Identifying factors affecting a healthy lifestyle in the post-COVID-19 era.

BACKGROUND: A healthy lifestyle is one of the important global concepts in the post-COVID-19 era, which can lead to maintaining and improving the health of societies. This study aimed to identify the factors affecting a healthy lifestyle in the post-COVID-19 era. MATERIALS AND METHODS: The current research is a qualitative study that was conducted in the field by theoretical sampling method. The qualitative method used in the current research was Strauss-Corbin's method. The data collection tool in the current research was a semi-structured interview. The researcher reached theoretical saturation by the end of the 13th interview, and for more certainty, the interviews continued until the 15th interview. The statistical population of the research was all professors and experts with specialized doctorate degrees in Mashhad University of Medical Sciences, and finally, 15 people were selected according to the entry and exit criteria for the study. Data analysis was done by summarizing and coding and analyzing the hidden content from expert interviews using MAXQDA software. RESULTS: The factors affecting a healthy lifestyle in the post-COVID-19 era (cultural norms, social norms, biological norms, technological factors, and economic factors) emerged from the intuitive opinions of experts. CONCLUSION: Providing and maintaining health is not a simple task, as it involves biological, individual, familial, cultural, societal, economic, political, and health factors. Promotion of healthy lifestyles is not merely the responsibility of health-related organizations and bodies; rather, they necessitate extensive coordination and empathy among educational, health, cultural, service, and even political institutions and bodies.

Comparison of the Distribution of Household Financial Contributions to the Health System before and during COVID-19 Outbreak: Evidence from Nationwide Survey in Iran.

Background: Health and economy has substantially been influenced by the coronavirus disease 2019 (COVID-19) pandemic. Because of these impacts, household financial contribution to health system is likely to be changed. This study aimed to compare the distribution of household financial contributions before and during the COVID-19 epidemic. Methods: This is a cross-sectional study. The data were obtained from Iran's Households Income and Expenditure Survey as a national representative survey and included 38,328 households in 2019 (before COVID-19) and 37,577 households in 2020 (during COVID-19 pandemic). The household expenditures deflated according to the Consumer Price Index. The indices of households' out-of-pocket Payments (OPP), catastrophic health expenditures (CHE), and impoverishment were calculated based on a standard methodology. Data analysis was done using an Excel-based software. Results: The households' total expenditures declined for both urban and rural areas during the COVID-19 outbreak. Meanwhile, health expenditure experienced a negative growth rate for urban and rural households at -25.75% and -15.47%, respectively. The average per capita of OOP annually was 1,220,416 ($41.086 PPP) Rials for urban households and 1,017,760 Rials ($34.263 PPP) for rural households in 2020 (the era of COVID-19), which had dropped -30% and -16%, respectively, relative to 2019 (before COVID-19). The proportional share of health service types from the total health expenditure did not change importantly after the onset of COVID-19. The incidence of CHE and impoverishment due to health payments reduced after the onset of COVID-19. Conclusion: The households' health expenditures changed considerably during the COVID-19 pandemic and these changes were the same for the urban and rural areas. Despite COVID-19 multi-faceted shocks, the findings of this study showed a slight decline in the incidence of CHE and impoverishment caused by health expenditures. It might be due to forgone health services during the COVID-19 pandemic. Data from these household surveys have some limits to depicting the real effects of this crisis.

Determining the key performance indicators of human resource management of military hospital managers; a TOPSIS study.

BACKGROUND: Proper human resource management in military health centers leads to long-term development and improved health-care quality. As a result, the purpose of this research is to identify the key performance indicators of human resource management for military hospital managers, and the unique indicators of military hospitals were obtained. METHODS: This cross-sectional study was performed by the TOPSIS method in the fall of 2021. This study used a checklist consisting of 20 performance indicators of human resource management, which were scored by 20 senior military hospital managers based on two criteria: "importance" and "measurability in military hospitals". The Shannon entropy method was used to weight the indicators, and the BT-TOPSIS Solver software was used to analyze and prioritize them. RESULTS: Among the 20 indicators in human resource management, the staff satisfaction index in military hospitals, the competitiveness rate of salaries in military hospitals relative to the national sector, the number of permanent staff in military hospitals, and the percentage of contract labor costs in military hospitals have the highest coefficient, respectively. CONCLUSIONS: The importance of human resource management and organizational performance is due to their influence on each other. As a result, human resource management should pay special attention to the professional and personal development of human resources, as this has an impact on the performance of the organization in the long run. In light of the sensitive nature of human resource management and its crucial role in achieving any organization's strategic goals, selecting appropriate indicators is essential. The Department of Military Health requires indicators unique to the military sector to assess the human resource management of the military hospital, since according to the existing circumstances, the indicators of the military sector and those of the civilian sector are different.

Comparison of outcomes and costs of extracorporeal blood purification therapies in critically ill COVID-19 patients.

INTRODUCTION: Plasmapheresis and hemoperfusion are used against cytokine release syndrome in COVID-19. This study aims to compare their outcomes, costs, and side-effects. METHODS: Survival, costs and side-effects were compared in intensive care unit (ICU) patients receiving plasmapheresis (n = 49), hemoperfusion (n = 20), or none (n = 107), followed until death or discharge. RESULTS: Plasmapheresis survival time was higher than hemoperfusion or controls (HR = 0.764, p = 0.397 and HR = 0.483, p = 0.002, respectively), although the latter diminished after controlling for age and disease severity (p = 0.979). There was no significant difference in ICU costs for plasmapheresis and hemoperfusion (p = 0.738) while both costed more than controls (both p < 0.001). Hypocalcemia and thrombocytopenia incidence did not differ between two groups (p = 0.124 and p = 0.389, respectively) while being higher than controls in plasmapheresis (both p < 0.001) and hemoperfusion (p < 0.001 and p = 0.056, respectively). CONCLUSION: Plasmapheresis and hemoperfusion do not differ significantly in patient survival, ICU costs and side-effects with a higher incidence of hypocalcemia and thrombocytopenia compared witcontrols.

Evaluation of COVID-19 Patient Safety Compared to Non-COVID-19 Patients and Predisposing Factors of Nursing Errors / Evaluación de la seguridad del paciente con COVID-19 en comparación con pacientes sin COVID-19 y factores predisponentes de los errores de enfermería / Avaliação da segurança do paciente com covid-19 em comparação com o paciente sem covid-19 e fatores predisponentes de erros de enfermagem

Objetivo: o objetivo deste estudo foi determinar a segurança em pacientes internados com covid-19 em comparação com os que não tinham covid-19 e encontrar fatores predisponentes de erros de enfermagem segundo a percepção de enfermeiros. Materiais e método: trata-se de pesquisa descritivo-comparativa, que utilizou dados de pesquisas com 800 enfermeiros em oito hospitais iranianos em 2021, com base em três questionários com alta confiabilidade e validade, elaborados por pesquisadores, que incluíam dados sociodemográficos, índices de segurança do paciente e fatores predisponentes de erros de enfermagem. Os dados coletados foram analisados com ANOVA, teste t independente e software SPSS22. Resultados: as pontuações médias de segurança dos pacientes com e sem covid-19 foram 3,42 ± 0,17 e 3,74 ± 0,06, respectivamente. As maiores diferenças em segurança do paciente foram atribuídas às dimensões de controle de infecções (0,66) e queda do paciente (0,56). As causas mais comuns dos erros de enfermagem estiveram relacionadas com o aspecto gerencial (2,67 ± 1,39) e os fatores predisponentes mais comuns dos erros de enfermagem foram a alta carga de trabalho, a baixa proporção de enfermeiros por paciente e a fadiga. Conclusões: os pacientes com covid-19 têm menor segurança do que os que não apresentam a doença. Além disso, a gestão inadequada e a alta carga de trabalho levam a erros de enfermagem. Portanto, as autoridades devem elaborar estratégias adequadas para reduzir a carga de trabalho dos profissionais de saúde e melhorar a segurança do paciente, em especial daqueles com covid-19.

Objetivos: el presente estudio tuvo como objetivo determinar la seguridad en pacientes hospitalizados con covid-19 en comparación con los que no tenían covid-19 y encontrar factores predisponentes de errores de enfermería según la percepción de los enfermeros. Métodos: esta investigación descriptiva-comparativa empleó datos de encuestas de 800 enfermeros en ocho hospitales iraníes en 2021 mediante tres cuestionarios con alta confiabilidad y validez elaborados por investigadores que incluían datos sociodemográficos, indicadores de seguridad del paciente y factores predisponentes de errores de enfermería. Los datos recopilados se analizaron mediante ANOVA, prueba t independiente y el software SPSS22. Resultados: las puntuaciones medias de seguridad de los pacientes con y sin covid-19 fueron 3,42 ± 0,17 y 3,74 ± 0,06, respectivamente. Las mayores diferencias en seguridad del paciente se atribuyeron a las dimensiones de control de infecciones (0,66) y caída del paciente (0,56). Por otra parte, las causas más comunes de los errores de enfermería estuvieron relacionadas con el aspecto gerencial (2,67 ± 1,39), y los factores predisponentes más comunes de los errores de enfermería fueron la alta carga de trabajo, la baja proporción de enfermeros por pacientes y la fatiga. Conclusiones: los pacientes con covid-19 tienen menor seguridad que los que no presentan la enfermedad. Además, la gestión inadecuada y la alta carga de trabajo conducen a errores de enfermería. Por lo tanto, las autoridades deben diseñar estrategias adecuadas para reducir la carga de trabajo de los enfermeros y mejorar la seguridad del paciente, en especial en aquellos con covid-19.

Objectives: The present study aims to determine Patient Safety in hospitalized patients with COVID-19 compared to non-COVID-19 ones and find predisposing factors of nursing errors according to nurses' perceptions. Methods: This descriptive-comparative research employed data from 800 nurses in eight Iranian hospitals in 2021 using three researcher-made questionnaires of sociodemographic, patient safety indicators, and predisposing factors of nursing errors, with high reliability and validity. The collected data were analyzed using ANOVA, independent t-test, and the SPSS22 software. Results: The mean patient safety scores in patients with and without COVID-19 were 3.42 ± 0.17 and 3.74 ± 0.06, respectively. The highest differences in patient safety were attributed to infection control (0.66) and patient fall (0.56) dimensions. The most common causes of nursing errors were related to management (2.67 ± 1.39), and the most common predisposing factors of nursing errors were high workload, low ratio of nurses to patients, and fatigue. Conclusions: COVID-19 patients have lower safety than non-COVID ones. Also, improper management and high workload lead to nursing errors. Therefore, the authorities must devise appropriate strategies to reduce the nurses' workload and improve patient safety, especially in COVID-19 patients.

Approaches to Investigate the Quality of Life Diagnosis and Management in Infertile Women in the Iranian Health System.

Background: Infertility requires long term care and treatments which would influence different aspects of health, including emotional problems such as anger, depression, mental health and psychological issues, social isolation and withdrawal as well as low self-esteem. The present study was conducted to determine strategies for the diagnosis and management of infertile women's quality of life in the Iranian health system. Materials and methods: This descriptive-analytical study was conducted on 59 infertile women. It was a questionnaire-based study and all data analyses were done using SPSS version 22 statistical software. Results: The majority of gynecologists (88.14%) approved all three management strategies that were used for diagnosis and management of infertile women's quality of life. The first and third management strategy obtained the highest (86.44%) and lowest (3.39%) scores, respectively. There was a significant relationship between our management strategies and the scoring of gynecologists (P=0.010). Also, there was a significant relationship (P=0.001) between the order of our management strategies and gynecologists' prioritization. Conclusion: Based on the results of the present study, it is expected that health officials and practitioners should be able to identify infertile women and even women at high risk of infertility and provide the necessary training and classes as well as individual and medical consultations.

Omentopexy for patch repair of diaphragmatic defect.

BACKGROUND: There are many techniques in the reconstructive of congenital diaphragmatic hernia defect. In this study, we present our results from a prospective, randomised trial of using the omentum (omentopexy) for repair of large diaphragmatic defects. MATERIALS AND METHODS: Twenty white, male, New Zealand rabbits were used to compare incidence and severity of adhesion bands formation in abdominal cavity with/without of omentopexy after repair of diaphragm defect with the non-absorbable patch (Dacron). They were divided in to two groups, GI (10 animals with omentopexy and repair) and GII (10 animals with repair, without omentopexy). On the 60 th day, animals were re-operated. In each case, adhesion band formation and its severity were recorded. RESULTS: The difference between the incidence of adhesion band formation among the two group was statistically significant (P = 0.019).The majority of rabbits in GII (60%) had substantial adhesion bands (Grade >2 or severe score), whereas, in GI, none of rabbits had substantial adhesion bands (P = 0.019). CONCLUSION: Our study showed that the use of omentopexy as a cover in repair of diaphragmatic defect is versatile technique with a good success for decreasing of adhesion band formations at short-term follow-up.