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Ahmad Siar Sadr, Roohollah Tavallaee, Mohammad Ali Afshar Kazemi,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Enterprise Architecture based on laboratory needs, and by using of the commons of valid and existing enterprise architecture frameworks, leads to the aligns of needs with organizational strategies and goals and information technology infrastructure. The aim of this study was the investigation of the effect of enterprise architecture model implementation on laboratory information management systems.
Materials and Methods: In this quantitative study in 2020, proposed enterprise architecture model which was based on the compilation of Zachman and service-oriented architecture models was investigated by the maturity of enterprise architecture at Sharif University. The statistical community of this study was 100 laboratory specialists based on Morgan sample determination table CCM (Capacity Maturity Model), which was designed based on the Likert spectrum, was used as a questionnaire assessment tool. For data analysis, descriptive indicators such as frequency, percentage and one-sample t-test to compare the mean in SPSS software was used.
Results: Assessing the maturity of enterprise architecture including four areas of IT (Information Technology) planning and organization, IT development and implementation, IT service and support, and IT monitoring and evaluation. Among the various dimensions of enterprise architecture maturity, the lowest average was related to the field of monitoring and evaluation and the highest average was related to the field of service and support. Dimensions in terms of status were: service and support dimension, planning and organizing dimension, development and implementation dimension, monitoring and evaluation dimension, respectively. The test results were significantly different in the areas related to the maturity of enterprise architecture, including the planning and organization areas, development and implementation, service and support (P<0.0001). There was no significant difference in monitoring and evaluation.
Conclusion: The use of enterprise architecture specific to laboratory management systems causes the optimal use of resources and ease of interaction. Evaluation of the implementation of the proposed architectural framework in the laboratory environment showed that the proposed model has matured in the three areas of planning and organization, development and implementation, service and support. In order to improve the maturity of enterprise architecture, more attention should be paid to the field of monitoring and evaluation and the reform program should start from this field.
Materials and Methods: In this quantitative study in 2020, proposed enterprise architecture model which was based on the compilation of Zachman and service-oriented architecture models was investigated by the maturity of enterprise architecture at Sharif University. The statistical community of this study was 100 laboratory specialists based on Morgan sample determination table CCM (Capacity Maturity Model), which was designed based on the Likert spectrum, was used as a questionnaire assessment tool. For data analysis, descriptive indicators such as frequency, percentage and one-sample t-test to compare the mean in SPSS software was used.
Results: Assessing the maturity of enterprise architecture including four areas of IT (Information Technology) planning and organization, IT development and implementation, IT service and support, and IT monitoring and evaluation. Among the various dimensions of enterprise architecture maturity, the lowest average was related to the field of monitoring and evaluation and the highest average was related to the field of service and support. Dimensions in terms of status were: service and support dimension, planning and organizing dimension, development and implementation dimension, monitoring and evaluation dimension, respectively. The test results were significantly different in the areas related to the maturity of enterprise architecture, including the planning and organization areas, development and implementation, service and support (P<0.0001). There was no significant difference in monitoring and evaluation.
Conclusion: The use of enterprise architecture specific to laboratory management systems causes the optimal use of resources and ease of interaction. Evaluation of the implementation of the proposed architectural framework in the laboratory environment showed that the proposed model has matured in the three areas of planning and organization, development and implementation, service and support. In order to improve the maturity of enterprise architecture, more attention should be paid to the field of monitoring and evaluation and the reform program should start from this field.
Seyed Amir Reza Nejat, Mahmoud Bigler, Seyedeh Bahareh Kashian,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Intellectual capital, with its basic knowledge nature, is an intangible, strategic, unique and competitive advantage resource. The purpose of this study is to investigate the current state of intellectual capital maturity in the field of management and planning of Tehran university of medical sciences.
Materials and Methods: This research was applied in terms of purpose and with a quantitative approach in 1400 and a questionnaire was used to collect information. The statistical population is the middle and basic managers of the Vice Chancellor for Resource Management Development and Planning. Using Morgan table, 57 people were randomly selected and analyzed by t-test and non-parametric statistical tests using SPSS software. Has been. The content validity of the questionnaire was obtained by examining the research background and obtaining the opinions of experts, and the Cronbach’s alpha coefficient was used to assess the reliability, the value of which was 0.874.
Results: Statistical tests show that the five levels of intellectual capital management maturity follow a nonlinear pattern and the level of realization of the initial level characteristics, ie lack of intellectual capital structure, is higher than acceptable, but the statistical test of other levels of maturity Included; Managed, defined, quantified and optimal management is not significant at the significance level of 0.05.
Conclusion: The current situation of intellectual capital in the study population indicates that management is unaware of the importance of intellectual capital and no action has been taken to implement the knowledge capital management process. Although there is a lot of necessary infrastructure in the Vice Chancellor, however, insufficient understanding of the capabilities of intellectual capital management as a strategic resource is evident in this research. To reach the defined level and the next levels, the organization needs to identify, activate and direct the intangible source and then quantify, standardize and manage quantitatively and analyze the strengths and weaknesses and finally the continuous improvement of processes and Focus on innovation.
Materials and Methods: This research was applied in terms of purpose and with a quantitative approach in 1400 and a questionnaire was used to collect information. The statistical population is the middle and basic managers of the Vice Chancellor for Resource Management Development and Planning. Using Morgan table, 57 people were randomly selected and analyzed by t-test and non-parametric statistical tests using SPSS software. Has been. The content validity of the questionnaire was obtained by examining the research background and obtaining the opinions of experts, and the Cronbach’s alpha coefficient was used to assess the reliability, the value of which was 0.874.
Results: Statistical tests show that the five levels of intellectual capital management maturity follow a nonlinear pattern and the level of realization of the initial level characteristics, ie lack of intellectual capital structure, is higher than acceptable, but the statistical test of other levels of maturity Included; Managed, defined, quantified and optimal management is not significant at the significance level of 0.05.
Conclusion: The current situation of intellectual capital in the study population indicates that management is unaware of the importance of intellectual capital and no action has been taken to implement the knowledge capital management process. Although there is a lot of necessary infrastructure in the Vice Chancellor, however, insufficient understanding of the capabilities of intellectual capital management as a strategic resource is evident in this research. To reach the defined level and the next levels, the organization needs to identify, activate and direct the intangible source and then quantify, standardize and manage quantitatively and analyze the strengths and weaknesses and finally the continuous improvement of processes and Focus on innovation.
Amin Jalili Sarqaleh, Mohammad Azizi, Kianosh Khamoshyan,
Volume 16, Issue 1 (3-2022)
Volume 16, Issue 1 (3-2022)
Abstract
Background and Aim: Multiple Sclerosis is a chronic disease of myelin sheath degradation that reduces the quality of life in patients. Recent studies emphasize on the effect of exercise and natural supplements on the improvement of disease symptoms and quality of life. The aim of this study was to evaluate the effect of eight weeks combined training at home with red grape juice supplementation on quality of life in women with Multiple Sclerosis.
Materials and Methods: In this study, 48 women with MS in the age range of 20-40 years were voluntarily selected and divided into 4 groups: training (n=12), supplement (n=12), training+supplement (n=12) and control (n=12). Combined training included 8 weeks and 3 sessions per week for 60 minutes of endurance and resistance training with an intensity of 10-12 rate of perceived exertion. Subjects consumed 250 cc of grape juice supplement with 68% concentration for 8 weeks, 3 times a week. The control group engaged in their daily activities. Quality of life was measured with standard questionnaire (WHOQOL-BREF) 48 hours before and after the end of the study.
Results: Eight weeks of intervention made a significant change in the quality of life. Based on the correlation t the results were as follows training groups (P=0.001)(7.1%), supplement (P=0.001)(10.5%) and training+supplement (0.000), There was a significant difference between the pre-test and the post-test (P≤0.05). But the changes in the training+supplement group were more than the other groups (P=0.000)(13.3%). In addition, based on the results of one-way analysis of variance, the amount of changes between the groups was also significant (P≤0.05). There was a significant difference between the training group and the control group, supplement group and supplement+training group (P≤0.05). Also, the supplement group had a significant difference with the exercise group and the control group, but there was no significant difference with the supplement + training group (P≥0.05). A significant difference was observed in the supplement+training group with all groups except the supplement group (P≤0.05).
Conclusion: According to the results of the present study, women with Multiple Sclerosis can use combined training at home with red grape juice supplement to improve their quality of life.
Materials and Methods: In this study, 48 women with MS in the age range of 20-40 years were voluntarily selected and divided into 4 groups: training (n=12), supplement (n=12), training+supplement (n=12) and control (n=12). Combined training included 8 weeks and 3 sessions per week for 60 minutes of endurance and resistance training with an intensity of 10-12 rate of perceived exertion. Subjects consumed 250 cc of grape juice supplement with 68% concentration for 8 weeks, 3 times a week. The control group engaged in their daily activities. Quality of life was measured with standard questionnaire (WHOQOL-BREF) 48 hours before and after the end of the study.
Results: Eight weeks of intervention made a significant change in the quality of life. Based on the correlation t the results were as follows training groups (P=0.001)(7.1%), supplement (P=0.001)(10.5%) and training+supplement (0.000), There was a significant difference between the pre-test and the post-test (P≤0.05). But the changes in the training+supplement group were more than the other groups (P=0.000)(13.3%). In addition, based on the results of one-way analysis of variance, the amount of changes between the groups was also significant (P≤0.05). There was a significant difference between the training group and the control group, supplement group and supplement+training group (P≤0.05). Also, the supplement group had a significant difference with the exercise group and the control group, but there was no significant difference with the supplement + training group (P≥0.05). A significant difference was observed in the supplement+training group with all groups except the supplement group (P≤0.05).
Conclusion: According to the results of the present study, women with Multiple Sclerosis can use combined training at home with red grape juice supplement to improve their quality of life.
Seyede Mahrokh Alinaghi-Maddah, Maryam Zahedi Tabarestani, Kazem Kazemnejad-Tabrizi, Samira Ghasemi, Fatemeh Mehravar,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Atracurium, as one of the neuromuscular relaxants, is one of the most important irritants of the allergic reaction during anesthesia, which causes the release of histamine. This study was conducted with the aim of determining the effect of hydrocortisone on hemodynamic changes resulting from atracurium drug in patients with upper limb fractures under general anesthesia.
Materials and Methods: In this double-blind randomized clinical trial study, 50 patients with upper limb fractures under general anesthesia, 18 to 60 years old with ASA class 1 and 2, were randomly assigned to two groups of hydrocortisone and placebo (distilled water). In intervention group, 30 minutes before entering the operating room, vial oxycort (hydrocortisone) was administered intravenously and bolus with 300 ml of normal saline. Hemodynamic changes in patients before administration of hydrocortisone, 30 minute after administration, 5 minutes after the peak effect of atracurium (before intubation) and after extubation were recorded in the relevant checklist and comparisons were made between the two groups.
Results: There was no significant difference between the two groups in terms of age, gender and duration of surgery. Systolic blood pressure 5 minutes after the peak effect of atracurium (before intubation) in the control group was lower than the intervention group and this difference was statistically significant (P=0.02). Thirteen minute after hydrocortisone administration, mean blood pressure systolic and diastolic patients decreased and this decrease continued after administration of histamine release atracurium (before intubation); but after extubation, the patients’ mean blood pressure has increased. Also, after administration of atracurium, the mean heart rate of patients decreased by 14.44 units as compared to before administration of hydrocortisone and this decrease was significant (P=0.001).
Conclusion: The results of this study show that hydrocortisone can be used as an effective factor in maintaining hemodynamic stability in patients under general anesthesia. However, its use as a factor in maintaining hemodynamics has not yet been widespread and needs further investigation.
Materials and Methods: In this double-blind randomized clinical trial study, 50 patients with upper limb fractures under general anesthesia, 18 to 60 years old with ASA class 1 and 2, were randomly assigned to two groups of hydrocortisone and placebo (distilled water). In intervention group, 30 minutes before entering the operating room, vial oxycort (hydrocortisone) was administered intravenously and bolus with 300 ml of normal saline. Hemodynamic changes in patients before administration of hydrocortisone, 30 minute after administration, 5 minutes after the peak effect of atracurium (before intubation) and after extubation were recorded in the relevant checklist and comparisons were made between the two groups.
Results: There was no significant difference between the two groups in terms of age, gender and duration of surgery. Systolic blood pressure 5 minutes after the peak effect of atracurium (before intubation) in the control group was lower than the intervention group and this difference was statistically significant (P=0.02). Thirteen minute after hydrocortisone administration, mean blood pressure systolic and diastolic patients decreased and this decrease continued after administration of histamine release atracurium (before intubation); but after extubation, the patients’ mean blood pressure has increased. Also, after administration of atracurium, the mean heart rate of patients decreased by 14.44 units as compared to before administration of hydrocortisone and this decrease was significant (P=0.001).
Conclusion: The results of this study show that hydrocortisone can be used as an effective factor in maintaining hemodynamic stability in patients under general anesthesia. However, its use as a factor in maintaining hemodynamics has not yet been widespread and needs further investigation.
Leila Shahmoradi, Niloofar Kheradbin, Ahmad Reza Farzanehnejad, Niloofar Mohammadzadeh, Atefeh Ghanbari Jolfaei,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Identifying risk factors is recommended as the first step for depression management in children and adolescents. This study aims to determine the data elements required for developing a clinical decision support system for screening major depression in young people.
Materials and Methods: This research was a descriptive-analytical study. The research population included a variety of mental health specialists that were both psychologists and students in psychiatry and guidance & counseling majors as well as electronic databases including Scopus, Pubmed, Embase, PsychInfo, WOS and Clinical key. The data collection tool was a questionnaire designed in three main sections which was answered by a convenient sample of 8 people who were specialists in the field. To analyze the extracted data Content Validity Ratio (CVR) and Mean measures were calculated for each item in questionnaire. Content Validity Index (CVI) and Cronbach’s Alpha (using SPSS software) were calculated which were equal to 0.74 and 0.824 respectively which confirmed validity and reliability of the research tool.
Results: According to Lawshe’s table, data elements with CVR between 0 and 0.75 and Mean less than 1.5, like “Ethnicity and race” (CVR=-0.25, Mean=1.125), were rejected. Items such as “Gender” (CVR=0.5) with a CVR equal to or less than 0.75, as well as items with a CVR between 0 and 0.75 and a Mean equal to or more than 1.5, like “Marital status” (CVR=0.5, Mean=1.625) were retained and considered to be included as the minimum data set for screening major depression in ages 10 to 25 years. Data elements were categorized in three categories: Demographic, Clinical and Psychosocial
Conclusion: Clinical decision support systems can facilitate providing healthcare at different levels such as screening major depression. These systems can be used for screening major depression risk factors to improve accessibility to mental health practitioners, assure the implementation of guidelines and provide a common language between different levels of healthcare. Determining the minimum data set for screening major depression in ages 10 to 25 years, is the first step toward developing a clinical decision support system for screening individuals for major depression.
Materials and Methods: This research was a descriptive-analytical study. The research population included a variety of mental health specialists that were both psychologists and students in psychiatry and guidance & counseling majors as well as electronic databases including Scopus, Pubmed, Embase, PsychInfo, WOS and Clinical key. The data collection tool was a questionnaire designed in three main sections which was answered by a convenient sample of 8 people who were specialists in the field. To analyze the extracted data Content Validity Ratio (CVR) and Mean measures were calculated for each item in questionnaire. Content Validity Index (CVI) and Cronbach’s Alpha (using SPSS software) were calculated which were equal to 0.74 and 0.824 respectively which confirmed validity and reliability of the research tool.
Results: According to Lawshe’s table, data elements with CVR between 0 and 0.75 and Mean less than 1.5, like “Ethnicity and race” (CVR=-0.25, Mean=1.125), were rejected. Items such as “Gender” (CVR=0.5) with a CVR equal to or less than 0.75, as well as items with a CVR between 0 and 0.75 and a Mean equal to or more than 1.5, like “Marital status” (CVR=0.5, Mean=1.625) were retained and considered to be included as the minimum data set for screening major depression in ages 10 to 25 years. Data elements were categorized in three categories: Demographic, Clinical and Psychosocial
Conclusion: Clinical decision support systems can facilitate providing healthcare at different levels such as screening major depression. These systems can be used for screening major depression risk factors to improve accessibility to mental health practitioners, assure the implementation of guidelines and provide a common language between different levels of healthcare. Determining the minimum data set for screening major depression in ages 10 to 25 years, is the first step toward developing a clinical decision support system for screening individuals for major depression.
Zahra Otroj, Firoozeh Zare-Farashbandi, Fatemeh Rastegari,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Health information seeking behavior can be influenced by several factors and variables such as personality traits, beliefs, values, tendencies, contextual factors and personal emotions. Health information has a direct relationship with the quality of life of people in society, it can be influential in decisions related to personal and social health and improve people’s performance in this field. This study aimed to determine the relationship between personality types of graduate students of Isfahan University of medical Sciences (IUMS) and their health information seeking behavior based on the Miller model.
Materials and Methods: This was an applied survey study. The study population was all graduate students of IUMS. The sample size was determined using the Morgan table of 297 people. Data collection tools are Neo Five Personality Factor Questionnaire and Miller Information Behavior Questionnaire. Data were analyzed by SPSS software.
Results: The results showed that there is an inverse relationship between personality type “Psychotic” and the component of “active search for health information”. Also there is a direct relationship between persons who are “Eager for new experiences” and “conscientiousness” with the component of “active search for health information”. But there is no significant relationship between personality types “extroversion” and “agreeability” with the components of health informing behavior. The studied students are not responsible and conscientious in terms of personality type, they often prefer solitude and are introverted and conservative. But more than half of them are balanced in the dimension of “agreeability”.
Conclusion: This study showed that people who are eager for new experiences and conscientious, search health information actively, but Psychotic persons are not willing to be active in seeking health information This means that the more responsible and conscientious people are, or the more eager they are for new experiences, the more actively they search for health information. Therefore, it is better for health policy makers to plan in such a way that the necessary health information is provided to them interactively based on the personality of the people.
Materials and Methods: This was an applied survey study. The study population was all graduate students of IUMS. The sample size was determined using the Morgan table of 297 people. Data collection tools are Neo Five Personality Factor Questionnaire and Miller Information Behavior Questionnaire. Data were analyzed by SPSS software.
Results: The results showed that there is an inverse relationship between personality type “Psychotic” and the component of “active search for health information”. Also there is a direct relationship between persons who are “Eager for new experiences” and “conscientiousness” with the component of “active search for health information”. But there is no significant relationship between personality types “extroversion” and “agreeability” with the components of health informing behavior. The studied students are not responsible and conscientious in terms of personality type, they often prefer solitude and are introverted and conservative. But more than half of them are balanced in the dimension of “agreeability”.
Conclusion: This study showed that people who are eager for new experiences and conscientious, search health information actively, but Psychotic persons are not willing to be active in seeking health information This means that the more responsible and conscientious people are, or the more eager they are for new experiences, the more actively they search for health information. Therefore, it is better for health policy makers to plan in such a way that the necessary health information is provided to them interactively based on the personality of the people.
Mostafa Shanbehzadeh, Hadi Kazemi-Arpanahi, Raoof Nopour,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Breast cancer is one of the most common and aggressive malignancies in women. Timely diagnosis of breast cancer plays an important role in preventing the progression of this disease, timely treatment measures, and aftermath reducing the mortality rate of these patients. Machine learning has the potential ability to diagnose diseases quickly and cost-effectively. This study aims to design a CDSS based on the rules extracted from the decision tree algorithm with the best performance to diagnose breast cancer in a timely and effective manner.
Materials and Methods: The data of 597 suspected people with breast cancer (255 patients and 342 healthy people) were retrospectively extracted from the electronic database of Ayatollah Taleghani Hospital in Abadan city with 24 characteristics, mainly pertained to lifestyle and medical histories. After selecting the most important variables by using the Chi-square Pearson and one-way analysis of variance (P<0.05), the performance of selected data mining algorithms including RF, J-48, DS, RT and XG -Boost was evaluated for breast cancer diagnosis in Weka 3.4 software. Finally, the breast cancer diagnostic system was designed based on the best model and through C# programming language and Dot Net Framework V3.5.4.
Results: Fourteen variables including personal history of breast cancer, breast sampling, and chest X-ray, high blood pressure, increased LDL blood cholesterol, presence of mass in upper inner quadrant of the breast, hormone therapy with estrogen, hormone therapy with Estrogen-progesterone, family history of breast cancer, age, history of other cancers, waist-to-hip ratio and fruit and vegetable consumption showed a significant relationship with the output class at the P<0.05. Based on the results of the performance evaluation of selected algorithms, the RF model with sensitivity, specificity, accuracy, and F- measure equal to 0.97, 0.99, 0.98, 0.974, respectively, AUC=0.936 had higher performance than other selected algorithms and was suggested as the best model for breast cancer diagnosis.
Conclusion: It seems that using modifiable variables such as lifestyle and reproductive-hormonal characteristics as input to the RF algorithm to design the CDSS, can detect breast cancer cases with optimal accuracy. In addition, the proposed system can be effectively adapted in real clinical environments for quick and effective disease diagnosis.
Materials and Methods: The data of 597 suspected people with breast cancer (255 patients and 342 healthy people) were retrospectively extracted from the electronic database of Ayatollah Taleghani Hospital in Abadan city with 24 characteristics, mainly pertained to lifestyle and medical histories. After selecting the most important variables by using the Chi-square Pearson and one-way analysis of variance (P<0.05), the performance of selected data mining algorithms including RF, J-48, DS, RT and XG -Boost was evaluated for breast cancer diagnosis in Weka 3.4 software. Finally, the breast cancer diagnostic system was designed based on the best model and through C# programming language and Dot Net Framework V3.5.4.
Results: Fourteen variables including personal history of breast cancer, breast sampling, and chest X-ray, high blood pressure, increased LDL blood cholesterol, presence of mass in upper inner quadrant of the breast, hormone therapy with estrogen, hormone therapy with Estrogen-progesterone, family history of breast cancer, age, history of other cancers, waist-to-hip ratio and fruit and vegetable consumption showed a significant relationship with the output class at the P<0.05. Based on the results of the performance evaluation of selected algorithms, the RF model with sensitivity, specificity, accuracy, and F- measure equal to 0.97, 0.99, 0.98, 0.974, respectively, AUC=0.936 had higher performance than other selected algorithms and was suggested as the best model for breast cancer diagnosis.
Conclusion: It seems that using modifiable variables such as lifestyle and reproductive-hormonal characteristics as input to the RF algorithm to design the CDSS, can detect breast cancer cases with optimal accuracy. In addition, the proposed system can be effectively adapted in real clinical environments for quick and effective disease diagnosis.
Ali Reza Yavar, Zahra Batooli, Fatemeh Sheikhshoaei, Sara Ahmadizadeh,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: The outbreak of the Covid-19 pandemic has led to the emergence of new information needs for people with diverse information literacy. Both infected and healthy people feel the need to have essential and practical information about this pandemic. One of the concerns of Covid-19 patients is their need for reliable and sufficient information about various aspects of the disease. Understanding the information needs of patients and the experiences of people who have been infected and recovered from the disease can be a suitable and reliable source of information. So the aim of this study was to identify the information needs of patients with Covid-19.
Materials and Methods: This research was employed a qualitative approach using conventional content analysis. Key informants were Covid-19 recovered patients in Kashan city who had a history of admission in medical centers. Sampling consisted 17 participants (11 males and 6 females) who were selected from almost different social classes through purposeful method. The data were collected using a semi-structured interview and the saturation point was reached at 17 interviews. Data were analyzed using the Diekelmann’s seven-stage method.
Results: The results of this study included 430 primary codes that after removing and merging duplicate codes, seven main themes and 30 categories were identified in the field of information needs were extracted. Main themes and categories included understanding the nature of the disease (the origin of the disease, knowledge about the symptoms, transmission and types of mutations), prevention (health protocols, prevention equipments, and vaccination), treatment (diagnostic tests, type of disease treatment, disease process, costs, psychological support), nutrition (the type of nutrition for prevention, during illness and after recovery), communication with others (type, length and conditions of quarantine, how to communicate with others), statistics, and information sources (up-to-date, valid, and types).
Conclusion: The most critical information needs of Covid-19 patients include information about the nature, treatment, and preventive measures of the disease. Social media and oral information such as doctors, friends, and acquaintances were also reported as the most important sources of information. Therefore, this study suggests that health managers provide the most up-to-date and reliable information and news related to Covid-19 through the most appropriate and accessible media.
Materials and Methods: This research was employed a qualitative approach using conventional content analysis. Key informants were Covid-19 recovered patients in Kashan city who had a history of admission in medical centers. Sampling consisted 17 participants (11 males and 6 females) who were selected from almost different social classes through purposeful method. The data were collected using a semi-structured interview and the saturation point was reached at 17 interviews. Data were analyzed using the Diekelmann’s seven-stage method.
Results: The results of this study included 430 primary codes that after removing and merging duplicate codes, seven main themes and 30 categories were identified in the field of information needs were extracted. Main themes and categories included understanding the nature of the disease (the origin of the disease, knowledge about the symptoms, transmission and types of mutations), prevention (health protocols, prevention equipments, and vaccination), treatment (diagnostic tests, type of disease treatment, disease process, costs, psychological support), nutrition (the type of nutrition for prevention, during illness and after recovery), communication with others (type, length and conditions of quarantine, how to communicate with others), statistics, and information sources (up-to-date, valid, and types).
Conclusion: The most critical information needs of Covid-19 patients include information about the nature, treatment, and preventive measures of the disease. Social media and oral information such as doctors, friends, and acquaintances were also reported as the most important sources of information. Therefore, this study suggests that health managers provide the most up-to-date and reliable information and news related to Covid-19 through the most appropriate and accessible media.
Saman Mohammadpour, Reza Rabiei, Elham Shabahrami, Kamyar Fathisalari, Maryam Khakzad, Mostafa Langarizadeh,
Volume 16, Issue 2 (5-2022)
Volume 16, Issue 2 (5-2022)
Abstract
Background and Aim: Cancer is the second leading cause of death in the world, which leads to the death of more than 10 million people in the world every year. Its early diagnosis, management and proper treatment play an important role in reducing complications and mortality. One of the support tools in early diagnosis, treatment and management of this disease are Clinical Decision Support System (CDSS), which are divided into two groups, rule-based and non-rule-based. Rule-based decision support systems are created based on clinical guidelines, while non-rule-based decision support systems use machine learning. In this research, the effects of decision support systems, rule-based and non-rule-based, on cancer diagnosis, treatment and management were measured.
Materials and Methods: The present study was conducted using a systematic review method, which was conducted by searching the Web of Science, Scopus, IEEE and PubMED databases until 12/31/2021. After removing duplicates and evaluating the characteristics of the inclusion and exclusion criteria, studies related to the goal were selected. The selection of articles was based on the title, abstract and full text The data collection tool was the data extraction form, which included year of study, type of study, system of body, organ of body, the service provided by the decision support system, type of decision support system, effect, effect index and the score of effect index. Narrative synthesis were used for data analysis.
Results: Out of 768 articles, 16 articles related to the objectives of the study were identified. Studies were presented in two categories of clinical decision-support systems: Rule-based and non-Rule based. The effects evaluated in the clinical decision support systems were Rule-based, dose adjustment, symptoms, adherence to treatment guidelines, care time, smoking, need for chemotherapy and pain management, all of which except pain management were significant and positive. The effects evaluated were in the category of non-Rule based clinical decision support systems, diagnostic and therapeutic decisions, controlling neutropenia, all of which were significant and positive except controlling neutropenia.
Conclusion: The results obtained for the effectiveness of both Rule-based and non-Rule-based decision support systems indicated different benefits of these two categories. Therefore, using their combination in the field of cancer can bring very useful results.
Materials and Methods: The present study was conducted using a systematic review method, which was conducted by searching the Web of Science, Scopus, IEEE and PubMED databases until 12/31/2021. After removing duplicates and evaluating the characteristics of the inclusion and exclusion criteria, studies related to the goal were selected. The selection of articles was based on the title, abstract and full text The data collection tool was the data extraction form, which included year of study, type of study, system of body, organ of body, the service provided by the decision support system, type of decision support system, effect, effect index and the score of effect index. Narrative synthesis were used for data analysis.
Results: Out of 768 articles, 16 articles related to the objectives of the study were identified. Studies were presented in two categories of clinical decision-support systems: Rule-based and non-Rule based. The effects evaluated in the clinical decision support systems were Rule-based, dose adjustment, symptoms, adherence to treatment guidelines, care time, smoking, need for chemotherapy and pain management, all of which except pain management were significant and positive. The effects evaluated were in the category of non-Rule based clinical decision support systems, diagnostic and therapeutic decisions, controlling neutropenia, all of which were significant and positive except controlling neutropenia.
Conclusion: The results obtained for the effectiveness of both Rule-based and non-Rule-based decision support systems indicated different benefits of these two categories. Therefore, using their combination in the field of cancer can bring very useful results.
Reza Abbasi, Fatemeh Rangraz Jeddi, Shima Anvari, Reza Khajouei,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
Background and Aim: Hospital managers are one of the key decision-makers in the implementation of health information systems. This study aimed to determine the implementation challenges of health information systems based on the hospital managers’ perspective.
Materials and Methods: This descriptive-analytical study was conducted in 2019 on the hospital managers of three provinces (Kerman, Yazd, Sistan and Baluchestan). Data were collected using a self-administrated questionnaire. The face validity of this questionnaire was approved by experts in health informatics and health information management and its reliability was confirmed by Cronbach’s alpha (α=96.7%). Data were analyzed using SPSS. To investigate the relationship between the mean of each challenge with demographic variables, Pearson, Independent T-test, and ANOVA tests were used.
Results: In this study, the factors related to ignoring the hospital manager’s needs in system selection (1.333 out of 2 points), hardware purchase cost, insufficient user training to using the system (1.238), inadequate manpower and health informatics specialists (1.19), software purchase cost, insufficient financial resources (1.142), high cost of system launching, the lack of integration and interoperability among information systems, lack of support from health care professionals (1.047), and lack of management experience in choosing the best system (one out of 2) had the highest scores (out of 2 points). Also, personnel training costs to work with the system (-0.092) and Lack of improvement in work processes (-0.047) obtained the lowest scores. Data analysis showed that managers with clinical backgrounds considered financial and human challenges more important than non-clinical managers (P<0.031).
Conclusion: The hospital managers believed that financial, human, technical, managerial, and organizational factors are the most important challenges in implementing health information systems in Iran’s hospitals respectively. The health policy-makers and planners at large and small levels can address many of the challenges before implementing systems by focusing on identified priorities.
Materials and Methods: This descriptive-analytical study was conducted in 2019 on the hospital managers of three provinces (Kerman, Yazd, Sistan and Baluchestan). Data were collected using a self-administrated questionnaire. The face validity of this questionnaire was approved by experts in health informatics and health information management and its reliability was confirmed by Cronbach’s alpha (α=96.7%). Data were analyzed using SPSS. To investigate the relationship between the mean of each challenge with demographic variables, Pearson, Independent T-test, and ANOVA tests were used.
Results: In this study, the factors related to ignoring the hospital manager’s needs in system selection (1.333 out of 2 points), hardware purchase cost, insufficient user training to using the system (1.238), inadequate manpower and health informatics specialists (1.19), software purchase cost, insufficient financial resources (1.142), high cost of system launching, the lack of integration and interoperability among information systems, lack of support from health care professionals (1.047), and lack of management experience in choosing the best system (one out of 2) had the highest scores (out of 2 points). Also, personnel training costs to work with the system (-0.092) and Lack of improvement in work processes (-0.047) obtained the lowest scores. Data analysis showed that managers with clinical backgrounds considered financial and human challenges more important than non-clinical managers (P<0.031).
Conclusion: The hospital managers believed that financial, human, technical, managerial, and organizational factors are the most important challenges in implementing health information systems in Iran’s hospitals respectively. The health policy-makers and planners at large and small levels can address many of the challenges before implementing systems by focusing on identified priorities.
Mahya Jafarnejad, Esmaeil Mohammadnejad, Leila Sayadi, Shima Haghani, Reza Ghanei Gheshlagh, Afzal Shamsi,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
Background and Aim: Fractures and dislocations of the femur are a common and disruptive public health problem worldwide. One of the most common ways is to identify the factors associated with common outcomes that increase mortality, length of hospital stay, and postoperative complications. By identifying these factors, the adverse outcomes of elderly hip fractures can be prevented. Therefore, the aim of this study was to determine the relationship between factors affecting hip fracture and its consequences.
Materials and Methods: The present study was a descriptive cross-sectional observational study. The study population in this study included patients with hip fractures. Patients’ information was examined between 2017-2020 years. Data were analyzed by SPSS applying descriptive statistics, Fisher Exact test, chi-square, independent t-tests, and analytical regression.
Results: The results showed that in this study, the majority of patients with hip fracture had an underlying disease (73.9%). The most common underlying diseases in patients included high blood pressure (20.7%), diabetes (13.2%) and heart diseases (10.5%). The most common causes of death was include old age (40.4%), prevalence of covid-19 (20.2%), heart attack (11.7%), pulmonary embolism (10.6%) and surgical wound infection (10.6%). The most common cause of hip fracture was osteoporosis (26.3%) and falling from a height (24.7%). Also level of education (P=0.0001), causes of fracture (P=0.001), type of anesthesia (P=0.001), history of hospitalization in special wards (P=0.001), readmission (P=0.0001), age (P=0.001) and level of self-care (P=0.001) were significantly associated with elderly mortality. There was a significant relation between type of surgery (P=0.038), history of hospitalization in intensive care units (P=0.001), history of blood transfusion (P=0.021) and level of self-care (P=0.001) with length of hospital stay of fractured elderly hip.
Conclusion: It can be concluded that by identifying the factors affecting the length of hospital stay, surgical wound infection and mortality of the patients with hip fractures, witness better surgery results, shorter hospital stay, less postoperative complications and reduced death. Some factors such as osteoporosis are preventable, which can be prevented with timely education.
Materials and Methods: The present study was a descriptive cross-sectional observational study. The study population in this study included patients with hip fractures. Patients’ information was examined between 2017-2020 years. Data were analyzed by SPSS applying descriptive statistics, Fisher Exact test, chi-square, independent t-tests, and analytical regression.
Results: The results showed that in this study, the majority of patients with hip fracture had an underlying disease (73.9%). The most common underlying diseases in patients included high blood pressure (20.7%), diabetes (13.2%) and heart diseases (10.5%). The most common causes of death was include old age (40.4%), prevalence of covid-19 (20.2%), heart attack (11.7%), pulmonary embolism (10.6%) and surgical wound infection (10.6%). The most common cause of hip fracture was osteoporosis (26.3%) and falling from a height (24.7%). Also level of education (P=0.0001), causes of fracture (P=0.001), type of anesthesia (P=0.001), history of hospitalization in special wards (P=0.001), readmission (P=0.0001), age (P=0.001) and level of self-care (P=0.001) were significantly associated with elderly mortality. There was a significant relation between type of surgery (P=0.038), history of hospitalization in intensive care units (P=0.001), history of blood transfusion (P=0.021) and level of self-care (P=0.001) with length of hospital stay of fractured elderly hip.
Conclusion: It can be concluded that by identifying the factors affecting the length of hospital stay, surgical wound infection and mortality of the patients with hip fractures, witness better surgery results, shorter hospital stay, less postoperative complications and reduced death. Some factors such as osteoporosis are preventable, which can be prevented with timely education.
Mohammad Hossein Sadeghian, Seyed Amirhossein Mahdavi, Farhad Habibi, Masoud Shafiei,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
Background and Aim: The American Psychiatric Association identifies suicide as the third leading cause of death among people aged 15 to 24. This study was conducted with the aim of investigating factors affecting of the occurrence of suicides leading to death in corpses referred to the Forensic Medicine Organization of Tehran Province from 2010 to 2019.
Materials and Methods: This research was a descriptive and analytical cross-sectional study in 2019 year. The statistical population includes all bodies referred to forensic medicine. The information related to all corpses referred to forensic medicine which was analyzed between 2010 and 2019 were 5471 cases. Descriptive and analytical statistical methods were used to analyze the data. P-value less than 0.05% was considered valid.
Results: The results showed that 50% of suicide deaths were under 32 years old. Sixty-nine point two percent of suicides leading to death are male and the rest are female. The highest frequency in terms of method was related to the hanging method, 39.3%, and in the youth age group, in terms of the level of education in men, high school diploma and diploma in women. The highest frequency of suicide related to singles was 47.1% and 27.4% in the summer season. The most common method of suicide was hanging, with more than 39%, followed by poisoning with poison, with more than 25% of cases. The least used method was drowning.
Conclusion: Based on the results of this study, it seems that factors such as age, sex, level of education, and even geographic and social factors are among the factors that affect suicide, which can help policymakers, managers, psychologists, psychiatrists, and related organizations. Paying attention to educational literacy, employment status and income level of people, special attention of families to adolescent and young boys and girls and especially their marital status can be effective measures to prevent suicide.
Materials and Methods: This research was a descriptive and analytical cross-sectional study in 2019 year. The statistical population includes all bodies referred to forensic medicine. The information related to all corpses referred to forensic medicine which was analyzed between 2010 and 2019 were 5471 cases. Descriptive and analytical statistical methods were used to analyze the data. P-value less than 0.05% was considered valid.
Results: The results showed that 50% of suicide deaths were under 32 years old. Sixty-nine point two percent of suicides leading to death are male and the rest are female. The highest frequency in terms of method was related to the hanging method, 39.3%, and in the youth age group, in terms of the level of education in men, high school diploma and diploma in women. The highest frequency of suicide related to singles was 47.1% and 27.4% in the summer season. The most common method of suicide was hanging, with more than 39%, followed by poisoning with poison, with more than 25% of cases. The least used method was drowning.
Conclusion: Based on the results of this study, it seems that factors such as age, sex, level of education, and even geographic and social factors are among the factors that affect suicide, which can help policymakers, managers, psychologists, psychiatrists, and related organizations. Paying attention to educational literacy, employment status and income level of people, special attention of families to adolescent and young boys and girls and especially their marital status can be effective measures to prevent suicide.
Alireza Monadi Sefidan, Reza Afrisham,
Volume 16, Issue 3 (8-2022)
Volume 16, Issue 3 (8-2022)
Abstract
Background and Aim: Previous studies have shown that viral and host miRNAs play a role in the process of controlling or progressing the disease and can even be considered as therapeutic targets. Accordingly, the present review study was designed to evaluate the role of host miRNAs and Covid-19 virus in the disease process.
Materials and Methods: The current study was a review study that was conducted during 2012-2022. Studies were extracted from PubMed, Google Scholar, Web of Science and Scopus scientific databases. The researchers selected relevant resources and a summary of them was presented in this review.
Results: The present review study showed that some host miRNAs such as miR-23b-5p, miR-200c, and miR-125a-5p had an inhibitory effect on ACE2 receptor, while miR-3909, miR-4677, and miR-133a had a stimulatory effect on this receptor. Furthermore, host miR-98-5p had an inhibitory effect on TMPRSS2 gene expression. On the other hand, host miR-146a, miR-21, and miR-142 induced inflammation through MAPK and NF-Ƙβ signaling. While, host miR-124, miR-410, and miR-1336 inhibited factor STAT3 and prevented inflammation. Furthermore, host miR-302b and miR-372 targeted the mitochondrial antiviral signaling protein (MAVS), resulting in silencing of type 1 interferon signaling. It has also been established that host exosomal miR-7-5p, miR-24-3p, miR-145-5p, and miR-223-3p inhibited the replication of SARS-CoV-2 and the expression of S protein and their decreased expression in elderly and Diabetic subjects was associated with decreased inhibition of SARS-CoV-2 replication. Moreover, viral miR-359-5p regulated the expression of MYH9 (non-muscle myosin heavy chain 9), which caused virus invasion and release in the host cell.
Conclusion: This study showed that many miRNAs play a role in controlling or progressing the disease of Covid-19 and it is possible to treat the disease of Covid-19 by changing the expression of viral and host miRNA. However, more research is needed in this regard.
Materials and Methods: The current study was a review study that was conducted during 2012-2022. Studies were extracted from PubMed, Google Scholar, Web of Science and Scopus scientific databases. The researchers selected relevant resources and a summary of them was presented in this review.
Results: The present review study showed that some host miRNAs such as miR-23b-5p, miR-200c, and miR-125a-5p had an inhibitory effect on ACE2 receptor, while miR-3909, miR-4677, and miR-133a had a stimulatory effect on this receptor. Furthermore, host miR-98-5p had an inhibitory effect on TMPRSS2 gene expression. On the other hand, host miR-146a, miR-21, and miR-142 induced inflammation through MAPK and NF-Ƙβ signaling. While, host miR-124, miR-410, and miR-1336 inhibited factor STAT3 and prevented inflammation. Furthermore, host miR-302b and miR-372 targeted the mitochondrial antiviral signaling protein (MAVS), resulting in silencing of type 1 interferon signaling. It has also been established that host exosomal miR-7-5p, miR-24-3p, miR-145-5p, and miR-223-3p inhibited the replication of SARS-CoV-2 and the expression of S protein and their decreased expression in elderly and Diabetic subjects was associated with decreased inhibition of SARS-CoV-2 replication. Moreover, viral miR-359-5p regulated the expression of MYH9 (non-muscle myosin heavy chain 9), which caused virus invasion and release in the host cell.
Conclusion: This study showed that many miRNAs play a role in controlling or progressing the disease of Covid-19 and it is possible to treat the disease of Covid-19 by changing the expression of viral and host miRNA. However, more research is needed in this regard.
Alireza Monadi Sefidan, Ziba Majidi,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: It is important to understand how inflammation caused by COVID-19 affects patients and leads to more complications and diseases. According to the importance of controlling COVID-19 related complications, the current study was designed to evaluate the inflammation caused by COVID-19 and its related complications.
Materials and Methods: The present study is a review study. Studies were retrieved from PubMed, Web of science, Scopus and Google scholar databases. Finally, according to the purpose of the study, the relevant resources were selected by the researchers and a summary of their results was presented in this study.
Results: The present study showed that SARS-CoV-2 viruses enter their genome into the host cell after entering the cell by the spike protein (S) and the important receptor of coronavirus, angiotensin converting enzyme 2 (ACE - 2), and causes the onset of cytokine storms and consequently increase of primary cytokines involved in inflammation. IL-6, IL-8, TNF-α and IL-1 cytokines are key factors; These factors in turn activate macrophages, dendritic cells (DC) and other immune cells. Studies revealed that the inflammation caused by SARS-CoV-2 in the liver by inducing IL-6 activates the JAKs/STAT3 pathway, whose receptor is only found in the liver and immune cells, and causes cytokine release syndrome. Cytokines also cause the release of reactive oxygen species (ROS), superoxide anion, and nitric oxide, so that all of them can damage myocardial cells and cause insulin resistance and diabetes. In addition, the increase of inflammatory cytokines such as IL4, IL10 and IL6 and immune cells lead to cardiac disorders such as arrhythmia. The entry of the virus into the digestive system reduces the bacteria secreting butyrate (with anti-inflammatory effects) and leads to the induction of severe inflammation. Also, corona virus causes obsessive-compulsive disorder, depression and other neurological disorders by increasing pro-inflammatory cytokines and increasing the activity of indoleamine 2,3 dioxygenase (IDO).
Conclusion: Studies have shown that the inflammation caused by COVID-19 plays an important role in the development of the related complications such as disorders in the digestive, hepatic, cardiac, neurologic, pancreas systems and other organs. Therefore, targeting cytokines can potentially improve survival and reduce mortality.
Materials and Methods: The present study is a review study. Studies were retrieved from PubMed, Web of science, Scopus and Google scholar databases. Finally, according to the purpose of the study, the relevant resources were selected by the researchers and a summary of their results was presented in this study.
Results: The present study showed that SARS-CoV-2 viruses enter their genome into the host cell after entering the cell by the spike protein (S) and the important receptor of coronavirus, angiotensin converting enzyme 2 (ACE - 2), and causes the onset of cytokine storms and consequently increase of primary cytokines involved in inflammation. IL-6, IL-8, TNF-α and IL-1 cytokines are key factors; These factors in turn activate macrophages, dendritic cells (DC) and other immune cells. Studies revealed that the inflammation caused by SARS-CoV-2 in the liver by inducing IL-6 activates the JAKs/STAT3 pathway, whose receptor is only found in the liver and immune cells, and causes cytokine release syndrome. Cytokines also cause the release of reactive oxygen species (ROS), superoxide anion, and nitric oxide, so that all of them can damage myocardial cells and cause insulin resistance and diabetes. In addition, the increase of inflammatory cytokines such as IL4, IL10 and IL6 and immune cells lead to cardiac disorders such as arrhythmia. The entry of the virus into the digestive system reduces the bacteria secreting butyrate (with anti-inflammatory effects) and leads to the induction of severe inflammation. Also, corona virus causes obsessive-compulsive disorder, depression and other neurological disorders by increasing pro-inflammatory cytokines and increasing the activity of indoleamine 2,3 dioxygenase (IDO).
Conclusion: Studies have shown that the inflammation caused by COVID-19 plays an important role in the development of the related complications such as disorders in the digestive, hepatic, cardiac, neurologic, pancreas systems and other organs. Therefore, targeting cytokines can potentially improve survival and reduce mortality.
Hamzeh Amin-Tahmasbi, Kimia Malekzadeh Shafaroudi,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: Today, treatment is one of the important goals of tourism. Tourism in health and healthcare is growing rapidly in the world. Despite the fact that Guilan province, as one of the most important and touristic provinces of the country, has an annual population of 500,000 foreign tourists and can be the center of health tourism in Iran. Unfortunately, this province has not been able to have a proper share of the revenues of this field and attract foreign patients in parallel with its treatment capacities.
Materials and Method: The aim of this study was to identify the factors affecting the development of health tourism. In this regard, first, literature review was used and opinions of experts in this field, who were employees in five hospitals in Rasht, including Velayat, PourSina, Aria, Pars and Qaem hospitals, were selected using the Snowball sampling method. Twenty-five effective factors were identified and using Delphi method, 14 factors were selected as the final factor. Then by used of the Best and Worst Method (BWM), the importance of each factor was determined. Finally, using DEMATEL method, the effect of this factor on each other was determined.
Results: After conducting two rounds of Delphi, 11 factors that had an average lower than the average of the total opinions of the experts and there was more disagreement about them were eliminated. Then, by implementing the best-worst method, the quality of medical services was determined as the most important factor, and the ease of booking an appointment in advance for admission and the status of the banking system were determined as the least important factors among the final factors. Also, based on the results of the DEMATEL method, the quality of medical services has the greatest effect and the ease of booking an appointment in advance for admission has the least effect on other factors. Finally, the quality of medical services is the most effective and appropriate advertising about health tourism in domestic and foreign chambers of commerce has the least effectiveness.
Conclusion: Health tourism in Iran despite the relative quality and cheap price, has not yet found its place in the market due to the lack of proper advertising is still taking the first steps. Considering the environmental conditions and the existence of tourism aspects of Rasht, carrying out measures such as improving the quality of medical services, appropriate marketing, and improving infrastructures will lead to the development and improvement of health tourism, and as a result, increasing satisfaction and attracting more customers.
Materials and Method: The aim of this study was to identify the factors affecting the development of health tourism. In this regard, first, literature review was used and opinions of experts in this field, who were employees in five hospitals in Rasht, including Velayat, PourSina, Aria, Pars and Qaem hospitals, were selected using the Snowball sampling method. Twenty-five effective factors were identified and using Delphi method, 14 factors were selected as the final factor. Then by used of the Best and Worst Method (BWM), the importance of each factor was determined. Finally, using DEMATEL method, the effect of this factor on each other was determined.
Results: After conducting two rounds of Delphi, 11 factors that had an average lower than the average of the total opinions of the experts and there was more disagreement about them were eliminated. Then, by implementing the best-worst method, the quality of medical services was determined as the most important factor, and the ease of booking an appointment in advance for admission and the status of the banking system were determined as the least important factors among the final factors. Also, based on the results of the DEMATEL method, the quality of medical services has the greatest effect and the ease of booking an appointment in advance for admission has the least effect on other factors. Finally, the quality of medical services is the most effective and appropriate advertising about health tourism in domestic and foreign chambers of commerce has the least effectiveness.
Conclusion: Health tourism in Iran despite the relative quality and cheap price, has not yet found its place in the market due to the lack of proper advertising is still taking the first steps. Considering the environmental conditions and the existence of tourism aspects of Rasht, carrying out measures such as improving the quality of medical services, appropriate marketing, and improving infrastructures will lead to the development and improvement of health tourism, and as a result, increasing satisfaction and attracting more customers.
Niloofar Mohammadzadeh, Negin Ebrahimi, Mojgan Agah Heris,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: According to the report of the World Health Organization, overweight and chronic and psychological diseases caused by it have reached an alarming level in the world. Today, cognitive behavioral therapy as a specific method for controlling overweight teaches the audience how to identify and change inappropriate behavior patterns and destructive thoughts with distress that negatively affect their behavior and emotions. The purpose of this research was to provide a mobile-based application for overweight control with a cognitive-behavioral therapy approach.
Materials and Methods: This research was of applied-developmental type. In the first stage, by examining the available applications based on mobile and related to weight control and also Beck cognitive therapy protocol for weight loss, the capabilities of the application were identified and then based on a survey of experts, these capabilities were determined. Afterwards, the user interface of the application was designed and the necessary coding was done to use it. The database was then created using MySQL software and the application program was created using Flutter software and Dart programming language and was named CBTdiet. Finally, the usability of the application was evaluated by users using a standard QUIS questionnaire.
Results: Based on the entry and exit criteria, among the 247 identified applications, the capabilities of 17 applications were examined. Finally, according to the opinion of the experts, 21 capabilities, including the ability to send motivational messages to the audience and the ability to reward to achieve weight loss of one kilogram per week, were considered for the design of the application program. The application designed in this research was at a good level from the users’ point of view with an average of 7.99±1.1 and was able to obtain an acceptable level of satisfaction in the evaluation stage. The software’s overall capabilities section got the highest average score (8.12) and the screen section got the lowest average score (7.89) among all sections.
Conclusion: Based on the determined capabilities, a mobile-based application for controlling overweight was designed and created with a cognitive behavioral therapy approach, and it can be effective in overweight control by modifying lifestyle and changing destructive thoughts.
Materials and Methods: This research was of applied-developmental type. In the first stage, by examining the available applications based on mobile and related to weight control and also Beck cognitive therapy protocol for weight loss, the capabilities of the application were identified and then based on a survey of experts, these capabilities were determined. Afterwards, the user interface of the application was designed and the necessary coding was done to use it. The database was then created using MySQL software and the application program was created using Flutter software and Dart programming language and was named CBTdiet. Finally, the usability of the application was evaluated by users using a standard QUIS questionnaire.
Results: Based on the entry and exit criteria, among the 247 identified applications, the capabilities of 17 applications were examined. Finally, according to the opinion of the experts, 21 capabilities, including the ability to send motivational messages to the audience and the ability to reward to achieve weight loss of one kilogram per week, were considered for the design of the application program. The application designed in this research was at a good level from the users’ point of view with an average of 7.99±1.1 and was able to obtain an acceptable level of satisfaction in the evaluation stage. The software’s overall capabilities section got the highest average score (8.12) and the screen section got the lowest average score (7.89) among all sections.
Conclusion: Based on the determined capabilities, a mobile-based application for controlling overweight was designed and created with a cognitive behavioral therapy approach, and it can be effective in overweight control by modifying lifestyle and changing destructive thoughts.
Manouchehr Karami, Payam Kabiri, Farzaneh Fazli, Nahid Ramezanghorbani,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: One of the most important challenges in the field of research information management is the use of reliable and qualified software to manage research resources in health domain. This study aimed to develop a validation tools for research information management systems in Iran to utilize by universities in the process of using existing research information management systems.
Materials and Methods: This was a descriptive study conducted in two stages. In the first stage, a validation tool for research information management systems (Pajoohan, Pajooheshyar, Jiro, Yektaweb, Kuiper) was designed, and in the next stage, in order to ensure the validity of the produced tool, a self-assessment survey was conducted by users of research information management systems in medical sciences universities. Therefore, this tool was completed by 104 researchers from all over the country. The collected data were analyzed by Excel and SPSS software.
Results: The developed validation tool of research information management systems included four components and 82 indicators: software design and architecture (17 indicators), usability and user environment (16 indicators), professional use (36 indicators) and management (13 indicators). Based on the self-declared results of the users, this tool has 57 mandatory features, 26 preferred and 4 optional features. The results of the validation of research information management systems based on this tool showed that the highest rank in the component of architecture, professional use and software management was related to the Kuiper system, and in the component of usability and user environment was related to the Pajoohan system. In the self-declaration done by the users ,12 cases of Jiro system ,11 cases of Kuiper system ,11 cases of Pajoohan system ,7 cases of Pajooheshyar, and 5 cases of Yektaweb system have received confirmation above 75%.
Conclusions: The validation tool which developed by this study can be used in the evaluation of current research information management systems and the selection of new systems for use in the research field. In addition, it can be used to improve current systems and purchase new systems by academic universities and research centers.
Materials and Methods: This was a descriptive study conducted in two stages. In the first stage, a validation tool for research information management systems (Pajoohan, Pajooheshyar, Jiro, Yektaweb, Kuiper) was designed, and in the next stage, in order to ensure the validity of the produced tool, a self-assessment survey was conducted by users of research information management systems in medical sciences universities. Therefore, this tool was completed by 104 researchers from all over the country. The collected data were analyzed by Excel and SPSS software.
Results: The developed validation tool of research information management systems included four components and 82 indicators: software design and architecture (17 indicators), usability and user environment (16 indicators), professional use (36 indicators) and management (13 indicators). Based on the self-declared results of the users, this tool has 57 mandatory features, 26 preferred and 4 optional features. The results of the validation of research information management systems based on this tool showed that the highest rank in the component of architecture, professional use and software management was related to the Kuiper system, and in the component of usability and user environment was related to the Pajoohan system. In the self-declaration done by the users ,12 cases of Jiro system ,11 cases of Kuiper system ,11 cases of Pajoohan system ,7 cases of Pajooheshyar, and 5 cases of Yektaweb system have received confirmation above 75%.
Conclusions: The validation tool which developed by this study can be used in the evaluation of current research information management systems and the selection of new systems for use in the research field. In addition, it can be used to improve current systems and purchase new systems by academic universities and research centers.
Ehsan Zarei, Kheyrollah Chavosh Sani, Mohammad Saadati, Soheila Khodakarim,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: In recent years, public trust in health system has been considered one of the performance evaluation indicators of health systems. However, most of the research on public trust in health system is related to developed countries, and research in this regard is limited in Iran. A better understanding of trust in health system and some influential factors helps to develop targeted interventions to increase trust. The present study was conducted to investigate the level of public trust in health system in Rasht County.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Materials and Methods: In this cross-sectional study, 680 households (510 urban and 170 rural) were included. The data collection tool was a questionnaire to measure public trust in health system with 30 items and six dimensions, whose validity and reliability were confirmed. Mann-Whitney and Kruskal-Wallis tests were used to compare and analyze the difference in public trust in health system between groups.
Results: The overall score of trust in health system was 66.7 out of 112. The highest score for the quality-of-care dimension was 16.38 out of 28, and the lowest for the cooperation quality of providers dimension was 7.47 out of 12. Among service providers, the highest trust was in nurses and specialist doctors, and the least was in traditional medicine service providers. Women, government employees, people without health insurance, people with excellent and good health status, those who had used hospital services, and those who were satisfied with the last service received had a high level of trust in the health system (P<0.05).
Conclusion: The results showed that despite people’s trust in the expertise and knowledge of physicians and other providers, public trust in health system was relatively moderate, indicating deficiencies in the health system’s performance. Focusing on physician-patient communication and improving communication skills, establishing electronic records and sharing patient information between health service providers, and respecting patient rights can build greater trust in the health system.
Fatemeh Mohabati, Maryam Tajvar, Bahram Mohaghegh, Seyedpouria Hedayati, Mohammad Arab,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: Reforming the structure of medical universities and its continuous adaptation to the mission of the organization and new functions is an undeniable necessity. The purpose of this article was to explain how to implement this policy.
Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software.
Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders.
Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.
Materials and Methods: The current qualitative study was conducted in 2020 retrospectively based on Kingdon’s multiple streams model. Data collection was done using two methods: individual interviews and document review. Sampling of the managers and experts of the administrative development and transformation centers of the Ministry of Health and 12 universities of Medical Sciences as well as vice-chancellors of the universities was done in a purposeful and snowball method until data saturation was reached by conducting 19 individual interviews. Data analysis were done with framework and content analysis methods, and using MAXQDA 2020 software.
Results: The low of structural problems included quantitative and qualitative changes in new tasks in the environmental units of universities, interference and parallel work in the tasks of university units, and bargainings for restructuring by universities. The policy low included the obligation to make structural changes in the upstream laws and documents, including the Fifth Development Plan, and the cooperation of all stakeholders. The political process included the implementation of the Health Transformation and the Family Physician Plan, and the support of relevant policymakers and the approval of the law of becoming a university trustee in the law of the fifth plan of economic development and also gaining the all-round support of the stakeholders.
Conclusion: The medical sciences universities, as the headquarters arm of the Ministry of Health at the provincial level, need to have flexible structure in line with the needs of their surrounding units. In luential context factors in policy-making the reform of the structure of the headquarters of universities/colleges, in addition to the stream of structural problems, the main of which was the change in the duties of the units, along with the political determination created in the Ministry of Health, led to the simultaneous occurrence of three streams of problems, Politics and politics and finally opening the window of opportunity and changing the structure and organization of the headquarters of medical sciences universities.
Fahimeh Hasanzadeh, Ali Aghajanloo, Dr Mohammadreza Dinmohammadi,
Volume 16, Issue 4 (10-2022)
Volume 16, Issue 4 (10-2022)
Abstract
Background and Aim: The most recent threat to the global community is the ongoing outbreak of the disease known as Coronavirus Disease 2019 (COVID-19). Taking personal protection measures (PPM) is crucial to prevent the spread of COVID-19. This study aimed to determine the factors affecting the acceptance of PPM among patients before having COVID-19 admitted to hospitals in northwestern of Iran.
Materials and Methods: In this cross-sectional study, 560 eligible patients with a diagnosis of COVID-19 were selected by convenience sampling. Data were collected from January 6 to May 21, 2021, through a researcher-made questionnaire and were analyzed with descriptive statistics (number, percentage, mean, standard deviation), independent t-test, and multiple linear regression by SPSS. A significance level of 5% was selected.
Results: The average age of the participants was 60.1 (16.01) years with an age range of 21 to 95 years. Most of the participants were male (53.9%) and married (91.8%). The mean score of PPM acceptance among patients was 16.55 (2.59) out of 20 points. Multiple linear regression analysis determined employment status (β=0.29, P<0.001), residency (β=-0.19, P<0.001), education level (β=0.11, P=0.048), smoking (β=-0.10, P=0.03) and income level (β=0.13, P=0.01), as predictors of acceptance of PPM. Other personal and occupational variables, including age, gender, marriage, living status, having children, and history of influenza vaccination, were not found to be effective in predicting the acceptance of personal protection measures among participating patients.
Conclusion: The acceptance of personal protection measures among patients was relatively high. Acceptance of the unemployed, rural residents, illiterate, smokers, and those with low-income level was low. This study emphasizes the need to pay attention to the changes in the individual, social and economic characteristics of the community and their effects on preventive health behaviors, especially in vulnerable groups.
Materials and Methods: In this cross-sectional study, 560 eligible patients with a diagnosis of COVID-19 were selected by convenience sampling. Data were collected from January 6 to May 21, 2021, through a researcher-made questionnaire and were analyzed with descriptive statistics (number, percentage, mean, standard deviation), independent t-test, and multiple linear regression by SPSS. A significance level of 5% was selected.
Results: The average age of the participants was 60.1 (16.01) years with an age range of 21 to 95 years. Most of the participants were male (53.9%) and married (91.8%). The mean score of PPM acceptance among patients was 16.55 (2.59) out of 20 points. Multiple linear regression analysis determined employment status (β=0.29, P<0.001), residency (β=-0.19, P<0.001), education level (β=0.11, P=0.048), smoking (β=-0.10, P=0.03) and income level (β=0.13, P=0.01), as predictors of acceptance of PPM. Other personal and occupational variables, including age, gender, marriage, living status, having children, and history of influenza vaccination, were not found to be effective in predicting the acceptance of personal protection measures among participating patients.
Conclusion: The acceptance of personal protection measures among patients was relatively high. Acceptance of the unemployed, rural residents, illiterate, smokers, and those with low-income level was low. This study emphasizes the need to pay attention to the changes in the individual, social and economic characteristics of the community and their effects on preventive health behaviors, especially in vulnerable groups.
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