Journal of

---

Abstract Background: Hospitals are the most important health organization and consume major part of health system`s budgets. Downsizing is one of the strategies used for providing suitable services in hospitals. This study was conducted to do a systematic search for hospital downsizing methods and theirs consequences in order to choose suitable method for Iran. Materials & Methods: Related Articles were identified by systematic search on databases such as Medlib, SID, Pub Med, Science Direct and Google Scholar meta search engine using keywords like Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merger, Hospital Reorganization and Persian equivalents. 379 articles were extracted and refined step by step. Finally, 25 articles were selected according to study`s goals. Results: The identified downsizing methods included reducing the number of employees and hospital beds, outsourcing, merging hospital wards and combination of fore mentioned methods. The most important consequences of using these methods were: cost, revenue, outpatient visits and surgery, length of stay and hospital admission rates, mortality rate, stakeholder satisfaction, workload of employees mental health and absenteeism . Conclusion: study results indicated that different methods of downsizing are used for providing suitable services and decreasing costs in hospitals. Using Merger and outsourcing are suggested among different methods in hospital wards according to current situation of our country.

---

Abstract Background: Human resource management has a critical role in organizations and organization culture is an outcome of human resource management performance. One of the dimensions of the organizational culture is power distance. This study aims to investigate the attitude of employees of selected hospitals of Tehran University of medical sciences towards the power distance in the organization and its consequences. Materials and Method: This is a cross sectional study with a descriptive research design conducted in a sample of 306 employees and managers from Tehran University of Medical Sciences hospitals located in Tehran, Iran. A distinctive questionnaire for each group was developed, distributed and collected as a main procedure to gather data. Data were analyzed using SPSS 16. Results: Study results indicates that there is a positive and significant relationship between power distance and employee participation, organizational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities in the level of 95%(p value<0.05). The moderated multiple regression results also supported the hypothesis that managers’ attitude towards power distance had a significant relationship with their manner with the employees, noticing their qualifications and abilities, giving them independence and responsibility and supporting them in their role. Conclusion: A limited power distance in an organization will result in more committed and satisfied employees with positive perception toward justice in the organizational interactions and ready to accept job responsibilities and movement toward the organization objectives.

---

Background: The increasing prevalence of Covid 19 virus in the world has various consequences for people involved in the treatment process of patients with this virus. Accordingly, the main purpose of this study was to identify and prioritize the psychological consequences of Covid 19 virus in nurses.
Materials and Methods: This study is based on the applied purpose and in terms of how to collect data in the field of descriptive survey studies. The analysis approach in this study is mixed and a combination of qualitative and quantitative methods. The statistical population of this study consists of nursing professors and medical specialists of Lorestan University of Medical Sciences. Using purposive sampling method and according to the principle of theoretical saturation, 14 professors and specialists were included as the research sample. The statistical population of the quantitative ward also included the managers of hospitals providing services to coronary patients in Lorestan province, which were selected as a research sample by 35 people using non-probability sampling method. Identification of psychological consequences was performed using analysis of interview data with Atlas.ti software and prioritization of consequences using a triangular fuzzy method.
Results: Analysis of interview data led to the identification of 16 psychological consequences affecting nurses. Prioritization of these factors showed that depression, decreased concentration and apathy are the most important psychological consequences of Covid virus 19.
Conclusion: Developing supportive strategies to maintain the health of nurses should be a priority in future plans, and a separate part of the annual hospital costs should be allocated to this important matter.

---

Background: Corona virus is a phenomenon that has faced the world with a crisis due to its rapid spread and uncontrollable nature. Although this crisis is only related to the medicine and health system, it is a multidimensional phenomenon whose effects and consequences can be observed and tracked in various economic, social, and political fields. The purpose of this article is to investigate the results of the Corona Virus on the environment.
Materials & Methods: The current study is a scoping review article that was performed based on the collection of information from articles published in the databases ScienceDirect, Web of Science, Google Scholar, and PubMed in the period from 2019 to 2022 with the aim of investigating the consequences of the Corona crisis on the environment.
Results: The findings of this research illustrate that the corona virus crisis and the quarantine conditions have brought many consequences for the environment. On the one hand, as a result of the cessation of many human activities, there is a significant reduction in the emission of pollutants, including greenhouse gases, and on the other hand, waste, especially medical and plastic waste, has increased.
Conclusion: Despite the positive effects of Covid-19 on environmental factors, its short-term and long-term negative effects are obvious. In addition, it seems that the economic activity of country will intensify after Corona, and therefore, with a comprehensive analysis of the effects of Covid-19 on several sectors, significant proceedings should be taken in this field.