BACKGROUND: Work relative value unit (wRVU) is a tool for assessing surgeons' performance, compensation, and productivity. It appears that wRVU for cardiovascular procedures does not consider complexity and its value for lengthy operations is low. The aim of the study is to determine wRVU for cardiovascular procedures in Iran according to the proposed approach. MATTERIALS AND METHODS: This study was conducted as a mixed method in teaching hospitals in Tabriz in the period of September 2020 to December 2021. According to Hospital Information System and expert opinions, six procedures in cardiovascular surgery were included in the study. They were compared with 18 procedures in neurosurgery, orthopedics, and otorhinolaryngology in terms of the operation time and wRVU/min. Then, we calculated new wRVUs for the selected procedures based on surgeons' opinions, time measurements, and anesthetists' points of view by content analysis in qualitative and statistical analysis in quantitative parts. RESULTS: Among the six cardiac procedures, the wRVU for five was under-estimated. The wRVU/min value ranged from 0/28 to 1/15 in the studied procedures. Findings demonstrate no significant relationship between the length of operations and the wRVU announced by the Ministry of Health and Medical Education (P value >0/05). Compared to studied procedures in four specialties, thoracoabdominal aortic aneurysm repair has the longest surgery time at 417 minutes. According to anesthesiologists, cardiovascular,orthopedics,ear, nose, and tongue,and neurosurgery specialties obtained 4/2, 2/9, 2/8, and 4, respectively, in terms of surgery duration, complexity, risk, and physical effort. CONCLUSION: Despite policymakers' attempts to bring justice to payments, it seems that there has been little progress in paying cardiovascular surgeons. Improper payment to cardiovascular surgeons will affect the future of the workforce in this specialty. Today, the need to reconsider the wRVUs in heart specialty is felt more than before.

One who undertakes is obligated to discharging his commitment and must discharge his debt with regard to obligee.We certainly can say that nowadays, compensation is the most common reason for lack of commitment. For this reason, various religious and civil schools have studied it, besides fulfillment of one's promises, sacrifice and succession commitment.This category, furthermore, put under comparative survey sense of adjustment and various kinds of it.It intends in this way to show searching jurisprudence and whatever distinguished Imamiyyah jurists have left in their written works.

Aims: The current study aimed to investigate and assess how the abilities and rewards of Infection Prevention and Control (IPC) Committee member affect their performance, with affective commitment acting as an intermediary factor. Instrument & Methods: This explanatory research was done on 447 members of the IPC Committee of Southeast Sulawesi. Data collection was conducted through the distribution of questionnaires to the respondents. The data analysis technique employed was structural equation modeling least squares (SEM-PLS). Findings: The results of the data analysis revealed that employee competence, which encompasses knowledge, soft skills, hard skills, and attitudes, as well as compensation, exhibited a substantial beneficial impact on both affective commitment and the performance of committee members. Additionally, affective commitment was found to have a significant positive impact on performance. Conclusion: Affective commitment plays a mediating role in the connection between skill, rewards, and performance of committee members.

Background and Objective: Multiple sclerosis (MS) is a chronic, progressive and degenerative myelin sheath of the central nervous system. Manifestation and side effect of this disease drastically impress patient’s body image and destruct self concept. The objective of the implementation of this study was to evaluate the effect of Orem self- care program on multiple sclerosis patients’ self concept.Materials and Methods: This quesi-experimental study was done on 34 MS patients referred to Ayatollah Kashani hospital in Shahrekord – Iran, during 2008. The patients were selected by convenience sampling. 8 sessions educational program based on patients needs and Orem self care frame work during 3 months were carried out and with self reporting sheets program was pursued. After 3 months self concept questionnaire completed and data were analyzed by using SPSS-11.5 software and paired T, will kakson and kruskal wallis tests.Results: Mean of self concept, prior and post intervention was 60.67±4.20, 118.26±3.53, respectively (P<0.05). No significant correlation was found between age, gender, educational level, marriage status, number of children, occupation, level of income, duration of outbreak, times of hospitalized with self esteem.Conclusion: This study showed that self care program based on the Orem frame work has positive effects on self esteem in multiple sclerosis patients. Therefore this program is recommended in MS patients.