[Outsourcing of hospitals services: lessons learned from the experience]

Introduction: Outsourcing of hospital care was widely used after the implementation of the Third Socio-economic Development Plan in 2000. A return in policy occurred since 2006. Contracts between private sector and hospitals were cancelled, and the Ministry of Health employed the private sector staff. Outsourcing did not achieve its primary goals of downsizing health sector and improving efficiency. This study aimed to describe the lessons learned from the experience

Method: We conducted a qualitative study. Data were gathered by documents analysis and observations of the hospitals of medical university in Tehran and ten interviews with stakeholders and key informed persons. These people include hospital managers; headquarter experts, contractors, and hospital staff. "Framework Analysis" is used to understand and analyze data

Results: We classified the factors related to unsuccessfulness of outsourcing into four categories [themes] and eight subcategories [sub-themes]: 1- Factors related to employers [hospitals] including weakness in designing and monitoring contracts and hospital managers' interference with the activities of the other side of the contracts [private administration] 2- Factors related to private firms including low management knowledge and skills and pursuing short time benefits 3- Factor related to workers including workers protests 4- Factors related to policy space [upper level than hospital] including the gap between work status of formal employees and private sector workers and problems related to management

Conclusion: Unsuccessfulness of outsourcing was related to factors resulted from weak governmental hospital management system. In fact, private sector abilities and efficiency were restricted by weak hospital management potentials in public hospitals. Performing reforms in public management system is essential for successfulness of outsourcing

[Zahabi's style in the book "al Teb al Nabavy"]

From the antiquity, Muslim scholars have always been interested in working on the Hadiths[talks] of the Prophet Mohammad [PBUH]. Since then, the hadiths, in all fields, especially in fields of health and medicine, have attracted the attention of many scholars, leading to the publication of a number of books on Hadiths as well as the collection of Hadiths, including those related to health. The books, whether having the title "Prophetic medicine" or not, contain issues such as Phlebotomy. This study has analyzed one of these books entitled Al-teb Al-nabavyof Shamsuddin Zahabi in terms of its composition, size and style. The present study, following the descriptive-analytic method, has shown that the writer of this book has been quite aware of the preceding books written in this field and has attempted to use and include the medical knowledge of other nations in his book. The writer has utilized verses and poems as well as narratives and stories. However, the dominant style of the writer is employing the narrative style and story- telling

Imputation in missing not at random SNPs data using EM algorithm

The relation between single nucleotide polymorphisms [SNPs] and some diseases has been concerned by many researchers. Also the missing SNPs are quite common in genetic association studies. Hence, this article investigates the relation between existing SNPs in DNMT1 of human chromosome 19 with colorectal cancer. This article aims is to presents an imputation method for missing SNPs not at random. In this case-control study, 100 patients suffering from colorectal cancer consulting with the Research Institute for Gastroenterology and Liver Disease of Shahid Beheshti University of Medical Sciences were considered as the case group and 100 other patients consulting with the same research institute were considered as the control group and the genetic test was applied in order to identify the genotype of the 6 SNPs of the DNMT1 of chromosom 19 for all the patients under investigation. The obtained data were analyzed using logistic regression, then a fraction of the data was eliminated both at random and not at random and the imputation was done through the EM algorithm and the logistic regression coefficients variation before and after the imputation was compared. The results of this study implied that in both methods, at random and not at random missing SNPs, the estimation of the logistic regression coefficients after the imputation through EM algorithm has a greater correspondence to the results obtained from the complete data in comparison with the method of eliminating the missing values