Payavard Salamat

Assessment of Women’s Learning Needs and Preferences in the Development of a Smartphone Application for Breast Self-examination

Mohamad Jebraeily

Background and Aim: Breast self-examination is a recommended screening method that can be used by any woman at any age. Smartphone applications can be a low-cost and effective strategy to prevent breast cancer by changing behavior and encouraging women to be aware of their breast health. The purpose of this research is to determine the learning needs and preferences of women in the development of a BSE smartphone application.
Materials and Methods: This descriptive-cross-sectional study was conducted in 2023, The statistical population of the study included 120 women working in the faculties of Urmia University of Medical Sciences, who were selected through stratified proportional sampling. To collect data, a questionnaire was designed, the validity of which was confirmed based on the content validity method and expert opinion. The test-retest method was also used to determine the reliability of the questionnaire, which resulted in a Pearson correlation coefficient of 85%. The rating of each item in the questionnaire was determined based on a five-point Likert scale (1-5). The Statistical analysis of the data was performed using SPSS software.
Results: From the perspective of women, the most important learning needs are related to breast cancer risk factors (4.68), the importance of early detection of breast cancer (4.33), how to perform breast self-examination (4.38), the role of breast self-examination in breast cancer prevention (4.18), ways to detect breast cancer early (4.11), types of physical activities (4.16) and healthy diet (4.08) related to breast cancer prevention. In terms of the technical capabilities of the application, the most important features include multimedia educational content (4.61), self-examination training (4.52), information about warning signs (4.33), self-examination time reminder (4.29) and ease of use (4.20).
Conclusion: The findings of the present study showed that educational content should present risk factors and the role of diet and physical activity in preventing breast cancer, and teach how to accurately perform breast self-examination with multimedia content. Also, the technical capabilities of the smartphone application should be designed in a way that suits women’s learning needs while maintaining the confidentiality of information and the privacy of individuals.

A Glance at the Experiences of Controlling the COVID-19 Disease in Kohgiluyeh and Boyer Ahmad Provinces Based on GIS Information

Seyed Hassan Faqihi

Background and Aim: The COVID-19 pandemic has confronted the world with various problems in the economic, social and political dimensions of health. The present study aimed to investigate control and preventive measures in controlling COVID-19, to investigate the epidemiology and cumulative incidence of COVID-19, as well as management activities, empowerment of personnel, and capacity estimation in Kohgiluyeh and Boyer Ahmad provinces; an attempt was also made to use GIS geographic information to guide policymakers.
Materials and Methods: The present study is a cross-sectional study that was conducted using a review of reliable information within a period of 41 months after the identification of the first case of the disease in the province. The collected information, including sampling cases, hospitalizations, deaths, and COVID-19 vaccination statistics, was collected from the portal of the Center for Infectious Disease Management of the Ministry of Health, the Integrated Health System (SIB), and the Health System Information Observatory of the Ministry of Health, Treatment and Medical Education.
Results: The cumulative number of cases and deaths due to COVID-19 in the province is 130,129 and 1,137, respectively. The total number of doses of vaccine administered in the province, based on the coverage area, according to the Integrated Health System (IHS), was 1,363,703. Also, increasing the bed capacity of the intensive care unit in the province to 55 beds, setting up three CT scanners in the provincial hospitals, and setting up a cellular and molecular laboratory in the two cities of Boyer Ahmad and Kohgiluyeh, in addition to distributing COVID-19 vaccines to all health centers, health bases, and health and medical centers, and sending mobile teams to conduct COVID-19 vaccinations to administer the vaccine door-to-door and in offices and organizations, were among the management activities in the field of COVID-19 control in the province.
Conclusion: Increasing the capacity to sample suspected cases and identify patients in the shortest possible time, isolating them, taking intervention measures to encourage people to get vaccinated, and creating awareness about preventing this disease have reduced the burden caused by it and increased the response capacity of the provincial health system.

Identifying the Role Players of the Gestational Diabetes Self-Management Network on Mobile Health (Based on the Social Network Analysis)

Mohammad Mehdi Sepehri

Background and Aim: The development of self-management application for gestational Diabetes based on mobile health, can increase the quality of life of pregnant mothers and reduce the cost of health care and treatment. In order to develop such an application, it is necessary to identify the key players of this system and examine the relationships between them. Then a gestational Diabetes self-management network based on mobile health tools can be presented.
Materials and Methods: The study was conducted in four phases. In the first phase, key players and roles were identified through literature review. In the second phase, interviews with experts were conducted to assess the identified players and their roles. The third phase involved identifying the relationships between players and their roles, accomplished by designing and completing questionnaires that explored the existence or absence of connections between them. In the final phase, the most critical roles and players were determined using social network analysis, employing three centrality indices: degree centrality, betweenness centrality, and closeness centrality.
Results: A total of 22 role players and 17 roles were identified. Based on the results, the Ministry of Health, with a degree centrality index of 41.12, was found to be the most influential and powerful role player in this network. The endocrinologist, nutritionist and obstetrician, with degree centrality indices of 38.52, 36.79, and 31.60. were ranked next. This indicates that the acceptance of this network by the medical community plays a critical role. Additionally, all three centrality indices showed that the role of patient education had the highest values, followed by roles such as education for specialists and healthcare staff, supporting patients in self-care behaviors, and ensuring patient safety and privacy, which were identified as the key roles.
Conclusion: This study aimed to identify various aspects of network design and the influential roles impacting the self-management of gestational Diabetes through mobile health. The Ministry of Health and the National Prevention Committee exhibited the most connections with each other in fulfilling their shared roles. Therefore, the Ministry of Health can fully delegate some roles to the National Prevention. Additionally, recognizing key roles underscores the necessity of prioritizing education and resource allocation for these roles.

The Evaluation of Relationship of Preoperative Hypertension with Intraoperative Hemodynamic Changes and Early Post-Operative Cardiovascular and Cerebral Complications in Cataract Surgery

Mehryar Taghavi Gilani

Background and Aim: Hypertension is one of the most common comorbidities in cataract surgery and severe hypertension sometimes cause surgery to be postponed. The purpose of this study is to evaluate the relationship between preoperative hypertension and intraoperative hemodynamic changes and postoperative early cardiovascular and cerebral complications on cataract surgery.
Materials and Methods: This study was performed on 160 patients with cataract surgery in Mashhad Khatam-al-anbia hospital. Before induction, the patients were divided into three groups by blood pressure measurement: normotensive (blood pressure <140/90) 100 patients, hypertensive (blood pressure 140/90 to 180/110) 30 patients and hypertensive crisis (blood pressure>180/110) 30 patients. Blood pressure and heart rate were assessed before entering to operating room, before induction and every 5 minutes to the end of surgery, after recovery and ward transfer. Cardiovascular and neurological complications were assessed 24 hours after surgery. Data were analyzed by SPSS software. P<0.05 was considered significant.
Results: There was no significant difference between patients for demographic and preoperative hemodynamic parameters. Preinduction, the blood pressure increased compared to the ward, which was more significant in the hypertensive and hypertensive crisis groups (P=0.001). After induction, systolic blood pressure reduced which was more significant in the hypertensive crisis group than two other groups (P=0.001). The heart rate increased after transferring to the operation room and returned to normal after induction of anesthesia, but in three groups were not statistically significant (P=0.25). Systolic blood pressure < 90 mmHg during the surgery, and also cardiovascular and nervous complications up to 24 hours were not significantly different in three groups (P=0.75 and P=0.08, respectively).
Conclusion: Blood pressure instability was more common in patients with hypertension crisis, but no early or debilitating complications were observed. Primary hemodynamic changes were rapidly reduced and controlled by induction of anesthesia. According to the findings, preinduction blood pressure alone is not sufficient to cancellation of cataract surgery.

Investigating the Association between Aquaporin-4 and Osteoporosis in Patients with Neuromyelitis Optica Spectrum Disorders

Zhila Maghbooli

Background and Aim: Neuromyelitis Optica Spectrum Disorders (NMOSD) is an uncommon disorder of the central nervous system mainly affecting the optic nerves and spinal cord. NMOSD is associated with IgG antibody binding to aquaporin-4 (AQP4) that triggers astrocyte and axon loss. Aquaporin 4 is also expressed skeletally and affects bioenergetic regulation pathways and calcium (Ca²⁺) translocations.
The aim of this study was the association between AQP4 and bone loss in NMOSD patients.
Material and Methods: In this study, 32 NMOSD patients were enrolled as the case group, and 37 age-matched individuals without a history of neurological disorders or other acute or chronic conditions served as the control group. Patients with NMOSD were diagnosed based on the criteria established by Wingerchuk et al. Dual x-ray absorptiometry (DEXA) was used to assess bone mineral density (BMD) at three bone sites: the total hip, femoral neck, and spinal lumbar vertebrae (L1-L4). Bone status was defined based on the Z-score in these regions, with a Z-score less than -2 classified as severe bone loss.
Results: Among patients with NMOSD, 15.6% exhibited severe bone densitometry loss in at least one area (total hip, femoral neck, or spine), compared to 5.4% in the control group (P=0.01). Bone densitometry results showed that the Z-score in the femoral neck and hip regions was significantly lower in individuals with NMOSD compared to the control group (P<0.05). In NMOSD patients, the Z-score in the femoral neck and hip regions was considerably lower in aquaporin-4 positive patients compared to the control group (P<0.05). In the regression model, after adjusting for age, sex, body mass index, and history of vitamin D supplementation, patients with aquaporin-4 had lower bone mass (P=0.02).
Conclusion: The study results indicate that aquaporin-4 may play a mediating role in the bone status of patients with NMOSD.

Analysis of Scientific Publications from Social Determinants of Health Research Centers in Iran: A Scientometric Study

Mehdi Moshki

Background and Aim: The Social Determinants of Health Research Centers in Iran utilize existing capacities to conduct research aimed at identifying and implementing effective methods to reduce social health inequalities. Therefore, this study analyzes the scientific publications of these centers using Bibliomerix tools.
Materials and Methods: This descriptive study employs a bibliometric aimed to analyze approach. The study population consisted of all scientific documents produced by the Social Determinants of Health Research Centers in Iran, ind in the Scopus database up to the end of 2023. Data analysis was conducted using the Bibliometrix package in the R programming language.
Results: The results revealed that Iranian Social Determinants of Health Research Centers have produced 8,358 scientific publications. The publication trend began in 2010, peaking in 2022. Original research articles (7,197 documents) constituted the majority of publications. The journals Health Education and Health Promotion, Medical Journal of the Islamic Republic of Iran, and Koomesh published the highest number of articles. Tehran University of Medical Sciences (1505 documents), Shahid Beheshti University of Medical Sciences (1080 documents), and Tabriz University of Medical Sciences (955 documents) were the leading institutions. Inter-institutional collaborations highlighted the pivotal role of Tehran University. International collaborations were primarily with United States, United Kingdom, and Australia. Key keywords included COVID-19, quality of life, and prevalence. Research themes focused on mental health, women, obesity, and diabetes, expanding in 2023–2024 toward primary healthcare and vulnerable populations.
Conclusion: The findings of this study indicate that research centers focusing on social determinants of health in Iran have experienced a growing trend in scientific production and the expansion of their research domains. This progress is evident not only in the increasing number of scientific publications but also in the shift of research approaches from focusing on specific diseases to broader issues such as health policy, mental health, and social health inequalities. These findings may serve of this study can serve as a valuable guide for policymakers and researchers in setting research priorities in the field of social determinants of health.

Study of Dimensions of Low Back Pain and Its Characteristics among Operating Room Nurses in Ahvaz Hospitals: A Cross-Sectional Study

Jaber Zabihirad

Background and Aim: Low back pain (LBP) is one of the most common musculoskeletal disorders among operating room nurses, and numerous studies have well explained its causes and factors. However, studies focusing on the characteristics and dimensions of low back pain and its relationship with influencing factors have not been conducted. Therefore, the aim of this study was to investigate the prevalence of the type of LBP, duration of back pain, and severity of back pain, and their relationship with the demographic characteristics of operating room nurses.

Materials and Methods: This cross-sectional study was conducted on 350 operating room nurses at Ahvaz teaching hospitals in Iran in 2023. Data were collected using a questionnaire that included demographic information and LBP characteristics. Data were analyzed using IBM SPSS.
Results: 64.8% of the subjects were female, 63.5% were married, and their mean age was 33.83±7.02 years. The prevalence of LBP among operating room nurses was 74.3%. In 60.7% of participant who have LBP, the first experience of back pain was in the past 5 years. The most common diagnosis of LBP was muscular disorders (29.9%). Also, 57.3% of them had pain only in the lower back and 42.7% of them had LBP radiating to the legs. We found no statistically significant relationship between the duration and severity of LBP and demographic characteristics (P<0.05). A statistically significant relationship was found between the type of LBP and gender and level of education, as well as between the duration of LBP and severity of LBP (P<0.05).
Conclusion: The findings of this study showed a high prevalence of LBP among operating room nurses, and differences in the type of LBP were observed based on gender and educational level, which may be attributed to individual factors. Additionally, the significant relationship between the duration of LBP and its severity may indicate the effect of the long duration of LBP on its severity, which suggests that providing counseling and treatment programs for nurses who are in the early stages of LBP.

Evaluation of Health Readiness Components in Isfahan Hospital Libraries

Maryam Kazerani

Background and Aim: Hospital library services are among the basic infrastructures for promoting e-health readiness. This study evaluated the components of e-health readiness in hospital libraries in Isfahan.
Materials and Methods: This is an applied-descriptive survey. The statistical population is 10 government hospital libraries in Isfahan city. The questionnaire completers are the managers of the aforementioned libraries. The research tool is a researcher-made questionnaire that was prepared by a deep and comprehensive review of related literature. The 61-question questionnaire is based on the Likert scale and has four sections: learning readiness (R1), core readiness (R2), social readiness (R3), and technology readiness (R4). To determine the content validity of the questionnaire, the opinions of professors, specialists, and experts were used and its validity was confirmed. Its reliability was confirmed using Cronbach’s alpha of 0.83. Descriptive statistics were used to examine the data.
Results: Isfahan government hospital libraries are in a good state in terms of learning readiness with a score of 3.77. They were in a moderate state in terms of core readiness with a score of 3.49. Social readiness with a score of 2.47 and technology readiness with a score of 2.48 were reported as poor state. “Literacy level of technology and services related to health care” component with a score of 2.9 from the core readiness, “reimbursement policies” component with a score of 1 from the social readiness, “resources training” component with a score of 1.8 from the learning readiness, and “organization access to ICT education” component with a score of 1.35 from the technology readiness were identified as weak components. In general, all government hospital libraries in Isfahan are in a moderate state in terms of e-health readiness.
Conclusion: Hospital libraries face various challenges in joining the e-health category, including a lack of readiness in the technology sector. The lack of appropriate policies for implementing e-health in libraries, lack of users’ skills in using information and communication technology, users’ ignorance of the e-health services needed in the library, lack of professional human resources, and lack of e-health-related training for users are some of the weaknesses of hospital libraries in the e-health readiness sector.