ObjectivesSuicide is a major global health problem imposing a considerable burden on populations in terms of disability-adjusted life years. There has been an increasing trend in fatal and attempted suicide in Iran over the past few decades. The aim of the current study was to assess overall, gender and social inequalities across Iran’s provinces during 2006–2010.DesignEcological study.SettingThe data on distribution of population at the provinces were obtained from the Statistical Centre of Iran. The data on the annual number of deaths caused by suicide in each province were gathered from the Iranian Forensic Medicine Organization.MethodsSuicide mortality rate per 100 000 population was calculated. Human Development Index was used as the provinces’ social rank. Gini coefficient, rate ratio and Kunst and Mackenbach relative index of inequality were used to assess overall, gender and social inequalities, respectively. Annual percentage change was calculated using Joinpoint regression.ResultsSuicide mortality has slightly increased in Iran during 2006–2010. There was a substantial and constant overall inequality across the country over the study period. Male-to-female rate ratio was 2.34 (95% CI 1.45 to 3.79) over the same period. There were social inequalities in suicide mortality in favour of people in better-off provinces. In addition, there was an increasing trend in these social disparities over time, although it was not statistically significant.ConclusionsWe found substantial overall, gender and social disparities in the distribution of suicide mortality across the provinces in Iran. The findings showed that men in the provinces with low socioeconomic status are at higher risk of suicide mortality. Further analyses are needed to explain these disparities.

BackgroundSuicide is a major global health problem, especially among youth. Suicide is known to be associated with a variety of social, economic, political and religious factors, vary across geographical and cultural regions. The current study aimed to investigate the effects of socioeconomic factors on suicide mortality rate across different regions in Iran.MethodsThe data on distribution of population and socio-economic factors (such as unemployment rate, divorce rate, urbanization rate, average household expenditure etc.) at province level were obtained from the Statistical Centre of Iran and the National Organization for Civil Registration. The data on the annual number of deaths caused by suicide in each province was extracted from the published reports of the Iranian Forensic Medicine Organization. We used a decomposition model to distinguish between spatial and temporal variation in suicide mortality.ResultsThe average rate of suicide mortality was 5.5 per 100,000 population over the study period. Across the provinces (spatial variation), suicide mortality rate was positively associated with household expenditure and the proportion of people aged 15–24 and older than 65 years and was negatively associated with the proportion of literate people. Within the provinces (temporal variation), higher divorce rate was associated with higher suicide mortality. By excluding the outlier provinces, the results showed that in addition to the proportion of people aged 15–24 and older than 65, divorce and unemployment rates were also significant predictors of spatial variation in suicide mortality while divorce rate was associated with higher suicide mortality within provinces.ConclusionThe findings indicate that both spatial and temporal variations in suicide mortality rates across the provinces and over time are determined by a number of socio-economic factors. The study provides information that can be of importance in developing preventive strategies.Electronic supplementary materialThe online version of this article (10.1186/s12939-018-0794-0) contains supplementary material, which is available to authorized users.

Background: the appropriate organizational climate and subsequent proper performance are goals that challenge hospital managers to achieve successful outcomes. A positive working climate motivates and enhances nurses' performance. Objectives: There was to identify the relationship between perceived organizational climate and nurses' performance. Methods: This is a cross-sectional descriptive study that is performed on nurses working in the private hospitals in Rasht, Iran. The data were collected through two questionnaires of organizational climate and job performance that its validity and reliability were confirmed. SPSS24 and descriptive and inferential statistics were used for data analysis. Results: According to the mean score obtained more than half of the nurses report a positive assessment of the climate in the hospitals. Also, less than one-third of nurses had a ideal level of performance regarding nurses' job performance. Also, the relationship between perceived organizational climate and the level of nurses' performance with the personal and occupational skills of nurses was emphasized. Finally, the relationship between perceived organizational climate and nurses' job performance was statistically significant (P ≤ 0.048). Conclusions: According to the results, the perceived organizational climate has a positive relationship with nurses' performance level. Therefore, managers and practitioners of private hospitals in Rasht should ultimately improve nurses’ performance by improving the organizational climate and by emphasizing variables such as providing work-related facilities, paying attention to nurses' interests, emphasizing team building, participating in decision-making, improving customer service, paying attention to hospital reputation improving relationships among staff and improving compensation practices.

Background: Work-related stress has been described as a harmful response to excessive pressures and demands that people experience as a result of their jobs. Occupational stress is an adaptive response to the external situation that leads to physical, psychological or behavioral abnormalities of the organization's members. Objectives: Considering the special nature of work in forensic medicine organization, this research tries to provide a model of stress management in this organization. Methods: The case used in this research is based on exploratory studies with fundamental orientation. Considering the qualitative nature of this research, the strategy used in it is grounded theory. 12 senior managers and experts of the forensic organization who had management records and scientific records related to value creation were selected as participants. All the conducted interviews were recorded and the text of the interviews was implemented in MAXQDA (version 10) and each interview was immediately coded and analyzed. Results: The research findings were classified into 6 main causal categories, background, intervention, background, strategies and consequences, based on which the stress management model in forensic medicine was explained. In this model, forensic medicine and the services provided by its units are among the businesses that deal with providing services in unusual conditions, and these services are a process that originates from the two-way communication between the forensic staff and the person receiving the service. Conclusions: The results show that, as a general rule, managers of forensic organizations should prioritize organizational changes to improve working conditions in the activities they perform to manage occupational stress.