days, bed turnover interval, and average length of stay had a significant impact on water consumption. Electricity consumption was significantly influenced by the number of surgeries, and gas consumption was significantly influenced by the number of surgeries and intensive care unit patients. Water consumption was significantly higher in autumn, electricity in summer, and gas in winter compared to other seasons. Thirty-three optimization strategies were categorized into five general areas, including modification of electrical systems, cooling and heating systems, water resource management, optimization of the building structure, and energy policy-making. Conclusion: The consumption of energy carriers in this hospital was primarily subject to seasonal variations. Optimizing the building structure in terms of thermal insulation and formulating effective energy policies can significantly prevent energy waste.
The hospital physical environment extends beyond a mere setting for healthcare delivery; it constitutes a critical component of the patient experience and influences perceptions of care quality. Evidence-based environmental design including optimization of lighting, spatial layout, and wayfinding has been shown to reduce patient stress, enhance perceived safety and autonomy, and improve overall patient satisfaction and loyalty. In addition, environmental cues implicitly communicate organizational values, operational standards, and patient-centeredness, thereby contributing to the hospital’s institutional image. This review synthesizes current research on hospital environmental design to elucidate its impact on patient experience and highlights its role as an implicit, nonverbal factor influencing patient perceptions and engagement
Background: Today, organizational commitment is regarded as one of the most important motivational issues in organizations. Organizational commitment refers to the extent of employees’ psychological attachment, loyalty, and willingness to invest effort on behalf of their organization. This construct comprises three primary dimensions: acceptance of organizational values and goals (affective commitment), tendency to contribute to the organization (normative commitment), and a strong desire to remain with the organization (continuance commitment). Accordingly, the present study aims to examine the effects of different dimensions of organizational trust on the three core components of organizational commitment among employees of Mortaz Hospital in Yazd City, while considering the moderating role of national identity. Methods: This study adopts a descriptive–survey design and is classified as applied research in terms of its objective. The statistical population comprises 400 employees (including managers and professional staff) of Mortaz Hospital in Yazd, from whom a sample of 196 respondents was determined using Cochran’s formula; they were selected through simple random sampling. Data were collected using a standardized questionnaire consisting of 46 items, the validity and reliability of which were confirmed at acceptable levels. Data analysis was conducted using structural equation modeling (SEM), employing Smart PLS 3 and SPSS 21 software packages. Model fit was subsequently assessed using established goodness-of-fit indices. Results: The findings indicate a significant and positive effect of employees’ perceived organizational trust at Mortaz Hospital in Yazd on all three dimensions of: affective commitment, continuance commitment, and normative commitment. Conclusion: The moderating role of national identity in the relationship between organizational trust dimensions and the three components of affective, continuance, and normative commitment—among employees of Mortaz Hospital in Yazd was not supported. This finding suggests that, within such organizational contexts, internal organizational factors like trust play a more prominent role than cultural or social characteristics in shaping organizational commitment. Consequently, enhancing organizational trust may serve as a more effective strategy for improving employee performance and reducing turnover rates.
Background: Generational differences in today's work environments, especially in hospitals, can affect organizational interactions, employee motivation, and the effectiveness of health services. The present research was conducted with the aim of identifying and explaining effective strategies in implementing multi-generational gravity in hospitals of Hamadan University of Medical Sciences to provide a practical framework for managing generational synergy. Methods: This study was conducted as a qualitative research using a content analysis approach. The target population consisted of senior and middle managers of hospitals affiliated with Hamadan University of Medical Sciences. Participants were selected through purposive sampling, and the sample size was determined based on the data saturation principle (30 individuals). Data were collected through semi-structured interviews and, after verbatim transcription, analyzed using qualitative content analysis. The validity and reliability of the data were assessed based on Lincoln and Guba’s criteria. Results: The results led to the identification of six main themes, including focus on motivation and reward, flexibility and adaptability to changes, intergenerational guidance and adaptive structure, organizational learning and knowledge sharing, communication networks and participation-oriented and organizational justice and coordination. These strategies were recognized as key components in forming multi-generational gravity in hospitals. Conclusion: The results of this research led to the identification of strategies that can be a theoretical basis for designing and formulating a structured approach in implementing multi-generational gravity in the future. The simultaneous application of these strategies can strengthen the interaction between generations, increase productivity, improve the quality of treatment services and create justice in resource allocation. The presented framework can be a basis for human resources managers' policy-making and designing organizational development programs in hospitals and provide the basis for realizing generational synergy and improving the performance of the health system.
Background: Health system governance, as one of the most critical domains of public health management, plays a decisive role in enhancing efficiency, transparency, accountability, and inter-institutional coordination. In many countries, the inclusion of civil institutions within the framework of health governance has been introduced as an effective mechanism for improving the legitimacy and effectiveness of decision-making processes. Despite the growing body of research on health governance, the specific role of civil institutions within an indigenous model has received limited scholarly attention. Therefore, the present study aimed to design a model of health system governance with an emphasis on civil institutions. Methods: This study employed a mixed-methods approach using an exploratory sequential design, conducted between October 2024 and June 2025, in three stages. In the first stage, the Fuzzy Delphi Technique was applied through three iterative rounds to identify the principal dimensions and key components. The statistical population consisted of 15 experts from the fields of health and civil society, including senior policymakers, Ministry of Health consultants, NGO managers, senior experts in health insurance organizations, and representatives of patient associations, particularly support groups for individuals with chronic conditions. Participants were selected through the snowball sampling method. Data collection instruments included a Delphi questionnaire, an expertise checklist, and a researcher-developed questionnaire comprising five dimensions and 24 components in the quantitative phase. A stratified random sampling method was employed, and sample size included 386 individuals. Data were analyzed using structural equation modeling (SEM), path analysis, and confirmatory factor analysis (CFA) via SmartPLS 4 software. Results: The results revealed that health system governance, focusing on civil institutions, consists of five major dimensions: network governance, collaboration and participation, financial resource management, transparent governance, and monitoring and evaluation. Furthermore, all components of the model showed statistically significant relationships with the main construct, with network governance demonstrating the highest factor loading, and public participation being identified as its key component. Conclusion: According to the findings, civil-society–based health governance can substantially enhance transparency, improve efficiency, and strengthen inter-organizational collaboration. The novelty of this study lies in its emphasis on the role of civil institutions in health governance and the integrated use of the Fuzzy Delphi technique and structural equation modeling. It is recommended that policymakers promote the institutional position of civil organizations, increase the transparency of financial mechanisms, and establish continuous feedback systems to create the necessary conditions for achieving excellent health governance.
Background: A Digital Twin (DT) is a digital replica of a physical object, person, system, or process, contextualized in a digital version of its environment. DTs can serve as a powerful tool to optimize processes, enhance the efficiency of healthcare systems, and create new opportunities for improving care delivery. Accordingly, this study aims to provide a comprehensive insight into DT technology and to examine its applications, opportunities, and challenges in the healthcare domain. Methods: In this study, articles were retrieved by searching the keywords Digital Twin Technology, Health System, Digital Health, and Digital Technology. Relevant studies published between 2020 and 2025 were collected from reputable databases including PubMed, Web of Science, Google Scholar, and Scopus. Out of 87 initially collected articles, 21 were included in this review and analyzed. Finally, following the PRISMA framework, a systematic review of the existing literature was conducted. Results: The results showed that digital twin technology can play a role in the areas of personalized medicine, remote monitoring, precision medicine, predictive analytics, preventive interventions, clinical operations optimization, training, simulation, and optimization of hospital management and resources. Conclusion: Despite the identification of various applications of digital twins in the health system, this technology is still an emerging technology in health systems. Health policymakers, especially in the education sector, can provide a suitable platform for learning educational courses and facilitating medical service processes by investing in the implementation of digital twin technology.
Background: Primary health care services’ resilience in managing pandemics can play an important role in the management of health centers Since health centers, by utilizing multipurpose infrastructure, high flexibility, and effective coordination, have been able to play a vital role in controlling the crisis and reducing pressure on hospitals, therefore; the present study has identified successful experiences in primary health care’s resilience in health centers. Methods: The present study was conducted with a qualitative approach in 2025. The study’s sample size was purposefully selected from 16 senior, middle, operational managers and employees of health and treatment centers and health centers of towns affiliated with Shiraz University of Medical Sciences who had experienced working during the pandemic. Data collection was carried out through semi-structured interviews. Then, the data were analyzed based on the Graniham-Lodman method and using MaxQDA 2020 software. Results: According to the participants' viewpoints, six main themes were identified in successful experiences of primary health care services’ resilience, which include human factors, physical and infrastructure, management, public informing and participation, strengthening of virtual infrastructure and education, planning and policy-making. From the participants' perspective, the most important factor related to strengthening of virtual infrastructure and education was identified. Conclusion: According to the results of this study, successful experiences of primary health care services’ resilience in managing pandemics show that health centers have been able to play an important role in controlling the disease and maintaining the continuity of services by adopting comprehensive and flexible solutions such as strengthening physical infrastructure, management factors, and rational and timely planning.
Background: The Fourth Industrial Revolution, with the integration of physical, digital, and biological technologies, has confronted global healthcare systems with numerous challenges and opportunities. The objective of this research is to design a readiness model for healthcare systems to enter the fourth generation of the industry. Methods: This study was conducted using a mixed methods (qualitative-quantitative) approach in an exploratory sequential design. In the qualitative section, 39 relevant articles (2016-2025) were content analyzed. Then, using the fuzzy Delphi method with the participation of 12 experts, the dimensions and components of the model were refined through three survey rounds. In the quantitative section, 245 healthcare system experts and specialists were selected using convenience sampling. The data collection instrument was a researcher-made questionnaire with confirmed validity and reliability. Data analysis was performed using confirmatory factor analysis. Results: The final healthcare system readiness model includes 7 dimensions and 48 components. The identified dimensions, in order of importance, are: Collaboration and integration, smart processes and services, technology and digital infrastructure, data management and artificial intelligence, governance and policy making, security and privacy, and human resources and skills. The resulting model has appropriate fit and all factor loadings were significant. The model was able to explain 93 percent of the variations in the healthcare system readiness variable. Conclusion: Healthcare system readiness for entering the fourth generation of industry requires simultaneous attention to various technical, human, procedural, data management, governance, security, and especially collaboration and integration dimensions.
The health facility environment is more than a backdrop to care; it is a key contributor to the quality of health care as perceived by patients. Evidence-based design—through lighting, layout, and wayfinding—reduces stress, enhances safety, and boosts satisfaction. These environmental cues also act as subtle forms of marketing of health services, signaling organizational values and patient-centeredness. This review highlights how hospital design shapes patient experience and influences nonverbal perceptions of care.
Background: Positive thinking is one of the healthy patterns in society. Positive thinking managers provide the basis for the growth of their organization by providing a clear horizon and increasing the motivation of their employees. The purpose of this research was to investigate the effect of positive thinking on job performance with the mediation of social responsibility in employees of the health system. Methods: The descriptive-correlation research method based on the structural equation modeling approach was used. The target population of the research was all the health employees of Zahedan University of Medical Sciences, totalling 4839 subjects. The sample size was estimated to be 367 subjects based on Singh and Masuku's sample size table. A stratified sampling method was used according to the volume (according to gender) and convenience sampling. Three questionnaires of positive thinking, social responsibility and job performance were used to collect data. The reliability of the questionnaires was obtained using Cronbach's test as 0.94, 0.78 and 0.86 respectively. The obtained data were analyzed using SPSS 25 and AMOS 24 software by structural equation modeling method. Results: The results showed that positive thinking has a positive and significant effect on job performance in the health system. Also, responsibility had a positive and significant effect on job performance in the health system. In addition, the mediating effect of responsibility in the relationship between positive thinking and job performance in the health system was positive and direct. Conclusion: Managers of healthcare organizations should emphasize creating a work environment based on positivity and social responsibility, and use it as a strategic tool to improve employee job performance, thereby helping to improve the quality of health programs.
Background: Examining the effects of environmental pollution emissions, the misery index, the food index, the urbanization rate, and household final consumption on life expectancy in Iran can provide valuable insights for policymakers. Therefore, this study investigates the impacts of these indicators. Methods: In the present study, with the approach of health economics, the effect of the variables of emission of environmental pollutants, especially CO2 emission, misery index, food index, urbanization rate and household final consumption on the life expectancy of Iranians was estimated using Markov switching regression in in Oxmetrics software for the period 1990 to 2021. Life expectancy was modeled through two regimes: regime1, representing high life expectancy, and regime 2, representing low life expectancy Results: The results indicated that CO2 emission variable in both regimes has had a negative and significant effect on life expectancy. In regime 1, there is a negative and significant relationship between the variable of the misery index and life expectancy, which is estimated to be negative and insignificant in regime 2. The food index has a positive effect on life expectancy in both regimes.. In a way, this relationship has been estimated to be significant in regime 1 and non-significant in regime 2. The observed relationship between the urbanization rate variable is negative and significant in regime 1 and positive and significant in regime two. Therefore, it can be said that it had an asymmetric effect on life expectancy. Household final consumption in both regimes has had a positive and significant effect on the life expectancy of Iranians, and its coefficient is higher in regime 1 than regime 2. Conclusion: Based on the findings of this study, the following policy recommendations are proposed: controlling inflation and reducing unemployment, strengthening social support programs, and protecting the environment. Therefore, policymakers are encouraged to adopt a comprehensive and integrated approach that addresses both economic and environmental dimensions in order to ensure sustainable health and well-being for future generations.
Objective: University technology transfer and commercialization are key pillars of the knowledge-based economy; however, their success is not limited to organizational and economic structures. Despite numerous studies, the role of social and cultural factors has not been comprehensively addressed. The aim of this study is to identify and analyze the social and cultural dimensions influencing this process through a review approach and to provide an integrated picture of the current situation. Information sources and selected methods for study: This review study was conducted based on non-systematic review method and the PRISMA guidelines. A systematic search was carried out in Scopus, Web of Science, and Google Scholar using defined keywords, with a five-year time limit for English articles and a ten-year limit for Persian articles. Out of 347 initially retrieved studies, after multi-stage screenings (removing duplicates, reviewing titles, abstracts, and full texts), 22 articles were finally selected for analysis. Results: A review of the literature indicates that various social factors influence the transfer and commercialization of university technology. Social trust, as the primary foundation for the establishment of sustainable collaboration between universities and industry, plays a fundamental role. The culture and organizational structure of universities can also act either as facilitators or as obstacles along the path of innovation. Furthermore, the institutional environment and the capabilities of technology transfer offices are of significance in reducing barriers and creating effective linkages between academia and industry. Ultimately, university policymaking is recognized as the principal guiding factor in this process. Conclusion: The commercialization of university technology is not merely an economic process; rather, it requires the synergy of social, cultural, and institutional factors. Success along this path depends on trust between universities and industry, flexible organizational structures, and capable technology transfer offices. At the policy-making level, an integrated and forward-looking approach can pave the way for the sustainable development of innovation ecosystems.
