Payavard Salamat

Security Challenges in Fog Computing in Healthcare

Mohammad Hossein Ronaghi

Background and Aim: The Fog Computing is a highly virtualized platform that provides storage, computing and networking services between the Cloud data centers and end devices. Fog computing fits the characteristics of real-time health monitoring systems. In such systems, a large amount of data is acquired from a multitude of bio and environmental sensors. On the other hand, its distribution and open structure makes it vulnerable and weak to security threats. Therefore, the aim of this paper was to identify the security challenges in healthcare.
Materials and Methods: This applied research has been done in three phases using mixed-method approach in 2019. In the first phase, security codes from library resources by content analysis was identified. In the second phase interpretation of experts by Delphi method, Panel of IT experts consists of twelve members who work on healthcare sector was evaluated. Finally, we used Analytic Hierarchy Process method for ranking security codes.
Results: According to fuzzy AHP results attacks(0.31), secure communications(0.23), authentication and access control(0.19), trust(0.15) and privacy preservation(0.12) are the most important criteria in security challenges of fog computing.
Conclusion: According to the results of this study, secure communications and network attacks are the major challenges in fog computing, because fog nodes are usually deployed in some places with relatively weak protection. They may encounter various malicious attacks. As a result, policymakers should be aware of the role of secure communications and network attacks in fog computing implementation.

Determination of Catastrophic Health Expenditures among Elderly People in Iran

Vahid Saberzadeh

Background and Aim: Given the rising trend of ageing and the vulnerability of the aged group to diseases and health costs, it is important to determine the exposure of elderly households to the burdensome costs of health.
Materials and Methods: The incidence and severity of elderly costs at provincial level and income quintiles were calculated; besides, chi-square test was used to determine the relationship between household socioeconomic variables and exposure levels. The sample included 9103 elderly people aged 65 and over, and the data of their own and their households were extracted from the statistical center in 2016. Data analysis was performed using SPSS16 software.
Results: The exposure rate of households with rural elderly people (9.74%) was higher than urban ones (6.2%), and the intensity of exposure was higher in rural areas than urban. In both groups, the highest exposure was in the second and the lowest in the fifth quintiles. The elderly households in Hormozgan province had the highest and in Kohgiluyeh and Boyer-Ahmad had the lowest exposure. Number of elderly people in family, place of residence, employment status, household dimension, costs of chemotherapy, addiction abandonment, orthopedics, special medications, household spending and out-of-pocket payment for health services were significantly correlated with exposure. However, elderly person's literacy, insurance, marital status and the presence of persons under 12 years in the family did not show a significant relationship with the amount of exposure.
Conclusion: The exposure rate and its intensity is higher among rural elderly people than urban ones, and the exposure of poorer elderly people is higher; these points indicate that the distribution of financial resources in the health system is not fair and requires purposeful policymaking decisions for these groups.

Strategic Planning Success Factors in Hospitals: A Qualitative Study

Ali Mohammad Mosadeghrad

Background and aim: Strategic planning (SP) is the art and science of strategic analysis of an organization, forecasting changes in an organization’s internal and external environments, setting strategic goals, developing suitable strategies, and allocating optimal resources to achieve competitive advantage. Strategic planning plays an important role in promoting hospital success. However, it has encountered various challenges in Iranian hospitals. This study aimed to identify the critical success factors (CSFs) of the strategic planning process in Iranin hospitals.
Materials and Methods: This qualitative study was performed using semi-structured interviews with 47 members of strategic planning committees of 17 hospitals in Tehran, Iran, in 2016. For data analysis, thematic analysis was used. Overall, 44 CSFs were identified for strategic planning and were grouped into 8 themes and 23 sub-themes.
Results: Managers’ belief in SP usefulness, SP justification, top managers’ commitment to and involvement in SP, setting up a competent SP team, using an appropriate SP model conducive to hospitals’ structure and culture, promoting teamwork and creativity, empowering employees to involve actively in SP, providing necessary financial and physical resources, and stablishing information management, process management systems, and patient centeredness are key factors in SP success.
Conclusion: The SP success depends on strong leadership and management, coherent planning, conducive organizational culture, organizatioanl learning, and effective management of employees, customers, resources and processes.

Development of Mobile Application for Self-management in Osteoporotic fractures care

Foziye Tahmasbi

Background and Aim: The incidence of osteoporotic fractures, which leads to morbidity and mortality in the elderly, is increasing worldwide. Mobile health application could empower patients to engage in managing their own health. This has a significant impact on improving health outcomes in chronic diseases. For this reason, this study was conducted to develop a mobile-based self-management application for patients with Osteoporotic fractures.
Materials and Methods: In this descriptive-developmental study, initially, the data required in this research were collected through searching in library resources, clinical guidelines and application review. Then, a questionnaire was applied by physician to validate and determine the significance of these elements and the rational design of application was provided with the obtained elements. Finally, the application was developed in Android Studio environment and then evaluated.
Results: The main application parts include: Disease prevention information, fracture risk assessment tool and information for self-management in osteoporotic fractures care which was divided into two parts: Hip fracture and other fractures. Moreover, provides functions like exercise program adjustments, reminders and patient records. The application functions were evaluated and was able to meet the expectations.
Conclusion: This is a mobile application with validated content and can be used to help patients with osteoporotic fractures to manage their disease and to obtain self-management skills.

Information Science Academic Members of Iranian Public Universities Sharing Information Resources in ResearchGate Social Scientific Network: It’s Relation on their Scientific Output in Scopus Database and Google Scholar Search Engine

Abbas Doulani

Background and Aim: The purpose of the present study was to investigate the scientific outputs of the faculty members of the information science and science departments of Iranian state universities in the Science Research Network and its impact on their scientific outputs in databases and search engines.
Materials and Methods: This study was applied in terms of purpose, survey methodology and Altmetrics approach. The statistical population of the study consisted of 118 faculty members in the field of information science and social sciences active in Social- Scientific Network from 29 Governmental universities in the country. Pearson correlation coefficient, independent t-test, Kruskal-Wallis were used for data analysis.
Results: The findings showed that the authors of Isfahan, Tehran University of Medical Siences and Shahid Chamran of Ahvaz Universities are the most active members of the faculty in ResearchGate in terms of Altmetrics characteristics. In terms of RG score, faculty members with associate's degree perform better than the others. There is also a positive correlation between the Altmetrics indicators of ResearchGate network and the scientometric indicators of Scopus citation database and Google Scholar.
Conclusion: Since there was a positive correlation between Altmetrics indexes in ResearchGate with Scinientometrics indexes in Google Scholar and Scopus, so this leads to the visibility of their scientific work and their improvement of citation indexes in databases.

SIGMA: A Serious Game Based on a New Approach to Improving Visual Acuity in Children with Laze Eye(Amblyopia)

Ali Reza Mokhtari

Background and Aim: One of the main reasons of blindness -- unilateral vision weakness in children, adolescents and middle aged people -- is amblyopia. The goal of this study is to design and produce a serious game to treat amblyopia and to investigate its effect on children's lazy eye.
Materials and Methods: In this interactive analysis, 60 people suffering from unilateral amblyopia with average age 7 years old entered the research; they were divided into two experimental groups and one control group. From these people, six left during the research period. To intervene during the project, a produced tool, namely SIGMA (smart phone), was used. Visual acuity of samples was measured before and after the intervention. The collected data were analyzed using SPSS software version 22 in two levels of descriptive and inferential statistics.
Results: In the first experimental group, visual acuity of 12 samples(63%) improved and in 7 samples(37%), no changes were observed. In the second experimental group, visual acuity of 11 samples(65%) improved, but no changes were observed in 6 samples(35%). In control group, however, visual acuity of 5 samples(27%) improved, but no changes were observed in 13 samples(72%). The findings show a meaningful difference(p≤0.05) between the number of improved samples of experimental groups and control group.
Conclusion: Using SIGMA games alone or along with other treatments can improve visual acuity in children’s lazy eye.

Evaluation of Electronic Health Literacy Level of Patients Referring to a Selected Military Hospital in Tehran

Zahra Sadat Asadi

Background and Aim: Currently, electronic health(e-health) tools are known as an effective means of communication and educational tool in the field of health to manage conditions in sensitive situations. The purpose of this study was to evaluate the level of electronic health literacy of patients referring to a selected military hospital.
Materials and Methods: The present descriptive-analytical study was performed on 204 patients who referred to a selected military hospital in Tehran in 2019. Data collection tools included a demographic information questionnaire and an e-health literacy questionnaire. SPSS software was used for data analysis, and the level of significance was set at 0.05.
Results: The mean score of electronic health literacy was 29.28±5.47. The level of e-health literacy of patients with different educational backgrounds was significantly different. Also, the electronic health literacy of patients using the Internet differed significantly. Patients' e-health literacy had a significant correlation with their educational level(p=0.02, r =0.169) and using the Internet(p<0.001, r=0.328).
Conclusion: Higher education is associated with higher levels of e-health literacy, and can be improved by creating internet training areas to access health information to improve e-health literacy.

The Effect of Eight Weeks of Aerobic Training on Serum Lipid Profile and Serum Level of Fibrinogen in Middle-Aged Men with Heart Failure

Hoda Haghir

Backgrounds and Aim: Cardiovascular diseases, especially atherosclerosis, are among the main causes of mortality in developing countries of Asia and West Asia. The purpose of this study was to investigate the effect of eight weeks of aerobic training on serum lipid profile and fibrinogen in middle-aged men with heart failure.
Materials and Methods: Twenty men with aged 50 to 60 years, with heart failure grade 1 to 3, and heart power of less than 45% were selected and then randomly divided into experimental and control groups. Aerobic exercise was included of eight weeks of aerobic training with intensity of 35-65% of maximal heart rate with a three-session frequency per week. Fasting blood samples were collected from participants before and after of eight weeks. Data were analyzed by Paired sample t-test and Independent sample t-test.
Results: The results showed that after eight weeks of intervention, mean changes of HDL, TC / HDL ratio and fibrinogen were statistically significant (P<0.05). On the other hand, mean changes in LDL, TG, TC and LDL / HDL ratio were not significant (P>0.05).
Conclusion: The results of this study indicate that performing aerobic exercises along with drug therapy can be useful as a good way to prevent cardiovascular disease in people with heart failure