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Rasoul Alinejad, Mahdi Yousefi, Hossein Ebrahimipoor, Ali Taghipour, Amin Mohammadi,
Volume 14, Issue 2 (5-2020)
Volume 14, Issue 2 (5-2020)
Abstract
Background and Aim: The efficiency and effectiveness of any organization depend greatly on proper and effective management and use of human resources. Due to the importance of activities and the motivation of personnel fighting against diseases, as well as the high share of personnel costs in total health expenditures, the use of appropriate methods to determine their workload is important.
Materials and Methods: The present research is a descriptive and applied study, conducted in two quantitative and qualitative dimensions. The research environment was the urban-rural health centers of Savadkuh health network. During the process of calculating the workload, the steps were: identifying activities, correcting and approving activities, determining the percentage of acceptable unemployment, calculating standard time, determining the number of repetitions, calculating work units, determining the workload, and determining the required manpower.
Results: Activities in the field of fighting against diseases were identified and organized in the form of 77 activities. By taking the frequency of each activity into account, the total time of these activities in one month was equal to 10273 work units. The main activities related to vaccine injection and registration of vaccinated specifications in relevant offices and forms included 137 and 115 work units, respectively.
Conclusion: Determining the workload of different health care fields by using this study method creates the potential to estimate the number of manpower required to give all predicted services, and has the potential to reduce the demand for surplus labor and increase employees’ tendency to give more services, if used in current structures.
Materials and Methods: The present research is a descriptive and applied study, conducted in two quantitative and qualitative dimensions. The research environment was the urban-rural health centers of Savadkuh health network. During the process of calculating the workload, the steps were: identifying activities, correcting and approving activities, determining the percentage of acceptable unemployment, calculating standard time, determining the number of repetitions, calculating work units, determining the workload, and determining the required manpower.
Results: Activities in the field of fighting against diseases were identified and organized in the form of 77 activities. By taking the frequency of each activity into account, the total time of these activities in one month was equal to 10273 work units. The main activities related to vaccine injection and registration of vaccinated specifications in relevant offices and forms included 137 and 115 work units, respectively.
Conclusion: Determining the workload of different health care fields by using this study method creates the potential to estimate the number of manpower required to give all predicted services, and has the potential to reduce the demand for surplus labor and increase employees’ tendency to give more services, if used in current structures.
Raoof Nopour, Mohammad Shirkhoda, Sharareh Rostam Niakan Kalhori,
Volume 14, Issue 2 (5-2020)
Volume 14, Issue 2 (5-2020)
Abstract
Background and Aim: Colorectal cancer is one of the most common gastrointestinal cancers among human beings and the most important cause of death in the world. Based on the risk of colorectal cancer for individuals, using an appropriate screening program can help to prevent the disease. Therefore, the purpose of this study was to design a model for screening colorectal cancer based on risk factors to increase the survival rate of the disease on the one hand and to reduce the mortality rate on the other.
Materials and Methods: By reviewing articles and patients' records, 38 risk factors were detected. To determine the most important risk factors clinically, CVR(content validity ratio) was used; and considering the collected data, Spearman correlation coefficient and logistic regression analysis were applied for statistical analyses. Then, four algorithms -- J-48, J-RIP, PART and REP-Tree -- were used for data mining and rule generation. Finally, the most common model was obtained based on comparing the performance of the algorithms.
Results: After comparing the performance of algorithms, the J-48 algorithm with an F-Measure of 0.889 was found to be better than the others.
Conclusion: The results of evaluating J-48 data mining algorithm performance showed that this algorithm could be considered as the most appropriate model for colorectal cancer risk prediction.
Materials and Methods: By reviewing articles and patients' records, 38 risk factors were detected. To determine the most important risk factors clinically, CVR(content validity ratio) was used; and considering the collected data, Spearman correlation coefficient and logistic regression analysis were applied for statistical analyses. Then, four algorithms -- J-48, J-RIP, PART and REP-Tree -- were used for data mining and rule generation. Finally, the most common model was obtained based on comparing the performance of the algorithms.
Results: After comparing the performance of algorithms, the J-48 algorithm with an F-Measure of 0.889 was found to be better than the others.
Conclusion: The results of evaluating J-48 data mining algorithm performance showed that this algorithm could be considered as the most appropriate model for colorectal cancer risk prediction.
Reza Safdari, Farnoosh Larti, Kamyar Fathi Salari, Saman Mohammadpour,
Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: Cardiovascular diseases and medication errors are among the leading causes of morbidity and mortality around the world. Electronic prescribing and Medication Administration(ePMA) systems can prevent medication errors to some extent. This study aimed to determine the information requirements of ePMA systems.
Materials and Methods: This descriptive study was conducted in Imam Khomeini Hospital of Tehran and School of Allied Medical Sciences affiliated to Tehran University of Medical Sciences (TUMS) in the summer of 2019 in two phases: literature review and survey-based questionnaire. Information items obtained from reviewing the texts of 100 articles were organized in three questionnaires. In the survey phase, questionnaires were distributed among physicians, nurses, and the experts of health information management(HIM) and medical informatics, using census sampling method. The reliability of the questionnaires was measured using Cronbach's coefficient alpha. Statistical analysis was done using SPSS.
Results: The findings showed that based on specialists’ point of view, patients' demographic information items and unique identifiers gained the highest average, above 4.7. Physicians agreed most with clinical information, including medication history and generic names. From the nurses’ point of view, the information items of the patients’ problems and the procedures performed and the types of drug doses obtained a complete average of 5.
Conclusion: The need for information items varies among different users of ePMA systems, but there may be items that are common for them. Future studies should further investigate financial and pharmaceutical information requirements based on the perspectives of other hospital pharmacy and accounting staff.
Materials and Methods: This descriptive study was conducted in Imam Khomeini Hospital of Tehran and School of Allied Medical Sciences affiliated to Tehran University of Medical Sciences (TUMS) in the summer of 2019 in two phases: literature review and survey-based questionnaire. Information items obtained from reviewing the texts of 100 articles were organized in three questionnaires. In the survey phase, questionnaires were distributed among physicians, nurses, and the experts of health information management(HIM) and medical informatics, using census sampling method. The reliability of the questionnaires was measured using Cronbach's coefficient alpha. Statistical analysis was done using SPSS.
Results: The findings showed that based on specialists’ point of view, patients' demographic information items and unique identifiers gained the highest average, above 4.7. Physicians agreed most with clinical information, including medication history and generic names. From the nurses’ point of view, the information items of the patients’ problems and the procedures performed and the types of drug doses obtained a complete average of 5.
Conclusion: The need for information items varies among different users of ePMA systems, but there may be items that are common for them. Future studies should further investigate financial and pharmaceutical information requirements based on the perspectives of other hospital pharmacy and accounting staff.
Ahmad Siar Sadr, Roohollah Tavallaee, Mohammad Ali Afshar Kazemi,
Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: Laboratories are one of the most important scientific and research centers. Laboratory information management systems provide a platform for recording the information and collaborating between researchers. The main purpose of this study was suggesting an organizational architecture model of laboratory information management systems.
Materials and Methods: This study was a qualitative study. In this study, we extracted available documentation and information on laboratory information management systems from databases. Then, 16 faculties and staffs using the Sharif University of Technology's laboratory services were selected by snowball sampling and interviewed to determine needs. Based on needs, enterprise architecture models were extracted from databases. 16 experts have evaluated the enterprise architecture model to select the best model suitable for laboratory services. Due to various technical and managerial aspects of laboratory management systems two models of Zachman architecture and service-oriented architecture models were combined. In the next step, experts from laboratory service systems have evaluated the proposed model, using Delphi technique in three rounds.
Results: The findings were analyzed in two parts: Evaluation of the needs of the laboratory information management system and presentation of the proposed model. In the proposed model, the content of each cell of the Zachman framework is approached Service-oriented were selected and integrated according to the specifications of the laboratory management system.The model was evaluated based on five levels of organizational architecture maturity. The improvement in the maturity of organizational architecture was evident at higher levels.
Conclusion: The use of enterprise architecture for laboratory management systems leads to optimal use of resources and ease of collaboration.
Materials and Methods: This study was a qualitative study. In this study, we extracted available documentation and information on laboratory information management systems from databases. Then, 16 faculties and staffs using the Sharif University of Technology's laboratory services were selected by snowball sampling and interviewed to determine needs. Based on needs, enterprise architecture models were extracted from databases. 16 experts have evaluated the enterprise architecture model to select the best model suitable for laboratory services. Due to various technical and managerial aspects of laboratory management systems two models of Zachman architecture and service-oriented architecture models were combined. In the next step, experts from laboratory service systems have evaluated the proposed model, using Delphi technique in three rounds.
Results: The findings were analyzed in two parts: Evaluation of the needs of the laboratory information management system and presentation of the proposed model. In the proposed model, the content of each cell of the Zachman framework is approached Service-oriented were selected and integrated according to the specifications of the laboratory management system.The model was evaluated based on five levels of organizational architecture maturity. The improvement in the maturity of organizational architecture was evident at higher levels.
Conclusion: The use of enterprise architecture for laboratory management systems leads to optimal use of resources and ease of collaboration.
Shahpar Zakipour, Behzad Farrokh Sersht, Mohammad Javad Taghipourian, Hasan Ali Aghajani,
Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: In recent decades, increasing productivity and reducing losses by improving abnormal behaviors in the workplace have attracted the attention of organizational behavior experts, especially health researchers. The purpose of the present research is to study the factors influencing the reduction of abnormal behaviors in health workplace.
Materials and Methods: By using meta-synthesis technique, the findings of the related internal and external studies were systematically analyzed using Sandelowski and Barroso seven-step method. The identified codes were classified, analyzed and interpreted by MAXQDA10. Kappa method and SPSS were used to measure reliability and quality control. The calculated kappa coefficient was 0.893, which indicated a good consistency.
Results: From 435 articles investigated in this field, 46 articles were selected, based on which 68 factors were identified. These factors were classified into 3 main categories and 11 pivotal codes. The influential factors identified in this study include individual factors(psychological, demographic, religious, and contextual), group factors(communication, appropriate reward system, and deterrent behaviors) and organizational factors(organizational space, organizational measures, organizational emotions, and job position perception).
Conclusion: The results of this study show that individual factors are the most important ones affecting the reduction of abnormal behaviors. Therefore, the findings of this study emphasize psychological, demographic, religious, and contextual factors in planning and managers’ interventions to increase productivity in health workplace.
Materials and Methods: By using meta-synthesis technique, the findings of the related internal and external studies were systematically analyzed using Sandelowski and Barroso seven-step method. The identified codes were classified, analyzed and interpreted by MAXQDA10. Kappa method and SPSS were used to measure reliability and quality control. The calculated kappa coefficient was 0.893, which indicated a good consistency.
Results: From 435 articles investigated in this field, 46 articles were selected, based on which 68 factors were identified. These factors were classified into 3 main categories and 11 pivotal codes. The influential factors identified in this study include individual factors(psychological, demographic, religious, and contextual), group factors(communication, appropriate reward system, and deterrent behaviors) and organizational factors(organizational space, organizational measures, organizational emotions, and job position perception).
Conclusion: The results of this study show that individual factors are the most important ones affecting the reduction of abnormal behaviors. Therefore, the findings of this study emphasize psychological, demographic, religious, and contextual factors in planning and managers’ interventions to increase productivity in health workplace.
Ebrahim Hassanzadeh, Edris Hassanpoor, Seyed Sajjad Razavi, Mohammad Reza Sheikhy-Chaman,
Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: Human resources are one of the most important assets of any organization and the creation of a safe working environment enhances the quality of services in addition to satisfying this valuable capital. The purpose of this study was to evaluate the safety of diagnostic laboratories of hospitals affiliated to Iran University of Medical Sciences (IUMS).
Materials and Methods: This cross-sectional descriptive study was conducted in 7 IUMS hospitals in 2019. Data collection was performed using a checklist that was validated after being translated (by qualitative face validity method); Then, the safety status of the studied laboratories was classified into four categories: Excellent, good, average and poor. Finally, data were analyzed using descriptive statistics and SPSS software.
Results: In determining the validity of the checklist using qualitative face validity, experts' opinions were applied as changes in the tool. In the descriptive part of the study and among the safety dimensions of diagnostic laboratories, the highest mean score was related to the dimensions of "communication hazards" and "safety information" and the lowest to the dimension of "fire safety".
Conclusion: According to the results of the study, the overall safety status of the diagnostic laboratories of the hospitals under investigation is at a good level; however, the "fire safety" component as one the most important safety components was considered poor, and necessary steps must be taken to improve it.
Materials and Methods: This cross-sectional descriptive study was conducted in 7 IUMS hospitals in 2019. Data collection was performed using a checklist that was validated after being translated (by qualitative face validity method); Then, the safety status of the studied laboratories was classified into four categories: Excellent, good, average and poor. Finally, data were analyzed using descriptive statistics and SPSS software.
Results: In determining the validity of the checklist using qualitative face validity, experts' opinions were applied as changes in the tool. In the descriptive part of the study and among the safety dimensions of diagnostic laboratories, the highest mean score was related to the dimensions of "communication hazards" and "safety information" and the lowest to the dimension of "fire safety".
Conclusion: According to the results of the study, the overall safety status of the diagnostic laboratories of the hospitals under investigation is at a good level; however, the "fire safety" component as one the most important safety components was considered poor, and necessary steps must be taken to improve it.
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Volume 14, Issue 3 (7-2020)
Volume 14, Issue 3 (7-2020)
Abstract
Background and Aim: Due to the increasing number of radiographic tests, TLD dosimeters can be used to measure the effective dose of critical organs in various radiographic tests. In this research, the progression of analogue to digital radiology devices, which facilitates and accelerates the performance of radiographs, especially emergency patients, was investigated, and then the effective dose of critical organs in digital radiographic devices was calculated using a thermoluminescence dosimeter.
Materials and Methods: In this cross-sectional study 29 thermoluminescence GR-200 dosimeters(LiF: Mg, Cu, P) were used first, the TLDs were calibrated by the Atomic Energy Organization of Tehran Protection Center, then using TLDs, equivalent doses were used in radiographic tests and finally, the effective dose of critical organs was calculated.
Results: Data were analyzed using Anova in SPSS software. The mean effective doses of critical organs were 0/034±0/0015 mSv for eyes(in skull radiography), 0/0063±0/0004 for thyroid(in cervical radiography), 0/0067±0/0009 for breast(in lung radiography) and 0/2010±0/0652 for ovarian(in abdominal radiography). We found significant differences between effective doses of thyroid and ovaries in common position(Postero Anterior)(p˂0.05). We found non-significant differences between effective doses of the eyes and breast in common position(AntroPosterior)(p˃0.05).
Conclusion: According to the results of this study, the effective dose of the patient in radiographic exames depends on the thickness of the target organ and the patient's position, which has a significant effect on the dose of radiation absorbed by the patient.
Materials and Methods: In this cross-sectional study 29 thermoluminescence GR-200 dosimeters(LiF: Mg, Cu, P) were used first, the TLDs were calibrated by the Atomic Energy Organization of Tehran Protection Center, then using TLDs, equivalent doses were used in radiographic tests and finally, the effective dose of critical organs was calculated.
Results: Data were analyzed using Anova in SPSS software. The mean effective doses of critical organs were 0/034±0/0015 mSv for eyes(in skull radiography), 0/0063±0/0004 for thyroid(in cervical radiography), 0/0067±0/0009 for breast(in lung radiography) and 0/2010±0/0652 for ovarian(in abdominal radiography). We found significant differences between effective doses of thyroid and ovaries in common position(Postero Anterior)(p˂0.05). We found non-significant differences between effective doses of the eyes and breast in common position(AntroPosterior)(p˃0.05).
Conclusion: According to the results of this study, the effective dose of the patient in radiographic exames depends on the thickness of the target organ and the patient's position, which has a significant effect on the dose of radiation absorbed by the patient.
Mahdi Shahraki, Simin Ghaderi,
Volume 14, Issue 4 (10-2020)
Volume 14, Issue 4 (10-2020)
Abstract
Background & Aim: Physicians as human capital and resources are one of the main components of health production. The imbalance of physician supply and demand affects the health and economics. Therefore, this study aimed to estimate and forecast the supply and demand of physician working in Iranian medical universities.
Materials and Methods: This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.
Results: The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.
Conclusion: In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.
Materials and Methods: This a descriptive-analytical and applied study was conducted at national level for Iran during 1991-2017. The statistical population was physicians working in Iranian medical universities. ARIMA method was used to estimate and forecast physician supply and Vector Error Correction Models was used for physician demand. The data is annual time series that was extracted from the statistical yearbooks of the Statistical Center of Iran and the World Bank database. Eviews 10 software was used to estimate the models.
Results: The results showed that physician demand in Iran was affected by Gross Domestic Product, age structure and hospital beds, and according to the forecast of supply and demand of physicians, we will be faced to the physician shortage in the years 2018-2030.
Conclusion: In the coming years, Iran is facing with physician shortage. Therefore, it is recommended to adopt policies to increase physician capacity in medical universities and to increase strong incentives to retain physicians and prevent their migration.
Samira Daniali, Nosrat Riahi,
Volume 14, Issue 4 (10-2020)
Volume 14, Issue 4 (10-2020)
Abstract
Background and Aim: The purpose of the present study is to map the coronavirus domain citation network to better understand this domain based on all other citation networks.
Materials and Methods: The present study is applied in terms of purpose, and is descriptive scientometrics in terms of type, which has been done with the all-citation method. In this study, all scientific publications on coronavirus(6980 documents) in the period 1985-2019 AD were studied on April 10, 2020 in the Web of Science database. For analysis and drawing all citation maps, VOSviewer and Excel software were used.
Results: In the field of coronavirus, 6815 documents, 10246 journals, and 40298 authors were identified. Ksiazek(2003) with the acute respiratory syndrome(SARS) topic received 875 citations and won the first place. The most cited documents in the field of coronavirus have 5 clusters; and the first cluster with 201 documents and with the topic of studying the structure of coronavirus is the largest one. Journal of Virology -- with the thematic range of genome structure and replication, virus identification, etc. -- ranked first with 35,383 citations. The most cited journals in the field of coronavirus are 5 thematic clusters, and the first one is the largest cluster with 121 journals and with the thematic domains of health policy, coronavirus, etc. Also, Woo won PCY first place with his specialization in identifying new microbes and emerging infectious diseases, and receiving 1491 citations. The most cited authors in the field of corona virus are in 6 thematic clusters; the first cluster with 195 authors in specialized field of virology and coronavirus is the largest cluster.
Conclusion: By identifying the highly cited scientific products in the field of coronavirus, efforts have been made to provide a comprehensive view of top documents, top journals, and top authors so that it can be a decision-making tool in the shortest possible time.
Materials and Methods: The present study is applied in terms of purpose, and is descriptive scientometrics in terms of type, which has been done with the all-citation method. In this study, all scientific publications on coronavirus(6980 documents) in the period 1985-2019 AD were studied on April 10, 2020 in the Web of Science database. For analysis and drawing all citation maps, VOSviewer and Excel software were used.
Results: In the field of coronavirus, 6815 documents, 10246 journals, and 40298 authors were identified. Ksiazek(2003) with the acute respiratory syndrome(SARS) topic received 875 citations and won the first place. The most cited documents in the field of coronavirus have 5 clusters; and the first cluster with 201 documents and with the topic of studying the structure of coronavirus is the largest one. Journal of Virology -- with the thematic range of genome structure and replication, virus identification, etc. -- ranked first with 35,383 citations. The most cited journals in the field of coronavirus are 5 thematic clusters, and the first one is the largest cluster with 121 journals and with the thematic domains of health policy, coronavirus, etc. Also, Woo won PCY first place with his specialization in identifying new microbes and emerging infectious diseases, and receiving 1491 citations. The most cited authors in the field of corona virus are in 6 thematic clusters; the first cluster with 195 authors in specialized field of virology and coronavirus is the largest cluster.
Conclusion: By identifying the highly cited scientific products in the field of coronavirus, efforts have been made to provide a comprehensive view of top documents, top journals, and top authors so that it can be a decision-making tool in the shortest possible time.
Reza Safdari, Abdorreza Naser Moghadasi, Sahar Khenarinezhad, Ehsan Ghazanfarisavadkoohi,
Volume 14, Issue 5 (1-2021)
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: Taking a wide range of medications in Multiple sclerosis (MS) patients can lead to side effects and drug interactions. Therefore, the use of intelligent systems such as drug monitoring systems can help in the effective and timely treatment of MS disease. In this regard, the present study was conducted to design, development, and evaluation of the drug monitoring system for multiple sclerosis patients.
Materials and Methods: The present descriptive-developmental study was performed in four stages. In the first stage, by searching the library resources and valid guidelines, the minimum data set was determined and provided to neurologists and MS fellowships in the form of checklists for validation. Then the software was designed logically and coded based on the opinion of experts. In the last stage, the software was evaluated by end-users.
Results: The information elements in the software design were categorized into patient demographic information, medical history, clinical signs, imaging procedures, laboratory tests for ocrelizumab and fingolimod drugs, counseling, and treatment data. Finally, the performance of the drug monitoring system was evaluated with an average of 7.9 and was approved by users.
Conclusion: The results of software evaluation showed that the drug monitoring system can help general practitioners, neurologists, and MS fellowships in monitoring and follow-up of patients and lead to increased patient safety.
Materials and Methods: The present descriptive-developmental study was performed in four stages. In the first stage, by searching the library resources and valid guidelines, the minimum data set was determined and provided to neurologists and MS fellowships in the form of checklists for validation. Then the software was designed logically and coded based on the opinion of experts. In the last stage, the software was evaluated by end-users.
Results: The information elements in the software design were categorized into patient demographic information, medical history, clinical signs, imaging procedures, laboratory tests for ocrelizumab and fingolimod drugs, counseling, and treatment data. Finally, the performance of the drug monitoring system was evaluated with an average of 7.9 and was approved by users.
Conclusion: The results of software evaluation showed that the drug monitoring system can help general practitioners, neurologists, and MS fellowships in monitoring and follow-up of patients and lead to increased patient safety.
Marjan Ghazi Saeedi, Gholam Reza Esmaeili Javid, Niloufar Mohammadzadeh, Hamide Asadallah Khan Vali,
Volume 14, Issue 5 (1-2021)
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: Diabetes is one of the most common metabolic diseases in the world, of which one of the most common and painful complications is diabetic foot ulcer. The accuracy and comprehensiveness of the contents of electronic medical record is effective in improving the quality of treatment and the care of diabetic foot ulcer patients. The aim of this study is to determine the minimum data set (MDS) essential for diabetic foot patients' electronic medical records.
Materials and Methods: In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research (ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences (TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability.
Results: Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.
Conclusion: The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section, they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.
Materials and Methods: In this descriptive-analytical study, authoritative internet and library resources were studied to collect diabetic foot ulcer information elements. Fourteen physicians and nurses working and collaborating with the Wound Healing Center affiliated to Academic Center for Education, Culture and Research (ACECR) were selected for clinical survey, and 5 health information technology specialists of Tehran University of Medical Sciences (TUMS) were chosen for demographic information survey. The study tools were a researcher-made questionnaire, CVR content validity method and test-retest method for reliability.
Results: Out of 23 information elements surveyed in demographic section, cases above 99% of the agreement were selected. Also, out of 86 information elements of the clinical section, more than 51% of the cases were selected. Clinical experts included 6 wound specialists, 4 general practitioners and 6 nurses. In the demographic information section, the lowest agreement was related to the element of identity and Education level with 20% agreement. In clinical information, the lowest agreement was related to surgery, leech therapy and MRI of the foot with 0% and PRP, G-CSF, Sono-Doppler liver with 14%.
Conclusion: The minimum information elements of diabetic foot ulcer electronic medical record were divided into history, wound information, lower limb information, paraclinical results, wound management, and follow-up in clinical section; and in demographic information section, they were divided into identity, admission, finance, reporting, and system capability. The proposed model for manual and electronic medical records is available.
Amin Reza Nabi Zadeh, Ali Reza Nobari,
Volume 14, Issue 5 (1-2021)
Volume 14, Issue 5 (1-2021)
Abstract
Background and Aim: Business process management is a comprehensive management approach that aims to align all dimensions and activities of the organization in line with customer needs and automates all processes of the organization. The aim of this study was to determine the effect of business process management on the financial performance of Tehran University of Medical Sciences.
Materials and Methods: This research is an applied, descriptive and survey type and was conducted between the financial managers of Tehran University of Medical Sciences and Health Services in 2019. The research sample is 181 managers of 85 hospitals, faculties and research and development centers of the university who were selected from Cochran's formula and targeted sampling method. Data collection was done by questionnaires, in financial performance of Hernaeus et al.(2012) and business process management questionnaire, Yarmohammadian, et al.(2012). The validity of the questionnaires was confirmed by convergent and divergent validity and Cronbach's alpha reliability. In data analysis, 65.2% of male respondents, 55.49% had a master's degree or higher, 40.49% had an age of 40 years and 34.4% had more than 20 years of experience. Structural equation modeling (Smart.PLS software) was used to test the hypotheses.
Results: Correlation of index structures of guidelines and treatment procedures and electronic files with mean variance(AVE) of 0.587 and 0.823 and profitability structures of medical centers, return on investment and value added 0.737, 0.755 and 0.750, Shows sufficient and high correlation. The effect of business process management on university financial performance was confirmed as the main hypothesis with a path coefficient of 0.881 and a significant value of 15.383. Also, the effect of corrections related to guidelines and treatment procedures with financial performance with a coefficient of 0.422 and a significant value of 3.702 and corrections related to electronic records of patients with a coefficient of 0.476 and a value of 4.334.
Conclusion: Business process management system includes tools for modeling and analyzing data, integration programs, monitoring and optimization of activities that are effective in financial performance.
Materials and Methods: This research is an applied, descriptive and survey type and was conducted between the financial managers of Tehran University of Medical Sciences and Health Services in 2019. The research sample is 181 managers of 85 hospitals, faculties and research and development centers of the university who were selected from Cochran's formula and targeted sampling method. Data collection was done by questionnaires, in financial performance of Hernaeus et al.(2012) and business process management questionnaire, Yarmohammadian, et al.(2012). The validity of the questionnaires was confirmed by convergent and divergent validity and Cronbach's alpha reliability. In data analysis, 65.2% of male respondents, 55.49% had a master's degree or higher, 40.49% had an age of 40 years and 34.4% had more than 20 years of experience. Structural equation modeling (Smart.PLS software) was used to test the hypotheses.
Results: Correlation of index structures of guidelines and treatment procedures and electronic files with mean variance(AVE) of 0.587 and 0.823 and profitability structures of medical centers, return on investment and value added 0.737, 0.755 and 0.750, Shows sufficient and high correlation. The effect of business process management on university financial performance was confirmed as the main hypothesis with a path coefficient of 0.881 and a significant value of 15.383. Also, the effect of corrections related to guidelines and treatment procedures with financial performance with a coefficient of 0.422 and a significant value of 3.702 and corrections related to electronic records of patients with a coefficient of 0.476 and a value of 4.334.
Conclusion: Business process management system includes tools for modeling and analyzing data, integration programs, monitoring and optimization of activities that are effective in financial performance.
Mohammad Zarbi, Reza Safdari, Nahid Einollahi,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Medical diagnostic laboratories are among the most important centers in the treatment cycle of patients. Today, the conscious choice of such laboratories is one of the challenges that patients face in the treatment process. This study was conducted with the aim of improving the knowledge of software users in the field of laboratory sciences and also facilitating the conscious and intelligent selection of the laboratory required by users.
Materials and Methods: This is a descriptive-developmental research with an applied approach. The steps consisted of library studies, questionnaire-based needs assessment, collection of knowledge and identity data, design through drawing UML diagrams, implementation using Java programming language, and software evaluation.
Results: A comprehensive system of laboratory information and experiments can be performed in all laboratories in Tehran, based on factors such as location access, types of laboratories and types of tests, a system was designed that allows users to access the most appropriate laboratory centers with high speed and less mobility, sufficient information, and in accordance with their needs. The evaluation was done using a researcher-made questionnaire whose validity and reliability were confirmed. The target population consisted of eleven specialists and forty ordinary users. According to the Likert criterion, the results obtained from the answers of all participants in the study to the questions of the questionnaire were higher than 4.05.
Conclusion: The software showed that the factors that had priority in the need assessment significantly increased user satisfaction and also provided ease of use of laboratory services in accordance with users' needs.
Materials and Methods: This is a descriptive-developmental research with an applied approach. The steps consisted of library studies, questionnaire-based needs assessment, collection of knowledge and identity data, design through drawing UML diagrams, implementation using Java programming language, and software evaluation.
Results: A comprehensive system of laboratory information and experiments can be performed in all laboratories in Tehran, based on factors such as location access, types of laboratories and types of tests, a system was designed that allows users to access the most appropriate laboratory centers with high speed and less mobility, sufficient information, and in accordance with their needs. The evaluation was done using a researcher-made questionnaire whose validity and reliability were confirmed. The target population consisted of eleven specialists and forty ordinary users. According to the Likert criterion, the results obtained from the answers of all participants in the study to the questions of the questionnaire were higher than 4.05.
Conclusion: The software showed that the factors that had priority in the need assessment significantly increased user satisfaction and also provided ease of use of laboratory services in accordance with users' needs.
Omid Zadi Akhule, Mojgan Lotfi, Ebrahim Nasiri, Saba Chalangari, Yasna Torkali Pur,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: In order to improve patient safety, countries are seeking to monitor the safety of health systems and since surgical safety is an important part of patient safety, this study aimed to determine performance of Operating Room Personnel regarding the observance of surgical safety principles.
Materials and Methods: This cross-sectional descriptive study was conducted on operating rooms of hospitals of Mazandaran university of medical sciences in 2019. Research population included 271 personnel of operating room selected via stratified random sampling. Data were collected using demographic characteristics questionnaire and Surgical Safety Checklist of the World Health Organization. The data was analyzed using SPSS software.
Results: The mean scores of performance of surgical technologists in the circulating and scrub roles and anesthesia technologists regarding the observance of surgical safety principles, were 23.2±3.1, 18.4±3 and 28.2±3.5 respectively. The performance level of all three specialties was moderate. Findings showed that there was a significant difference between performance score with educational level. The mean score of performance was significantly higher in the technologists with bachelor’s degree as compared to the technologists with associate degree (p<0.05).
Conclusion: Considering that the performance of the participants of the study regarding the observance of surgical safety principles, it was not at a desirable level, thus it is recommended to encourage operating room personnel to upgrade their education and to continue monitoring the performance of them regarding the observance of surgical safety principles.
Materials and Methods: This cross-sectional descriptive study was conducted on operating rooms of hospitals of Mazandaran university of medical sciences in 2019. Research population included 271 personnel of operating room selected via stratified random sampling. Data were collected using demographic characteristics questionnaire and Surgical Safety Checklist of the World Health Organization. The data was analyzed using SPSS software.
Results: The mean scores of performance of surgical technologists in the circulating and scrub roles and anesthesia technologists regarding the observance of surgical safety principles, were 23.2±3.1, 18.4±3 and 28.2±3.5 respectively. The performance level of all three specialties was moderate. Findings showed that there was a significant difference between performance score with educational level. The mean score of performance was significantly higher in the technologists with bachelor’s degree as compared to the technologists with associate degree (p<0.05).
Conclusion: Considering that the performance of the participants of the study regarding the observance of surgical safety principles, it was not at a desirable level, thus it is recommended to encourage operating room personnel to upgrade their education and to continue monitoring the performance of them regarding the observance of surgical safety principles.
Marjan Ghazi-Saeedi, Roya Riahi, Rasool Nouri,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: In this study, in order to increase the visibility of articles in Scopus journals of Tehran University of Medical Sciences (TUMS), selective dissemination of information (SDI) service was presented and its impact on some citation indices was investigated.
Materials and Methods: This is a semi-experimental study of two groups (pretest-posttest design with a control group). In this study, TUMS Scopus indexed journals (20 titles) were randomly divided into test and control groups and their citation indices were assessed. Then, the SDI services for test group journals were designed based on PubMed's Alert system and presented to the university's top researchers for one year. Finally, the citation indices of the journals of test and control groups were reassessed and compared. For data analysis, independent t-test, paired t-test and, covariance analysis were used.
Results: Comparison of mean citations as well as SJR, SNIP and CiteScore indices before and after the intervention showed no significant difference between the test and control groups. But the average CiteScore in both groups after the intervention was significantly higher than the average before the intervention.
Conclusion: The results showed that the provision of the aformentioned services in the time period defined in this study had no significant effect on the citation indices. However, the valuable experiences gained in this study will undoubtedly be applicable to future research as well as services to researchers, librarians, and journal managers.
Materials and Methods: This is a semi-experimental study of two groups (pretest-posttest design with a control group). In this study, TUMS Scopus indexed journals (20 titles) were randomly divided into test and control groups and their citation indices were assessed. Then, the SDI services for test group journals were designed based on PubMed's Alert system and presented to the university's top researchers for one year. Finally, the citation indices of the journals of test and control groups were reassessed and compared. For data analysis, independent t-test, paired t-test and, covariance analysis were used.
Results: Comparison of mean citations as well as SJR, SNIP and CiteScore indices before and after the intervention showed no significant difference between the test and control groups. But the average CiteScore in both groups after the intervention was significantly higher than the average before the intervention.
Conclusion: The results showed that the provision of the aformentioned services in the time period defined in this study had no significant effect on the citation indices. However, the valuable experiences gained in this study will undoubtedly be applicable to future research as well as services to researchers, librarians, and journal managers.
Elahe Behmani, Rastegar Hoseini, Ehsan Amiri,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Multiple sclerosis (MS) is a progressive disease of the central nervous system, of which the symptoms and problems reduce the quality of life. Recent research has identified sport exercises as an important part of healthy lifestyle in reducing the symptoms of the disease and improving the quality of life; however, the most effective type of exercise is not yet clearly known. The aim of this study was to provide information about the beneficial effects of exercise in MS patients and guidelines for prescribing exercise programs for them.
Materials and Methods: This article is an overview of the ways different sport exercises affect MS. To access scientific articles, databases of PubMed, SID, Google Scholar, and Mag Iran, and the keywords including multiple sclerosis (MS), aerobic training, resistance training, and combined training were used.
Results: Recent reports show that different types of sport exercises lead to a significant increase in the improvement of MS symptoms, although there are many discrepancies between researchers in prescribing different exercise programs (various training protocol, duration, and intensity). However, according to the results of studies, regular moderate-intensity exercise training leads to the functional benefits and improvement and control of the disease process without exacerbation of inflammation through various physiological mechanisms. thus, contrary to popular belief, modulated exercise training can have beneficial effects on MS patient.
Conclusion: Based on the findings of the present study, regular exercises (aerobic, resistance and combination) with moderate intensity improve the symptoms of MS and increase the quality of life.
Materials and Methods: This article is an overview of the ways different sport exercises affect MS. To access scientific articles, databases of PubMed, SID, Google Scholar, and Mag Iran, and the keywords including multiple sclerosis (MS), aerobic training, resistance training, and combined training were used.
Results: Recent reports show that different types of sport exercises lead to a significant increase in the improvement of MS symptoms, although there are many discrepancies between researchers in prescribing different exercise programs (various training protocol, duration, and intensity). However, according to the results of studies, regular moderate-intensity exercise training leads to the functional benefits and improvement and control of the disease process without exacerbation of inflammation through various physiological mechanisms. thus, contrary to popular belief, modulated exercise training can have beneficial effects on MS patient.
Conclusion: Based on the findings of the present study, regular exercises (aerobic, resistance and combination) with moderate intensity improve the symptoms of MS and increase the quality of life.
Reza Dehghan, Hamideh Reshadatjoo, Kambeiz Talebi, Hossein Dargahi,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Health tourism is one of the most important tourism types in Iran. Iran has many strengths in health tourism. Also, there are challenges such as communication and information inconsistency in the health tourism industry and the outbreak of COVID-19 disease. Due to the unknown issues about COVID-19, it is important to determine effective strategies to control the consequences and reduce the economic and social effects of the virus in all industries, especially the health tourism industry.
Materials and Methods: In this systematic review study, 500 published papers from 2018 to 2020 were evaluated. In the group interview section, we used the views of participated health tourism experts in the scientific events in Iran, Turkey, and Oman. Also, the SWOC Analysis model (strengths, weaknesses, opportunities, and challenges) and MAXQDA software were applied.
Results: The results showed that the selected strategies were defensive and competitive. This research showed that the strengths of the health tourism industry overcome the weaknesses and development opportunities outweigh the challenges. Also, the maintenance strategy is the best strategy to support health tourism in the current situation in Iran.
Conclusion: It is necessary to be following issues for the politicians of Iran's health tourism industry to design a comprehensive document of Iran Health Tourism Diplomacy, preparation of a strategic plan for the development of health tourism, establish an independent organization of Iran Health Tourism, develop electronic health in the health tourism industry, design a health tourism insurance system, and…, with the aim of entrance to the current markets and creating new foreign markets.
Materials and Methods: In this systematic review study, 500 published papers from 2018 to 2020 were evaluated. In the group interview section, we used the views of participated health tourism experts in the scientific events in Iran, Turkey, and Oman. Also, the SWOC Analysis model (strengths, weaknesses, opportunities, and challenges) and MAXQDA software were applied.
Results: The results showed that the selected strategies were defensive and competitive. This research showed that the strengths of the health tourism industry overcome the weaknesses and development opportunities outweigh the challenges. Also, the maintenance strategy is the best strategy to support health tourism in the current situation in Iran.
Conclusion: It is necessary to be following issues for the politicians of Iran's health tourism industry to design a comprehensive document of Iran Health Tourism Diplomacy, preparation of a strategic plan for the development of health tourism, establish an independent organization of Iran Health Tourism, develop electronic health in the health tourism industry, design a health tourism insurance system, and…, with the aim of entrance to the current markets and creating new foreign markets.
Mohamad Jebraeily, Ali Rashidi, Taher Mohitmafi, Rooghayeh Muossazadeh,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Electronic prescription systems can improve patient safety and the quality of health care services. These systems must provide the capabilities required to reduce medical errors and enhance the performance of health care providers. The purpose of this study is to evaluate the capabilities of the e-prescription system from the perspective of physicians in the polyclinics of the Social Security Organization (SSO) of Urmia.
Materials and Methods: The present study is a descriptive cross-sectional study that was conducted in 2020. The study population consisted of 82 physicians working in 3 polyclinics of the SSO in Urmia, which was determined by census. The instrument used in this study is a self-designed questionnaire that the validity of it was determined based on the opinions of experts and its reliability was evaluated by Cronbach's alpha coefficient. Data analysis was performed using SPSS software.
Results: The results showed that in the section of documentation and access to information, the highest score was related to the possibility of drug prescribe (4.58), request for examination and radiology (4.44). In terms of decision support capabilities, the highest score for providing alerts related to drug interactions (4.18) and controlling the amount of medication prescribed for chronic patients (3.83) and also in the field of technical capabilities, the highest score related to easy to use (3.87) and fit of user interface (3.66).
Conclusion: The e-prescription system under survey has gained fewer score in some capabilities, such as access to pharmaceutical information based on reliable sources, advice to treatment options based on original diagnosis and the customized system. Therefore the system developer should be improved capabilities of it through communicating properly with users and understanding their real needs.
Materials and Methods: The present study is a descriptive cross-sectional study that was conducted in 2020. The study population consisted of 82 physicians working in 3 polyclinics of the SSO in Urmia, which was determined by census. The instrument used in this study is a self-designed questionnaire that the validity of it was determined based on the opinions of experts and its reliability was evaluated by Cronbach's alpha coefficient. Data analysis was performed using SPSS software.
Results: The results showed that in the section of documentation and access to information, the highest score was related to the possibility of drug prescribe (4.58), request for examination and radiology (4.44). In terms of decision support capabilities, the highest score for providing alerts related to drug interactions (4.18) and controlling the amount of medication prescribed for chronic patients (3.83) and also in the field of technical capabilities, the highest score related to easy to use (3.87) and fit of user interface (3.66).
Conclusion: The e-prescription system under survey has gained fewer score in some capabilities, such as access to pharmaceutical information based on reliable sources, advice to treatment options based on original diagnosis and the customized system. Therefore the system developer should be improved capabilities of it through communicating properly with users and understanding their real needs.
Mohammad Saber Malaki, Leila Rouhi, Khalil Khashei Varnamkhasti,
Volume 14, Issue 6 (1-2021)
Volume 14, Issue 6 (1-2021)
Abstract
Background and Aim: Lactobacillus is the most important genus of lactic acid bacteria and the use of some species of lactobacillus with the probiotic potential can be effective for inhibition of the growth of some pathogens and control of
gastrointestinal diseases and cancers. In this study, the pro-apoptotic and antimicrobial effect of Lactobacillus sakei on human colorectal adenocarcinoma cell line and some gastrointestinal pathogenic species was examined.
Materials and Methods: In this study, the antimicrobial activity of metabolites of Lactobacillus sakei was assessed by Well Diffusion Agar (WDA) method against some gastrointestinal pathogenic bacteria. HT-29 colorectal adenocarcinoma cancer cells were cultured in DMEM medium with 10% bovine serum. The cells were treated in 5, 10, 15 and 20 mg/ml concentrations of sakei metabolites and incubated at 24 and 48 hours. Apoptosis was analyzed by Annexin V-FITC/PI kit according to the manufacturers protocol in both incubation times. For error reduction, each test was performed in triplicate
Results: The results of this study indicate that sakei was able to produce antimicrobial metabolites against gastrointestinal pathogenic bacteria. Also, the results of the Annexin test showed that with increasing concentration of sakei metabolites in dose dependent manner, induction of apoptosis in this cell line increases (P<0.05).
Conclusion: It seems that there is a good research field for the use of bioactive compounds produced by Lactobacillus sakei in the control of gastrointestinal pathogenic bacteria and treatment of human colorectal adenocarcinoma.
gastrointestinal diseases and cancers. In this study, the pro-apoptotic and antimicrobial effect of Lactobacillus sakei on human colorectal adenocarcinoma cell line and some gastrointestinal pathogenic species was examined.
Materials and Methods: In this study, the antimicrobial activity of metabolites of Lactobacillus sakei was assessed by Well Diffusion Agar (WDA) method against some gastrointestinal pathogenic bacteria. HT-29 colorectal adenocarcinoma cancer cells were cultured in DMEM medium with 10% bovine serum. The cells were treated in 5, 10, 15 and 20 mg/ml concentrations of sakei metabolites and incubated at 24 and 48 hours. Apoptosis was analyzed by Annexin V-FITC/PI kit according to the manufacturers protocol in both incubation times. For error reduction, each test was performed in triplicate
Results: The results of this study indicate that sakei was able to produce antimicrobial metabolites against gastrointestinal pathogenic bacteria. Also, the results of the Annexin test showed that with increasing concentration of sakei metabolites in dose dependent manner, induction of apoptosis in this cell line increases (P<0.05).
Conclusion: It seems that there is a good research field for the use of bioactive compounds produced by Lactobacillus sakei in the control of gastrointestinal pathogenic bacteria and treatment of human colorectal adenocarcinoma.
Mona Sarhadi, Mohammad Amin Shayegan,
Volume 15, Issue 1 (3-2021)
Volume 15, Issue 1 (3-2021)
Abstract
Background and Aim: For effective treatment of Alzheimer's disease (AD), it is important to accurately diagnosis of AD and its earlier stage, Mild Cognitive Impairment (MCI). One of the most important approaches of early detection of AD is to measure atrophy, which uses various kinds of brain scans, such as MRI. The main objective of the current research was to provide a computerized diagnostic system for early diagnosis of AD, using leraning machine algorithms, to help physicians. The proposed system diagnoses AD by examining the hippocampal atrophy of brain MRI images and increases the accuracy of the diagnosis.
Materials and Methods: In this study, hippocampus was segmented from the other parts of the brain by using active contour and convolutional neural network and then, three groups of “Normal Controls: NC”, AD and MCI were classified by using the SVM classifier.
Results: The proposed method has succeeded in classifying AD against NC with 98.77%, 98.74% and 97.96% in average for accuracy, sensitivity and specificity, respectively. Also in classification of MCI against NC, the mean accuracy, sensitivity and specificity of 96.14%, 96.23% and 88.21% were achieved, respectively. Compared with the nearest rival method, the proposed method showed improvement accuracy and sensitivity of classification AD from NC with 1.64% and 2.81% respectively. Also, in classification of MCI from NC it showed improvement for accuracy with 8.9% and sensitivity with 2.16%, respectively. Improving in results were due to the use of a modified ACM segmentation algorithm, the use of a combination of features extracted from hippocampal images and features already created by the ImageNet network, the removal of inappropriate features from the feature vector, and the use of deep Inception v3 network.
Concolusion: Based on the results, the combination of polygon surrounding the hippocampus features and deep network features can be useful for detection of AD and MCI.
Materials and Methods: In this study, hippocampus was segmented from the other parts of the brain by using active contour and convolutional neural network and then, three groups of “Normal Controls: NC”, AD and MCI were classified by using the SVM classifier.
Results: The proposed method has succeeded in classifying AD against NC with 98.77%, 98.74% and 97.96% in average for accuracy, sensitivity and specificity, respectively. Also in classification of MCI against NC, the mean accuracy, sensitivity and specificity of 96.14%, 96.23% and 88.21% were achieved, respectively. Compared with the nearest rival method, the proposed method showed improvement accuracy and sensitivity of classification AD from NC with 1.64% and 2.81% respectively. Also, in classification of MCI from NC it showed improvement for accuracy with 8.9% and sensitivity with 2.16%, respectively. Improving in results were due to the use of a modified ACM segmentation algorithm, the use of a combination of features extracted from hippocampal images and features already created by the ImageNet network, the removal of inappropriate features from the feature vector, and the use of deep Inception v3 network.
Concolusion: Based on the results, the combination of polygon surrounding the hippocampus features and deep network features can be useful for detection of AD and MCI.
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