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Background and Objective: Budget reforming and distribution of source is considered as one of economic bases of health and treatment. In the ministry of health, performance based budgeting has been performed since 2000. This study was done to identify barriers of operational treatment budget in Islamic Republic of Iran, ministry of health and medical education. Materials and Methods: In this descriptive study, data were gathered by questionairs to identify the barriers in six parts including: human resource, financial management system, financial information system organization structure, performance measurement system and legal necessities during 2007. The questionnaire were distributed among 80 executive staffs whome were responsible to perform operational budgeting plan. Data were analyzed using SPSS-16, fisher's exact test, Karl Pearson, Spearman correlation coefficient tests and Entropy criterion. Results: Disorder in commitment accontity statistical aconite system (0.1464), financial information system, weakening of quantity and proper index (0.1442) for estimating performance program performance measurement system were identified as major barriers. In organizational structure, assignment of authorities and responsiblies for managers and expert were identified as the most priorities (0.1447) of weakness of exact cost controlling system (0.1450) allocated the most rating in the financial management system. Staff resistance (01449) was with high rating in human resource dimension. weakness of rules and internal guidelines for establishment of mentioned budgeting the highest rate in legal barriers. Conclusion: This study indicated that there is corrolation between financial information, performance measurement, financial management systems, organizational structure human resource with barriers of budgeting establishment.

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Background and Objective: Loneliness is one of the problems experienced by the aging population, and the lack of social communication plays a major role in the emergence of loneliness. This study was conducted to determine the effects of telenursing on the loneliness of the elderly.
Methods: This field trial was conducted on 100 elderly people over 60 years of age who were selected by convenience sampling from the clients of Gonabad (Iran) community health centers during 2017. The elderly participants were randomly assigned to 2 groups of 50 people, intervention and control. Then, the demographic information questionnaire, the Informant Questionnaire for Cognitive Decline in the Elderly, and Dehshiri et al.'s Loneliness Scale were completed. The intervention group received face-to-face training by the researcher for 2 hours. There was no intervention for the control group, and the elderly received routine care from the family health unit. After the face-to-face meeting, phone calls were made by the researcher to the intervention group for 12 weeks. One month after the end of the intervention, the questionnaires were completed again by the two groups and evaluated and compared.
Results: The mean (standard deviation) score of loneliness was 60.82±21.07 and 57.48±18.76 before the intervention in the intervention and control groups, respectively, and this value after the intervention was 35.06±14.20 and 61.40±18.72, respectively, in the intervention and control groups. After the intervention, a statistically significant difference was found in terms of a reduction in the loneliness score of the elderly in the intervention group compared to the control group (P<0.05).
Conclusion: This study showed that telenursing was effective in reducing the loneliness of the elderly.