Information System Success of the Iranian Integrated Health Record System Based on the Clinical Information System Success Model.

Background: The Integrated Health Record System, locally known as the "SIB," is the most used information system for recording public health services provided to the Iranian population. The objective of this study was to evaluate the success rate of the SIB using the Clinical Information System Success Model (CISSM). Methods: This is a psychometric and evaluation study. The CISSM has a 26-item instrument that assesses 7 constructs in 3 following stages: (1) the socio-technical stage (facilitating conditions, social influence, information quality, and system performance(; (2) the integrated stage (system use dependency and user satisfaction); and (3) success outcome stage (net benefit). A Persian version of the CISSM instrument was validated and applied in this study. Based on this instrument, the reliability and the validity of the CISSM were assessed. The SIB success rate was evaluated using a validated CISSM. The study participants were 758 SIB users from different disciplines and different levels. Results: Assessment of content validity, construct validity, internal consistency, and test-retest reliability showed acceptable psychometric properties of the CISSM instrument. The results demonstrated that the SIB success rate was in the moderate range (59.6%). Facilitating conditions and information quality were strong predictors of use dependency and user satisfaction, while both of these 2 constructs significantly influenced net benefit. Conclusion: The SIB success was in the moderate range, and it needs to be enhanced. Therefore, Iranian healthcare policymakers should consider working on the most important factors influencing SIB success (facilitating conditions, information quality, use dependency, and user satisfaction) to improve SIB success.

Effects of zinc, vitamin D, and their co-supplementation on mood, serum cortisol, and brain-derived neurotrophic factor in patients with obesity and mild to moderate depressive symptoms: A phase II, 12-wk, 2 × 2 factorial design, double-blind, randomized, placebo-controlled trial.

OBJECTIVE: The aim of this study was to investigate the effects of zinc, vitamin D, and their co-supplementation versus placebo on changes in the Beck Depression Inventory II (BDI-II) score, serum cortisol level, and brain-derived neurotrophic factor (BDNF) in obese/overweight patients with depressive symptoms. METHOD: This 2 × 2 factorial, double-blind, randomized, placebo-controlled trial with obese/overweight patients with depressive symptoms was conducted in the Endocrinology and Metabolism Research Center (EMRC), Vali-Asr, Emam Khomeini Hospital between July 2016 and February 2017. The intervention period was 12 wk. There were 140 randomized participants who were obese or overweight (mean ± SD, 38.35± 6.70 y of age; mean ± SD body mass index, 30.1 ± 3.78 kg/m2) with BDI ≥ 10. Participants were randomly assigned to one of four groups in a 1:1:1:1 ratio: 2000 IU/d vitamin D + zinc placebo; 30 mg/d zinc gluconate + vitamin D placebo; 2000 IU/d vitamin D + 30 mg/d zinc gluconate; or vitamin D placebo + zinc placebo for 12 wk. RESULTS: We analyzed 125 participants, and a significant decrease in BDI-II was found among those who received zinc, vitamin D, or joint zinc-vitamin D supplements compared with the placebo group (P < 0.001). Zinc was significantly more effective than vitamin D on decreasing the depression score. Supplementation with zinc, vitamin D, or a combination of the two had no significant effects on serum cortisol (P = 0.974) or BDNF (P = 0.076). Fifteen patients discontinued participation owing to pregnancy (n = 1), severe anemia (n = 1), and unspecified unwillingness to continue (n = 13). CONCLUSION: Supplementation with zinc, vitamin D, or in combination for 12 wk yielded significant beneficial effects on the BDI-II score in obese or overweight patients with BDI-II ≥10.

Designing a model for trauma system management using public health approach: the case of Iran.

Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS) to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.