Views of health system experts on macro factors of induced demand

The probability and severity of effects of induced demand are because of the interaction between a range of factors that can affect physicians and patients behavior. It is also affected by the laws of the markets and organizational arrangements for medical services. This article studies major factors that affect the phenomenon of induced demand with the use of experts' experiences of the Isfahan University of Medical Sciences. The research is applied a qualitative method. Semi-structured interview was used for data generation. Participants in this study were people who had been informed in this regard and had to be experienced and were known as experts. Purposive sampling was done for data saturation. Seventeen people were interviewed and criteria such as data "reliability of information" and "stability" were considered. The anonymity of the interviewees was preserved. The data are transcribed, categorized and then used the thematic analysis. In this study, thematic analysis was conducted, and 77 sub-themes and 3 themes were extracted respectively. The three main themes include infrastructural factors, social factors, and organizational structural factors affecting induced demand. Each of these also has some sub-themes. Results of this research present a framework for analyzing the major causes of induced demand. The causes identified here include complexity of medicine, information mismatch between service providers and consumers, clinical uncertainty, false beliefs, advertisements, insufficient supervision, scarcity of clinical guidelines, weakness of education system, and ignorance of medical ethics. These findings help policymakers to investigate the induced demand phenomenon clear-sighted

[ relationship between metacognitive awareness of reading strategies and students' academic status in Isfahan University of medical sciences]

Introduction: Learning and studying are considered among the most basic processes of every educational system. One of the most essential factor in determining learning behaviours, is metacognitive awareness and perception. This study was performed to determine the relationship between students' metacognitive awareness of reading strategies and their academic status

Methods: In a descriptive correlational study, 191 students were selected through stratified random sampling out of total students of schools of Isfahan University of Medical Sciences in 2008-2009 academic years. Metacognitive Awareness of Reading Strategies Inventory [MARSI] was distributed among study sample. Academic status of students was defined based on their grand point average. Data was analyzed by SPSS version 10 software using Pearson correlation, independent t, and variance analysis tests

Results: The mean and standard deviation of metacognitive awareness score of students was 66.62 +/- 14.8. The mean score of metacognitive awareness showed a significant correlation with students' score of academic status meaning that students with average score higher that 17, had a significantly higher metacognitive awareness. Metacognitive awareness showed no significant relationship with variables of age, gender, and residence place. But, there was a significant relationship with academic level, so as MS students had higher metacognition score compared to that of PhD students

Conclusion: Metacognitive awareness and knowledge may lead to a more effective learning and studying in different courses. Considering the fact that metacognitive awareness and knowledge could be learnt both in family or educational settings in all levels of learners, it is recommended that educational and cultural institutions develop a comprehensive and detailed plan in this regard