Objective: Although various studies have linked environmental toxins, mumps infections, alcohol consumption, and abnormal body mass index (BMI) to impaired semen quality, the precise causes of infertility remain unclear. This study investigates the impact of BMI on oxidative stress markers in semen analysis among infertile men, illuminating the role of oxidative stress in cases of unexplained infertility. Methods: In this cross-sectional study, 280 patients exhibiting infertility symptoms were recruited. Comprehensive semen analysis was conducted, evaluating reactive oxygen species (ROS) levels, sperm plasma membrane lipid peroxidation via flow cytometry, total antioxidant capacity (TAC), and results from the sperm chromatin structure assay. Participants were categorized based on their BMI, facilitating comparisons between obese and non-obese individuals. Results: Both BMI and age significantly influenced male fertility, particularly in obese individuals. Strong correlations were identified between elevated BMI, increased ROS levels, and decreased TAC. The obese infertile group exhibited substantially lower TAC compared to controls, highlighting obesity's detrimental effect on antioxidant defenses. Furthermore, significant reductions in sperm count, motility, and normal morphology were observed, alongside an increase in non-motile sperm. These outcomes demonstrate the complex relationship among oxidative stress, BMI, and fertility, emphasizing the necessity for targeted interventions addressing obesity's effects on reproductive health. Conclusion This study underscores the importance of managing obesity and understanding its impact on oxidative stress as essential components in improving reproductive outcomes among affected men.

SITUATIONAL ANALYSIS OF GENERAL PRACTITIONERS USING A FORECASTING APPROACH UNTIL 2025 AND A MULTI-STATE MARKOV MODEL: A RETROSPECTIVE LONGITUDINAL STUDY ntroduction: Undesirable working conditions, insufficient professional development and other labour market pressures have significantly impacted the status of general practitioners (GPs). This study aimed to conduct a situational analysis of GPs in Iran using a forecasting approach until 2025. Methods: Data were collected concurrently through direct contact, data matching among databases and tracking among graduates from four clusters of medical science universities over the past decade. This retrospective longitudinal study determined the status of GPs over consecutive years. Multi-state Markov and binary logistic regression analyses were performed using R and Stata 14. Results: Of 430 graduates over the past decade, 94% were successfully identified. Only 20% of the graduates remained active as GPs. The greatest fluctuations in transfer occurred in the third year after graduation, with the remaining proportion of GPs dropping to less than 50%. The probability of remaining as GPs was 0.76 per year, while the highest transition was observed towards specialisation (0.12). Additionally, 2% of the GPs chose not to work, and less than 1% transitioned to a different specialty. Based on the transfer matrix for 2025, only 19% of the GPs were projected to remain, with the majority (59%) transitioning to specialisation. Conclusion: The transfer probability varies across different years, indicating higher flow rates among GPs. However, only a limited number of GPs are projected to remain until 2025. A comprehensive set of interventions should be considered, spanning the pre-medical stage, during education and after graduation, to mitigate the factors contributing to GPs leaving their profession.

Objectives: The health system reform process is highly political and controversial, and in most cases, it fails to realize its intended goals. This study was conducted to synthesize factors underlying the failure of health system reforms. Methods: In this systematic review and meta-synthesis, we searched 9 international and regional databases to identify qualitative and mixed-methods studies published up to December 2019. Using thematic synthesis, we analyzed the data. We utilized the Standards for Reporting Qualitative Research checklist for quality assessment. Results: After application of the inclusion and exclusion criteria, 40 of 1837 articles were included in the content analysis. The identified factors were organized into 7 main themes and 32 sub-themes. The main themes included: (1) reforms initiators’ attitudes and knowledge; (2) weakness of political support; (3) lack of interest group support; (4) insufficient comprehensiveness of the reform; (5) problems related to the implementation of the reform; (6) harmful consequences of reform implementation; and (7) the political, economic, cultural, and social conditions of the society in which the reform takes place. Conclusions Health system reform is a deep and extensive process, and shortcomings and weaknesses in each step have overcome health reform attempts in many countries. Awareness of these failure factors and appropriate responses to these issues can help policymakers properly plan and implement future reform programs and achieve the ultimate goals of reform: to improve the quantity and quality of health services and the health of society.

MONITORING, VIDEO AND AUDIO RECORDING CLASSROOMS BY CCTV CAMERAS: IRANIAN EFL STUDENTS’ PERCEPTIONS Abstract Nowadays our way of working and studying are becoming more and more cyber. So, we can’t turn a blind to the fact that technology is already affecting our educational system. Abundant gadgets and equipment are being applied to schools, universities, and institutes for many specific reasons. One of which is installing cameras in classrooms. In Iran, some of the English language teaching institutes have installed cameras in their classrooms to monitor (and evaluate) teachers’ and students’ actions and performances. Some issues such as: whether both teachers and students are informed about the presence of cameras, the purposes behind installing cameras in classes, recording and monitoring classroom activities, and other aspects of equipping a classroom with cameras are not known clearly. The present study aimed to explore the perceptions and feedbacks of Iranian EFL students on video-recording and monitoring English language classrooms via CCTV cameras. In this study an attempt was made to find more about EFL students’ beliefs and feedbacks on monitoring, video and audio recording classrooms by CCTV cameras in language institutes in Iran. The researcher himself designed a questionnaire having four different sections to gather students’ feedbacks. The student participants (N=57) were supposed to answer the questionnaire via online google forms. The findings of the study revealed that students believed and claimed that there exist differences between camera-equipped classrooms and those that are not camera-equipped. ASEAN Journal of Psychiatry, Vol. 24 S(Advancements in psychology and mental health), July-August 2023; 1-5.