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Showing 14 results for Assessment
Mental health intervention in Bam earthquake crisis: a qualitative study
Bolhari J, Chime N,
Volume 65, Issue 13 (3-2008)
Abstract
Background: Mental health needs to increase in disasters and this study assesses the basic and mental health needs and delivered services during the first month after Bam (Iran) earthquake disaster in year 2004.
Methods: Thirty Five mental health professionals and experts were involved in mental health care and interventions for survivors in Tehran general hospitals and in the Bam, were participated in a focus group qualitative study, and finding analyzed after coding from tape recorder.
Results: The primary and immediate needs of survivors were: water, food, shelter, security, finding family members, treating and helping injured ones, respect and good relationship by others, and information and news about disaster and others. Second and long time needs and services were the previous needs and services and also immediate starting the daily routine activities, opening schools and workplaces, participating in community services and resettlement or housing. Lack of previous program and inadequate services are discussed in the paper.
Conclusion: It is the first time in Iran survivors get immediate mental health intervention in disaster, but based on finding and the survivors needs, and the problems reported in services were delivered, the study proposes a new mental health intervention program in natural disaster for Iran.
Normative data on Temperament and Character Inventory (TCI): complimentary findings
Kaviani H,
Volume 67, Issue 4 (7-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: It is extremely important to validate psychological (psychometric) tools before use in research projects. In fact without reliable and valid psychological tools, we can not rely on research results. TCI contains subscales designed to measure seven different personality traits and characteristics. This paper presents complementary findings to a previous study. In fact, the aim of this study was to summarize a normative data of TCI for an Iranian sample of men and women with different ages.
Methods: At first all research workers, who collected data in present study, were trained for the skills needed in order to communicate with the participant and to conduct the questionnaire. Randomly selected participants (n=1212) completed TCI questionnaire.
Results: The results showed normative data for the subscales novelty seeking (NS), harm avoidance (HA), reward dependence (RD), persistence (Per), self directiveness (SD), cooperation (Co) and self transcendence (ST) for different gender and age classes.
Conclusions: Similarities and differences of the present findings and other studies will be theoretically discussed. The sample of participants in this study allows us to generalize the collected data. The results shows that now we can benefit from using the questionnaire in Iranian society. Different applications of TCI in various clinical and normal settings will be discussed. The present results is complementary to the previous findings reported in the same journal.


A comparison between the growth trend of normal and low birth weight newborns during the first year of life
Nayeri F, Kheradpisheh N, Shariat M, Akbari Asbagh P,
Volume 67, Issue 4 (7-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Low-birth-weight (LBW) children are at higher risk for failure to thrive. The aim of the study was to establish the trend of physical growth in Until now their growth was evaluated with normal birth weight baby's chart.
Methods: In this cohort study we investigated demographic characteristics and growth trend during the first of life 406 newborn divided into three groups: LBW (Low Birth Weight) n=103, VlBW (Very Low Birth Weight) n=20 and NBW (Normal Birth Weight) n=303. Body weight, length and head circumference were measured at the time of birth and several follow ups until 12 months of chronological age.
Results: NBW growth trend adopts the standard chart. Significant differences in terms of physical growth (weight- height- head circumference) were seen between the two groups of preterm (LBW & VLBW) and NBW children. Although it was demonstrated that growth velocity of preterm & NBW children were the same. Significant differences for weight was seen between VLBW and LBW group only until 6 months after birth. This difference was seen for height and Head circumference until the end of the first year of life.
Conclusions: VLBW and LBW babies need special growth charts. But the adjustment method of anthropometric traits to gestational age may be useful to evaluate LBW baby's growth.


Measurement of airway related distances: virtual bronchoscopy in 140 cases
Noyan Ashraf Ma, Samadi Sh, Ghanaati H, Farahani Dawood-Abadi A,
Volume 67, Issue 5 (8-2009)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The insertion depth of tracheal tube differs based on sex, age, position of head and neck, type of surgery, and anatomical consideration. The aim of this study was to determine the airway related distances in Iranian patients with a non-invasive, and accurate method, the computerized reconstruction of High Resolution CT (HRCT) Virtual Bronchoscopy.
Methods: A total of 140 Iranian patients who became candidate for sinus and chest tomography, were enrolled in a cross- sectional study in Imam Khomeini Hospital Complex, Tehran, Iran, from 2006 to 2008. After reconstruction of airway related distances, Incisor- Vocal cord (IVD), Vocal cord- Carina (VCD) and Incisor- Carinal (ICD) Distances were determined.
Results: A total of 140 patients were evaluated, while 70(50%) were male. There was no statistically significant difference between age groups, sex and BMI in study patients. The measured IVD were 145.5±9.7 (males), 127.29±6.3 (females) and 136.43±12.29mm (total). For VCD, the distances were 131±13.99 (males), 122.59±11.7 (females), and 127.09±13.65mm (total). The measures for ICD in males, females, and total of patients were 277.17±16.63, 249.88±11.54, and 263.52±19.66mm respectively.
Conclusion: The insertion depth for fixation of endotracheal tube in Iranian adult patients is the same as that of anesthesia textbooks. There were no statistically significant difference between our study data and previously measured distances using invasive and less accurate methods. Virtual bronchoscopy is a noninvasive and accurate method based on reconstruction of computed tomographic images and the reconstructed images of tomography could be useful in measuring and assessment of airway anatomy.


Nourodevelopmental follow-up in high-risk infants: review article
Farin Soleimani , Nasibe Sharifi , Fereshteh Rasti Borujeni , Mina Amiri , Somayeh Khazaiyan , Azita Fathnezhad Kazemi ,
Volume 72, Issue 11 (2-2015)
Abstract
Growing and developing are influenced by genetic, social and environmental factors and it's most important and initial phase step is formed of the early life of the fetus and infant. According to the world health organization, the incidence of preterm birth and low birth weight are increasing in most countries that most of it related to developing countries. Low birth weight (LBW) and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems that can affect growing and developing so that it can threaten public health. Advances in medical technology in recent decades at intensive care unit, increased survival of premature infants and high-risk specialist care is needed, but failed, to reduce the complications of premature birth but it couldn’t reduce complications of preterm birth. There is also an increased recognition of the potential disconnect between perinatal outcomes and long-term outcomes. The administration of oxygen and postnatal steroids are prime examples of interventions that may have immediate positive effects but negative long-term effects. Many premature babies will be encounter with mobility problems, cognitive, neurosensory impairments, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances in the future. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Without a doubt, one of the tragedies of the world is people with physical or mental damage caused by premature birth, many of these disorders are not early diagnosed and the prediction of long term complications of infants discharged from the NICU is difficult. Although nourodevelopmental follow-up of these babies is a necessary part of the neonatal assessment but there is no standard process for it. The present review article aims to introduce the care process and tools that is used for following-up these babies, also introduces the application of screening tools for neuro-developmental care.
Closed suction drainage using Lichtenstein technique in preventing wound complications following inguinal hernioplasty: brief report
Hamid Reza Hemmati , Mehdi Sadat-Hashemi , Raheb Ghorbani , Toraj Jafari ,
Volume 72, Issue 12 (3-2015)
Abstract
Background: Inguinal hernia is a common surgical problem which increases with aging especially in men. A common method for treatment is surgical repair using prosthesis, Lichtenstein technique. One frequent complication after inguinal herniorrhaphy is soft tissues seroma. There are several methods to prevent or to drain seroma. Some surgeons suggest the insertion of closed suction drainage system but others disagree. Methods: In this clinical trial study, 42 patients who are candidate for hernia repairing (Lichtenstein technique), referred to Amir Al-Momenin Hospital in Semnan, Iran, from 2011 to 2012, were randomly divided into two groups. So that, the list of eligible patients in the study, were numbered, and then using the patients' code, patients, who assigned an odd number in the registration list, were allocated to group 1, the remainder were placed in group two. The two first numbers in registration list (1 or 2), were randomly assigned to groups. Group 1 underwent hernia surgery without closed suction drainage and the second group underwent hernia surgery with closed suction drainage. The patients were evaluated for seroma, hematoma or wound infection after 24 hours, during days 4 to 7 and days 10 to 15 following surgery. Results: No adverse event including hematoma, seroma or wound infection occurred in either group with or without closed suction drainage in the first 10 days after surgery. Only one patient carried wound infection during days 10 to 15 following operation who was in the group with closed drainage (P=1.00). Conclusion: In this study, Seroma and hematoma was not observed in patients with and without closed suction drainage. To avoid drains' complications, indiscriminate use of antibiotics, prolonged hospital stay, we do not recommend the use of drains in this type of surgery.
Development of a simple risk score model to predict renal artery steno-sis
Seyyed Mohammad Reza Khatami, Arash Jalali , Saeid Sadeghian , Elmira Zare , Fatemeh Shokooei Zadeh , Elham Rostami ,
Volume 76, Issue 1 (4-2018)
Abstract
Background: Renal artery stenosis (RAS) is a known cause of secondary hypertension and renal failure. The most patients with renal artery stenosis are asymptomatic. So, the exact prevalence of this disease is unknown. The gold standard of diagnosis of RAS is renal angiography that is an expensive somewhat hazardous procedure and may revealed nothing. The aim of this study was to develop a simple risk model score to predict significant RAS based on known risk factors. This may enable us to select patients with high probability of having RAS to perform angiography.
Methods: A total of 4177 patients whom underwent renal angiography from April 2001 to March 2016, were randomly assigned to a development and a validation dataset in ratio of 2:1 respectively. The clinical and laboratory data of patients were analyzed by multivariate regression analysis. The factors of female sex, history of hypertension and glomerular filtration rate were determined as predicting factors and they were assigned a weighted integer, the sum of the integers was a total risk score for each patient. This model was examined at validation set.
Results: We retrospectively evaluated all patients undergoing renal artery angiography since 15 years ago. We extracted all risk factors of RAS including age, sex, height, weight, and history of diabetes, hypertension and hyperlipidemia. We also looked at coronary or peripheral vascular diseases and presence of heart failure. The age of patients was 63.5±11.2 years and 40% of the patients were female. The significant RAS was defined as 70% or more narrowing of renal artery. The prevalence of renal artery stenosis was 14.4% and 13.5% in development and validation dataset respectively. The area under curve and confidence interval for final mode in development dataset was 67.9% (65.0-70.8%). The rates of RAS increased with increasing risk score. In 1402 patients in validation dataset the model showed good discrimination power (cstatistic= 0.76)
Conclusion: This model simply assesses the risk of RAS using available information. This model can be used both in clinical and research purposes. The power of model for diagnosis of RAS is estimated to be 72.6% (68.8%-76.4%).

Inter- and intra-rater reliability of brief BESTest in balance evaluation of patients with stroke: brief report
Parisa Komijani , Soofia Naghdi , Noureddin Nakhostin Ansari , Fatemeh Bolhasani , Amin Nakhostin Ansari ,
Volume 76, Issue 1 (4-2018)
Abstract
Background: Impaired balance is one of the most common symptoms that occur after stroke. There are several tests for evaluating balance in neurological disorders. Brief-balance evaluation systems test (Brief-BESTest) is the short version of BESTest that assess the systems contributing to postural control. The purpose of this study was to investigate the inter- and intra-rater reliability of the Persian version of Brief-BESTest for balance evaluation in patients with stroke.
Methods: Patients with stroke recruited from the Tehran University of Medical Sciences Physiotherapy Clinics in Tehran participated in this cross-sectional study. Patients were included in the study with first ever stroke, able to follow instructions, able to walk without aid, and willingness to participate in the study. The study was conducted from August to December 2016. Two physiotherapists independently scored the videotaped performance of patients on Persian Brief-BESTest in one session for inter-rater reliability. The first physiotherapist recorded the patients’ performance on Persian Brief-BESTest after 1 week for intra-rater reliability. The physiotherapists were blinded to each other’s scores. Intraclass correlation coefficient (ICC) was used to assess the reliability. SPSS statistical software, version 18 (IBM, Armonk, NY, USA) was used for all analyses.
Results: Thirty patients with stroke (10 males, 20 females, mean age 57.3±13.5 years, duration 40.7±47.3 months) participated in this study. The ICC values for inter-rater reliability and intra-rater reliability of total scores were 0.98 (95% CI: (0.95-0.99)) and 0.99 (95% CI: (0.98-0.99)), respectively. The ICC values for inter- and intra-rater reliability of each item score were 0.72-1.0, and 0.87-1.0 respectively.
Conclusion: The Persian version of Brief-BESTest has high inter- and intra-rater reliability for evaluation of balance in patients with stroke. Therefore, it is recommended for use by clinicians in the clinic and for research purposes in the clinical trials.

Responsiveness of the Persian version of oxford shoulder score in subjects with shoulder pain: brief report
Seyedeh-Saeideh Hoseini, Noureddin Nakhostin Ansari, Soofia Naghdi ,
Volume 78, Issue 6 (9-2020)
Abstract
Background: Oxford Shoulder Score (OSS) is a specific questionnaire for the assessment of pain and function in subjects with shoulder pain. The reliability and validity of the Persian version of this questionnaire have been shown previously. But its responsiveness has not been investigated yet. This study aimed to determine the Persian OSS responsiveness in subjects with shoulder pain.
Methods: This was a prospective cohort study design conducted in the Physiotherapy Clinic, School of Rehabilitation, Tehran University of Medical Sciences in 2018.  Thirty-one subjects with shoulder pain (20 females and 11 males) with a mean age of 50±15.3 participated in this study. They completed the Persian OSS, Disability of Arm, Shoulder & Hand (DASH) questionnaire, and Visual Analog Scale (VAS) before and after 10 physiotherapy sessions. After the 10th session, the Global Rating of Change (GRC) was also completed. The statistical analysis included the Effect Size (ES), Standardized Response Mean (SRM), and the Spearman or Pearson correlation coefficients.
Results: The results showed that the ES and SRM of the Persian OSS were 1.73 and 1.79, respectively. The correlation between the Persian OSS and the VAS scores was 0.69 and between the Persian OSS and the DASH scores was 0.89. The correlation between the Persian OSS changes and GRC was not statistically significant (r=0.25, P=0.18). However, a significant moderate correlation was identified between the VAS and DASH with the GRC scores (r=0.43, r=0.42, respectively). 
Conclusion: The Persian OSS has internal and external responsiveness for the assessment of subjects with shoulder pain. The Persian OSS, as a responsive instrument, can be used to investigate the effectiveness of interventions in the clinical settings and research to detect the changes in patients with shoulder pain. Further study with larger sample of patients with shoulder pain is warranted to confirm the findings and to estimate the minimally clinically important change.

Assessing the status of medical ethics Unit education in Tehran University of Medical Sciences and deterrent factors on its effectiveness
Sepehr Sahraian , Alireza Parsapour, Amir Ahmad Shojaee ,
Volume 80, Issue 6 (9-2022)
Abstract
Background: Medical ethics is an applied branch of ethics that deals with ethical challenges in medical and health environments, and its related topics have a long history, but its education as an academic subject in universities has received a lot of attention in the last 40 years. In recent years, medical universities have made extensive efforts to expand medical ethics education, which has been accompanied by significant progress, but given that the modern medical ethics education system is a growing and nascent structure, more research is needed. Therefore, this study aims to assess the status of the medical ethics education system at Tehran University of Medical Sciences to identify its gaps so that the current situation can be improved with proper planning.
Methods: The type of this research is descriptive quantitative-qualitative and it was collected from December 2018 to September 2019 at Tehran University of Medical Sciences. First, the educational curriculum of 165 educational levels at Tehran University of Medical Sciences was reviewed and described in terms of the existence of a medical or professional ethics course in the educational curriculum. Then, a semi-structured interview was conducted with the 13 professors in charge of teaching this course in all faculties, and content analysis was performed to describe and identify the obstacles in its effectiveness.
Results: The results showed that in 53% of the educational levels, there was no separate medical or professional ethics course in the educational curriculum and the most educational coverage of this course took place in the faculties of medicine, dentistry, nursing and midwifery. The obstacles in the effectiveness of teaching this unit were categorized into five main themes of educational curriculum, hidden curriculum, teaching methods, teachers and education management.
Conclusion: The results show that the content of curricula needs to be revised and education should be inclusive. Creating a coherent educational organization and monitoring the hidden curriculum are other issues that should be considered to increase the effectiveness of this education.

Assessment of TUMS affiliated hospitals’ preparedness for dealing with Covid_19
Ebrahim Jaafaripooyan, Haniye Sadat Sajadi , Maryam Tajvar, Elham Ehsani Chimeh , Iman Falah, Farhad Habibi,
Volume 80, Issue 6 (9-2022)
Abstract
Background: The prevalence of emerging and re-emerging diseases has made the need for basic preparations for all health care organizations more crucial. Strengthening preparedness and formulating crisis strategies will have a great impact on reducing casualties. Given the importance of preparing hospitals to deal with such an outbreak and reduce the resulting mortality, the present study was conducted to assess their readiness against Covid-19.
Methods: The present study is a quantitative and descriptive cross-sectional research conducted from October to March 2019. Data collection used the standard checklists prepared by the European Center for the Prevention and Control of Coronavirus and the Centers for Disease Control and Prevention, consisting of eight domains and 21 components. The minimum score that each hospital could get in this checklist was 143 and the maximum was 429. The sampling method in the present study was a census, and nine reference hospitals for Corona were included in the study. All hospitals’ directors, managers, quality officers and crisis secretaries and others related to hospital readiness during Covid-19 were recruited by the census.
Results: On average, the hospitals scored 391 out of 429, indicating a fairly "high readiness" in dealing with Covid-19. The highest score obtained by the hospitals was 425 and the lowest score was 349. In terms of preparation areas, the hospitals’ readiness was higher than 80% in all areas. The highest readiness of hospitals was in the fifth  domain, i.e. Hand hygiene, personal protective equipment and hospital waste management. The 7th domain namely, patient placement and relocation, and patient visitor access was of the lowest preparation.
Conclusion: The hospitals were of fairly appropriate readiness to deal with Covid-19. This level of preparedness, despite being desirable, might not reflect the real capacity of hospitals to deal with this disease. Regular evaluation of the Covid referral hospitals could help make these hospitals more prepared. Also, the experiences of hospitals that were more prepared should be used to improve the condition of other hospitals.

Methodology of pharmacoeconomic evaluation studies in Iran: a brief report
Sara Emamgholipour, Rajabali Darroudi , Abdoreza Mousavi, Samira Alipour , Fakhraddin Daastari,
Volume 80, Issue 11 (2-2023)
Abstract
Background: Given the limited resources of health system, economic evaluations studies can provide appropriate evidences for resource allocation by clarifying the possible consequences of a decision. Present study aimed to evaluate the implemented approaches for economic evaluation studies of pharmacoeconomic in Iran.
Methods: This study was carried out using the critical review method. All studies related to economic evaluation studies of pharmacoeconomic in Iran, indexed in PubMed and SID databases and Google Scholar search engine, were searched by using appropriate keywords and search strategies until 2021. Further, published papers from Iranian researchers in the field of health economics and pharmacoeconomics and pharmaceutical administration were extracted with the scientometric system of the Health Ministry. Then, retrieved papers were screened by title, abstract, and the whole text. Finally, papers were evaluated by applying the Drummond quality assessment checklist, and finally appropriate ones were selected. Finally, 29 papers were selected and analyzed.
Results: Out of total available papers (n=1324), 29 papers had inclusion criteria to evaluate. The selected papers were analyzed based on 10 parameters, including type of analysis, type of comparator, source of clinical effectiveness, time horizon, used model, perspective of the analysis, measured expected outcomes, discounting of costs and outcomes, sensitivity analysis, and subgroup analysis. Most studies have used cost utility analysis. Shortcomings were found in some aspects as follows: some studies did not mention the applied model, or the time horizon. Moreover, some studies had time horizon more than one year, while the cost and consequences were not discounted.
Conclusion: In recent years, economic evaluation studies in the field of pharmacoeconomic in Iran have been center attention in line with global trend. In order to make a decision regarding the allocation of resources based on the findings of economic evaluation studies, these studies should be conducted with the systematic and transparent approach. Therefore, it is necessary to develop a standard framework for implementing and reporting the results of economic evaluation studies in Iran.
Keywords: cost-benefit analysis, cost-effectiveness analysis,

Presenting a model for assessing general medical students: a brief report
Neda Negahban Jouzan , Hossein Karimi Moonaghi , Hoorak Poorzand, Mohammad Khajedaluee,
Volume 81, Issue 1 (4-2023)
Abstract
Background: By examining the comprehensive system for evaluating the academic progress of general medical students, often the objectives of the cognitive domain and the form of cumulative evaluation were used, and the tests were not used much for feedback to the students. The aim of the study is to develop a model that fits the levels of Miller's evaluation pyramid in formative-cumulative forms.
Methods: The search was started in Iranian and international databases, magazines, curriculum of prestigious universities in the world. To find out about the latest events in the field of assessment, AMEE international virtual conferences in August 2021 and the summary booklet of medical education articles of Shahid Motahari 1400 (the 22nd national conference of medical education) were reviewed. Data analysis was done by Beredy's adaptive model. The search and analysis lasted for 11 months. Finally, a model was developed according to Miller's evaluation pyramid. Its validation was done in the focus group meeting in two ways, in person at Mashhad Medical School and virtual.
Results: According to the extracted data, the approach of assessment is towards formative assessment format and improvement of traditional methods along with modern methods, which was clearly observed in the study of the curriculum of Harvard-Stanford University in America and Oxford University in England. Integrating the results with Miller's evaluation levels, and the formative and cumulative evaluation format, led to the formulation of a model with the most favorable opinions of experts. In addition, the majority of opinions and suggestions of experts were related to the change in the way of executive policies of universities and providing a context for the emergence of new idea.
Conclusion: A model including measurement methods according to the levels of Miller's evaluation pyramid was developed in formative-cumulative. It is suggested that the model be reviewed by the relevant experts and notified by taking into account the implementation conditions for the correct evaluation process.

Risk assessment of carcinogenic and non-carcinogenic effets of exposure to heavy metals in hookah smoke using the monte carlo simulation technique
Taibe Ruenifard, Ali Oghazyan, Mohammad Hossien Saghi , Mahdi Ghorbanian , Ayoob Rastegar, Shahram Nazari ,
Volume 81, Issue 4 (7-2023)
Abstract
Background: This study aimed to evaluate the carcinogenic and non-carcinogenic health risks of heavy metals in seven types of tobacco widely consumed in the east of the country through inhalation exposure.
Methods: This descriptive-analytical study was conducted from April 2022 to October 2022 in the city of Bojnord, Iran on sook of seven popular tobacco brands. Metal concentrations in sook of tobacco were determined using inductively coupled plasma-optical emission spectroscopy. In order to analyze the data and ensure the accuracy of the results, the amount of metals in the samples was repeated three times, and their average was analyzed. Monte Carlo software was used to assess possible risks.
Results: The results of this study showed heavy metal concentrations in sook tobaccos were, respectively, Fe>Zn>Mn>Ba>Pb>Ni>Cu>Mo>Cr>As>Cd. The concentration of heavy metals such as arsenic, cadmium and molybdenum in Alrah brand tobacco was higher than other types of tobacco. So that the amounts of heavy metals including arsenic, cadmium and molybdenum for this brand were 14.2±0.05, 10.4±0.06 and 11.6±0.04 micrograms per gram, respectively. The hazard index (HI) values for different types of tobacco, including Al-Rah, Amordadsub, Al-Fakher, Al-Rubi, Mazaya, traditional flavorless, and Nakhle, were 2.64, 2.41, 2.05, 1.7, 1.49, 1.46, and 1.44, respectively. The lifetime cancer risk (ILCR) for Amordadsub, Al-Rah, Nakhla, Mazaya, Al-Rubi, Al-Fakher, and traditional flavorless tobaccos was 2.8×10-3, 2.43×10-3, 1.72×10-3, 1.58×10-3, 1.43×10-3, 9.58×10-4, and 8.08×10-4, respectively. Lead in Alrah tobacco sook had the highest non-carcinogenic risk value with a value of 1.59.
Conclusion: According to the obtained results, Alrah tobacco sook has a higher cancer and non-cancer risk than regular tobacco and can cause non-carcinogenic and carcinogenic risks for consumers. Thus, it is necessary to regularly monitor the quality of prevalent tobacco to reduce delete human health risks.

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