Smartphone-based educational and counseling interventions for women with high body mass index at Urmia's health centers.

BACKGROUND AND PURPOSE: Overweight and obesity in women of reproductive age not only contribute to chronic diseases but also lead to fertility issues, adverse pregnancy outcomes, and psychological challenges. Among the detrimental behaviors associated with obesity, the consumption of fast foods and sedentary lifestyles have the most significant impact on weight gain and require effective interventions. This study aims to examine the effectiveness of an educational and counseling smartphone intervention in raising awareness and modifying behaviors related to sedentary behavior and fast food consumption in women with high body mass index. MATERIALS AND METHODS: This randomized controlled trial was conducted with two parallel groups comprising 106 women of reproductive age who sought assistance at Urmia health centers in 2022. Participants with diverse social and economic backgrounds were included. They were randomly assigned to either a control group or an intervention group. Valid and reliable questionnaires were administered to assess awareness regarding sedentary behaviors and fast foods consumption, as well as engagement in sedentary behaviors and consumption of fast foods. In addition to standard care, the intervention group received educational and counseling sessions through a dedicated smartphone application. Data analysis was performed using SPSS 20 software at a significance level of P < 0.05. FINDINGS: The results of a statistical t-test indicated a noteworthy disparity between the control and intervention groups concerning the average awareness scores related to fast foods consumption (P < 0.001) and sedentary behaviors (P < 0.001) before and 3 months after the intervention. Additionally, a substantial statistical difference was observed in the mean consumption of fast foods (P < 0.001) and hours of sedentary behaviors (P < 0.001) before and 3 months after the intervention when comparing the two groups. CONCLUSION: Educational and counseling programs, when applied effectively, can serve the dual purpose of enhancing awareness concerning sedentary behaviors and fast foods consumption while concurrently fostering a reduction in the prevalence of these behaviors. The study was registered in the Iranian Registry of Clinical Trials (IRCT Id: IRCT20210722051953N1) at 04/08/2021.

Requirements specification, design, and evaluation of dental image exchange and management system with user-centered approach: A case study in Iran.

Background and Aims: Systems existing in hospital or clinic settings offer services within the physical environment. Examples of such systems include picture archiving and communication systems, which provide remote services for patients. To develop a successful system, methods like software development life cycles (SDLCs) and design techniques, such as prototyping, are needed. This study aimed to specify requirements, design, and evaluation of dental image exchange and management system using a user-centered approach. Methods: This cross-sectional study was conducted in four phases, each corresponding to different stages of SDLCs. User-needs data were used to gathered by interviews and observations. A prototype was developed using object-oriented programming and presented to users for feedback. Finally, focus group was used to finalized the prototype into the desired system. Results: User needs were identified and prioritized from the outset, with ease of use, security, and mobile apps being their most essential requirements. The prototype underwent several iterations of design and evaluation in focus group sessions until users were satisfied, and their feedback was incorporated. Eventually, the prototype was refined into the final system with users' consent. Conclusion: The study revealed that instant access to information, voluntary participation, user interface (UI) design, and usefulness were critical variables for users and should be integral to any system. Successful implementation of such a system requires careful consideration of end-users' needs and their application to the system. Moreover, integrating the system with electronic health records can further enhance the treatment process and the efficiency of medical staff. The voluntary perspective of users played a significant role in achieving an exemplary UI and overall satisfaction with the system. Developers and policymakers should consider these aspects in similar system development projects.

Identifying factors that affect the use of health information technology in the treatment and management of hypertension.

BACKGROUND: We conducted this study with the aim of identifying factors that affect the use of health information technology in the treatment and management of hypertension. METHODS: This paper is a descriptive-analytic study conducted in 2022. To obtain relevant articles, databases including Scopus, Web of Science, IEEE, and PubMed were searched and the time period was between 2013 and 2022. Based on the review of similar articles, a five-point Likert scale checklist was developed in the second phase. The statistical population of the present study was specialist physicians (N = 40) and patients (N = 384). In order to analyze the data, SPSS Statistics 24 was used. To analyze the data obtained from the checklist, we used summary statistics (mean and standard deviation). RESULTS: As a result of the review literature process, 50 papers were screened, that based we can distinguish motivational and inhibitory factors affecting the use of health information technology in hypertension management. Indeed, Motivational factors and inhibitory factors can be classified into five groups: organizational, economic, technical, personal, and legal/moral factors. Based on the results of the checklist, the factors that were identified as most influential on motivation and inhibitory patients and specialist physicians' to use of health information technology to manage and treat hypertension. CONCLUSION: Utilizing technologies for hypertension, its management can be improved by identifying motivating and inhibiting factors. Our approach can improve the acceptability of these technologies, save costs, reduce long-term complications of hypertension, and improve patient quality of life.

End-users' perspectives on factors affecting implementation and utilization of the Iranian electronic health record system: a qualitative study in a developing country.

BACKGROUND: As one of the most important information technologies for storing, managing, and exchanging health information, the electronic health record (EHR) plays a major role in the health system. However, these systems in developing countries have been associated with multidimensional issues. The purpose of the present study was the assessment of nonclinical end-users' points of view on the implementation and utilization of the Iranian electronic health record system. METHODS: This was a large qualitative study conducted in 2021 for 7 months from February to August. In this study, data were collected through in-depth semi-structured interviews with 70 non-clinical end-users in 22 public and six private hospitals of West Azerbaijan province in Iran. To analyze the data, the thematic analysis method was used. RESULTS: The study results indicated that technical, human, cultural, managerial, and financial readiness are the most important factors affecting the implementation of EHRs in Iran. Among the mentioned factors, technical and human readiness were emphasized more by the users. Also, technical, organizational, human, and managerial factors were identified as factors influencing EHRs utilization, and technical and organizational factors had a stronger role in the system utilization. CONCLUSIONS: According to the results, several factors influence EHR implementation and adequate utilization in Iran. To achieve the predetermined goals of this system, implementation issues and problems of using the system should be considered and solved.

Designing and evaluating the children's developmental motor disorders system: an experience from a developing country.

BACKGROUND: Developmental disorders are a prevalent problem in the health sector of low- and middle-income countries (LMICs), and children in these countries are at greater risk. A registry system is helpful and vital to monitoring and managing this disease. OBJECTIVE: The present study aims to develop an electronic registry system for children's developmental motor disorders. METHODS: The study was conducted between 2019 and 2020 in three phases. First, the requirements of the system were identified. Second, UML diagrams were first drawn using Microsoft Visio software. Then, the system was designed using the ASP.NET framework in Visual Studio 2018, and the C# programming language was used in the NET 4.5 technology platform. In the third phase, system usability was evaluated from the users' viewpoint. RESULTS: The findings of this research included system requirements, a conceptual model, and a web-based system. The client and system server connection was established through the IP/TCP communication protocol in a university physical network. End users approved the system with an agreement rate of 87.14%. CONCLUSION: The study's results can be used as a model for designing and developing systems related to children's developmental movement disorders in other countries. It is also suggested as a valuable platform for research and improving the management of this disease.

The effects of electronic nursing handover on patient safety in the general (non-COVID-19) and COVID-19 intensive care units: a quasi-experimental study.

BACKGROUND: The unprecedented increase in the nurses' workload is one of the issues affecting the quality and safety of patient care in the Intensive Care Units (ICUs). The electronic nursing handover can share sufficient, relevant, and necessary data about patients with greater efficiency and accuracy and prevent their information from being deleted. Therefore, this study aimed to determine and compare the effect of the Electronic Nursing Handover System (ENHS) on patient safety in General ICU and COVID-19 ICU. METHOD: This is a quasi-experimental study conducted during an 8-month period from 22 to 2021 to 26 June 2022 using a test-retest design. A total of 29 nurses working in the General and COVID-19 ICUs participated in this study. Data were collected using a five-part questionnaire consisting of demographic information, handover quality, handover efficiency, error reduction, and handover time. Data analysis was conducted in IBM SPSS Statistics for Windows, version 26 (IBM Corp., Armonk, N.Y., USA) using the chi-squared test, paired t-test, and Analysis of Covariance (ANCOVA). RESULTS: The results showed that the mean scores of handover quality and efficiency, reduction of clinical error, and handover time in the electronic handover were significantly higher than those obtained in the paper-based method. The results showed that the mean score of patient safety in the COVID-19 ICU was 177.40 ± 30.416 for the paper-based handover and 251.40 ± 29.049 for the electronic handover (p = .0001). Moreover, the mean score of patient safety in the general ICU was 209.21 ± 23.072 for the paper-based handover and 251.93 ± 23.381 for the electronic one (p = .0001). CONCLUSION: The use of ENHS significantly improved the quality and efficiency of shift handover, reduced the possibility of clinical error, saved handover time, and finally increased patient safety compared to the paper-based method. The results also showed the positive perspectives of ICU nurses toward the positive effect of ENHS on the patient safety improvement.

Effectiveness of a smartphone-based educational intervention to improve breastfeeding.

BACKGROUND: Exclusive breastfeeding (EBF) is essential during the first six months of life and confers countless benefits to mothers and infants. This study aimed to assess the effectiveness of a smartphone-based educational intervention to improve new mothers' breastfeeding for infants younger than six months of age in Urmia, Iran. METHODS: A randomized controlled trial study was conducted from January to December 2019 with 40 new mothers and their first child aged < 3 months, assigned to the intervention (mobile app education + routine care) and control groups (routine care). The mean age of infants was 1.25 and 0.98 months for each group consequently. The designed app content categorized according to seven sections (the importance of breastfeeding, behavioral methods, complementary feeding and EBF, pumping and manual expression, managing common breast-related and breastfeeding problems, breastfeeding tips in special situations, and common queries) for educating the required knowledge to nursing mothers. RESULTS: Forty mothers were assessed for primary outcomes in each group. At three months, the mothers' knowledge, attitude, and practice (KAP) had meaningful differences in the intervention group compared to the control group. In the intervention group, the degree of changes in knowledge and attitude were 5.67 ± 0.94 and 8.75 ± 1.37 respectively more than the control group (p < 0.001, p < 0.001). However, this amount for the practice score was 0.8 ± 0.49 which is considered to be marginally significant (p = 0.063). During the study, the mothers' breastfeeding self-efficacy showed significant progress in favor of the intervention group. The score enhancement was 26.85 ± 7.13 for the intervention group and only 0.40 ± 5.17 for the control group that was confirmed to be significant (p < 0.001). CONCLUSION: The smartphone-based app for educating new mothers on breastfeeding had a significantly positive effect on breastfeeding self-efficacy and maternal KAP. In future studies, the intervention can be tested in both prenatal and postpartum periods.

Endectocides as a complementary intervention in the malaria control program: a systematic review.

BACKGROUND: Malaria is the most common vector-borne disease transmitted to humans by Anopheles mosquitoes. Endectocides and especially ivermectin will be available as a vector control tool soon. The current review could be valuable for trial design and clinical studies to control malaria transmission. METHODS: PubMed/MEDLINE, Scopus, Web of Science, and Science Direct were searched for original English published papers on ("Malaria chemical control" OR "Malaria elimination" OR "Anopheles vector control" OR "Malaria zooprophylaxis") AND ("Systemic insecticides" OR "Endectocides" OR "Ivermectin"). The last search was from 19 June 2019 to 31 December 2019. It was updated on 17 November 2020. Two reviewers (SG and FGK) independently reviewed abstracts and full-text articles. Data were extracted by one person and checked by another. As meta-analyses were not possible, a qualitative summary of results was performed. RESULTS: Thirty-six published papers have used systemic insecticides/endectocides for mosquito control. Most of the studies (56.75%) were done on Anopheles gambiae complex species on doses from 150 µg/kg to 400 µg/kg in several studies. Target hosts for employing systemic insecticides/drugs were animals (44.2%, including rabbit, cattle, pig, and livestock) and humans (32.35%). CONCLUSIONS: Laboratory and field studies have highlighted the potential of endectocides in malaria control. Ivermectin and other endectocides could soon serve as novel malaria transmission control tools by reducing the longevity of Anopheles mosquitoes that feed on treated hosts, potentially decreasing Plasmodium parasite transmission when used as mass drug administration (MDA).

Smartphone-Based Maternal Education for the Complementary Feeding of Undernourished Children Under 3 Years of Age in Food-Secure Communities: Randomised Controlled Trial in Urmia, Iran.

The mothers' nutritional literacy is an important determinant of child malnourishment. We assessed the effect of a smartphone-based maternal nutritional education programme for the complementary feeding of undernourished children under 3 years of age in a food-secure middle-income community. The study used a randomised controlled trial design with one intervention arm and one control arm (n = 110; 1:1 ratio) and was performed at one well-child clinic in Urmia, Iran. An educational smartphone application was delivered to the intervention group for a 6-month period while the control group received treatment-as-usual (TAU) with regular check-ups of the child's development at the well-child centre and the provision of standard nutritional information. The primary outcome measure was change in the indicator of acute undernourishment (i.e., wasting) which is the weight-for-height z-score (WHZ). Children in the smartphone group showed greater wasting status improvement (WHZ +0.65 (95% Confidence Interval (CI) ± 0.16)) than children in the TAU group (WHZ +0.31 (95% CI ± 0.21); p = 0.011) and greater reduction (89.6% vs. 51.5%; p = 0.016) of wasting caseness (i.e., WHZ < -2; yes/no). We conclude that smartphone-based maternal nutritional education in complementary feeding is more effective than TAU for reducing undernourishment among children under 3 years of age in food-secure communities.

Comparative study of virtual and traditional teaching methods on the interpretation of cardiac dysrhythmia in nursing students.

INTRODUCTION: Due to the importance of correct interpretation of electrocardiogram (ECG) in the quality of healthcare delivery, new educational methods are increasingly being implemented and evaluated. In this regard, the purpose of this study was to compare the traditional and virtual teaching methods on the interpretation of cardiac dysrhythmia in nursing students. METHODS: The present study is a quasi-experimental research with pretest and posttest design. Sixty nursing students in the seventh semester from schools of nursing in Urmia and Khoy cities were randomly assigned to two virtual and traditional education groups. Students' knowledge was measured by a researcher-made 30-item test. RESULTS: The mean and standard deviation of the students' scores in the traditional education group was 11.20 ± 4.41 and 14.40 ± 4.62 and in the virtual group was 11.30 ± 2.74 and 18.43 ± 4.68, pre- and post-training, respectively. Paired t-test showed a significant difference between the mean score of pretest and posttest in both types of training (P < 0.001). According to the results of independent sample t-test, there were no significant differences between the two groups before the training (P > 0.05). However, in the posttraining period, there were significant differences between traditional and virtual education groups (P < 0.001). CONCLUSION: Considering the results of this study, which shows the positive effects of virtual education method on nursing students' knowledge about cardiac dysrhythmia, this method can be used as an alternative or complementary method to the traditional education.

The Structure of the World Pharmaceutical Market: Prioritizing Iran's Target Export Markets.

Iran`s pharmaceutical products market has faced fluctuations over time. Suitable market selection is necessary for stability of pharmaceutical exports. This study aimed to determine the structure of the world pharmaceutical market and to identify the target of Iranian pharmaceutical export. T do so, concentration ratios and Herfindahl index were used to address the world pharmaceutical market from 2001 to 2012. Also, a composite index was used to identify the target markets of Iran's pharmaceutical industry. The results showed that the export side of world pharmaceutical trade has shifted to open oligopoly, thereby decreasing the monopolistic power of exporters. The import side, however, follows monopolistic competition. It has been observed that the structure of Iran's pharmaceutical export is shifting to open oligopoly; though, pharmaceutical importers from Iran have not been stable. Moreover, 27 countries were identified as target markets. Due to significant differences between the current and potential export destinations of Iran's pharmaceutical products, exporters should choose suitable strategies in order to diversify export markets. Such mechanisms as setting preferential tariffs on the basis of bilateral agreements, following effective advertisment, and paying attention to global consumers'preferences can be used to develop Iran's pharmaceutical export to target countries.

Mobile phone applications to overcome malnutrition among preschoolers: a systematic review.

BACKGROUND: Malnutrition is one of the most important reasons for child mortality in developing countries, especially during the first 5 years of life. We set out to systematically review evaluations of interventions that use mobile phone applications to overcome malnutrition among preschoolers. METHODS: The review was conducted and reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses: the PRISMA statement. To be eligible, the study had to have evaluated mobile phone interventions to increase nutrition knowledge or enhance behavior related to nutrition in order to cope with malnutrition (under nutrition or overweight) in preschoolers. Articles addressing other research topics, older children or adults, review papers, theoretical and conceptual articles, editorials, and letters were excluded. The PubMed, Web of Science and Scopus databases covering both medical and technical literature were searched for studies addressing preschoolers' malnutrition using mobile technology. RESULTS: Seven articles were identified that fulfilled the review criteria. The studies reported in the main positive signals concerning the acceptance of mobile phone based nutritional interventions addressing preschoolers. Important infrastructural and technical limitations to implement mHealth in low and middle income countries (LMICs) were also communicated, ranging from low network capacity and low access to mobile phones to specific technical barriers. Only one study was identified evaluating primary anthropometric outcomes. CONCLUSIONS: The review findings indicated a need for more controlled evaluations using anthropometric primary endpoints and put relevance to the suggestion that cooperation between government organizations, academia, and industry is necessary to provide sufficient infrastructure support for mHealth use against malnutrition in LMICs.

The Study of Effective Factors on Iran's Pharmaceutical Export Supply and Demand.

The importance of drug as a valuable export product in the global economy becomes clearer every day. Understanding the problems of exports and factors affecting it, can be an important step to keep Iran's position in the world markets and further export development of this product. In this study, Iranian pharmaceutical exports' supply and demand functions were calculated using co-integration and error correction techniques through time series quarterly data of 2000-2014 in order to identify the factors affecting pharmaceutical exports (short run and long run relationships among the variables) and price and income elasticities. The long run price elasticity of demand of -2.28 indicates that an increase in Iran's export price relative to competitor's export price will have a negative impact on pharmaceutical export volume. Also, the long run income elasticity of foreign demand for pharmaceutical exports of Iran is 1.11. That is an increase in income of foreign countries will have a positive impact on Iran's pharmaceutical export. On the other hand, the long run price elasticity of export supply is 1.09, indicating that the supply of pharmaceutical export is sensitive to the relative price changes. In other words, an increase in export price relative to domestic price as well as an expansion of the pharmaceutical production capacity will increase its export supply. Being aware of the factors affecting the pharmaceutical exports can prepare the ground to develop the pharmaceutical industry and balance the supply and demand in the long run. Therefore, the results of this study can help Iran's policymakers and managers to choose a clearer path for the pharmaceutical trade policies.

Effective Factors in Adoption of Mobile Health Applications between Medical Sciences Students Using the UTAUT Model.

BACKGROUND: Students with complex health care services process face constant challenges with regard to health education. The mobile devices are an important tool that can install various applications for using information such as clinical guidelines, drug resources, clinical calculations, and the latest scientific evidence without any time and place limitations. And this happens only when students accept and use it. OBJECTIVE: The purpose of this article is to identify the factors influencing students in their intention to use mobile health (mHealth) by using Unified Theory of Acceptance and Use of Technology (UTAUT) model. METHODS: A standard questionnaire was used to collect the data from nearly 302 Lorestan University of medical science students including nutrition and public health, paramedicine, nursing and midwifery, pharmacy, dentistry, and medical schools. The data were processed using LISREL (Scientific Software International, Inc., Lincolnwood, Illinois) and SPSS (IBM Corp., Armonk, New York) softwares and the statistical analysis technique was based on structural equation modeling (SEM). RESULT: A total of 300 questionnaires including valid responses were used in this study. The results showed that mediator of age did not affect the predictors of intention to use mHealth, and the level of education and gender directly affected the intention to use. In addition, effort expectancy, facilitating condition, and behavioral intention directly and indirectly have effect on use, whereas the result revealed no significant relationship between two important processes of performance expectancy and social influence with students' behavioral intention to use the mHealth. CONCLUSIONS: The present study provides valuable information on mobile health acceptance factors for widespread use of this device among students of universities of medical sciences as a base infrastructure for a variety of information about health services and learning. Review and comparison of results with other studies showed that mHealth acceptance factors were different from other end users (elderly, patients, and health professionals).

Identification and Validation of Requirements for a Registry System of Children's Developmental Motor Disorders in Iran.

BACKGROUND: Despite recent advances in the field of medical sciences, children's developmental motor disorders (DMDs) are considered as one of the challenges in this area. Establishment of electronic systems for recording and monitoring children's DMDs can play an effective role in identifying patients and reducing the costs and consequences of the disease management. The aim of this study was to identify and validate the requirements for a registry system of children's DMDs in Iran. METHODS: The present descriptive-analytical study was performed in three main stages. In the first step, the literature was reviewed to identify the requirements. In the second stage, the information obtained from the literature review was used to develop a questionnaire for validating and selecting the requirements for an electronic system of recording DMDs in infants. In the final stage, the requirements were validated by selected experts (22 specialists). Data were analyzed using SPSS 20 software (IBM Corporation, New York, United States). RESULTS: According to findings, the requirements of a registry system for children's DMDs were identified in three areas of demographic (24 data elements), clinical data (87 data elements), and technical (28 capabilities). In the demographic section, data elements of "family history of motor disorders" (mean = 1.18) and "drug allergy" (mean = 2.9) gained an average score of < 2.5 and therefore were not selected as data elements necessary for the registry system of data recording and monitoring children's DMDs. CONCLUSION: In such developing countries as Iran, standard information recording and management is not properly done due to a large amount of information and the lack of comprehensive information registry systems. The findings of this study can help to design and establish information registry systems in the field of children's DMDs. Based on the findings of this research, it is recommended that future research be done to explore infrastructures necessary for providing a suitable platform to design and implement information registry systems in the field of children's DMDs.

A Systematic Review of the Technology Acceptance Model in Health Informatics.

BACKGROUND: One common model utilized to understand clinical staff and patients' technology adoption is the technology acceptance model (TAM). OBJECTIVE: This article reviews published research on TAM use in health information systems development and implementation with regard to application areas and model extensions after its initial introduction. METHOD: An electronic literature search supplemented by citation searching was conducted on February 2017 of the Web of Science, PubMed, and Scopus databases, yielding a total of 492 references. Upon eliminating duplicates and applying inclusion and exclusion criteria, 134 articles were retained. These articles were appraised and divided into three categories according to research topic: studies using the original TAM, studies using an extended TAM, and acceptance model comparisons including the TAM. RESULTS: The review identified three main information and communication technology (ICT) application areas for the TAM in health services: telemedicine, electronic health records, and mobile applications. The original TAM was found to have been extended to fit dynamic health service environments by integration of components from theoretical frameworks such as the theory of planned behavior and unified theory of acceptance and use of technology, as well as by adding variables in specific contextual settings. These variables frequently reflected the concepts subjective norm and self-efficacy, but also compatibility, experience, training, anxiety, habit, and facilitators were considered. CONCLUSION: Telemedicine applications were between 1999 and 2017, the ICT application area most frequently studied using the TAM, implying that acceptance of this technology was a major challenge when exploiting ICT to develop health service organizations during this period. A majority of the reviewed articles reported extensions of the original TAM, suggesting that no optimal TAM version for use in health services has been established. Although the review results indicate a continuous progress, there are still areas that can be expanded and improved to increase the predictive performance of the TAM.

Determinants of Iran's BilateralIntra-industry Trade in Pharmaceutical Industry.

Among non-oil and in trade arena, drug has always been strategic importance and most government especially industrialized countries pay special attention to its production and trade issues. Thus, having a comprehensive view from economic perspective to this section is essential for suggesting intervention. This was a descriptive-analytical and panel study. In this study, gravity model is used to estimate Iran's bilateral intra-industry trade in pharmaceutical products in the 2001-2012 periods. To illustrate the extent of pharmaceutical's intra-industry trade between Iran and its major trading partners, the explanatory variables of market size, income, factor endowments, distance, cultural contributions, and similarities and also special trade arrangements have been applied. Analysis of factors affecting Iran's bilateral intra-industry trade in pharmaceutical industry showed that the average GDP and cultural similarities had a significant positive impact on Iran's bilateral IIT, while the difference in GDP has a negative and significant effect. Coefficients obtained for the geographical distance and the average ratio of total capital to the labor force is not consistent with theoretical expectations. Special trade arrangements did not have significant impact on the extent of bilateral intra-industry trade between Iran and its trading partners. The knowledge of the intra-industry trade between Iran and its trade partners make integration between the countries. Factors affecting this type of trade pattern underlie its development in trade relationship. Therefore, the findings of this study would be useful in helping to develop and implement policies for the expansion of the pharmaceutical trade.

Factors Affecting Acceptance of Hospital Information Systems Based on Extended Technology Acceptance Model: A Case Study in Three Paraclinical Departments.

OBJECTIVE: Regardless of the acceptance of users, information and communication systems can be considered as a health intervention designed to improve the care delivered to patients. This study aimed to determine the adoption and use of the extended Technology Acceptance Model (TAM2) by the users of hospital information system (HIS) in paraclinical departments including laboratory, radiology, and nutrition and to investigate the key factors of adoption and use of these systems. MATERIALS AND METHODS: A standard questionnaire was used to collect the data from nearly 253 users of these systems in paraclinical departments of eight university hospitals in two different cities of Iran. A total of 202 questionnaires including valid responses were used in this study (105 in Urmia and 97 in Khorramabad). The data were processed using LISREL and SPSS software and statistical analysis technique was based on the structural equation modeling (SEM). RESULTS: It was found that the original TAM constructs had a significant impact on the staffs' behavioral intention to adopt HIS in paraclinical departments. The results of this study indicated that cognitive instrumental processes (job relevance, output quality, result demonstrability, and perceived ease of use), except for result demonstrability, were significant predictors of intention to use, whereas the result revealed no significant relationship between social influence processes (subjective norm, voluntariness, and image) and the users' behavioral intention to use the system. CONCLUSION: The results confirmed that several factors in the TAM2 that were important in previous studies were not significant in paraclinical departments and in government-owned hospitals. The users' behavior factors are essential for successful usage of the system and should be considered. It provides valuable information for hospital system providers and policy makers in understanding the adoption challenges as well as practical guidance for the successful implementation of information systems in paraclinical departments.

Determinant of successful implementation of Computerized Provider Order Entry (CPOE) system from physicians' perspective: Feasibility study prior to implementation.

BACKGROUND: Health information technology is a solution for medical error reduction through the implementation of Computerized Provider Order Entry (CPOE). OBJECTIVE: The aim of this study was to determine physicians' attitudes toward the implementation of CPOE. METHODS: This cross-sectional study was started in March 2017 and completed in June 2017. The study used a questionnaire to collect data from physicians in hospitals affiliated to Urmia University of Medical Sciences. We invited 200 physicians who were not using a CPOE system. Questionnaires were randomly distributed among physicians. In order to understand the physicians' attitude about implementation the CPOE system, we used the Diffusion of Innovation Theory, developed by E.M. Rogers. Data were analyzed by SPSS version 16.0, using descriptive statistics and one-way ANOVA. A p value <0.05 was considered to be statistically significant. RESULTS: Most of the physicians were women (n=54, 60%) and the average age of the physicians was 36.39±8.42 years. About three-quarters of the physicians (76.66%) reported that they found the CPOE system adapted to their specific professional practice. The relative advantage of the CPOE system was estimated to be 42.22% for physicians and the complexity of that was 13.33%. There was no significant relationship between Compatibility, Relative advantages and Complexity with physicians' experience in HIS use and physicians' degree of education (p>0.05). CONCLUSION: Since the role of CPOE systems is very important in hospitals in order to reduce medication errors and to improve the quality of care, our results can be used to assist the planning and introduction of CPOE systems.

The Most Common Smartphone Applications Used By Medical Students and Barriers of Using Them.

INTRODUCTION: Medical knowledge is rapidly expanding and updating. It is very important that students can timely access to information and the latest scientific evidence without any time and place limitation. The smartphone is one of ICT tools that adopted greatly by healthcare professionals. Today, the most medical sciences universities have provided smartphone as an educational aid tool and acquisition licenses for medical apps resources in training of their students. AIM: This research was conducted to determine common smartphone applications among medical students of Urmia University of medical sciences and to identify barriers in using them. MATERIALS AND METHODS: This research was a descriptive type of study carried out in 2016. Population of the study included 530 medical students completing the clinical course in Urmia University of Medical Sciences. Data were collected using researcher-developed questionnaire. The validity of it determined based on the view of experts and the reliability of it obtained by calculating the value of Cronbach's alpha (α = 0.82). RESULTS: 82.3% of the students had smartphone, which in terms of operating system the highest was related Andriod (53%) and iPhone (32%). The most common applications used often by medical students included Up to date, PubSearch, Calculate by QxMD, Epocrates and OMnio. Lack of accreditation of medical apps by valid health institutions (4.63), lack of support and update of applications by their developers (4.44), lack of adequate skill to use applications (4.25) are the most important barriers in using these applications among students. CONCLUSION: To assurance quality of medical apps, it seems very important that academic and healthcare organizations should be involved to develop and update the apps and also provided guidelines for accreditation of apps. It is recommended that for promotion of knowledge and skill of students provide essential educations.