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ABSTRACTEpidermolysis bullosa acquisita is a rare acquired autoimmune subepidermal blistering disease that clinically resembles other vesiculobullous lesions such as pemphigus vulgaris and cicatricial pemphigoid. Multiple myeloma is the most common plasma cell malignant disorder characterized by a single clonal expansion and increased level of a single immunoglobulin. Epidermolysis bullosa acquisita has been reported with other systemic diseases such as lymphoma. In this case report, we present a patient with paraneoplastic epidermolysis bullosa acquisita associated with multiple myeloma.

Processes as one of the valuable knowledge resources can create sustainable competitive advantages in organizations. There is a large number of processes in organizations. They generate a high volume of process data that leads to the high‐dimensionality problems, complex relationships, dynamic changes, and difficulties in the understanding of the process by human resources. Traditional process improvement methodologies have weaknesses in environment with the large number of processes. Data mining techniques can support process improvement in this environment. They can recommend the improvement suggestions through extracting valuable patterns from a high volume of the process dataset. Recently, knowledge‐intensive processes have been increasingly concentrated in the field of process improvement. These types of processes can induce a competitive behavior over the other processes. The main problem is the improvement of competitive and knowledge‐intensive processes in a high volume of process dataset.The main purpose of this paper is to present a model to identify the behavior of competitive and knowledge‐intensive processes and recommend improvement suggestions. For this purpose, data mining techniques are applied to extract valuable patterns hidden in a high volume of process dataset. In this regard, K‐means clustering and C5 classification algorithms are applied to extract valuable patterns. A real process dataset was used to evaluate the effectiveness and applicability of the model. The results confirmed that the proposed model can apply data mining techniques to support competitive and knowledge‐intensive process improvement in a high volume of process dataset.

Purpose of the study: The current paper seeks to evaluate the feasibility of good governance in the Ministry of Health (Case study at Tehran University of Medical Sciences). In this regard, good governance and providing its requirements including participation, rule of law, transparency, accountability, consensus, fairness, efficiency, and effectiveness. Methodology: The population of this study were managers at Tehran University of Medical Sciences. According to the characteristics of the population in which the number of employees and experts is unlimited and uncertain, 300 questionnaires were distributed and 267 questionnaires were collected. Main Findings: The result of the Friedman test for ranking the components of good governance showed that the highest average among good governance factors was related to the resource factor. Structure factors were placed in the second rank and process factors had the last rank among good governance factors. Applications of this study: The results of this study can be applied in the government's decision and as a result, effective management of policy-making, assistance in the implementation of general policies of the administrative system of the country, achieving the positive consequences of the effective implementation of the country's policy-making management system, helping the growth and development of the organization, managers, and employees of the organization. Novelty/Originality of this study: According to the studies and archival studies in the field of good governance, the model of good governance in the Ministry of Health and Medical Education in Iran has not been worked on before. This can lead to the expansion of knowledge and the production of science.

Mental health is a fundamental human right and is part of the well-being of society. The public health burden of mental health disorders affects people's social and economic status around the world. Coronavirus's (COVID-19) negative impact on the economy and mental health worldwide is concerning. This is a worldwide emergency, and there is an urgent need for research about this topic to prevent long-lasting adverse effects on the population. Unpreparedness and inconsistencies in guidelines, lockdowns, containment strategies, unemployment, financial losses, physical distancing, isolation, chaos, and uncertainty are among factors that lead to a rise in emotional distress, anxiety, and depression. Governments' decisions affect the socioeconomic status of a country and the psychological well-being of the people. COVID-19 pandemic exposed disparities in multiple mental health care systems by having adverse mental health effects in people with pre-existing mental health disorders and previously healthy individuals. Aggregation of concurrent or cumulative comorbid risk factors for COVID-19 disease and its psychosocial sequelae could provide invaluable information for the public health stakeholders. This review aims to address the burden and the psychosocial impact of the COVID-19 pandemic, the challenges and opportunities facing mental health systems, and proposes new strategies to improve the mental health outcomes in the post-COVID era.

Backgrounds and aims: Iran has 2.1 and 1.8 of its 15�64-year-old population living with illicit substance and opioid use disorders, respectively. To address these problems, Iran has been developing a large and multi-modality addiction treatment system, spanning the time before and after the Islamic Revolution. Methods: Iran's current drug treatment scene is a combination of services, ranging from medical/harm reduction services to punitive/criminal justice programs. Included in this array of services are drop-in centers providing low-threshold harm reduction services, such as distribution of sterile needles and syringes; opioid maintenance treatment clinics providing methadone, buprenorphine and opium tincture; and abstinence-based residential centers. We will review the evolution of this system in four phases. Results: In 1980, Iran's revolutionary government shut down all voluntary treatment programs and replaced them with residential correctional programs. The first shift in the addiction treatment policies came 15 years later after facing the negative consequences. Addiction is viewed as a disease, and new voluntary treatment centers offering non-agonist medications and psychosocial services were established. With an increased number of people who inject drugs and HIV/AIDS epidemics, in the second shift an extensive move towards harm reduction strategies and opioid-maintenance programs has been implemented to reduce HIV-related high-risk behavior. The emergence of a methamphetamine use crisis creating an increased number of socially marginalized addicted people resulted in public and political demands for stricter policies and ended in the third shift starting in 2010, with extended compulsory court-based residential programs. Currently, there is a new shift towards reducing the severity of criminal penalties for drug use/sales and promoting proposals for opium legalization. Conclusion: Iran's evolutionary experience in developing a large addiction treatment program in a complex combination of medical/harm reduction and punitive/criminal justice addiction treatment can be examined in its political, clinical and pragmatic context. © 2019 Society for the Study of Addiction

The field of nursing has a lot of responsibilities and workload and is considered as a hard job. If a person does not have the spirit of being responsible for work or interest in service, he cannot survive in the difficult conditions that exist in the field of nursing, such as fatigue, work shifts, stress. Occupational concerns such as insufficient staff, high workload, long working hours and work pressure make nurses unable to play their role in front of their families. On the other hand, nurses are usually unable to perform their duties in the workplace due to family problems. In this study, related articles from the years 2000-2020 were reviewed. The results of studies showed that due to the importance of work-life balance in nurses, it is recommended that managers create the conditions for creating effective methods and techniques for job flexibility for nurses and help nurses to better perform these approaches with the necessary training. Taking care of nurses living conditions, question and answer sessions and interviews with nurses, establishing kindergartens with long working hours can also be effective in creating balance.