Design and psychometric evaluation of health system intervention assessment tools for children in floods.

BACKGROUND: Flood is one of the most frequent disasters in Iran, which has highly affected the population and consequences on the health system. Children as the most vulnerable group too need to receive health services during floods. The aim of the present study was to develop a national tool for evaluating the provision of health services to children in floods. MATERIAL AND METHODS: This study is a sequential-exploratory mixed method study that consists of two qualitative and quantitative stages. The qualitative part includes the analysis of documents and panel of experts while the quantitative part includes the design and validation of the tools. RESULTS: In this study, organizations providing health services to children were first identified, and according to their mission the relevant items were extracted and the initial checklist was designed. Then validity and reliability of the tools were done. The content validity ratio and content validity index for the tool were 59 and 98%, respectively. Cronbach's alpha and intraclass correlation coefficient were determined as 0.7 and 0.964, respectively. The final tool was presented with 64 items. CONCLUSIONS: The response program, the scope of interventions, service coverage, and the effectiveness of the response after the flood can help reduce the risk of disasters in children. Using the assessment tool of evaluating the health services to children can assist the stakeholder organizations to meet the standards and best quality of services. Assessing the needs of the children affected by floods, identifying the strengths and weaknesses of health services, and proposing corrective strategies according to the information extracted from this tool are other achievements of this study.

Long non-coding RNAs and female infertility: What do we know?

Ten percent of people who are of reproductive age experience infertility. Sometimes the most effective therapies, including technology for assisted reproduction, may lead to unsuccessful implantation. Because of the anticipated epigenetic alterations of in vitro as well as in vitro fertilization growth of embryos, these fertility techniques have also been linked to unfavorable pregnancy outcomes linked to infertility. In this regard, a variety of non-coding RNAs such as long noncoding RNAs (lncRNAs) act as epigenetic regulators in the various physiological and pathophysiological events such as infertility. LncRNAs have been made up of cytoplasmic and nuclear nucleotides; RNA polymerase II transcribes these, which are lengthier than 200 nt. LncRNAs perform critical roles in a number of biological procedures like nuclear transport, X chromosome inactivation, apoptosis, stem cell pluripotency, as well as genomic imprinting. A significant amount of lncRNAs were linked into a variety of biological procedures as high throughput sequencing technology advances, including the development of the testes, preserving spermatogonial stem cells' capacity for differentiation along with self-renewal, and controlling spermatocyte meiosis. All of them point to possible utility of lncRNAs to be biomarkers and treatment aims for female infertility. Herein, we summarize various lncRNAs that are involved in female infertility.

Prevalence of Psychological Disorders among Health Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Background: Repeated contact with patients with COVID-19 and working in quarantine conditions has made health workers vulnerable to psychological distress during the COVID-19 pandemic. The goal of the present systematic review and meta-analysis was to examine the prevalence of the various psychological distresses among health workers during the COVID-19 pandemic. Methods: PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched for access to papers examining psychological distress among healthcare workers during the COVID-19 pandemic. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity among the studies was examined using the Cochran's Q test; because heterogeneity was significant, the random effects model was used to examine the prevalence of psychological distress. Results: Overall, 12 studies with a total sample size of 5265 were eligible and included in the analysis. Prevalence rates of depression, anxiety, and PTSD were 20% (95% CI: 14-27), 23% (95% CI: 18-27), and 8% (95% CI: 6-9), respectively. The highest prevalence rates of depression and anxiety were related to the SDS and the GAD-7, respectively, and the lowest prevalence rates of the two aforementioned variables were related to the DASS-21. Conclusions: The high prevalence of psychological distress among healthcare workers during the COVID-19 epidemic can have negative effects on their health and the quality of services provided. Therefore, training coping strategies for psychological distress in this pandemic seems necessary.

The economic cost of cancer treatment in Iran.

BACKGROUND: With more than 12 million new cases of cancers and nearly 7.6 million deaths worldwide in 2020, cancer is currently the third leading cause of mortality in the world. The costs spent on treating patients with cancer account for a significant amount of healthcare costs. Healthcare expenditures for cancer treatment have also increased significantly and are projected to skyrocket further over the next decade. This study was conducted to determine medical and non-medical direct costs for the prevention of cancer in patients hospitalized in 10 selected educational hospitals in Iran. MATERIALS AND METHODS: The study employed a cross-sectional design and was conducted in 10 selected educational hospitals in Tabriz, Tehran, Isfahan, Mashhad, and Shiraz in 2020. Using a researcher-made questionnaire, we assessed direct medical costs and direct non-medical costs of cancer in patients over 20 years old with kinds of breast, prostate, leukemia, lymphatic, stomach, liver, lung, bladder, uterine, and intestine cancers who undertook oncology treatments (n = 2410). Data were analyzed using descriptive statistics including mean and standard deviation and analytic statistics such as Kolmogorov-Smirnov, analysis of variance, and t-test, using SPSS 18 and P ≤0.05. RESULT: The mean direct non-medical cost paid out of pocket per month was $99.6 ± $10.81 USD, and the mean direct medical cost per month was $1029.4 ± $68.5 USD. The total cost paid by the patients was $889.4 ± 69.81 USD per month. CONCLUSION: Given the increasing number of patients with cancer, it is necessary to increase the number of special centers for the prevention and treatment of cancers. Dissemination of information about the costs of illnesses and their complications enables decision-makers to make a proper comparison between different uses of resources. Moreover, to support the patients, the health system must implement plans to decrease out-of-pocket payments by patients.

Facilitating and Inhibiting Factors of Clinical Knowledge Sharing among Medical Specialists in University Hospitals.

Background: Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational-treatment hospitals in Iran. Methods: This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi-structured interview. The participants were 13 medical specialists and sub-specialists working in educational-treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman's five-step method, which was followed by codes, sub-categories, main categories, and classifications. Results: After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of "education in the context of culture, society and university", "planning and implementation management", and "behavioral-motivational factors" and inhibiting factors in the four main categories of "infrastructural, policy-making and cultural challenges", "technological and scientific infrastructural challenges", "personality-behavioral challenges", and "financial and non-financial motivations" were classified. Conclusions: The participants of the research pointed out the effective role of CKS in keeping them up-to-date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.

Iran's Struggling Health System in the Policy of Managing the COVID-19 Pandemic.

Background: Infectious diseases are one of the most important problems that affect the whole world. The World Health Organization (WHO), an active health organization, has identified coronavirus disease 19 (COVID-19) as a public health emergency and advises governments not to waste time on effective measures and interventions to attack and suppress the virus. In Iran, so far, the total number of screening tests has exceeded 21 million tests and more than 5 million doses of vaccine have been injected. However, we are still far from controlling the epidemic wave. Given the current situation, it is necessary to identify the challenges of managing the new coronavirus epidemic (COVID-19) in the country's medical universities. Methods: This qualitative study was conducted from January 2020 to January 2021 to explore the views of a group of service providers and staff managers of medical universities who were selected via purposeful sampling (n = 47). Data were collected through semi-structured interviews and analyzed using Graneheim and Lundman's conventional content analysis methods. The trial version of MAXQDA 16 software was used to manage the coding process. Results: Upon analysis of data by service providers and staff managers of medical universities, five main themes including governance and leadership, service delivery, human resources, medicine and technology, and financing and 15 sub-themes including management and leadership, culture and society, process, infrastructure, manpower, training and skills, mental pressure, work pressure, nutrition, safety, employee motivation, medical equipment, medicine, payment, and funds were found. Conclusions: Identification of the most important challenges of service providers and staff managers can play an important role in improving the management of the new coronavirus epidemic (COVID-19). It seems that in order to solve some of these challenges, coordination is needed outside the field of health, and considering the formation of the National Corona Headquarters at the national level, it is possible to use this infrastructure to provide the necessary policies and strategies.

Prevalence of Post-traumatic Stress Disorder After Flood: A Systematic Review and Meta-Analysis.

Introduction: Flood as the most common kind of the natural disasters has unpleased short, medium, and long-term consequences on the victims' welfare, relationships, and physical and mental health. One of the most common mental health disorders in these victims is Post-traumatic stress disorder (PTSD). The aim of this study is to investigate the prevalence of PTSD on the flood victims. Methods: Data resources including PubMed, Scopus, Web of Science, Science Direct, Embase, Google Scholar, conference and congress papers, key journals, the reference list of selected articles as well as systematic reviews were searched to identify studies that reported the prevalence of PTSD in flood victims. Random Effect Model was used to perform meta-analysis of the studies. Cochran test and I2 indicator were used to explore heterogeneity between the studies. Publication bias of the study was evaluated using Begg'test. Data were analyzed by STATA (version 14) software. Results: After a comprehensive search, 515 papers were extracted. After eliminating duplicates and final screening, 23 studies were selected and entered the meta-analysis phase after qualitative evaluation. The results showed that the prevalence of PTSD in flood victims is 29.48% (95% CI: 18.64-40.31, I2 = 99.3%, p-value < 0.001). Conclusion: The results of the present study showed that the prevalence of PTSD is relatively high in the flood victims. So, it is necessary to take preventive, supportive, therapeutic and effective actions for them.

Withdrawn: A Review of Current Evidence from Cardiovascular Manifestations and Outcomes in Patients with COVID-19

The article has been withdrawn at the request of the editor of the journal Current Pharmaceutical Design.Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused.The Bentham Editorial Policy on Article Withdrawal can be found at https://benthamscience.com/editorial-policies-main.php. Bentham Science Disclaimer: It is a condition of publication that manuscripts submitted to this journal have not been published and will not be simultaneously submitted or published elsewhere. Furthermore, any data, illustration, structure or table that has been published elsewhere must be reported, and copyright permission for reproduction must be obtained. Plagiarism is strictly forbidden, and by submitting the article for publication the authors agree that the publishers have the legal right to take appropriate action against the authors, if plagiarism or fabricated information is discovered. By submitting a manuscript, the authors agree that the copyright of their article is transferred to the publishers if and when the article is accepted for publication. ©

Identification of the factors related to the clinical knowledge sharing: A protocol for systematic review.

Today, the ability of the organizations to successfully knowledge management and sharing can help them in better performance. Effective knowledge sharing (KS) in the clinical context provides better clinical decisions and improves the quality of care services. This systematic review will be conducted to identify the factors related to the clinical KS (CKS). This systematic literature review will be conducted to search the published documents about the affecting factors on the (clinical) KS. To this end, PubMed, Scopus, Web of Science, ProQuest, Cochrane, Embase, SID, Magiran, IranDoc, and ISC will be thoroughly assessed with considered keywords and search strategy. No time limit will be considered and all relevant documents published will be evaluated until the start date of the search. To the best of our knowledge, no systematic review study has been conducted on the factors related to CKS and our research will try to comprehensively extract the effective factors in this topic. Identifying the factors affecting CKS will lead to transparency in the exchange and interpretation of clinical knowledge in clinical care delivery and making the best clinical decisions as well as improving the quality of clinical care. It will also provide a condition to facilitate the delivery of more effective clinical education for policymakers in the field of clinical education.

Evaluation of medical equipment management in educational hospitals in Isfahan.

BACKGROUND: Medical equipment plays an important role in the diagnosis, treatment, and medical education, and each year the major share of hospital costs (about 5%-15% annually) is allocated to the purchase of medical equipment. The selection and allocation of medical equipment should be appropriate and in line with the actual needs of the medical centers, clinical goals, human resources, and the conditions required to ensure safety. The purpose of this study was to study and evaluate current systems of medical equipment management and identify their strengths and weaknesses in Isfahan educational hospitals in 2018. MATERIALS AND METHODS: This is a descriptive-applied research that was done in a cross-sectional way in 2018. The statistical population of the research is the authorities of medical equipment and other persons related to the management of medical equipment of selected educational hospitals in Isfahan. The data collection tool is a questionnaire. RESULTS: The result of this study was gathered in four areas: medical equipment management, safety, preventive maintenance, and training. CONCLUSION: According to this study, there is no comprehensive program in hospitals for how to manage medical equipment, which itself causes the loss of material and equipment capital of the organization. In most cases, the lack of a system for planning and controlling the amount of inventory and purchasing and maintaining medical equipment creates many problems, such as the accumulation and depreciation of equipment or the lack of these facilities in critical situations. In this study, it is suggested initially a scientific control system. Medical equipment is designed so that the hospital's need for equipment at any time of year and the amount of its equipment are clear so that it can be easily decided in this field.

A Comprehensive Review on Various Aspects of SARS-CoV-2 (COVID-19) Vaccines.

This is a comprehensive review based on the published papers in the field of COVID-19 vaccines and vaccination. Many efforts have been made to develop vaccines to combat this pandemic. Since December 2020, more than 200 vaccines have been tested in various research stages and in clinical trials on humans, of which eight vaccines reached phase four clinical trials in humans and approved by FDA and EUA. After the Pfizer-BioNTech vaccine that had the highest efficacy (95%), the efficacy of the other vaccines are as follows: Moderna 94.5%, Sputnik V 91%, Novavax 89.7%, Sinopharm 79.3%, Oxford/AstraZenaca 70.4%, Johnson and Johnson 66.9%, and Sinovac 50.7%. At present, protein-based vaccines, with 35% of all available COVID-19 vaccines, are the most common technique in the vaccine production, and then there are vaccines of non-replicating viral vector (13.3%), mRNA1 (12.1%), DNA (10.2%), replicating viral vector (9.8%), and inactivated vaccines (8.2%). The most frequently recognized adverse effects within 7 days of each vaccine dose involved fever, fatigue, headache, chill, and myalgia. The mRNA-based vaccines were associated with a higher occurrence of local side effects (78.3 vs. 70.4%; Sig. = 0.064), whereas the viral vector-based vaccine was associated with a higher prevalence of systemic side effects (87.2 vs. 61%; Sig. < 0.001). Based on the evidence and articles in the field of vaccination, AstraZeneca-Oxford and Sinopharm vaccines reported the highest and lowest side effects, respectively. Because of being emerging, pathogenicity, and high infectivity of COVID-19, vaccination against the disease to prevent its incident rate and decrease the prevalence rate is recommended immediately. Being informed of various aspects of the existing vaccines such as efficacy, effectiveness, safety, etc.can accelerate to make effective and useful choices and consequently have a vaccinated community against the epidemic.

The Effect of the Nursing Care Based on the Roy Adaptation Model on the Level of the Quality of Life and Fatigue in the Patients Undergoing Coronary Artery Bypass Graft Surgery.

This article reports the findings of a study designed to investigate the effectiveness of the Roy Adaptation Model, as it relates to improvements in nursing care outcomes for patients undergoing coronary bypass graft surgery. Results revealed that the implementation of a training program based on this model enhanced staff education and led to decreases in the level of fatigue and improved the quality of life for this group of patients.

Different Approaches to Confronting the Biological Epidemic; Prevention Tools with an Emphasis on COVID-19: A Systematized Study.

BACKGROUND: The World Health Organization has identified COVID-19 as a public health emergency and is urging governments to stop the virus transmission by adopting appropriate policies. In this regard, authorities have taken different approaches to cutting the chain or controlling the spread of the disease. The aim of this study was to determine the approaches to biological epidemics and related prevention tools with emphasis on COVID-19 disease. METHODS: The present study was a systematize study of publications related to the prevention strategies for Covid-19 disease. The study was carried out based on the PRISMA guidelines, CASP and AACODS. The data resources included ISI/WOS, PubMed, Scopus, science direct, Ovid and ProQuest. WHO website, published reports of countries, as well as the Worldometer website were evaluated. The time-frame of the study was from 1 December 2019 to 30 May 2020. RESULTS: The study findings showed that in order to confronting the COVID-19 epidemic, in general, there are three approaches of "mitigation", "active control", and "suppression" and four strategies of "quarantine", "isolation", "social distance", and "lockdown" in both individual and social dimensions to deal with epidemics. Selection and implementation of each approach requires specific strategies and has different effects when it comes to controlling and inhibiting the disease. CONCLUSION: One possible approach to control the disease is to change individual behavior and lifestyle. In addition to prevention strategies, use of masks, observance of personal hygiene principles such as regular hand washing and non-contact of contaminated hands with the face, as well as observance of public health principles such as sneezing and coughing etiquettes, safe extermination of personal protective equipment must be strictly observed. The use of the previous experiences in the world, along with the current experiences of countries, can be very helpful in choosing the accurate approach for each country in accordance with the characteristics of that country and lead to the reduction of possible costs at the national and international levels.

Challenges of the Health System in Preventing Non-Communicable Diseases; Systematized Review.

BACKGROUND: The basis of prevention of non-communicable diseases is the identification of primary risk factors and the prevention and control of these factors. The purpose is to prevent the spread of the disease and to control it as much as possible. If population growth continues at this rate, by 2030, 52 million people will die from these diseases each year. The aim of this study was to evaluate the challenges of preventing non-communicable diseases. METHODS: The present study was a systematic review that conducted in July 2020 and the articles related to prevention of non-communicable diseases on databases of web of science, PubMed, Scopus, science direct, Ovid, Pro Quest and Google Scholar. Strategy for searching and selecting the articles was PRISMA Guidelines. RESULTS: Challenges of non-communicable disease prevention, in 4 main codes, including infrastructure, economic, demographic and management and 12 sub-codes that include, lack of preventive infrastructure, restrictions on access to medicine, restrictions on primary health care, restrictions on access to Technology, disease-oriented disease, unsustainable financial resources, failure to implement poverty reduction projects, increase in aging population, migration, rapid and unplanned urban planning, hasty planning and lack of internal and external coordination were classified. CONCLUSIONS: To reduce non-communicable diseases, strengthen global capacities, reduce risk factors for NCDs and place social determinants by creating health-promoting environments, strengthen health systems to implement prevention and control of NCDs, and place determinants Social can play an effective role through people-centered primary health care.

How to Write a Systematic Review: A Narrative Review.

In recent years, published systematic reviews in the world and in Iran have been increasing. These studies are an important resource to answer evidence-based clinical questions and assist health policy-makers and students who want to identify evidence gaps in published research. Systematic review studies, with or without meta-analysis, synthesize all available evidence from studies focused on the same research question. In this study, the steps for a systematic review such as research question design and identification, the search for qualified published studies, the extraction and synthesis of information that pertain to the research question, and interpretation of the results are presented in details. This will be helpful to all interested researchers.

Aspects of Epidemiology, Pathology, Virology, Immunology, Transmission, Prevention, Prognosis, Diagnosis, and Treatment of COVID-19 Pandemic: A Narrative Review.

Undoubtedly, COVID-19 pandemic is one of the largest pandemics and one of the biggest international challenges for health-care system of various countries in the world. This is a narrative review study based on the studies published related with different aspects of COVID-19. The highest numbers of active cases are in the USA, Brazil, India, Russia, South Africa, as well as Colombia and the disease surveillance system must operate more quickly, timely, effectively, and sensitively in these countries. What is clear is that the SARS-CoV-2 basic reproduction number is significantly higher than one and its transmission power is extremely high. In general, it can be stated that mortality and fatality risk due to COVID-19 in men, age increase, severity of disease, systemic disease, as well as inadequate access to the sufficient health-care services will increase. There is currently no specific treatment and effective vaccine for COVID-19. The novel coronavirus pandemic is more consistent with the epidemiological triangle model, which emphasizes that the disease is the result of the interaction of three factors of host, agent, and environment. Therefore, prevention and treatment activities should focus on cutting the virus transmission chain. The main way to deal with viral epidemics is prevention. The emerging of this ruthless virus has once again reminded us that communicable diseases should never be underestimated and forgotten. Considering the rapid transmission of COVID-19, the health-care authorities and workers should consider timely detection and safeguards to prevent the transmission to healthy individuals.

The Cost-Effectiveness and Cost-Utility of Statin Drug for the Treatment of Patients with Cardiovascular Disease, A Systematic Review.

Cardiovascular diseases impose a burden of disease and economic burden on society. With regard to different drugs are used to treat cardiovascular disease; these interventions should be economically evaluated and them that the most cost-effective were selected. The aim of this study was to investigate the studies carried on the cost-effectiveness and cost-utility of statin drugs for the treatment of patients with cardiovascular disease between 2004 and 2020. Quality assessment of the articles was examined by Drummond's checklist. Given that the inclusion criteria, 26 articles included in the review. The results of this review showed that many articles related to the economic evaluation of statin drugs adhered international standards for performing economic evaluation studies. All the studies mentioned the source of effectiveness (the second criteria) and alternative options for the comparison (the third criteria). Atorvastatin and rosuvastatin drugs were the main options for the comparison in the studies. Although the results of the studies were different in some aspects, such as the type of modeling, costs items and the study perspective, they reached the same results which the use of statin drugs versus no-drug can decrease cost, cardiovascular events and deaths and increase QALY. The results were nearly different due to study design, time horizon, efficacy, and drug prices.

Strategic purchasing and the performance of health-care systems in upper middle income countries: A comparative study.

BACKGROUND: Providing financial resources for health services is one of the most important issues in the study of health systems, of which purchasing health services is very essential. The World Health Organization considers strategic purchasing as a key option for improving the performance of health systems. The aim of this study was to identify payment methods for service providers and strategic purchasing strategies in upper middle income countries. MATERIALS AND METHODS: The present study was conducted in the form of a comparative analysis involving comprehensive surveys from 2000 to 2019, by searching keywords for the objective of the study by the search engines through databases including ProQuest, PubMed, Google Scholar, Irandoc, SID, Magiran, Science Direct, Scopus, ISI Web of Science, EBSCO, and Cochrane. RESULTS: A total of five upper middle income countries that used strategic purchases entered the study. Overall, all of them implemented rather similar strategies in terms of strategic purchasing and paying to the providers of the services. CONCLUSION: According to the results of this study, per capita payment for primary health-care and outpatient services seems to be the best option for controlling the costs of the health sector, while the appropriate option for the inpatient department is the most common use of diagnosis-related group. The payment method is to control the costs of the inpatient department.

Barriers in the performance-based payment in Iran health system: Challenges and solutions.

BACKGROUND: One of the main goals of hospital management is to attract, maintain, and increase the number of qualified and efficient human resources, and one of the key and most important factors in achieving this goal is to design and implement a fair and efficient payment system. The purpose of this project is to determine the challenges of the performance-based payment system and provide solutions to overcome its obstacles in the city of Tehran. MATERIALS AND METHODS: This qualitative research sought to perform content analysis so as to explore the experiences and perceptions of a purposeful group of specialists and managers of Tehran's educational and medical centers (n = 10). Data were collected using in-depth semi-structured interviews and were ongoing until the point of saturation. RESULTS: On analysis of data by Specialists and managers of Tehran's educational and medical centers, three main themes including behavior, organization, rules and regulation were defined alongside seven subthemes includes scheduling, platform, education, quantity-oriented, motivation, implementation, and payment system. CONCLUSION: In general, it can be concluded that for the successful implementation of any project, the necessary infrastructure must be provided for implementation. In this plan, despite the challenges in the field of behavior, organization, and rules and regulations, the need for necessary training before implementing the plan, special attention to quality instead of quantity, motivating employees to cooperate in implementing the plan as successfully as possible, creating a platform Appropriate before the implementation of the plan and most importantly, the pilot implementation of the plan before its widespread implementation seems necessary.