Payavard Salamat

New Applications of Point of Care Tests (POCTs) in Health Care: A Scoping Review

Nasser Keikha

Background and Aim: Point of Care Tests (POCTs) are a laboratory diagnostic system that can be performed at the patient care location and help diagnose diseases quickly. Due to the increase in population, the prevalence of contagious diseases, none access of society members to laboratories, the global need for the availability of modern diagnostic and health technologies at the place of patient care, the aim of research was to explore new aspects of the application of Point of Care Tests to patients as well as the process of developing these technologies in the field of healthcare.
Materials and Methods: A scoping review method were applied by determining the key words through medical subject headings and related articles, searching in the databases of Web of Science, Scopus and PubMed databases as well as Google Scholar, Google and Magiran and Scientific information database. Furthermore to preserve the variety of sources and articles, the criteria for entering the study were English-language articles and no time limit was applied.
Results: Most of the 17 related articles were reviews. The most common technologies in POCTs were lateral flow assays (LFA) that applied to diagnosis of Cryptococcus fungal infection, tuberculosis, hepatitis, legionella, malaria and covid-19, and nucleic acid amplification tests have helped to detect viruses and bacteria using DNA and RNA. From NAAT (Nucleic Acid Amplification Tests) based on microsialate, it can be referred to RT-PCR (Reverse transcription- polymerase chain reactio) and LAMP oop-Mediated- Isothermal Amplification (LAMP), where in recent years are widely used for detection of infectious diseases specially SARS-CoV-19. Additional basic diagnostic tools have focused on Small handheld, POCT devices with a monitoring device, cartridge, and other devices; whereas in the new generations, special focus were on quality assurance, microfluidics, Nano-biosensors and smart phones.
Conclusion: The analysis of published studies showed that the diagnostic tools of tests on POCTs are expanding and have been able to provide better clinical and economic results. In addition to the extensive use of two advanced types of lateral flow assays and nucleic acid amplification tests to diagnose tests at the patient’s bedside; Microfluidics, Nano biosensors and smart phones have also expanded. Quality assurance also requires the determination of accurate quality management procedures, policy programming and necessary policy formulation by officials to achieve reliable results for patient care.

Strategies for Retention of Faculty Members in Health Sector

Tahereh Sharifi

Background and Aim: Retention of faculty members is one of the fundamental challenges of the country’s health system. Therefore, this study aimed was conducted with the aim of providing strategies for retaining faculty members in the health field.
Materials and Methods: This study was conducted in a combined manner in three stages in 2024. In a field review, related articles were reviewed from the Magiran, SID, PubMed databases and using the Google scholar search engine. Out of 18,977 identified studies, 37 articles were selected and reviewed after several stages of screening. In the second stage, 12 semi-structured interviews were conducted with relevant experts and managers using an inductive approach based on the rules of directional content analysis to identify the factors of retention of faculty members in the health field. Accordingly, the human resource management framework, which includes 5 stages of familiarization with the data, identification of the thematic framework, indexing, display with a diagram, and interpretation of the results, was used for data analysis in this study. MAXQDA-2020 software was used to analyze the research data. Finally, in the third stage, using a prioritization matrix, the solutions were scored and prioritized by 17 experts.
Results: Strategies were identified and classified into 10 areas based on the human resources management cycle, including recruitment, selection and hiring, growth and development, performance evaluation, compensation, organizational culture, improving working conditions, motivation, termination of employment, and external factors. Then, those in each area were prioritized based on their level of efficacy, with the highest priority solutions including improvement of the country’s financial and economic conditions (mean score=4.92 out of 5), an increase in faculty members’ salaries (4.90), removal of the salary cap (4.88), establishment of housing cooperatives (4.82), respect for the dignity and social status of retired professors (4.80), provision of recreational facilities for faculty members (4.79), enhancement of transparency, accountability, and adherence to the rule of law in the country (4.79), and increased faculty participation in decision-making processes (4.47).
Conclusion: Given the results, strategies such as focusing on improving the financial situation, promoting transparency, and increasing the well-being of faculty members can be effective in increasing the motivation and retention of faculty members in the health sector. Therefore, the implementation of these strategies by policymakers and education administrators is expected to improve the retention of faculty members in this sector.

Developing a Predicting Model for Neonatal Hypoxic-Ischemic Encephalopathy Using Data Mining

Somayeh Nasiri

Background and Aim: Neonatal hypoxic-ischemic encephalopathy (HIE) is a clinical syndrome characterized by impaired brain function resulting from oxygen deprivation and reduced cerebral blood flow. Developing predictive models can serve as valuable tools for physicians in forecasting disease outcomes and facilitating early interventions. The present study was conducted with the aim of constructing a predictive model for neonatal hypoxic-ischemic encephalopathy using data mining algorithms.
Materials and Methods: This applied study was conducted using a descriptive approach. In the first stage, the factors influencing the prediction of neonatal hypoxic-ischemic encephalopathy were identified through expert surveys. In the second stage, data pertaining to 4,000 neonates were collected from the Iman system, available in the database of the Ministry of Health and Medical Education, during the years 2020–2021. Following preprocessing, a dataset comprising 3,962 records with 13 features was extracted. Subsequently, predictive models were developed using algorithms including artificial neural networks, decision tree variants, random forest, support vector machines, logistic regression, and Bayesian networks. Model construction was performed using the Python programming language within the Anaconda environment. Finally, performance evaluation and comparison were carried out using metrics such as accuracy, precision, specificity, F1-score, and the Area Under the Curve (AUC).
Results: The findings of the study revealed that the Area Under the Receiver Operating Characteristic Curve (AUROC) for models developed using logistic regression, artificial neural networks, random forest, Bayesian networks, support vector machines, and decision trees were 86%, 86%, 84%, 82%, 76%, and 74%, respectively. The highest performance was achieved by the logistic regression algorithm, with an accuracy of 81%, sensitivity of 85%, and specificity of 96%. The greatest sensitivity was observed in logistic regression, artificial neural networks, and support vector machines, whereas the naïve Bayesian algorithm demonstrated the lowest performance metrics. In the predictive model for hypoxic-ischemic encephalopathy, the most influential feature was the first-minute Apgar score, while the least influential factor was delivery outside the hospital.
Conclusion: The findings of the present study indicated that the predictive model for neonatal hypoxic-ischemic encephalopathy based on the logistic regression algorithm demonstrated superior performance. It is anticipated that the application of practical data-driven algorithms for neonates with hypoxic-ischemic encephalopathy will play a crucial role in the rapid identification of the condition and the provision of appropriate treatment. Such approaches can enable healthcare professionals to act within the critical window of opportunity, thereby improving the quality of care, preventing disease progression, and reducing the severity of adverse outcomes.

Perceptions of Operating Room and Anesthesia Students and Instructors Regarding the Impact of the Hidden Curriculum on the Promotion of Professional Ethics

Hossein Vakili Mofrad

Background and Aim: The hidden curriculum is considered the most powerful means of transmitting professional values. Given the critical importance of managing the hidden curriculum to institutionalize professional ethics and professionalism within health higher education institutions, the present study was conducted to explore the perceptions of operating room and anesthesia students and instructors regarding the impact of the hidden curriculum on the promotion of professional ethics.
Materials and Methods: This study was conducted using a qualitative approach based on conventional content analysis. The study population included final-year students and instructors from the operating room and anesthesia disciplines at Hamadan University of Medical Sciences. Participants were selected through purposive and theoretical sampling methods. Data were collected via in-depth, semi-structured interviews. Data saturation was achieved after conducting 24 interviews. The data analysis followed the qualitative content analysis approach proposed by Graneheim and Lundman (2004), and was carried out in seven steps: 1. familiarization with the data, 2. identification of meaning units, 3. initial coding, 4. formation of subcategories, 5. development of categories, 6. extraction of themes, and 7. final review.
Results: The content analysis of the interviews resulted in the identification of 456 initial codes. Following refinement and consolidation, these codes were organized into four overarching categories and ten subcategories. The main categories comprised: ‘Components of the hidden curriculum in professional ethics education’, ‘Mechanisms through which the hidden curriculum exerts influence’, ‘Consequences of the hidden curriculum’, and ‘Strategies for enhancing professional ethics’. The findings indicated that the hidden curriculum, manifested through the behavioral patterns of faculty members and instructors, organizational culture, and interpersonal interactions, plays a pivotal role in shaping students’ ethical attitudes and behaviors. Furthermore, the hidden curriculum, through processes of unconscious learning, reinforcement or erosion of formal values, and the manner in which rules are implemented, can yield both positive outcomes—such as the development of ethical decision-making skills—and negative outcomes, including diminished ethical sensitivity.
Conclusion: This study revealed that the hidden curriculum in operating room and anesthesia education functions as a dual-force phenomenon. On one hand, it fosters the development of professional ethics through constructive role modeling and authentic clinical experiences. On the other hand, it can contribute to ethical erosion by conveying contradictory messages and unhealthy norms. Achieving sustainable ethical learning requires active management of the hidden curriculum through three key strategies: aligning the formal and hidden curricula, empowering instructors as agents of ethical value transmission, and shifting the organizational culture paradigm toward learning from error.

Assessing Knowledge of Pelvic Floor Disorders in Women Referring to Clinics of Teaching Hospitals of Mashhad University of Medical Sciences in 2024 (Descriptive Cross-Sectional Study)

Zahra Hadizadeh-Talasaz

Background and Aim: Lack of awareness and inadequate knowledge about pelvic floor dysfunction (PFD), its nature, complications, prevention, and available treatments leads to increased anxiety, exacerbation of disease symptoms, and decreased quality of life. Given the high prevalence of pelvic floor disorders, this study aimed to determine the knowledge of pelvic floor disorders in women referring to clinics of teaching hospitals of Mashhad University of Medical Sciences.
Materials and Methods: A descriptive-cross-sectional study was conducted in the women’s clinics of teaching hospitals of Mashhad University of Medical Sciences in the period from July and December 2024. 205 people were included in the study using a convenience sampling method with inclusion criteria. Eligibility criteria included Iranian women over 18 years who spoke Persian and could read and write, and who provided consent to participate in the study. Participants who completed the questionnaires incompletely (more than 20% of questions unanswered) were excluded from the study. The data collection tool was a demographic and prolapse and incontinence knowledge questionnaire (PIKQ). Data analysis was performed using SPSS after checking for normality with Kolmogorov-Smirnov.
Results: The median age of the participants was 41. The median knowledge in the field of pelvic organ prolapse was 9 (total score range from 0 to 12), and in the field of urinary incontinence was 8 (total score range from 0 to 12), and the median overall score of the questionnaire was 17 (total score range from 0 to 24), and an interquartile range of 7. 98. (47.8%) of the women had poor and moderate knowledge, and 107 (52.2%) had good knowledge. The highest level of knowledge was related to the etiology domain, while the lowest was related to the diagnosis domain. An analysis of the relationship between demographic variables and the knowledge of pelvic floor disorders showed that, overall, there was no significant association between age (P=0.60), history of pelvic floor disorders (P=0.73), number of deliveries (P=0.67), and mode of delivery (P=0.37) with the knowledge score of pelvic floor disorders.The majority of participants (106 individuals, 51.7%) obtained their required health information from physicians, midwives, or other healthcare providers.
Conclusion: The results of this study showed that almost half of the participants had poor to moderate levels of knowledge, and the lowest level of knowledge among participants with both disorders was in the areas of diagnosis and treatment. It is recommended that educational programs be designed and implemented to increase the awareness of women in the community about pelvic floor disorders. Additionally, the use of a pelvic floor disorders knowledge questionnaire may aid physicians in monitoring educational and therapeutic interventions for patients and ensuring that they receive the information necessary to manage their condition effectively.

Relationship between Structural Empowerment and Entrepreneurial Organizational Culture in Health Centers of Tehran Province Municipality

Leila Nazarimanesh

Background and Aim: Today, structural empowerment has been considered as one of the key factors in improving the performance of organizations, especially in the field of health and treatment. This study was conducted with the aim of investigating the relationship between structural empowerment and entrepreneurial organizational culture of employees in health and treatment centers of Shahr Salem Company.
Materials and Methods: This study is a descriptive-analytical study with an applied purpose, which is positivist in terms of research philosophy, with a deductive and quantitative approach, correlational in terms of research purpose, and cross-sectional in terms of time, and the data were collected using a survey method. The sample size was determined using the Cochran formula to be 263 people and was selected using a stratified, simple, and questioning random method. Standard Kanter structural empowerment questionnaires and Cornwall and Baron entrepreneurial organizational culture questionnaires were used to collect data. The data were analyzed with SPSS and Smart PLS 3 software.
Results: The findings showed that structural empowerment has a significant relationship with entrepreneurial organizational culture (rs=0.606 and P=0.000). Also, empowerment dimensions including opportunity (rs=0.505), information (rs=0.484), resources (rs=0.552) and support (rs=0.509) have a positive effect on entrepreneurial organizational culture. Statistical results showed that the greatest effect was related to the resource dimension. The opportunity dimension also plays a significant role in increasing employee motivation, which can pave the way for promoting entrepreneurial culture. In addition, in the first hypothesis, the relationship between entrepreneurial organizational culture and opportunity has been examined, which indicates the existence of a positive and significant relationship between these two variables. Also, P-value is 0.000, which is less than the significance level of 0.05, making this relationship statistically significant. In the second hypothesis, the relationship between information and entrepreneurial organizational culture has been confirmed with rs=0.484. The P-value less than 0.05, indicating the P-value is 0.009 which is significance of this relationship. the relationship between support and entrepreneurial organizational culture has been tested, indicating that this relationship is also positive and significant. The P-value is 0.008, which is less than 0.05, indicating the significance of this relationship. In the relationship between resources and entrepreneurial organizational culture, the P-value is 0.004, which is less than 0.05, this relationship is confirmed.
Conclusion: The findings of this study showed that structural empowerment, especially in the dimensions of access to resources, information, opportunities, and organizational support, has a positive and significant effect on strengthening the entrepreneurial organizational culture in health centers. Creating supportive infrastructures and providing opportunities for growth and improvement of employees’ skills can increase their motivation, creativity, and innovation. Making decision-making processes transparent and designing reward systems based on innovation promotes employee participation and responsibility. In addition, facilitating the free flow of information and knowledge, supporting innovative ideas, and developing creative skills pave the way for creating a sustainable entrepreneurial culture and improving the overall performance of the organization, and strengthening organizational capacities.

Evaluating the Effect of Training the Standardized SBAR Communication Model on the Quality of Patient Handoff and Operating Room Staff Satisfaction

Mohsen Yaghmaei

Background and Aim: Shift handover is one of the key processes in clinical settings, during which patient care is transferred from one healthcare team to the next. Weaknesses in this process—particularly in high-pressure environments such as operating rooms—may lead to reduced quality of information transfer and staff dissatisfaction. This study aimed to determine the effect of the standard SBAR communication model on the quality of the shift handover process and the satisfaction of operating room personnel.
Materials and Methods: This quasi-experimental study with a pretest–posttest design was conducted in 2023 at Imam Khomeini Hospital in Jiroft. Sampling was performed using a census method, and a total of 66 operating room staff members participated in the study. The intervention consisted of a two-hour training session (including theoretical and practical components) on the SBAR model. Data were collected using the standard CEX checklist to assess handover quality and a modified version of the Petrovic questionnaire to evaluate staff satisfaction. The validity and reliability of the instruments were confirmed. Data analysis was performed using SPSS and paired t-tests. A significance level of less than 0.05 was considered.
Results: The study participants included 66 operating room staff members, comprising 39 women and 27 men, with a mean age of 30.2±2.45 years. The mean score of shift handover quality significantly increased after SBAR training, rising from 73.80±13.99 before the training to 102.18±10.69 after the training, which corresponds to an improvement of approximately 20.9% relative to the total score range of the instrument (P<0.001). Furthermore, staff satisfaction with the shift handover process also improved, increasing from 37.85±4.77 to 42.41±4.76, representing an improvement of approximately 11.4% relative to the total instrument score range (P<0.001). These changes indicate the positive impact of SBAR training on both the shift handover process and the staff experience.
Conclusion: The findings indicated that training and implementation of the SBAR model were associated with significant improvements in handover quality and staff satisfaction. These results suggest that using structured communication tools may help improve certain aspects of the handover process. However, due to the lack of a control group and the short follow-up period, it is not possible to draw firm conclusions about the long-term effects of the intervention. Therefore, SBAR-based training may be considered as a recommended option; however, further studies with stronger designs and in diverse clinical settings are needed to more accurately evaluate its outcomes.

A Review of Published Scientific Outputs in the Field of Budgeting Methods in the Health System

Mahsa Akbari

Background and Aim: Budgeting in the health system plays a crucial role in enhancing the quality of healthcare services, increasing equitable access to health care, and reducing costs. Financial decision-making based on scientific data and evidence can improve the efficiency of the health system and ensure equity in resource allocation. This study aimed to examine the scientific status and trends of published literature on budgeting methods in the health system using bibliometric analysis to assist policymakers in making better financial decisions.
Materials and Methods: This study is a bibliometric review with a descriptive–analytical approach, analyzing 222 scientific documents indexed in Scopus between 1974 and 2024. Data were analyzed using Excel, Bibexcel, VOSviewer, and Gephi software to map the knowledge structure, co-word relationships, and international collaborations in this field.
Results: The United States (30%), Taiwan (15%), and Canada (10%) were the leading contributors to scientific output in this field. Journal articles comprised nearly 90% of all publications. The most frequent keywords were “budget,” “health care cost,” and “financial management,” reflecting a strong emphasis on cost control and resource management. Three main budgeting approaches were identified: performance-based, traditional (historical), and needs-based. Traditional budgeting remains dominant in developing countries, particularly where information infrastructure and managerial capacity are limited. International collaboration involved 18 countries, with the strongest cooperation observed between the United States and Taiwan.
Conclusion: Improving the health budgeting system requires strengthening information systems, training managers, and enhancing international scientific collaboration. Resource allocation based on scientific data and bibliometric insights can optimize resource distribution and enhance equity in access to health services. Such measures would lead to greater health system efficiency and more comprehensive financial decision-making.