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Experts' Analysis Of The Strengths Of Health System Financial Management Reform In The First Phase: A Qualitative Approach 
Masoud Abolhallaj, Peivand Bastani, Maryam Ramezanian, Javad Jafari,
Volume 6, Issue 6 (17 2013)
Abstract

Background and Aim: Financial reforms in the healthcare system go back to 1384. This study aims to analyze and summarize the most important strengths of implementing the first phase of the reform in units affiliated with the Ministry of Health and Medical Education from the experts' point of view at middle and operational levels.

Materials and Methods: In this qualitative research study, 15 coaches of the new financial health management reform along with 8 financial managers of Medical Universities were selected purposefully to participate in expert panels to be interviewed. Data were saturated following the interviews. The data analysis process was conducted applying Kruger method with one of the researchers having no conflicts of interest with the topic.

Results: Human resources enabling, effective trainings, integrated information system, dynamic culture, structural appropriateness, efficiency and effectiveness, and perfect facilities were the seven themes extracted from the content analysis of the interviews each theme was further divided into some sub-themes.

Conclusion: Recognition of the strengths of the first phase of health system's financial management reform may help bring about the possibility of more correct and exact planning to direct these changes and maintain the achievements as well as designing a long-term horizon and determining an ideal vision for the next phases of the reform.


Investigating the Association between Aquaporin-4 and Osteoporosis in Patients with Neuromyelitis Optica Spectrum Disorders
Zhila Maghbooli, Solaleh Emamgholipour, Majid Ramezani, Mohammad Ali Sahraian,
Volume 19, Issue 1 (4-2025)
Abstract
Background and Aim: Neuromyelitis Optica Spectrum Disorders (NMOSD) is an uncommon disorder of the central nervous system mainly affecting the optic nerves and spinal cord. NMOSD is associated with IgG antibody binding to aquaporin-4 (AQP4) that triggers astrocyte and axon loss. Aquaporin 4 is also expressed skeletally and affects bioenergetic regulation pathways and calcium (Ca²⁺) translocations.
The aim of this study was the association between AQP4 and bone loss in NMOSD patients.
Material and Methods: In this study, 32 NMOSD patients were enrolled as the case group, and 37 age-matched individuals without a history of neurological disorders or other acute or chronic conditions served as the control group. Patients with NMOSD were diagnosed based on the criteria established by Wingerchuk et al. Dual x-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) at three bone sites: the total hip, femoral neck, and spinal lumbar vertebrae (L1-L4). Bone status was defined based on the Z-score in these regions, with a Z-score less than -2 classified as severe bone loss.
Results: Among patients with NMOSD, 15.6% exhibited severe bone densitometry loss in at least one area (total hip, femoral neck, or spine), compared to 5.4% in the control group (P=0.01). Bone densitometry results showed that the Z-score in the femoral neck and hip regions was significantly lower in individuals with NMOSD compared to the control group (P<0.05). In NMOSD patients, the Z-score in the femoral neck and hip regions was considerably lower in aquaporin-4 positive patients compared to the control group (P<0.05). In the regression model, after adjusting for age, sex, body mass index, and history of vitamin D supplementation, patients with aquaporin-4 had lower bone mass (P=0.02).
Conclusion: The study results indicate that aquaporin-4 may play a mediating role in the bone status of patients with NMOSD.

 
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