Payavard Salamat

Enterprise Architecture Maturity Assessment of Research Laboratory Management Systems

Roohollah Tavallaee

Background and Aim: Enterprise Architecture based on laboratory needs, and by using of the commons of valid and existing enterprise architecture frameworks, leads to the aligns of needs with organizational strategies and goals and information technology infrastructure. The aim of this study was the investigation of the effect of enterprise architecture model implementation on laboratory information management systems.
Materials and Methods: In this quantitative study in 2020, proposed enterprise architecture model which was based on the compilation of Zachman and service-oriented architecture models was investigated by the maturity of enterprise architecture at Sharif University. The statistical community of this study was 100 laboratory specialists based on Morgan sample determination table CCM (Capacity Maturity Model), which was designed based on the Likert spectrum, was used as a questionnaire assessment tool. For data analysis, descriptive indicators such as frequency, percentage and one-sample t-test to compare the mean in SPSS software was used.
Results: Assessing the maturity of enterprise architecture including four areas of IT (Information Technology) planning and organization, IT development and implementation, IT service and support, and IT monitoring and evaluation. Among the various dimensions of enterprise architecture maturity, the lowest average was related to the field of monitoring and evaluation and the highest average was related to the field of service and support. Dimensions in terms of status were: service and support dimension, planning and organizing dimension, development and implementation dimension, monitoring and evaluation dimension, respectively. The test results were significantly different in the areas related to the maturity of enterprise architecture, including the planning and organization areas, development and implementation, service and support (P<0.0001). There was no significant difference in monitoring and evaluation.
Conclusion: The use of enterprise architecture specific to laboratory management systems causes the optimal use of resources and ease of interaction. Evaluation of the implementation of the proposed architectural framework in the laboratory environment showed that the proposed model has matured in the three areas of planning and organization, development and implementation, service and support. In order to improve the maturity of enterprise architecture, more attention should be paid to the field of monitoring and evaluation and the reform program should start from this field.

Development of Iranian Provinces in Terms of Health Indicators Using Weighted Centrality and Numerical Taxonomy Methods

Mohammad Reza Shahraki

Background and Aim: The healthcare sector plays an important role in the development of communities by ensuring the health of individuals in each community and can have many social and economic effects on the lives of individuals in the community. The purpose of this study was to determine the development of the country’s provinces based on health facilities and the level of access to these facilities, to find solutions to reduce differences between different parts of the country.
Materials and Methods: This study was an applied study with a descriptive-analytical approach. In this study, 31 provinces of the country have been studied in terms of 10 indicators. Data and information of this study were extracted from the national statistical yearbook and ranked using Center-weighted index method by using Excel software. Then, using taxonomy method, the degree of development of the provinces has been determined.
Results: The results of the study show that South Khorasan province with a centrality index of 45,692 is in the first place, Yazd province with a centrality index of 43,933 is in the second place and Ilam province with a centrality index of 40,668 is in the third place. East Azerbaijan province with a centrality index of 27,375 is ranked 29th, Qom province with a centrality index of 25,417 is ranked 30th and Hormozgan province with a centrality index of 24,286 is ranked 31st. The degree of development of the provinces is between 0.507 to 0.98, which in terms of development of Yazd province is in the first rank and Hormozgan province is in the last rank.
Conclusion: The results show that there is a deep gap between the provinces in terms of development and access to health indicators; Therefore, it needs more attention and adopt the necessary policies and plans to reduce this gap.

Evaluating the Efficiency of Hospitals Using Network Data Envelopment Analysis (NDEA) and Providing a Suitable Model of Allocating Resources for Future Investments

Ali Reza Pouya

Background and Aim: Hospitals are the most important component of the health system and accurate evaluation of their performance is important. So far, much research has been done on the evaluation of hospitals using DEA models, but in these studies, organizations are considered as a black box and system processes and relationships between them are ignored. In this study, the efficiency of hospitals was evaluated using network envelopment analysis and its results were compared with simple envelopment analysis.
Materials and Methods: The method of the present research was ptactical and the nature of the survey was descriptive. The research population was all hospitals and educational centers affiliated to Mashhad University of Medical Sciences with a capacity of more than one hundred beds, which included twelve public hospitals and forty-eight sections. To collect information, methods of observing and studying documents, records and statistics of hospital activities have been used. For validation, by calculating Spearman correlation coefficient, it was found that the proposed model has a significant correlation with the Black Box DEA Model and the validity of the model was confirmed. SOLVER DEA and EXCEL software were used to implement the model.
Results: The results show that by considering the internal departments of the organization as well as the relations between the departments, a more accurate analysis of the efficiency of the hospitals would be done and we will have a better separation in the ranking between the organizations. Also, by using the network DEA model, the overall efficiency, the efficiency of each department and the rank of each department in comparison with similar departments in other hospitals are determined.
Conclusion: The framework presented in this study can be an appropriate criterion for measuring the efficiency of hospitals and their internal sections by determining the overall position of each hospital relative to other hospitals and by determining the efficiency of the section. By determining the efficiency of the internal departments of hospitals, a suitable priority is provided for allocating resources and investing in different departments in the direction of organizational improvement.

Risk Assessment of the Operating Room Processes Using the Failure Mode, Effects, and Criticality Analysis (FMECA) Method: A Case Study

Zhila Najafpour

Background and Aim: Operation rooms have several specialty processes, a higher level of technology, complicated treatment protocols, and the need for skillful human recourses, which is one of the highest risk wards in the hospital. Therefore, this study was initiated to identify and evaluate potential errors by using the Failure Mode, Effects, and Criticality Analysis (FMECA) approach to recognize the potential errors in operation rooms of Golestan hospital of Ahvaz.
Materials and Methods: This research was done with a qualitative approach in seven stages and it was based on the FMECA protocol. Data were obtained through direct observation, assessment of documents and interviews with the related staff. In this regard, surgical processes were extracted from the beginig of the surgical planning to discharge patient from the post-anesthesia care unit, after that the potential errors associated with each process were identified. Finally, the risk priority number of each of them was calculated according to the indicators of Occurrence (O), Severity (S), and Detectability (D). Score analysis was performed using descriptive statistics and SPSS software.
Results: In the present study, during the analysis of processes related to surgical care, 17 primary surgery processes and 75 sub processes (from surgical planning to discharg from the post-anesthesia care unit) were identified. Seventy failure modes were identified. Ultimately, after analyzing the failure modes in the risk matrix, among the 70 identified failure modes, two failure modes had unacceptable risk, including no proper cleaning of the operation theatre and marking the surgical site, and there was Seven other failure modes with moderate risk, including unappropraite hand hygiene and environmental and operating room fixed equipment disinfection, central oxygen disconnection, lack of equipments in night shift, delay in delivery of prostheses to the surgical site, transfer of patient who requires intensive care to the ward, were identified. Human and organizational causes contributed the most to the occurrence of potential errors.
Conclusion: Analysis of failure modes showed that the highest probability of error occurs in the processes during surgery and due to human and organizational factors. Identification of 70 potential errors in 17 processes of the Operating Room indicates the integrity of FMECA’s preventive approach in identifying and prioritizing the high-risk areas of the processes, insensitive parts such as the operating room.

The Effect of Eight Weeks of Home Based Combined Training with Red Grape Juice Supplementation on Quality of Life in Women with Multiple Sclerosis

Mohammad Azizi

Background and Aim: Multiple Sclerosis is a chronic disease of myelin sheath degradation that reduces the quality of life in patients. Recent studies emphasize on the effect of exercise and natural supplements on the improvement of disease symptoms and quality of life. The aim of this study was to evaluate the effect of eight weeks combined training at home with red grape juice supplementation on quality of life in women with Multiple Sclerosis.
Materials and Methods: In this study, 48 women with MS in the age range of 20-40 years were voluntarily selected and divided into 4 groups: training (n=12), supplement (n=12), training+supplement (n=12) and control (n=12). Combined training included 8 weeks and 3 sessions per week for 60 minutes of endurance and resistance training with an intensity of 10-12 rate of perceived exertion. Subjects consumed 250 cc of grape juice supplement with 68% concentration for 8 weeks, 3 times a week. The control group engaged in their daily activities. Quality of life was measured with standard questionnaire (WHOQOL-BREF) 48 hours before and after the end of the study.
Results: Eight weeks of intervention made a significant change in the quality of life. Based on the correlation t the results were as follows training groups (P=0.001)(7.1%), supplement (P=0.001)(10.5%) and training+supplement (0.000), There was a significant difference between the pre-test and the post-test (P≤0.05). But the changes in the training+supplement group were more than the other groups (P=0.000)(13.3%). In addition, based on the results of one-way analysis of variance, the amount of changes between the groups was also significant (P≤0.05). There was a significant difference between the training group and the control group, supplement group and supplement+training group (P≤0.05). Also, the supplement group had a significant difference with the exercise group and the control group, but there was no significant difference with the supplement + training group (P≥0.05). A significant difference was observed in the supplement+training group with all groups except the supplement group (P≤0.05).
Conclusion: According to the results of the present study, women with Multiple Sclerosis can use combined training at home with red grape juice supplement to improve their quality of life.

Therapeutic Response and Antifungal Susceptibility to Fluconazole in Women with Vulvovaginal Candidiasis

Mehdi Nazeri

Background and Aim: Vulvovaginal candidiasis (VVC) is a vaginal fungal infection that mainly caused by Candida albicans. Among various treatments and their controversial outcomes, oral fluconazole has been accepted as a common and efficient treatment for acute and chronic cases. The aim of this study is about therapeutic effect of fluconazole and evaluation of its antifungal susceptibility.
Materials and Methods: In this cross-sectional study Samples were collected from 107 suspected patients to vulvovaginal candidiasis who went to the gynecology clinic of Kashan University of Medical Sciences in (2020-2022). At first consent and then demographic registrations were obtained. All samples were collected and cultured on Chromagar and Sabouraud’s dextrose agar and incubated at 30°C for 72 h. Yeast colonies were identified based on their colors and morphologic criteria.
All patients were treated by a single dose of fluconazole (150 mg/ml) or two continuous additional doses, depending on the absence or history of recurrence. Improvement of clinical and mycological symptoms in patients were followed for 30-35 days. Antifungal susceptibility to fluconazole was determined by microdilution method (CLSI, document M27-A3).
Results: A total of 107 patients were diagnosed with vulvovaginal candidiasis. Candida albicans (79.4%) was the most common identified species. total response to fluconazole treatment based on mycological findings (negative culture and direct smear) was 62.6% (P=0.012), there was no significant difference between candida species, albicans (64.7%) and non-albicans (54.5%), type of vaginal candidiasis forms (recurrent and non-recurrent) and antifungal susceptibility to fluconazole (MIC≤8)(P>0.05). Consideration of MICs≤1 and MICs>1 as a cutoff point there was a significant difference between failure and response to treatment (P=0.014).
Conclusion: According to empiric treatment of Vulvovaginal candidiasis, concurrent Laboratory diagnosis with anti-fungal susceptibility could help us in selecting the appropriate treatment protocol and prevent the emergence or increase of resistant species.

Assessing the Maturity of Intellectual Capital in the Field of Management and Planning of Tehran University of Medical Sciences

Seyed Amir Reza Nejat

Background and Aim: Intellectual capital, with its basic knowledge nature, is an intangible, strategic, unique and competitive advantage resource. The purpose of this study is to investigate the current state of intellectual capital maturity in the field of management and planning of Tehran university of medical sciences.
Materials and Methods: This research was applied in terms of purpose and with a quantitative approach in 1400 and a questionnaire was used to collect information. The statistical population is the middle and basic managers of the Vice Chancellor for Resource Management Development and Planning. Using Morgan table, 57 people were randomly selected and analyzed by t-test and non-parametric statistical tests using SPSS software. Has been. The content validity of the questionnaire was obtained by examining the research background and obtaining the opinions of experts, and the Cronbach’s alpha coefficient was used to assess the reliability, the value of which was 0.874.
Results: Statistical tests show that the five levels of intellectual capital management maturity follow a nonlinear pattern and the level of realization of the initial level characteristics, ie lack of intellectual capital structure, is higher than acceptable, but the statistical test of other levels of maturity Included; Managed, defined, quantified and optimal management is not significant at the significance level of 0.05.
Conclusion: The current situation of intellectual capital in the study population indicates that management is unaware of the importance of intellectual capital and no action has been taken to implement the knowledge capital management process. Although there is a lot of necessary infrastructure in the Vice Chancellor, however, insufficient understanding of the capabilities of intellectual capital management as a strategic resource is evident in this research. To reach the defined level and the next levels, the organization needs to identify, activate and direct the intangible source and then quantify, standardize and manage quantitatively and analyze the strengths and weaknesses and finally the continuous improvement of processes and Focus on innovation.

Conceptual Model Design and Evaluation of a Preeclampsia Self-Management Application; Android based

Shahrbanoo Pahlevanynejad

Background and Aim: Preeclampsia is one of the most serious cases of high-risk pregnancies that endanger women’s health worldwide, especially in developing countries. Preeclampsia is a specific pregnancy syndrome with a prevalence of about 7-14%, which is one of the three leading causes of death in pregnant women. Preeclampsia is the second most common cause of maternal mortality in Iran and accounts for 14% of maternal mortality. The present study was conducted to design, create and evaluate mobile-based preeclampsia self-care application.
Materials and Methods: This study was conducted in four stages to assess the needs of information elements, design, create and evaluate preeclampsia self-care application. In needs assessment step, 42 specialists, assistants and personnel related to the subject working in the Amir Al-Momenin (AS) Educational, Research and Treatment Center affiliated to Semnan University of Medical Sciences participated. The program was then initially evaluated by 7 physicians, and finally the suggestions provided by users in the design of the program were applied and the final version of the program was completed. The application was designed in the Android Studio environment and then its usability was evaluated using the opinions of 20 mothers and the QUIS tool.
Results: The information elements and functional capabilities required by the program were determined. In addition, the program established communication between the patient and the provider, also created the possibility of care management and control of the disease process. The performance of the program was evaluated by physicians and experts and then evaluated by pregnant mothers in terms of usability. The findings showed that users were satisfied with the application.
Conclusion: The use of mobile-based applications is a useful way to increase knowledge and promote the health of pregnant mothers and facilitate their access to medical information and acquire the necessary skills in their disease. This program helps pregnant mothers with preeclampsia to control their disease by observing proper nutrition and treatment principles to minimize the complications of their disease.