RESUMEN
BACKGROUND: The aim of this study is to synthesize the existing evidence on various palliative care (PC) models for cancer patients. This effort seeks to discern which facets of PC models are suitable for various patient cohorts, elucidate their mechanisms, and clarify the circumstances in which these models operate. METHODS: A comprehensive search was performed using MeSH terms related to PC and cancer across various databases. The Preferred Reporting Items for Systematic Reviews and a comprehensive evidence map were also applied. RESULTS: Thirty-three reviews were published between 2009 and 2023. The conceptual PC models can be classified broadly into time-based, provider-based, disease-based, nurse-based, issue-based, system-based, team-based, non-hospice-based, hospital-based, community-based, telehealth-based, and setting-based models. The study argues that the outcomes of PC encompass timely symptom management, longitudinal psychosocial support, enhanced communication, and decision-making. Referral methods to specialized PC services include oncologist-initiated referral based on clinical judgment alone, via referral criteria, automatic referral at the diagnosis of advanced cancer, or referral based on symptoms or other triggers. CONCLUSION: The gold standard for selecting a PC model in the context of oncology is a model that ensures broad availability of early PC for all patients and provides well-timed, scheduled, and specialized care for patients with the greatest requirement.
Asunto(s)
Neoplasias , Cuidados Paliativos , Cuidados Paliativos/organización & administración , Humanos , Neoplasias/terapia , Oncología Médica/organización & administraciónRESUMEN
Background: Cystic fibrosis is a chronic and progressive genetic disease with a worldwide prevalence. As the disease progresses, symptoms develop, and make its management more challenging. Accumulating evidence suggests that early diagnosis of CF can significantly contribute to preventing reported nutritional problems including anemia, vitamin deficiencies, and hypoalbuminemia. This cross-sectional study was conducted to assess disease severity in cystic fibrosis patients using the Shwachman-Kulczycki score, as well as to determine its relation with anemia and vitamin D deficiency. Materials and Methods: Clinical and CF-related laboratory data were collected from the medical records of 57 CF patients with a definitive diagnosis. At the time of diagnosis, physicians performed simultaneous, blood sampling and scoring of patients using the Shwachman scoring system. Results: The mean age of patients was 16.12±6.48 years. Total scores of 86-100, 71-85, 56-70, 41-55, and <40, were reported in 5.4%, 7.1%, 14.3%, 14.3%, and 58.9% of CF patients, respectively. A significant correlation was found between disease severity and patients' age (P=0.02). The analysis also showed that the disease severity was significantly higher in anemic patients when compared to non-anemics (p =0.006). Based on the results, 33 patients with normochromic, 11 patients with microcytic, and 6 patients with macrocytic anemia were diagnosed in this study. We did not find a significant difference between disease severity and vitamin D levels (P=0.150). Conclusion: The scoring system used in the current study could reflect properly the clinical status of CF patients. However, simultaneous use of various methods using a larger sample size for comparison of results is suggested to improve the accuracy of findings.
RESUMEN
Background: Integration of healthcare services for preterm neonates at home and hospital by mobile technology is an economical and convenient intervention, which is being increasingly applied worldwide. We aimed to classify the outcomes of mobile applications tailored to parents of premature infants. Methods: This systematic review was conducted by searching the six main databases until May 2021. Mobile applications tailored to parents of premature infants and the reported outcomes of this technology were identified and classified. Quality of screened articles checked by MMAT tool. Results: Overall, 10703 articles were retrieved, and after eliminating the duplicated articles, 9 articles were reviewed ultimately. Identified outcomes were categorized into three groups parental, application, and neonatal outcomes. In the parental outcomes, maternal stress/stress coping, parenting self-efficacy, satisfaction, anxiety, partnership advocacy/improved parent-infant relationship, feeling of being safe, reassurance and confidence, increase awareness, as well as discharge preparedness, were identified. In the application outcomes, application usage, ease of use/user-friendly, and usability of the designed application were placed. Finally, the neonatal outcomes include health and clinical items. Conclusion: Mobile applications can be useful in prematurity for educating pregnant mothers, managing stress and anxiety, supporting families, and preparing for discharge. Moreover, due to the coronavirus condition, providing remote services for parents is an appropriate solution to reduce the in-person visits to neonatal care centers. Development of tailored apps can promote the neonates' health and reduce their parents' stress.
RESUMEN
Background: This overview is conducted to evaluate the effect of telerehabilitation on Health-Related Quality of Life (HRQOL) in patients with cardiovascular diseases (CVDs). Methods: A comprehensive search was performed through the [MeSH] keywords (heart diseases, coronary disease, coronary artery disease, myocardial infarction, coronary artery bypass, heart failure, cardiac rehabilitation and telemedicine) until January 20, 2021 in databases of Science Direct, Medline/PubMed, Web of Science, Scopus, ProQuest, Google Scholar and Cochrane library. Finally, 20 reviews were entered into the analysis. Results: The results of meta-analyses showed that receiving telerehabilitation program by telemedicine method has a positive effect on the physical dimension and changing the mental status of patients following this intervention depends on age so that the use of these technologies in heart patients with younger ages promotes mental status. On the other hand, increasing the duration of the intervention 18 months or more affects the physical dimension and 12 months or more affects promoting overall HRQOL. Among the various types of Telemedicine methods, telephone support has a greater effect on promoting the physical dimension. Conclusion: The ability to use virtual technology is less at older ages, so age conditions of patients should be considered in choosing this type of intervention. The living place of the people and the level of access to advanced care, seem to play an important role in changing outcomes and choosing this type of intervention because the main purpose of telerehabilitation is to provide treatment care in areas with low access levels.
RESUMEN
Background: Application of technology in virtual or remote cardiac rehabilitation programs can resolve the challenge of accessing healthcare services and reduce access level inequalities. This study aimed to evaluate the effect of technology on different clinical outcomes in cardiac rehabilitation programs used for cardiovascular (CVD) patients. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses and a comprehensive evidence map of overview was used. Two researchers searched electronic databases such as Science Direct, Medline / PubMed, Web of Science, Scopus, ProQuest, Google Scholar and Cochrane library at the time of publication until Mar 21, 2021. Results: Of 51 reviews published, most of them have reported that the virtual or remote cardiac rehabilitation had a positive effect on most outcomes compared to usual care, and the difference in the type of comparison group and the high heterogeneity in reviews with inconsistent results are due to different technologies used in the interventions, follow-up duration, the type of heart disease, tools, and reporting methods, the quality of the reviews, and the quality of the primary studies included in the reviews. Conclusion: Two important factors before choosing the remote cardiac rehabilitation technology include the complexity of technology and the level of satisfaction and acceptability of the interventions among participants. The simplicity of the interventions increases the acceptability level, and the more complex design and advanced monitoring level during the interventions and the need for specific equipment affect cost saving, so it is important to consider the above cases while choosing the type of technology.
RESUMEN
Background: It is widely accepted that concerns have been recently raised regarding the impact of air pollution on the health of children with cystic fibrosis (CF). Air pollution probably affects the exacerbation of CF and its laboratory findings. On the other hand, the World Health Organization (WHO) has asked all countries to update their data and reports on the distribution and prevalence of CF in different areas. The purpose of the present study was to investigate the distribution and prevalence of CF based on the levels of atmospheric pollutants, such as PM10, PM2.5, SO2, NO2, CO, and O3 in 22 zones of Tehran, and to report the abnormal laboratory findings that might indicate the exacerbation of CF. Materials and Methods: The studied statistical population included children with CF referred to Masih Daneshvari Hospital from 2003 to 2020. Demographic data, location of living area, and laboratory findings were extracted from patient records. The geographic information system (GIS) was applied to indicate the distribution and dispersion of the disease. The information related to air pollutants was collected from all stations in Tehran during the studied period by the Department of Environment of Tehran Province, and the average levels were used for final reporting. Results: The analysis results on 287 CF patients demonstrated that the risk of disease exacerbation significantly increased by the presence of air pollutants. In areas with multiple air pollutants, more laboratory findings were observed to be abnormal, and the lower survival rate for patients with CF was recorded. Investigating the CF distribution pattern based on climatic layers and above mean sea level (AMSL) indicated that distribution of the disease was higher in dry areas with lower AMSL and the higher volume of the atmospheric pollutants, which were primarily centralized in southern and central Tehran. Conclusion: Environmental factors, such as air pollution, can be considered vital parameters, along with high-risk factors, such as pure and integrated race, migration, and mutation, influencing the prevalence and exacerbation of CF symptoms. Considering the higher prevalence of CF in deprived areas of Tehran, households' cultural and economic level appears to be a factor in the lack of diagnostic screening and prevention of CF in these areas. On the other hand, continuous monitoring of the air pollution caused by traffic and giving warnings to CF patients and their parents is particularly important.
RESUMEN
Background: Premature birth is a global epidemic of significant public health concern. Counselling and education of pregnant women at risk of preterm birth or mothers with premature infants are essential to improve mother and infant health. Mobile applications are an increasingly popular tool among parents to receive health information and education. This study aims to evaluate the usages and the effects of a mobile application designed for premature births in order to improve health outcomes. Methods: This review will include all studies of different designs which evaluated the use and impact of interventions provided via mobile applications on pregnant women at risk of preterm birth or mothers with premature infants in order to address all health outcomes. A combination of keywords and MeSH(Medical Subject Headings) terms is used in the search strategy. Literature databases including Scopus, PubMed, ISI Web of Science, ProQuest, CINAHL and Cochrane Library will be searched to May 2021. Furthermore, eligible studies will be chosen from the reference list of retrieved papers. Two researchers will independently review the retrieved citations to decide whether they meet the inclusion criteria. Mixed Methods Appraisal Tool (MMAT) V.2018 will be used to assess the quality of studies. Relevant data are collected in a data extraction form and analysed. Results are reported under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Discussion: This systematic review will recognize and combine evidence about the usages and impact of mobile application interventions on the health improvement of pregnant women at risk of preterm birth or mothers with premature infants.
Asunto(s)
Enfermedades del Prematuro , Aplicaciones Móviles , Nacimiento Prematuro , Femenino , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Madres , Embarazo , Nacimiento Prematuro/epidemiología , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: We aimed to report the findings of the first Electrocardiography (ECG), before therapy initiation and receiving medication in COVID-19 patients, and to compare them with the ECG findings of healthy men. METHODS: A comprehensive and regular search was performed through the keywords ("Electrocardiographic" OR "ECG" OR; "COVID-19" OR "Coronavirus Disease 2019") without time and language restrictions in the Web of Science, Scopus, ProQuest, Cochrane Library, Science Direct, Medline, PubMed and Google Scholar. After evaluating the quality and reviewing the biases, 27 studies were finally enrolled. RESULTS: In 27 studies with a total number of 3994 COVID-19 patients, and mean age of 62.7 yr, 1993 subjects were male. The most common type of arrhythmia in them, especially in severe and critical cases, was 7% based on 10 studies (Atrial Fibrillation); while in 7 studies, QTc interval prolong (≥ 460 msec) was 15% and in 5 studies, QTc interval prolong (≥ 500 msec) was 18%. In COVID-19 patients at the time of admission and healthy men, HR (b per / min) was 85, 61.7 and PR interval (msec) was 285.4, 156 and QRS duration (msec) was 95, 94.3 and QT (msec) was 380. 384.1 and QTc (msec) (Bazett's formula) was 437, 387.1, respectively. In most cases, the variables were higher for COVID-19 patients. CONCLUSION: ECG abnormalities at the time of admission and prior to the initiation of medication that cause arrhythmic may have a clinically substantial effect on the course of the disease and confirm the effect of COVID-19 on increased cardiovascular risk in long-term.
RESUMEN
BACKGROUND: Given the limitations of traditional citation indicators, more indicators are needed to examine the effectiveness and improvement of existing indicators. The present study aimed to investigate the association between Altmetrics activity and quality citation indicators in Iranian journals based on Clarivate Analytics, Scopus, and Medline. METHODS: The research was carried out using Altmetrics method through scientometric approach. The population of the present study was Iranian medical journals, which were available at three databases of Clarivate Analytics, Scopus, and Medline. In order to obtain quality information, we've used the indicators of CiteScore, SJR, and SNIP at Scopus database as well as the impact factor at JCR database; besides, to find Altmetrics indicators and Altmetrics scores of articles, the Altmetrics explorer database was used. RESULTS: About 16% of the articles in the reviewed journals were cited at least once in the social media and had Altmetrics scores. Among the reviewed journals, the highest rate of social media coverage was related to the Iranian Journal of Basic Medical Sciences, and the highest Altmetrics score obtained from the mean Altmetrics score of the papers was related to Cell Journal (Yakhteh). A review of quality indicators of journals with Altmetrics coverage and Altmetrics score of journals showed that there was a significant and positive correlation between the Altmetrics score and impact factor. However, any significant association was neither found between the journal's coverage and SiteScore, SNIP, SJR, nor between the journal's Altmetrics score and quality indicators. CONCLUSIONS: According to the results of this study, policy makers of scientific journals should adopt strategies that bring about social media presence; thus, we will find further Iranian articles in the social media.
RESUMEN
Introduction: Sleep quality is an essential aspect in human health and function. Considering high prevalence of using smartphones and social networks among students and their impact on sleep quality, this study was conducted to determine the relationship between the overuse of cell phone and addiction to social networks and students' sleep quality. Materials and methods: This cross-sectional study was conducted in Kermanshah University of Medical Sciences, Kermanshah, Iran in 2018. Using cluster sampling, 321 students from different disciplines were selected. Data gathering tools consisted of the questionnaire of Pittsburgh Sleep Quality Index (PSQI). Cell phone use and addiction to social networks were assessed using Cell Phone Overuse Scale and a researcher-made questionnaire, respectively. Data were analyzed using SPSS software (version 19) and Pearson's correlation test. Results: The mean total score of sleep quality in students was 6.58 ± 1.05. There was a positive and significant correlation between sleep quality and social networks addiction score (p < 0.05, r = 0.5) and cell phone overuse (p < 0.05, r = 0.44); this is an inverse correlation, because higher scores of the total PSQI denote a lower sleep quality and, in Cell Phone Overuse Scale, higher scores shows overuse. Conclusions: According to the findings of this study, there was a significant statistical relationship between the overuse of cell phone and social networks and students' sleep quality. In other words, students who have had overuse of cell phones had poorer sleep quality. Therefore, providing effective educational programs to improve the sleep quality in this group is essential.
RESUMEN
INTRODUCTION: Immunodeficient children are at a high risk of disseminated Bacillus Calmette-Guérin [BCG] infection. We assessed the literature on clinical manifestations of BCGosis in children with specific primary immunodeficiencies. MATERIAL AND METHODS: We conducted a systematic review of clinical practice articles by searching Medline, PubMed, Embase, Scopus, Web of Science and Google Scholar from their inception to date. RESULTS: Thirty-seven articles were included regarding BCG vaccination and its dissemination in children with primary immunodeficiencies. Articles on dissemination after intravesicular BCG were excluded from the study. CONCLUSIONS: Since disseminated BCG vaccination may be the first manifestation of a primary immunodeficiency disease, a comprehensive search for immunological defects in children developing these problems after BCG vaccination seems rational.
Asunto(s)
Vacuna BCG/efectos adversos , Síndromes de Inmunodeficiencia/diagnóstico , Mycobacterium bovis/patogenicidad , Tuberculosis/prevención & control , Adyuvantes Inmunológicos/efectos adversos , Vacuna BCG/administración & dosificación , Humanos , Síndromes de Inmunodeficiencia/inmunología , Vacunación/efectos adversosRESUMEN
BACKGROUND: In recent years, the phenomena of access to the cell phone and addiction to the Internet have been developed among students due to their many applications and attractiveness. Therefore, the present study was conducted with the aim of evaluating general health status and also determining the predictive role of variables such as cell phone usage, sleep quality, internet addiction and social networks addiction in students. METHODS: This cross-sectional study was conducted on 321 students of Kermanshah University of Medical Sciences in an analytical approach. Data collection tools were: Goldberg's General Health Questionnaire, Pittburgh Sleep Quality Index, Young Internet Addiction Test, Social Network Addiction Questionnaire, and Cell Phone Overuse Scale. Data analysis was done using SPSS version 21 and general linear model. RESULTS: Based on the results, the mean (SD) score of the general health was 21.27 (9.49). Variables of gender, sleep quality, and levels of cell phone usage were independent predictors of student's health. Male students (ß (95% CI) = - 0.28 (- 0.49 to - 0.01) and students with favorable sleep quality (ß (95% CI) = - 0.22 (- 0.44 to - 0.02) had lower total health score than the reference category (female students and students with unfavorable sleep quality, respectively). In addition, students with cell phone overuse (ß (95% CI) = 0.39 (0.08 to 0.69) had a higher general health score than the reference category (students with cell phone little use).In general, this group of students had lower general health status (Low or high scores of general health indicate a higher and lower general health status for subjects, respectively). CONCLUSION: Variables of gender, sleep quality and cell phone use were the most important variables associating the general health of medical students.
RESUMEN
INTRODUCTION: New technologies, including health information technologies, play an important role in effectiveness of management and nursing care services. AIM: This study was aimed to determining the use of health information technology in patient care management in a case study in Iran. METHODS: This Mixed method study was conducted in 2018 in Kowsar Hospital of Semnan, Iran. Data gathered by an observational checklist and one questionnaire included two main parts, one demographic and another assessment of information technology use in care management of inpatients. The researcher prepared the questionnaire and its validity was verified. The data were organized and analyzed in the form of a descriptive analytic report. In the process of data collection, 10 participants including nurses, head nurses, physicians, radiology experts and Information Technology (IT) managers were interviewed and data analyzed using Directed Content Analysis. RESULTS: Nurses were satisfied with the computerized system and believed it can facilitate the affair. From the nurse's viewpoint, the most common use of the Health Information Technology (HIT) were access (observation) of patients admit and discharge information (100%), providing medicine and equipment, transfer of patients (92.3%). The least of them were retrieve of evidence in the care process (0 %) and judgment and analysis of radiological diagnostic procedures (0%). The potential of electronic record is not still applicable. CONCLUSION: Use of modern information and communication technology in hospitals facilitates access and transfer of information, and also accelerates patient's admission and discharge process, relation between hospital units, providing medical equipment supporting affairs' process and diagnostic procedures. However, modifying organizational policies, improve the infrastructure and enhancing nurses' motivation in documenting nursing reports can be effective in increasing the impact of information technology in care management processes especially in electronic record and nurse's clinical judgment and evidence-based care.
RESUMEN
INTRODUCTION: In spite of the fact that telemedicine has various advantages; similarly as in some other data systems, it is essential to investigate clients' perspective of technology. Besides, the clients' awareness and satisfaction of the telemedicine are significant issues that ought to be considered before starting a telemedicine program. The present examination in this way looks to assess Iranian doctors' demeanor and recognition toward the infrastructures of telemedicine development and implementation. METHODS: The participants of this examination included doctors working in health care organizations subsidiary to Semnan University of Medical Sciences during 2019 in Iran. A valid and reliable questionnaire was used in order to evaluate the subjects' attitudes. RESULTS: The mean score of physicians' attitudes towards human factors was 3.43 ± 0.59, towards educational factors was 3.68 ± 0.94 and towards security factors was 3.50 ± 0.52. Regression analysis showed that there were significant relationships between physicians' knowledge and their attitudes towards human (P < 0.001), educational (P < 0.001) and security (P = 0.046) infrastructures. CONCLUSION: the findings of this study show that there are several obstacles that can be reduced through teaching, change-management methods and personal patient-to-provider communication. These techniques can improve acceptance and continuous usage of telemedicine among Iranian physicians.
RESUMEN
BACKGROUND: People with poor health literacy are those who have less knowledge about disease management and health promotion behaviors, and generally have poorer health status. OBJECTIVE: The aim of this study was to investigate the impact of qualitative components of the health website of Semnan University of Medical Sciences on the students' health literacy. METHODS: This study was performed on 529 medical and allied health students in schools affiliated to Semnan University of Medical Sciences, Iran in 2016-2017. A researcher-made questionnaire and standard questionnaire were used. Descriptive statistics and regression test were used by SPSS 19 to analyze data in significance level of 0.01. RESULTS: The findings showed that there were poor relationships between communications in the health website and health literacy (R2=0.265, B=0.50), between understanding of concepts in the health website and health literacy (R2=0.259, B=0.38) and patient centeredness in the health website and health literacy (R2=0.241, B=0.30). CONCLUSION: It is concluded that the empowerment of students' health literacy through the University Health Department website can be realized when the health department website is used as a tool for learning and the website is much more active in social marketing in the field of health.
RESUMEN
BACKGROUND: Rural health houses constitute a major provider of some primary health services in the villages of Iran. Given the challenges of providing health services in rural areas, health houses should be established based on the criteria of health network systems (HNSs). The value of these criteria and their precedence over others have not yet been thoroughly investigated. The present study was conducted to propose a model for improving the distribution of rural health houses in HNSs. METHODS: The present applied study was conducted in Khuzestan province in the southwest of Iran in 2014-2016. First, the descriptive and spatial data required were collected and entered into ArcGIS after modifications, and the Geodatabase was then created. Based on the criteria of the HNS and according to experts' opinions, the main criteria and the sub-criteria for an optimal site selection were determined. To determine the criteria's coefficient of importance (ie, their weight), the main criteria and the sub-criteria were compared in pairs according to experts' opinions. The results of the pairwise comparisons were entered into Expert Choice and the weight of the main criteria and the sub-criteria were determined using the analytic hierarchy process (AHP). The application layers were then formed in geographic information system (GIS). A model was ultimately proposed in the GIS for the optimal distribution of rural health houses by overlaying the weighting layers and the other layers related to villages and rural health houses. RESULTS: Based on the experts' opinions, six criteria were determined as the main criteria for an optimal site selection for rural health houses, including welfare infrastructures, population, dispersion, accessibility, corresponding routes, distance to the rural health center and the absence of natural barriers to accessibility. Of the main criteria proposed, the highest weight was given to "population" (0.506). The priorities suggested in the proposed model for establishing rural health houses are presented within five zoning levels -from excellent to very poor. CONCLUSION: The results of the study showed that the proposed model can help provide a better picture of the distribution of rural health houses. The GIS is recommended to be used as a means of making the HNS more efficient.
Asunto(s)
Redes Comunitarias/organización & administración , Servicios de Salud Rural/provisión & distribución , Sistemas de Información Geográfica , Accesibilidad a los Servicios de Salud , Humanos , Irán , Modelos Organizacionales , Servicios de Salud Rural/organización & administraciónRESUMEN
BACKGROUND AND AIM: Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. METHODS: This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. RESULTS: Mean scores of the participants' attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects' demographic characteristics and their attitudes was significant (p<0.05). CONCLUSION: This study showed that interventional strategies are necessary to lead students to make effective use of the university's health department website. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy.
RESUMEN
BACKGROUND: The level of knowledge and using health information technology by clinicians, students and staff has always been one of the essential issues in the field of health. OBJECTIVE: The objective of the present study was to evaluate HIT knowledge, attitude, and practice habits among health care professionals and students in educational hospitals in Iran. METHODS: This case study was carried out in 2016 on 539 personnel of 65 educational hospitals in Iran entailing three subgroups of physicians (n=128), medical students (n=97), and health record staff (n=314). A pretested self-administered questionnaire was designed to evaluate the knowledge, attitude and practice of health information technology. It was comprised of three parts of "baseline general characteristics", "knowledge categories", and "attitude and practice". RESULTS: In total, 28.8% of participants had a good level of knowledge about computer science, whereas 37.7% had a poor level of knowledge. A total of 40% showed good attitude and practice, while 25.6% had poor attitude and practice. Furthermore, 16.4% of physicians, 32% of students and 33.1% of health record staff had good knowledge, while poor knowledge was reported in 45.3% of physicians, 25.8% of students, and 37.6% of staff (p=0.304). The trend of good attitude and practice habits were respectively 28.9%, 50.5%, and 40.8% in physicians, students, and staff, whereas these trends were respectively 30.5%, 4.1%, and 29.9% for poor attitude and practice (p=0.163). Generally, the knowledge level of participants was positively related to the rate of attitude and practice (r=0.847, p<0.001), so the higher knowledge level brought about the higher score in attitude and practice. CONCLUSION: The level of knowledge and practice of HIT was low among the physicians, students, and staff. Our university can provide a plenary program to promote the level of knowledge and information on practice of HIT.
RESUMEN
INTRODUCTION: Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. MATERIALS AND METHODS: In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter. The gathered data were compared with national and international standards. Statistical analysis was performed using descriptive statistics and one-way ANOVA, t-test, and Pearson's correlation test. RESULTS: Noise pollution level at majority of surgical procedures is higher than national and international documented standards. The highest level of noise pollution is related to orthopedic procedures, and the lowest one related to laparoscopic and heart surgery procedures. The highest and lowest registered sound level during the operation was 93 and 55 dB, respectively. Sound level generated by equipments (69 ± 4.1 dB), trolley movement (66 ± 2.3 dB), and personnel conversations (64 ± 3.9 dB) are the main sources of noise. CONCLUSION: The noise pollution of operating rooms are higher than available standards. The procedure needs to be corrected for achieving the proper conditions.
RESUMEN
BACKGROUND: Traffic accidents are one of the more important national and international issues, and their consequences are important for the political, economical, and social level in a country. Management of traffic accident information requires information systems with analytical and accessibility capabilities to spatial and descriptive data. OBJECTIVE: The aim of this study was to determine the capabilities of a Geographic Information System (GIS) in management of traffic accident information. METHODS: This qualitative cross-sectional study was performed in 2016. In the first step, GIS capabilities were identified via literature retrieved from the Internet and based on the included criteria. Review of the literature was performed until data saturation was reached; a form was used to extract the capabilities. In the second step, study population were hospital managers, police, emergency, statisticians, and IT experts in trauma, emergency and police centers. Sampling was purposive. Data was collected using a questionnaire based on the first step data; validity and reliability were determined by content validity and Cronbach's alpha of 75%. Data was analyzed using the decision Delphi technique. RESULTS: GIS capabilities were identified in ten categories and 64 sub-categories. Import and process of spatial and descriptive data and so, analysis of this data were the most important capabilities of GIS in traffic accident information management. CONCLUSION: Storing and retrieving of descriptive and spatial data, providing statistical analysis in table, chart and zoning format, management of bad structure issues, determining the cost effectiveness of the decisions and prioritizing their implementation were the most important capabilities of GIS which can be efficient in the management of traffic accident information.