Identification of Conflict-of-Interest Management Strategies in Iranian Healthcare System Comparing with Selected Countries: A Scoping Review

Hossein Dargahi

Background and Aim: The occurrence of conflict of interest in the Iranian health system has a negative impact on the provision of efficient and effective health care and services to patients, the training and education of students in medical sciences. Despite the efforts made in the country’s health system to manage conflict of interest, this phenomenon is currently observed through various factors, including the inefficiency of the financial structure, lack of transparency, and the lack of an integrated health information system in Iran.
Materials and Methods: The present scoping review study that aimed to identify and determine conflict of interest management strategies in the Iranian health system in comparison with selected countries and to select appropriate strategies in 2024-2025 using the Arksey and O’Malley guidelines. All relevant articles and resources from 2007 to 2024 were extracted from national and international databases by observing the entry and exit criteria and by selecting Persian and English keywords. After screening steps using Prisma flowchart, 23 studies in English and Persian language from international and national databases, were analyzed.
Results: Findings from 17 international studies—most of which were conducted in the United States—along with 6 domestic articles, showed main strategies of Iranian conflict of interest which included participation, transparency, legal oversight, processes reform, restructuring and reorganization. Although, using collective campaigns for correction of process behaviors and decisions, definition of ethical ethic codes, and standardization may help implementation of these strategies. Also, the most common cause of conflict of interest in the health system is individual rather than organizational, which requires regulation, the use of legislative levers, and the transparency of financial relations in the health system.
Conclusion: Accurate identification of potential examples of conflict of interests among the agents of health care system by implementing information clarification, and using modern procedures may decrease the challenges in formulating and implementing strategies of conflict of interests among Iranian health care system. Although benchmarking from successful countries will be helpful in these countries. The implementation of these recommendations may face challenges within Iranian society, including resistance from certain professional groups, a lack of financial and technical resources, and the complexity and specific conditions of the health system. Therefore, a step-by-step approach to implementing policy recommendations for managing conflicts of interest in the health system should be considered.

Self-Care in War-Injured Patients Immediately after Injury: A Narrative Review

Afzzal Shamsi

Background and Aim: War is an inseparable part of human history that brings many problems. Self-care plays a major role in reducing complications and mortality. The purpose of this study is to “familiarize war casualties with self-care immediately after injury.”
Materials and Methods: In this study, a narrative review of library resources and searching of internal and external databases related to the purpose of the study was used. Then, articles, books, dissertations, and other scientific resources related to the subject were examined.
Results: In wartime conditions, a set of clinical problems leads to the deterioration of casualties’ conditions. One of the most important factors influencing self-care during wars is having sufficient awareness and knowledge in first aid, which requires the development of integrated approaches for first aid content. Other factors include identifying and eliminating threatening factors; quickly stopping the damaging agent; immediate contact with rescuers; maintaining an open airway; general self-assessment and temporary control of external bleeding; more thorough examination to identify signs of injury and life-threatening conditions; monitoring status (consciousness, breathing, circulation) and psychological self-support; and ambulance transfer to medical centers.
Conclusion: To have a successful and effective self-care program for war casualties, first aid training specific to war crises should be provided to members of the community. Control of extensive bleeding, airway protection, wound dressing, pain control, and psychological self-support should be included in self-care programs. Accordingly, basic planning by relevant authorities, especially the health system, is recommended to increase the level of awareness and knowledge of self-care among members of the community in war crises.

Payavard Salamat

Identification of Conflict-of-Interest Management Strategies in Iranian Healthcare System Comparing with Selected Countries: A Scoping Review

Self-Care in War-Injured Patients Immediately after Injury: A Narrative Review