Payavard Salamat

Presenting a Model for Predicting Demand in the Supply Chain of Medical Tourism

Farzad Firouzi Jahantigh

Background and Aim: The tourism industry plays a very important role in the economic cycle of society. Medical tourism, as one of the types of tourism industries, has a direct result in globalizing health care. Therefore, by strengthening the supply chain in this area, a very high added value can be achieved. For this reason, the present study provides a conceptual framework for predicting the demand for medical tourism supply chain by determining the relationship between medical tourism demand and economic, medical, and welfare-service components of Zahedan city.
Materials and Methods: The present study is a descriptive-analytical and applied research. Data were collected using a questionnaire and field and library methods. The statistical population of interest was specialist doctors in Zahedan city, and 97 people were selected using simple random sampling with Morgan’s table. The validity of the questionnaire was confirmed by experts and its reliability was obtained using Cronbach’s alpha coefficient with SPSS software more than 0.7. Data analysis was performed using the tangent sigmoid neural network algorithm, linear regression criteria, and mean square error. For this purpose, SPSS software was used to examine the correlation between the data, and MATLAB software was used to design the neural network.
Results: There was anerrore in The basis for the optimality of the answers, linear regression criteria and mean square error. The results showed that the values related to regression, education, and health were more than 0.8 and were 0.9033, 0.8818, and 0.9985, respectively. The highest priorities of the respondents related to medical equipment, education, and health were 0.5657, 0.5558, and 0.20726, respectively.
Conclusion: According to the results obtained from the proposed model, the neural network has a high accuracy in predicting the demand for medical tourism supply chain in terms of education, health, and welfare. It is also predicted that the demand for medical tourism has been constant during the one-year period of research and it is expected that medical tourism in Zahedan city will decrease in future. Therefore, it is recommended that officials pay attention to the development and improvement of medical tourism to promote it.

Futures Studies in Health in Iran: A Scoping Review

Maryam Tajvar

Background and Aim: Futures studies are constantly evolving and help organizations and individuals for better identification of future events, opportunities, and threats. In the field of health, futures studies are also applied for better prediction of health issues in future, control of unpleasant condition and preparing for pleasant future in health system. The purpose of this study is to conduct a scoping review of the futures studies accomplished in the field of health in Iran,
Materials and Methods: This study is a scoping review, conducted based on the Arksey and O’Malley framework with 6 steps including research question identification, related study identification, study selection / screening, data segmentation, summarizing and reporting results and providing guidance and recommendations n. National and international databases and search engines including PubMed, Web Of Science (WOS), Scopus, ProQuest, SID, Magiran, IranDoc and Google Scholar were searched using related keywords. After removing duplicate articles, the remaining articles were screened according to inclusion and exclusion criteria. The results of the selected articles were finally categorized, summarized and reported based on the mentioned steps.
Results: Among of 6691 articles identified, 30 articles reached the final synthesis stage. The articles were classified into forecasting, foresighting, and mixed categories, with the scenario writing method being the most widely used and applied in 20 studies. Also, studies were classified in scope of nature based on quantitative or qualitative and time horizon. Types of futures studies methods in Iran, in the fields of public health, medicine, science and technology, financing, prescription, health tourism, diet, human resources, aging, Covid-19 epidemic, health policy, hospital and macro level of health system were used.
Conclusion: The use of futures studies methods in a targeted manner and on the issues of Iran’s health system can play an effective role in knowing the future for more informed decision-making and planning in order to build a desirable future. The results of this review showed that scattered studies have been conducted with futures studies methods in the field of health, among which the scenario writing method has received more attention.

A Survey on the Knowledge and Attitude and its Related Factors in Health Care Providers about Alzheimer’s Disease

Zahra Khaje

Background and Aim: Alzheimer’s is a chronic disease that causes cognitive disabilities, thinking, personality changes and disruptions in daily activities. Due to these disorders, patients need long-term care. Most care for Alzheimer’s patients is done at home by family members, which makes home caregivers mentally, physically, emotionally, socially and financially vulnerable. Health personnel have a key role to play in providing information and guidance and helping the family control these conditions. The purpose of this study was to examines the level of knowledge and attitude of health workers and determines the related factors.
Materials and Methods: This research is a cross-sectional study to evaluate the level of knowledge and attitude of health workers about Alzheimer’s disease and its related factors. All 260 health workers of Gorgan and Kordkuy districts were studied by census method to assess their knowledge and attitude about Alzheimer’s disease and its related factors. ANOVA and T-tests were used to determine the relationship between the independent variables and the dependent variable. Variables whose significant level of correlation with response variable was less than 0.2 in bivariate analysis were entered into the regression model and finally multiple linear regression was used to determine the factors related to level of knowledge and attitude.
Results: The mean level of knowledge was 46.73% (95% CI, 45.46 to 48.16) and the mean level of attitude was 55.61% (95% CI, 54.63 to 56.74). The results show that those with a history of previous education, a history of caring for Alzheimer’s patients, a higher level of work experience in the health care system, and having a female gender and be married have higher levels of knowledge and those with a history of previous education and Sistani descent had a higher attitude.
Conclusion: In general, the mean level of knowledge was 46.73(0-100) and the mean level of attitude was 55.61(0-100). Factors such as: gender, work history in the health system, history of participating in educational workshops, history of caring for sick patients, and marital status were related to the level of knowledge and factors such as ethnicity and history of participating in the training workshop were related to the level of attitude of the health care providers.

Changes in Echocardiography and Electrocardiogram among Patients Poisoned with Aluminum Phosphide Referred to the Baharloo Specialized Hospital

Mohammad Aarefi

Background and Aim: Aluminum phosphide poisoning is one of the fatal poisonings in Asian countries, including Pakistan and India, which requires urgent treatment. Since one of the most important symptoms in patients poisoned with aluminum phosphide is cardiovascular manifestations; it seems that electrocardiogram and echocardiographic changes are one of the important things that need to be measured in patients poisoned with this substance. Therefore, the study was designed to investigate electrocardiogram and echocardiographic changes in patients poisoned with aluminum phosphide.
Materials and Methods: The present study was conducted cross-sectionally 2019-2021 on 107 patients poisoned with aluminum phosphide who referred to the poisoning emergency of Baharloo Hospital in Tehran. All patients were included in the study due to taking tablets, solution or inhalation of aluminum phosphide. Finally, the patients› information was collected based on the variables investigated in this study including age, gender, poisoning dose, time interval between taking pills and admission to the hospital, systolic blood pressure level, electrocardiogram and echocardiography changes.
Results: The mean systolic blood pressure was 107 mmHg at the beginning of the study that changed to 103 mmHg after 24 hours. In addition, the mean diastolic blood pressure was 71.19 mmHg at the beginning of the study that changed to 68.66 mmHg after 24 hours. The blood pH of the patients at the beginning of the study and after 24 hours, was 6.99 and 7.39, respectively (P-value= 0.081). The mean EF was 40.68at the beginning of the study which, on average, changed to 46.57 mmHg after 24 hours (%5.21 increase, P-value= 0.029).
Conclusion: The results of the present study showed that extensive changes in the echocardiography of the heart, especially the left ventricular ejection fraction, as well as the patient›s ECG could indicate the severity of heart poisoning in patients poisoned with aluminum phosphide.

Psychometric Properties of Persian Version of the Mobile-Health Technology Engagement Index

Seyed Alireza Hasani

Background and Aim: The use of Mobile-Health is helpful in facilitating therapeutic communication between students and healthcare providers. Considering the benefits of the Mobile-Health, it is very important to have a tool that can check the motivation to use Mobile-Health. Therefore, this study was conducted with the aim of Psychometric properties of mHealth Technology Engagement Index.
Materials and Methods: The present study is psychometric research that was conducted in Tehran University of Medical Sciences in 1401. The participants of this study were 450 students of medical sciences in Tehran in undergraduate, master’s and doctorate levels who were included in the study through convenience sampling. The psychometric characteristics of the questionnaire were examined through face, content and construct validity respectively. Principal component analysis was performed using varimax rotation in order to check the factorial structure of the questionnaire. The reliability of the questionnaire was checked with the help of Cronbach’s alpha and intra- class correlation (ICC).
Results: The questionnaire’s content validity ratio (CVR) and content validity index (CVI) were 0.91 and 0.86, respectively. In the formal validity check, minor changes were made in the words of most of the items. Based on the results of face validity, some minor changes were made to the vocabulary of most items. The ICC coefficient was more than 0.80 in all dimensions. The results of exploratory and confirmatory factor analysis extracted five factors, autonomy, competence, relatedness, goal setting and goal attainment, and their cumulative variance was %71.48. The fit of the five-factor model was optimal based on standard goodness of fit indices such as CFI=0.978, GFI=0.930, RMSEA=0.040, CMIN/DF=1.307. Convergent and divergent validity was accepted for all factors. The reliability of the questionnaire was obtained using Cronbach’s alpha test of 0.71.
Conclusion: The five factor structure of the questionnaire of interaction with mobile health technology has good validity and reliability. Therefore, this questionnaire can be used to check the level of interaction of users of medical science students with mobile health technology.

Designing, Implementing, and Evaluating a User-Friendly Resource Management Dashboard for a General Hospital in a Low-Income Country

Parisa Yousefi Konjdar

Background and Aim: A medication dashboard could provide executive directors and managers with the ability to manage medication resources in hospitals. This study aimed to design, implement, and evaluate a medication resources management dashboard for general hospitals.
Materials and Methods: This study was of the development-applied type conducted in an academic therapeutic community center. Based on scientific sources, the dashboard’s key performance indicators (KPIs) and functional requirements were identified. The data collection tool was a questionnaire comprising demographic information, KPIs, and functional requirements. The dashboard conceptual model was designed using Rational Rose software, and then POWER BI software was used to develop the system. The usability of the dashboard was evaluated using the standard questionnaire for End User Computing Satisfaction by 10 users. The data were analyzed in SPSS software using descriptive statistics.
Results: The most important KPIs determined for a medication resources management dashboard in general hospitals were “the ratio of antibiotic consumption to total number of drugs”, “the ratio of the antibiotic prescribed by general practitioners to total number of drugs”, “the ratio of patients for whom antibiotics were prescribed to all patients”, and “the ratio of the number of drug items prescribed by specialists to all physicians”. The most important functional requirements determined were “updating information at specific intervals “, “checking the dashboard at different time intervals”, “defining access levels to view the information”, and “choosing between graphical and tabular displays”. Usability evaluation showed that users’ satisfaction with the dashboard content variable was “very high” and for the other variables was at a “high” level.
Conclusion: The KPIs associated with antibiotics and drug costs within the medication dashboard of general hospitals are high priority. Future studies should evaluate the impact of using a medication dashboard on hospital executive directors’ and managers’ decision-making.

Prevalence of Toxoplasma Gondii in Broiler Referred to Kashan Industrial Abattoir, Central Iran, 2023

Hossein Hooshyar

Background and Aim: Toxoplasma gondii is one of the important food-borne parasitic pathogens that infect humans and a wide range of warm-blooded animals. Consumption of poultry meat, especially chicken, is a potential risk of transmission of toxoplasmosis to humans. This study aimed to determine the prevalence of T. gondii infection in industrial broilers referred to the Kashan poultry abattoir, Iran, in 2023.
Materials and Methods: This cross-sectional study was performed on 114 brain and heart samples of industrial broilers were randomly collected from Kashan poultry abattoir. Two prepared direct smears from each sample were stained with Giemsa stain and examined microscopically for the presence of tissue cysts of T. gondii. The genomic DNA was extracted using a commercial kit. PCR method was used for detection of the B1 genome of T. gondii using specific primers. The PCR product was evaluated by electrophoresis on a 1.5% agarose gel. The results were analyzed with descriptive statistics using SPSS software.
Results: Of 114 chicken samples, 65 (57%) and 49 (43%), were male and female respectively. Totally, 12 samples (10.5%) were positive for T. gondii infection. T. gondii DNA fragments were detected in 8 (7.06%) of the samples. Microscopy examination revealed T.gondii in 6 (5.26%) samples. All infections were related to brain samples, and no infection was detected in heart muscle samples.
Conclusion: Infection with T. gondii is considerable in broilers in the Kashan region. Therefore, preventive measures such as training people to properly cook meat before consumption and avoiding eating raw or under‑cooked poultry meat products are recommended to prevent human infection to T. gondii. In order to stop life cycle of this parasite, avoiding using raw bird meat for feeding pets such as cats is recommended.

Conceptual Design of Self-Care Application for after Coronary Artery Bypass Surgery

Homa Hajizadegan

Background and Aim: Atherosclerosis of coronary arteries is the most common heart disease and indication of coronary artery bypass graft(CABG). After CABG, patients need proper self-care and lifestyle changes to increase their quality of life. The present research aimed to the conceptual design of self-care Android software, focusing on the third phase of cardiac rehabilitation.
Materials and Methods: This descriptive research has been carried out in two main phases and a total of six steps in order to assess the informational and functional needs of self-care software and design its conceptual model. After searching in reliable scientific sources and guidelines and checking the available Persian software, through the content validity index questionnaire of Lavshe, Welts and Bassel, 23 people from the medical staff with a history of caring for heart patients participated in the step of determining the requirements and the results were analyzed using SPSS Software. Descriptive analysis was done. Finally, the software model was prepared using integrated modeling language and th mind map was drawn.
Results: Sixty two items were identified in 6 general categories (personal information, medical records, interventions, personal health record, essential information, emergency communication). In the phase of determining the requirements by the experts, 52 items were accepted and 10 items were included in the conceptual model of the application program with minor changes and revisions.
Conclusion: Using mobile health in self-care and cardiac rehabilitation will be a suitable solution in order to increase treatment, follow-up and optimal continuation of self-care in patients. By having different functions, this tool can facilitate lifestyle change and help patients in secondary prevention of cardiovascular events and improve their health.